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Query: UMLS:C0024141 (
systemic lupus erythematosus
)
44,322
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
366 kidney biopsies from 339 patients, 290 of which were classified on combined light microscopy (LM) and clinical criteria as
glomerulonephritis
(GN) and 49 as non-
glomerulonephritis
nephropathy, were examined by immunofluorescent microscopy (IFM) without knowledge of the clinical or LM findings at the time of examination. The IFM findings in the glomeruli were correlated to (l) the LM diagnosis, (2) the clinical symptoms, (3) the clinical course, and (4) the effect of immunosuppressive treatment. A few IFM results were found to correlate significantly with the LM diagnosis and clinical symptoms, but not to the effect of immunosuppressive treatment. It was impossible using IFM alone to group patients into any specific categories with uniform symptomatology and prognosis. Defined by IFM "immune complex nephritis" was demonstrated in 72%, and linear nephritis was found in 2% of the patients with GN. IgA occurred more frequently in GN secondary to systemic disease, particularly in
SLE
(60%) and HSP (88%). IgA was demonstrated in only 10% of patients with nonglomerulonephritic nephropathy. Demonstration of IgA is therefore a good indicator for corroborating the LM diagnoses of GN. Demonstration of IgG and/or IgM in GN was not found to be sufficient evidence for GN because these deposits also appeared in 40% of patients with non-glomerulonephritic nephropathy. An immunopathological classification based solely on glomerular deposits of immunoglobulin/C3 appears to have no practical importance. The demonstration of glomerular deposits of immunoglobulin/C3, however, showed to be a necessary supplement to clinical and morphological findings in some instances, in order to attain practical diagnostic boundaries within the very ill-defined concept which today constitutes GN.
...
PMID:Immune deposits in human glomerulopathy. Fluorescent microscopy findings in 366 kidney biopsies correlated to symptoms, clinical course and immunosuppressive therapy. 39 71
Acute poststreptococcal glomerulonephritis (AGN) differed from membranoproliferative
glomerulonephritis
(MPGN) and lupus nephritis (
SLE
) in that two of the proteins that control the C3b-dependent convertase, beta 1H and the C3bC4b-inactivator cofactor (C3bC4bICo), were frequently absent from the glomerular deposits. In addition, factor B was distributed with C3 in the capillary walls in hypocomplementemic AGN patients. From this, it can be assumed that C3bBb is in the deposits, uninhibited by control proteins as would be predicted for alternative pathway activation. Factor B could not be found in normocomplementemic AGN, was rarely present in MPGN, but was usually present in
SLE
, most often in the mesangium. In MPGN and
SLE
, the control proteins were nearly always present in the glomeruli in a distribution like that of C3; IN MPGN they were particularly abundant. Complement profiles indicated an occasional transient reduction in serum C4 level early in AGN. Thus, although there is occasional evidence of early classical activation in AGN, more characteristic is a long period of alternative activation. Serum levels of control proteins did not deviate greatly from normal except for reduced serum beta 1H levels in MPGN type I.
...
PMID:Glomerular deposition of complement-control proteins in acute and chronic glomerulonephritis. 39 17
A soluble glomerular basement membrane (GBM) antigen was detected in the urines of patients with various glomerular diseases including chronic glomerulonephritis, nephrotic syndrome, chronic renal insufficiency, and
lupus
nephropathy. The urinary GBM antigen (u-GBM) was immunochemically distinct from other renal antigens and other serum components, but it was cross-reactive with trypsinized human GBM antigen (t-GBM). The molecular size of u-GBM was approximately the same as human serum albumin as estimated by elution patterns on Sephadex G-200. The concentration of u-GBM was estimated quantitatively by a single radial radioimmunodiffusion. Although differed from case to case, a rough correlation with the type and/or stage of nephrotic syndrom existed. It was also demonstrated that the amounts of u-GBM decreased in response to steroid therapy of nephrotic syndrome. It was further shown that in a case of membranoproliferative
glomerulonephritis
, anti-GBM antibody could be eluted from the kidney removed from the patient. These findings imply that the GBM antigen plays an important role in the pathogenesis of human renal diseases. The pathophysiological significance of urinary GBM excretion in renal diseases is also discussed here.
