Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022672 (acute tubular necrosis)
 2,175 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The concentrations of serum amyloid A protein, a high-density lipoprotein-associated protein synthesized in the liver, were monitored in 66 recipients of cadaveric renal allografts. Acute graft rejection episodes were associated with dramatic elevations of serum amyloid A. Electrofocusing and immunoblotting of rejection sera showed a polymorphic serum amyloid A pattern similar to that obtained with control (apo) serum amyloid A isolated from the high-density lipoprotein fraction of plasma. Rejections in patients receiving cyclosporine alone as posttransplantation immunosuppressive medication were characterized by significantly higher serum amyloid A levels than in those receiving cyclosporine in combination with methylprednisolone. Due to the dramatic rejection-induced serum amyloid A elevation, limit values could be used which combined high sensitivity (87-96%) with reasonably high predictive value of a positive test (82%). The serum amyloid A test was applicable also in patients with initially nonfunctioning or poorly functioning grafts. It is concluded that monitoring of the serum amyloid A concentrations offers a valuable noninvasive aid in the early diagnosis of acute renal allograft rejection, including patients with acute tubular necrosis of the graft.
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PMID:Posttransplantation monitoring of high-density lipoprotein-associated serum amyloid A protein: a new diagnostic aid in the detection of renal allograft rejection. 391 28

A 49-year-old lady with history of polysubstance use disorder, recurrent cutaneous abscesses, spinal diskitis and septic thrombophlebitis presented to the emergency room with complaints of intermittent fevers, worsening right hip pain and bilateral lower extremity edema. A month before the presentation, she had left another hospital against medical advice after being diagnosed with Methicillin-resistant Staphylococcus aureus bacteremia and right hip septic arthritis. Post discharge, she was off antibiotics, but continued heroin and methamphetamine use. On admission, she had right hip chronic osteomyelitis and was also in acute renal failure with evidence of nephrotic range proteinuria. Her renal biopsy subsequently revealed acute tubular necrosis and secondary (AA) amyloidosis with the classic apple green birefringence and positive immunohistochemical stain for serum amyloid A protein. Secondary amyloidosis, where there is deposition of fibrils composed of fragments of the acute phase reactant - serum amyloid A protein, often complicates chronic diseases with ongoing or recurring inflammation like spondyloarthropathies, inflammatory bowel disease and heredofamilial periodic fever syndromes. Epidemiological studies now indicate that chronic inflammation as noted in illicit drug users, especially heroin users is on the rise as the etiology for AA amyloidosis in some parts of the developed world. The most common organ system involved in AA amyloidosis is the kidney. Given the opioid epidemic, clinicians are more likely to encounter similar cases of secondary amyloidosis.
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PMID:Secondary amyloidosis associated with heroin use and recurrent infections - A case report. 3058 68