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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of membranous lupus nephritis with a previous history of long-standing nephrotic syndrome which developed an acute renal failure due to bilateral renal-vein thrombosis superimposed on a calcified thrombus of the inferior vena cava eight years after the diagnosis. The occurrence of acute renal-vein thrombosis is a possible but rarely described complication of systemic lupus erythematosus. The presence of a calcified thrombus of the inferior vena cava has been described in only one adult patient until now. An aggressive thrombolytic therapy with urokinase permitted the fresh thrombus to be dissolved with a marked improvement in renal function.
Nephrol Dial Transplant 1990
PMID:Acute bilateral renal vein thrombosis superimposed on calcified thrombus of the inferior vena cava in a patient with membranous lupus nephritis. 212 66

In spite of intensive endeavours, attempts to identify nephritogenic antigens in cases of immune complex glomerulonephritis have not yielded convincing results. Cationic antigens can have high affinity for the glomerular basement membrane and are prime candidates as nephritogens. They can be expected to play a role in post-infectious and in autoimmune glomerular disease. Histones show great promise in the latter case: we are able to demonstrate (1) a high affinity for the glomerular basement membrane and (2) their ability to promote glomerular deposition of anionic antigens as an additional target. Histones were detectable in glomerular deposits in two murine models of glomerulonephritis: the spontaneous lupus-like disease of NZB/W F1 mice and in graft-versus-host disease. We propose that histones may be responsible for the induction of glomerulonephritis in lupus-like syndromes, as well as other types of autoimmune renal disease. As an analogue, histone-like proteins from micro-organisms may also be responsible for glomerular disease in post-infectious nephritis.
Nephrol Dial Transplant 1990
PMID:The role of cationic proteins in the pathogenesis of immune complex glomerulonephritis. 215 42

Eighty-two consecutive Caucasian adults (52 males, 30 females, aged 17-86 years) with membranous glomerulonephritis were prospectively evaluated for possible aetiological factors 1-4 weeks after renal biopsy. Presumed causes were identified in 17 patients (21%) as follows: drugs in five (D-penicillamine 3, captopril 1, fenoprofen 1); malignancy in four; chronic thyroiditis in three; systemic lupus erythematosus (SLE) in two; secondary syphilis in one; hepatitis B virus (HBV) infection in one and non-insulin-dependent diabetes mellitus in one patient. Except for age (patients with secondary membranous glomerulonephritis were older), clinical presentation and histological stage distribution did not differ between the secondary and the primary groups. Ten out of the 17 patients with secondary membranous glomerulonephritis (59%) achieved complete clinical remission within 12 months. The incidence of associated conditions in adults with membranous glomerulonephritis in this study corresponds with that reported in the few previous series. Although membranous glomerulonephritis is deemed to be idiopathic in most cases, it seems warranted to search for medication, malignancy, SLE, HBV infection, syphilis and thyroiditis as possible aetiological factors. Further evaluation should be orientated by the clinical context. An improved outcome of membranous glomerulonephritis may be expected insofar as the underlying condition is controlled.
Nephrol Dial Transplant 1989
PMID:Aetiology of membranous glomerulonephritis: a prospective study of 82 adult patients. 251 87

In five patients suffering from recurrent thrombosis and/or fetal death, a lupus anticoagulant was associated with a renal vasculopathy. Ischaemic episodes also involved the skin, heart, eyes and/or central nervous system. All patients were hypertensive. Two had renal insufficiency, two had non-nephrotic proteinuria, and in the last patient renal cortical ischaemia was detected by a tomographic scan in the absence of proteinuria. Renal biopsy showed thrombosis and/or intimal fibrosis of intrarenal vessels, and normal or ischaemic glomeruli without proliferative lesions. High-titres of anticardiolipin antibodies were found in 3 of 3 cases, and persisted after steroid therapy even if the circulating anticoagulant factor disappeared. All patients received corticosteroid therapy, alone or in combination with immunosuppressive drugs; two patients had prolonged oral anticoagulation, but thrombotic episodes recurred after stopping the drug. One patient died; the remaining four survived 18 months to 11 years after diagnosis, with stable chronic renal insufficiency in one of them. These results show that a lupus anticoagulant may be associated with prominent renal vascular disease, in the absence of proliferative glomerular lesions, and suggest that continuous anticoagulation may be beneficial in these patients.
Nephrol Dial Transplant 1989
PMID:Recurrent thrombosis and renal vascular disease in patients with a lupus anticoagulant. 251 88

A circulating lupus anticoagulant factor was detected in a 38-year-old man with end-stage renal disease and a 'lupus-like' syndrome with a diffuse proliferative glomerulonephritis. When treated with steroids, the 'lupus' complications were controlled and the anticoagulant factor disappeared; however, renal function did not recover and the patient commenced regular haemodialysis. Four months later the patient received a cadaver kidney transplant. At transplantation and during follow-up there was neither clinical nor laboratory evidence of lupus activity, but 19 months after transplantation, when steroids were tapered to a low dose, the lupus anticoagulant factor was detected, and renal-vein thrombosis complicated by sepsis led to the patient's death. A membranous glomerulonephritis was found on autopsy. This is the first time in which a (probably 'de novo') membranous glomerulonephritis has been detected in the allograft of a patient with circulating lupus anticoagulant factor.
Nephrol Dial Transplant 1988
PMID:Allograft membranous glomerulonephritis and renal-vein thrombosis in a patient with a lupus anticoagulant factor. 314 30