...
PMID:Immunochemical characterization and quantitation of the human glomerular basement membrane antigen from the urine of patients with glomerular diseases. 40 15
Sixty six patients with
lupus
nephropathy with hypertonic syndrome are examined. In patients with latent (inactive)
lupus
glomerulonephritis
hypertonic syndrome developed 3--8 months after the initiation of the corticosteroid treatment, advancing with fluctuations, in some of the patients the arterial pressure being normalized after the discontinuation of that treatment. In patients with chronic active
lupus
glomerulonephritis
without nephrotic syndrome, the hypertension develops before the initiation of the corticosteroid treatment, fluctuating at the beginning, and gradually assumes a stable character 3--5 months after the beginning of such treatment, sometimes with a malignant course and rapid development of renal insufficiency. The hypertonic syndrome advances most severely and malignantly in chronic
lupus
glomerulonephritis
with nephrotic syndrome and is resistant to the active antihypertensive treatment. In 18, out of 25, such patients, the hypertonic syndrome is manifested in parallel with nephropathy before the inclusion of the cortocosteroid treatment. The grave and malignant course of the hypertonic syndrome is associated with the peculiarities of the clinical form and histomorphological type of that
lupus
nephropathy. In the patients with nephrosclerosis, the hypertonic syndrome is with a gradually progressing evolution, in parallel with the progress of the renal insufficiency.
...
PMID:[Symptomatic arterial hypertension in lupus nephropathy]. 43 52
Glomerulonephritis
constitutes an important category of renal diseases in animals and has been recognized with increasing frequency in the last decade. We report here the comparative morphologic aspects of
glomerulonephritis
as a naturally occurring disease of animals. We briefly review the immunopathogenesis of
glomerulonephritis
. The morphology of renal lesions occurring in
glomerulonephritis
in dogs, cats, cattle, sheep, horses and swine has been reviewed with emphasis on the range and specificity of various glomerular lesions and on the comparison of lesions between various species. A distinction was made between
glomerulonephritis
as a primary disease entity and
glomerulonephritis
associated with other disease processes. Primary idiopathic
glomerulonephritis
occurred in all species but was most commonly recognized as a clinically important disease in dogs and cats.
Glomerulonephritis
also occurred in association with other diseases such as equine infectious anemia, chronic hog cholera, canine pyometra, dirofilariasis, feline leukemia virus infection and canine
systemic lupus erythematosus
.
...
PMID:Comparative pathology of glomerulonephritis in animals. 44 47
Qualitative analysis of urinary proteins is contrasted with histological findings of 45 renal biopsies performed in patients with chronic glomerulonephritis. Compared to electrophoresis on cellulose acetate and immunoelectrophoresis, a method using polyacrylamide gel after sodium dodecylsulfate treatment makes for more refined and objective differentiation of protein abnormalities. On the whole, proteinuria of the selective glomerular or physiological type predominates in the event of minimal change or membranous lesions. The non-selective type is found more frequently with diffuse proliferative or membranoproliferative
glomerulonephritis
(p less than 0.025). There are, however, too many exceptions to this rule to allow certainty, and a precise diagnosis of the particular type of
glomerulonephritis
is thus only possible histologically. Each type of histological involvement may cause almost any of the qualitative abnormalities of proteinuria. On the other hand, qualitative analysis of urinary proteins is useful for the detection of
glomerulonephritis
. A glomerular type of proteinuria may sometimes reveal involvement of kidneys at a time when, quantitatively, there is no proteinuria. In cases of orthostatic proteinuria a persistent glomerular type of tracing in recumbency suggests an organic kidney ailment. All patients in this series had a glomerular type of proteinuria when excretion was pathological, thus allowing a distinction from pure tubular involvement. 10 patients of the group, however, although they clearly had glomerular lesions (3 were diffuse proliferative
glomerulonephritis
) showed perfectly normal proteinuria both quantitatively and qualitatively. This was the case in
systemic lupus erythematosus
where kidney biopsy was performed without clinical suspicion of renal involvement. In summary, qualitative abnormalities of proteinuria call attention to underlying
glomerulonephritis
, although no distinction can be made between the various forms and there may be no detectable abnormality even in the event of major kidney involvement.
