Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An immunologic study and a renal biopsy were performed in 64 patients with isolated hematuria. Fifty of them had macroscopic hematuria and 14 microscopic hematuria. The kidney was normal in 66% by light microscopy; in the remaining 34% glomerular lesions were moderate: thickening of the mesangial matrix, diffuse or segmentary mesangial proliferation. Four patterns were observed by immunofluorescence: C3 located either in the mesangium, or at the level of the vascular pole, mesangial IgA, mesangial IgM and lack of deposits. According to our experience IgA nephropathy presenting as isolated hematuria has a better prognosis than the other symptomatic forms of this glomerulonephritis. No patient with the other renal pathological changes so far developed hypertension or renal failure. We prefer to perform biopsies on patients with isolated hematuria, considering the frequency of IgA nephropathy and the possibility of finding mesangial deposits of IgM and C3 whose significance is so far poorly known.
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PMID:[Isolated hematurias: histologic and immunologic study]. 635 80

Fibrillary renal deposits and nephritis. The authors have studied 8 patients whose glomeruli contain abundant fibrils in their mesangial matrix and basement membranes. Although the location of these fibrils is very similar to that of amyloid, they are about twice the size of amyloid fibrils, averaging 20 nm in width, and fail to react as amyloid does with special stains. Immunofluorescence-microscopic studies are usually positive with antiserums to IgG, often IgM, and in some cases IgA, and also kappa and lambda light chains, C3, and C4. The fibrils are associated with diffuse mesangial widening and increased mesangial matrix strands. Although peripheral glomerular capillary walls appear to be spared initially, their eventual involvement leads to glomerular capillary collapse and glomerular obsolescence. Crescent formation occurred in 5 cases, focally in 3 and diffusely in 2. Tubular basement membrane involvement was seen in 1 case. These patients exhibit hematuria, and proteinuria, and often hypertension and renal insufficiency. Proteinuria was in the nephrotic range in 3 patients in whom involvement of glomerular capillary basement membranes was extensive. Unless electron microscopy is applied to renal biopsies, these cases may be considered to represent mesangiocapillary or rapidly progressive glomerulonephritis, or amyloidosis. The nature of these fibrils is as yet not determined. It is likely that they have been called "atypical amyloidosis" in the past.
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PMID:Fibrillary renal deposits and nephritis. 635 91

The fawn-hooded (FH) rat, a strain characterized by a platelet storage-pool disease, developed focal and segmental glomerulosclerosis at the age of 2-3 months (males) and approximately 6 months (females). Male animals died spontaneously at 11-13 months, and females at 15 months of age, both with overt malignant nephrosclerosis. During the first half year of life focal glomeruli showed depositions of IgG, IgA, IgM, C3 and fibrinogen in a segmental pattern and mainly in mesangial areas. Mesangial IgG and IgA were already demonstrable at the age of 5 weeks. On electron microscopy no electron-dense deposits suggestive of immune complexes were found. Mean arterial blood pressure in 5.5-month-old male FH rats was increased compared with that of matched Wistar rats. One-year-old FH rats had severe hypertension. The presumed relationship between the hypertension, the renal lesions and the blood platelet defect is discussed.
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PMID:Spontaneous hypertension and hypertensive renal disease in the fawn-hooded rat. 637 Feb 89

We report five cases of crescentic IgA nephropathy. All are males, 16-60 years of age. One case each came to medical attention with uremia, nephrotic syndrome, and gross hematuria; two cases presented with microhematuria and proteinuria on routine urinalysis. All had hypertension, azotemia (serum creatinine 1.6-9.4 mg/dl), proteinuria (greater than 6 g/24 hr in four cases), hypoalbuminemia (less than 3 g/dl), and hematuria (gross in two cases). All progressed to end-stage renal failure renal failure ending in dialysis (three cases) or death from unrelated causes (two cases). Prednisone, 60 mg/day for 1 month in two patients (with two 1-g doses of iv methylprednisolone in 1 case) did not improve the serum creatinine level, but one patient subsequently experienced a less rapid fall in renal function. A crescentic glomerulonephritis was present in all biopsies (crescents in 31-80% of glomeruli; mean, 50%). The size and stage of the crescents were variable. Numerous glomeruli had focal or diffuse sclerosis. In all cases, there was a 3 or 4+ deposition of IgA. Low-intensity staining for IgG and IgM was noted in four and three patients, respectively. On electron microscopy, dense granular mesangial deposits were noted in all cases and in four patients capillary subepithelial deposits were also observed. This form of IgA nephropathy is not common, but some studies indicate that it may occur in about 5% of patients with IgA nephropathy.
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PMID:Crescentic IgA nephropathy. 639 83

20 (12 men and 8 women) acute myocardial infarction (AMI) patients and 17 (14 men and 3 women) patients with arterial hypertension (II degrees stage according to OMS) in comparison to controls age and sex matched, were studied, serum IgA, IgG, IgM were evaluated with radial immunodiffusion and serum IgE with RIA. Ho significant changes ef immunoglobulins were observed between hypertensive patients and controls; whereas a significant increase of IgM, IgG and IgE, with out changes of IgA, were shown in AMI patients. Serum Ig and IgM were significantly augmented in AMI patients in comparison to hypertensive patients.
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PMID:[Changes in serum immunoglobulins in subjects with acute myocardial infarct and essential hypertension]. 642 58

