Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of kidney transplantation in a variety of renal diseases have been analyzed. The diseases causing end-stage kidney failure in recipients were Alport syndrome, amyloidosis, cystinosis, diabetes mellitus, Fabry disease, familial nephritis, gout, medullary cystic disease, oxalosis, and systemic lupus erythematosus. The data indicate that renal transplantation is justifiable and parallels functional results for the more common causes of end-stage renal disease in all but Fabry disease and oxalosis. Although Fabry disease did not recur in any grafted kidney, only three patients have a functioning graft one year after transplantation. From a group of ten patients with oxalosis who received a total of 14 kidneys, only one survives. In no other metabolic disease, except one instance of primary amyloidosis, did the metabolic disease notably affect the transplant as it did in oxalosis.
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PMID:Renal transplantation in congenital and metabolic diseases. A report from the ASC/NIH renal transplant registry. 80 49

AP isoenzymes were estimated in 292 patients with locomotor diseases and in 124 healthy controls. The diagnostic usefulness of AP determination is increased by estimation of isoenzymes. Investigations were made to study the biological profile of organ specific AP activities: 1. Rheumatoid arthritis and Reiter's syndrome - the total AP and L-AP activities were increased. 2. Ankylosing spondylitis treated by physiotherapy - the total AP, B-AP and I-AP activities were increased. After drug therapy an increase occurred also in L-AP activity while I-AP activity showed no significant change. 3. Progressive OA of hip and knee showed increased levels of total AP and B-AP activities. 4. Degenerative diseases of the spine, chiefly cases of discopathy, showed significantly reduced levels of AP and B-AP activities. 5. In osteoporosis there was an increase in total AP, L-AP, B-AP and I-AP activities. 6. In the active generalised form of Paget's disease, increased levels were found of total AP, B-AP, I-AP and L-AP activities. 7. In neoplastic diseases the isoenzymes can help to reveal metastatic dissemination and thus aid preoperative evaluation. 8. In gout and hyperuricemic syndromes there was a relative increase of B-AP activity and non-significant fall of L-AP activity. Increased levels of L-AP occured in patients with gallbladder disease, after immunosuppressive therapy or after infectious hepatitis. A fall of L-AP levels was found after Corticotrophin and after intraarticular administration of Kenalog. Increased B-AP activities occurred after total hip replacement, in acute or chronic pyelonephritis and in active osteonecrosis and osteoporosis. Anabolic therapy caused a significant fale of B-AP activity to fall significantly. Reduced B-AP levels were also found after antibiotic therapy. Increased I-AP activity was found in cases of osteoporosis, and in secondary amyloidosis; reduced I-AP activity was seen in mucous colitis. The activity of I-AP is assumed to increase as a result of the changed intestinal calcium and phosphorus regulation occurring in association with the enhanced bone tissue metabolism. From this point of view an order of significance is given for the activity of bone pathology in the separate diagnostic groups of locomotor diseases.
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PMID:The clinical significance of serum alkaline phosphatase isoenzymes in locomotor diseases. 105 9

Renal transplantation is associated with several abnormalities of function and structure of the musculoskeletal system. Some of these skeletal problems result from incomplete resolution of abnormalities of bone and mineral metabolism present at the time of transplantation. In this regard, persistent hyperparathyroidism, diabetes mellitus type 1, and accumulation of beta 2-microglobulin may lead to residual skeletal effects despite excellent function of the allograft. Persistent hyperparathyroidism may accelerate bone loss and increase the risk for osteonecrosis, as well as cause hypercalcemia and hypophosphatemia; some patients with severe hyperparathyroidism require parathyroid surgery. Osteonecrosis is the most debilitating skeletal complication after transplantation and frequently requires surgical therapy. Although osteomalacia associated with aluminum overload generally resolves after transplantation, bone complications due to dialysis amyloidosis and diabetes mellitus type 1 often fail to improve. Alternatively, skeletal abnormalities can be acquired after transplantation. Most of the new derangements of bone and mineral metabolism are due to the immunosuppressive medications. Toxic effects of glucocorticoids on bone contribute to the pathogenesis of osteonecrosis, increase the risk for fractures by decreasing cancellous bone mass and synthesis of bone matrix, and dampen the linear growth response in pediatric recipients. Whether cyclosporine independently causes appreciable toxic effects on bone metabolism is not yet clear, but use of this drug increases the prevalence of gout and dental problems. Osteonecrosis, osteopenia, and short stature remain important skeletal complications in recipients of renal allografts. Therapeutic efforts should be directed toward alleviating pretransplant bone disease and attenuating bone loss after transplantation.
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PMID:Musculoskeletal complications after renal transplantation: pathogenesis and treatment. 129 May 51

Surgery on patients with RA should be undertaken after careful consideration of a number of issues. These include an overall assessment of the status of the patient's arthritis, general health and preparedness for the procedure and the rehabilitation which follows. Special attention must be given to organs that may be affected by the systemic involvement which occurs with rheumatoid disease. Sites requiring specific review include the cervical spine, lungs, airway, bone, and bone marrow. Intraoperatively and postoperatively rheumatoid patients may require supplementary corticosteroids and an adjustment of the dose of their antirheumatic medications. Various systemic rheumatic diseases can have predominantly hand signs and symptoms at their onset. It is valuable to be familiar with the clinical features of gout with tophaceous inflammation, psoriatic arthritis, Raynaud's disease, and amyloidosis.
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PMID:Medical considerations and perioperative care for rheumatoid surgery. 266 68