...
PMID:[Value and limits of urinary protein electrophoresis with sodium dodecyl sulfate in the evaluation of glomerular nephropathies]. 45 9
The principal causes of death of 68 patients with
lupus
glomerulonephritis
were reviewed. Renal failure (40%), vascular events (25%), and infections (16%) were the predominant causes. Diffuse proliferative
glomerulonephritis
was associated with an increased frequency of renal failure. A bimodal pattern of early deaths due to active
lupus
and sepsis and late deaths from vascular events was found superimposed on a constant rate of death from renal failure.
...
PMID:Mortality in lupus nephritis. 45 3
Lupus nephritis in a sister and brother pair was histologically analyzed. The 12-year-old sister showed clinically progressive renal failure and her renal pathology disclosed segmental necrotizing and disorganizing
glomerulonephritis
. On the contrary, the 14-year-old brother exhibited nephrotic syndrome and his renal biopsy showed diffuse exudative and proliferative
glomerulonephritis
with segmental membraneous changes. Although the familial incidence of
SLE
suggests both genetic and environmental factors existing in the background of
SLE
of identical twins and siblings, the differences of clinical manifestation and histopathological findings imply that there might be little direct genetic and environmental control on determining the expression of the disease.
...
PMID:Different histological manifestation of glomerular lesions in familial systemic lupus erythematosus. 46 57
Thirty-two biopsies of kidneys and of normal skin were performed simultaneously on patients with
systemic lupus erythematosus
(
SLE
) to determine whether the deposition of immune reactants in skin was correlated with the severity of renal injury or with several serologic measures of systemic disease activity. Immunofluorescent deposits at the dermal-epidermal junction (
lupus
band test) did not correlate with any clinical or histologic measures of
glomerulonephritis
or with serologic abnormalities. Immune deposits in dermal venules were found in 56% of the skin biopsies and were correlated with hypocomplementemia and higher levels of immune complexes in serum, and possibly with glomerular subendothelial electron dense deposits. Azathioprine therapy was correlated with absence of both sub-epidermal and vascular immune deposits. Immuno-fluorescent findings on serial skin biopsies on 13 patients were highly inconsistent. It is concluded that the
lupus
band test is clinically useful only as a diagnostic aid but not helpful in assessing renal or serologic activity of
lupus
, and that dermal vascular deposits of immunoglobulin or complement are more frequent than previoulsy recognized and correlate with measures of circulating immune complexes.
...
PMID:Simultaneous immunologic studies of skin and kidney in systemic lupus erythematosus clinicopathologic correlations. 46 1
Thirteen patients with
systemic lupus erythematosus
(
SLE
) who had normal results of urinalysis, absence of proteinuria, and normal serum creatinine values underwent renal biopsy. Three of 13 patients had diffuse proliferative
glomerulonephritis
(group 1). Biopsy specimens showed segmental fibrinoid necrosis, diffuse mesangial hypercellularity, and substantial immunoglobulin deposition. Group 2 comprised those patients whose histologic findings did not portend a poor prognosis. Four had mesangial proliferative
glomerulonephritis
, three had focal proliferative
glomerulonephritis
, and three had minimal mesangial widening. The values of inulin clearance in group 1 did not differ significantly from those in group 2. Patients in group 1 had a mean age of 19 years, a value significantly lower than in group 2 (41.8 years). Review of previous reports also supports the thesis that this phenomenon is age related. Our study underscores the importance of renal biopsy in patients with
SLE
despite the absence of clinical evidence of renal involvement, particularly in patients under 30 years of age.
...
PMID:Clinically occult diffuse proliferative lupus nephritis. An age-related phenomenon. 47 19
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