Clinical data in 244 patients with IgA nephropathy and biopsy findings in 519 biopsies (107 patients had at least two biopsies) were analysed. Males predominated (73 per cent) and had more severe disease and a worse prognosis than females. The most frequent symptom was macroscopic haematuria, often with associated loin pain; however, this was typical only in young males. Hypertension was the major presenting feature in 23 per cent of patients. Urinary erythrocyte counts correlated with the presence of crescents on biopsy (p less than 0.0001). Serum IgA levels wer elevated in only 21 per cent, while IgM levels were raised in 43 per cent of patients. Two hundred and seventeen patients were followed for at least one year (mean 59.7 months, range 12-255 months). In 82 patients five-year follow-up and in 33 patients ten-year follow-up data were available. Five- and 10-year survival figures were 91.5 and 87.5 per cent respectively. Clinical resolution occurred in only 6 per cent of patients but in those who had biopsies following clinical resolution, diffuse mesangial cell proliferation and IgA deposits persisted in all. The rate of clinical deterioration correlated with proteinuria, hypertension, impaired renal function, crescents and sclerosed glomeruli on biopsy. Continuing high urinary erythrocyte counts were the strongest predictor of a progressive course.
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PMID:The clinical course of mesangial IgA associated nephropathy in adults. 646 97

Positive anti-DNA-antibodies and lowered C3 and C4 levels were found in serum of a 13 year old girl presenting with edema, microscopic hematuria and proteinuria. Renal biopsy revealed diffuse endo- and extracapillary glomerulonephritis with mesangial deposits of IgA, IgG, IgM, C1q, C3 and fibrinogen. In spite of treatment with prednisone (60 mg/m2/d) severe nephrotic syndrome (proteinuria greater than 20/d) developed with excessive hypertension and deterioration of renal function (GFR: 20 ml/min./1,73m2 BSA). Plasma exchange therapy (3 sessions) led to recovery of renal function, blood pressure and complement activity and to a reduction of anti-DNA-antibodies and protein excretion.
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PMID:[Plasma separation as an effective treatment of glomerulonephritis in lupus erythematosus]. 665 70

A retrospective and prospective study of 58 patients with IgA glomerulonephritis was undertaken between the 1st April 1975 and the 1st May 1982, to determine the clinical, biological and histological features associated with the onset of renal failure and a poor prognosis. At the end of this study the patients were classified into 4 groups according to the clinical stage of their disease: a) normal, b) minor urinary abnormalities, c) active disease and d) terminal renal failure. The renal biopsies were reviewed and an index of histological activity defined. The significant features associated with progression of the disease to renal failure were: persistent proteinuria, a transient nephrotic syndrome, hypertension, diffuse proliferative glomerular changes with epithelial crescent formation, tubulo-interstitial changes and vascular lesions on renal biopsy. When confronted with the clinical outcome, the histological results of the first renal biopsy performed when the disease was first diagnosed and quantified in an index of activity, had a good predictive value.
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PMID:[Indices of progression of IgA glomerulopathy]. 666 47

Serum immunoglobulin (G, A, M) levels were performed on 66 patients with non-insulin-dependent (type II) diabetes mellitus (NIDDM). When compared with 30 age-matched normal controls and 32 hospitalized controls there was no significant difference between the mean IgG and IgM levels. The IgA levels were significantly higher (P less than 0.005) in the diabetic group when compared with both control groups. This is true regardless of age, sex, duration of disease, and type of treatment (insulin/diet or oral hypoglycemic agents and/or diet). Thirty-six percent of the diabetic patients' IgA levels exceeded the mean +/- 2 SD of the normal control group. There were no significant differences in immunoglobulin levels between insulin-treated and non-insulin-treated diabetic groups. Since diabetic patients may have a number of secondary diseases, attempts were made to correlate the most common of these (acute and/or chronic bacterial infections, hypertension, arteriosclerotic heart disease, and diabetic neuropathy) with elevated IgA levels. Only IgA levels of diabetic patients with infections versus diabetic patients without infections were significantly different (P less than 0.05). However, IgA levels of uninfected diabetic patients remained significantly higher than those of normal controls (P less than 0.005), hospitalized controls (P less than 0.01), and hospitalized controls with bacterial infections (P less than 0.005). Possible reasons for the isolated elevations of IgA are discussed.
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PMID:Elevation of IgA levels in the non-insulin-dependent (type II) diabetic patient. 675 40

IgA-glomerulonephritis represents the most frequent glomerulonephritis (GN; 20%) among our patients. In contrast to data from the literature the prognosis is not benign. Renal insufficiency developed in 17 out of 50 investigated patients within 4 to 96 months, 3 of these patients had to undergo dialysis. Eleven of the 17 patients still had a normal renal function at the time of diagnosis. Malignant hypertension was present in 5 patients. An unfavourable course was predictable in cases of male gender, proteinuria, hypertension, age above 30 years, and histological changes indicating glomerulosclerosis, tubular atrophy, interstitial fibrosis and vascular lesions. Increased serum IgA levels, circulating IgA complexes, association with certain HLA-B or -Dr antigens as well as clinical symptoms and signs of haematuria, dysuria and kidney pains were not helpful either for diagnosis or for prognosis. The value of skin biopsy was comparatively small. Positive IgA demonstration was possible in 12 out of 41 cases with IgA-GN, however, also in 4 out of 21 patients with non-IgA-GN. None of 50 probands without renal disease showed IgA. Five out of 7 skin biopsies demonstrated IgA2, one IgA1 and one both IgA1 and IgA2. Increased serum IgA levels were found in a high percentage (21 out of 38 patients). The same applied to circulating IgA-complexes (8 out of 33 patients).
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PMID:[Mesangial IgA-glomerulonephritis]. 682 88


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