A patient with amyloidosis secondary to polyarticular gout is presented in whom amyloid protein A (AA) was demonstrated in the kidney with a monoclonal antibody against protein A. The rarity of this association is discussed and a pathogenetic mechanism proposed.
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PMID:Amyloidosis secondary to gout. Identification with a monoclonal antibody to amyloid protein A. 307 36

A study of the level of beta 2-microglobulin (beta 2-MG) in the blood serum and urine was conducted in 67 patients: 22 with chronic pyelonephritis, 13 with gout with renal lesion, 25 with chronic glomerulonephritis (5 without hyperuricemia, 20 with hyperuricemia) and 7 with amyloidosis accompanied mainly by renal lesion. A raised level of beta 2-microglobulin was found in the patients with chronic pyelonephritis, gout, latent glomerulonephritis with hyperuricemia, and in over half of the cases its raised level was found in the urine. The results obtained indicate a frequent and in some cases predominant involvement of the tubules as well as interstition in the patients with hyperuricemia.
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PMID:[Beta 2-microglobulin in the blood serum and urine of patients with interstitial kidney lesions]. 353 9

Two patients with gout and amyloidosis are reported. In contrast with other forms of chronic arthritis gout is apparently not associated with an increased incidence of amyloidosis. The possible reasons for this exception are discussed.
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PMID:Gout and amyloidosis. 745 37

Changes of the locomotor apparatus in prolonged uraemia with regular dialyzation treatment determine the quality of life with all its consequences for the patient. The greatest impact on osteodystrophic disease (the most typical finding on the skeleton) is exerted by the length of dialyzation treatment. Of 216 patients having regular dialyzation treatment in 1979 to 1992 the authors observed osteodystrophic disease in 25, i.e. 11.6%. As to other most frequently observed changes they recorded osteoporosis in 12.9%, only very rarely osteomalacia and even osteopetrosis (1.8%). Carpal tunnel syndrome was recorded in 17.4% as a symptom of so-called dialyzation amyloidosis and in one man they observed the development of typical rheumatoid arthritis shortly after the onset of haemodialyzation. This is a rare observation not described in the literature so far. Crystalline arthropathy, incl. typical attacks of gout, were recorded only in 11 patients (5%). Changes on the locomotor apparatus in conjunction with irreversible renal failure with regular dialyzation treatment were recorded in 45%. It is important to differentiate findings which are not associated with uraemia and haemodialysis. This applies in particular to osteoarthritis deformans of the joints and spine. In major uraemic changes participates in particular secondary hyperparathyroidism. These changes comprise in particular osteolysis or even spontaneous absorption, erosive changes and destructive spondylopathy. Contemporary findings on the locomotor apparatus are so varied that they must be classified.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The locomotor system in irreversible renal failure treated with regular dialysis]. 835 76

The noninvasive detection of amyloid deposits has recently become possible using scintigraphy with radiolabelled amyloid precursor protein (131I-beta 2-M). We studied 131I-beta 2-M scintigraphy in 15 dialysis patients with special attention to the mechanism of the localized accumulation of tracer. Scintiscans were positive in 8 of the 15 patients. Those with histologically proved amyloid deposits had positive images at the large joints with a continuous accumulation of tracer after 48, 72 and 144 hours. The most significant accumulation occurred bilaterally in the hip joints, followed by the shoulders and knees. Mild uptake was observed in the hands, elbows and feet. No apparent uptake of tracer occurred in patients with secondary hyperparathyroidism, pseudo-gout or AA-type amyloidosis. Three patients were operated for CTS during this study. The radioactivity of tissue excised during the operation was 2-18 times higher than that of fat or plasma. Study of synovial tissue showed that some of the cells surrounding the amyloid deposits took up the radiolabelled tracer. The present study suggests that circulating 131I-beta 2-M is taken up by the cells surrounding the amyloid deposits and detected as a positive scan. It is not known whether these cells react secondarily to amyloid deposits, or whether they take up beta 2-M and form amyloid fibrils.
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PMID:131I-beta 2-microglobulin scintigraphy in patients with dialysis amyloidosis. 860 55

By definition, monoarticular arthritis means one-joint involvement, even though, in fact, such a condition is often an oligoarthritis because as many as two or three separate joints will be involved. Arthritis is often limited and may regress, so that it is frequently misdiagnosed. Sometimes, a monoarticular condition may be a polyarthritis onset (i.e., rheumatoid arthritis). Monoarticular arthritis can be caused by many factors, such as infections (septic arthritis), nonspecific inflammatory processes (reactive arthritis), crystals deposition (gout, CPPD crystal deposition disease), trauma, neoplasm (pigmented villonodular synovitis), immunologic conditions (amyloidosis) and hormonal changes (parathyroid disease). Its onset is usually acute and sometimes dramatic, with fever, pain and joint swelling, so that a decision must be made promptly to stop rapid illness evolution and to prevent the irreversible destruction of cartilage and bone (especially in septic arthritis). Diagnostic studies are performed with mono-bilateral radiographs of the joint. Radiographic findings (i.e., soft tissue swelling, joint effusion, widening and thinning of joint spaces, bone erosions and destruction of bone surface) are typical of the disease, but some findings (e.g., type of evolution and progression), laboratory tests, synovial biopsy and arthroscopy can differentiate infectious from inflammatory forms. Scintigraphy can depict isotopic joint uptake, before articular abnormalities are demonstrated with radiography, thanks to its high sensitivity; nevertheless, because of its low specificity, scintigraphy may miss some kinds of lesions (including osteoarthritis) and cannot easily differentiate osteomyelitis from septic arthritis. CT and MRI play a secondary, though not negligible, role, especially to study such deep infections as psoas abscesses, which may mimic arthritides.
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PMID:[Monoarthritis]. 868 51


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