The course of lupus nephritis in 51 males was compared to that of 337 females. Nephrotic syndrome occurred with equal frequency in males and females, hypertension was more frequent in males, rapidly progressive lupus nephritis was much more frequent in males. The overall 10-year survival rate from the onset of systemic lupus erythematosus was 41 per cent in males and 60 per cent in females. The 10-year 'renal survival' - from the clinical evidence of renal disease to 'renal death' - was 40 per cent in males and 57 per cent in females. Thus the prognosis of lupus nephritis in males was worse than in females. In 10 males and 65 females acetylation rate of sulfadimezine was studied. The predominance of slow acetylators was especially marked in males and in patients with more severe disease.
Proc Eur Dial Transplant Assoc Eur Ren Assoc 1985
PMID:Lupus nephritis in males and females. 399 65

Renal plasma flow (RPF) and glomerular filtration rate (GFR) were estimated by 125I hippuran and 51Cr EDTA clearances using a single shot technique on two occasions at one-year intervals in 22 patients fulfilling the ARA criteria for systemic lupus erythematosus (SLE). All these patients had histologically proven renal disease. Filtration fraction was a better parameter than proteinuria, urinary sediment or GFR for recognising diffuse proliferative glomerulonephritis with a sensitivity of 61 per cent and a specificity of 88 per cent. After one year all the patients with an initially low filtration fraction (FF) had significantly changed their GFR, which demonstrates that this parameter indicates the presence of an active renal lesion.
Proc Eur Dial Transplant Assoc Eur Ren Assoc 1985
PMID:Filtration fraction: an index of renal disease activity in patients with systemic lupus erythematosus. 399 66

Thirty-nine patients with systemic lupus erythematosus (SLE) and diffuse proliferative glomerulonephritis have been enrolled in a multi-centre randomised controlled prospective study of chronic 4L plasma exchange therapy performed every three to four weeks. In the patients randomised to the pheresis (P) group and who received either albumin or plasma as replacement, there was a difference of 33 per cent better renal function at this time in the study. This difference did not achieve a significance with a p value of less than 0.05. However, the 30 patients randomised into the P group to receive albumin replacement did demonstrate a 50 per cent difference from the C group which was significant at a p value of less than 0.045. This also correlated with a statistically significant reduction in immune complex titres in the P versus the C groups. Chronic 4L plasma exchange with albumin replacement may be a useful therapeutic adjunct in patients with SLE and diffuse proliferative glomerulonephritis.
Proc Eur Dial Transplant Assoc 1983
PMID:Chronic plasma exchange in systemic lupus erythematosus nephritis. 636 59

In most of our membranous glomerulonephritis (MGN) patients, we have studied the HLA-A, B, DR phenotype, the clearance of anti-D rhesus coated 51Cr-labelled autologous erythrocytes, and T-lymphocyte subpopulations with monoclonal antibodies (OKT3, T4, T8). The frequency of B8 antigen in 28 patients with MGN (five cases associated with lupus excluded) is 57.14 per cent versus 14.42 per cent in controls (Pc = 0.0002). In 26 patients the frequency of DR3 antigen is 65.38 per cent versus 20.27 per cent in controls (Pc = 0.00008). The half-life of sensitised erythrocytes is respectively 35.36 +/- 8.50 minutes in nine controls and 67.05 +/- 69.64 min in 18 patients with MGN. The half-life is significantly prolonged in one-third of the patients at time of exacerbation. The peripheral blood T-lymphocyte subsets study showed a significant decrease of OKT3 and OKT4 positive cell subsets. T4/T8 ratio is high during exacerbation of disease and diminishes in remission. Our data are consistent with a latent subtle genetic immunodeficiency, only expressed during acute phases of the disease.
Proc Eur Dial Transplant Assoc 1983
PMID:Immunogenetics and immunopathology of human membranous glomerulonephritis. 641 Mar 85

Although DNA and anti-DNA antibodies have been eluted from diseased tissues in systemic lupus erythematosus (SLE) it is uncertain whether DNA and anti-DNA comprise circulating antigen-antibody complexes in SLE. Cryoglobulins from 20 patients with SLE were examined for (i) DNA, using a radioimmunoassay and an ethidium bromide assay, (ii) anti-DNA activity of IgG and IgM, isolated from the cryoglobulins by ultracentrifugation at pH 3.5, by a modified Farr assay (anti-dsDNA) and a solid phase ELISA (anti-ssDNA). DNA was found in each of the 20 cryoglobulins by both methods. Isolated IgG had anti-DNA activity in 14 cryoglobulins: 5 anti-dsDNA, 5 anti-ssDNA and 4 anti-ds- and ssDNA; isolated IgM had anti-dsDNA activity in 3 cryoglobulins. Isolated IgG/IgM had no anti-DNA activity in 6 of the 20 cryoglobulins. In controls with idiopathic nephritis (11 membranous, 13 mesangio-capillary) DNA was detected in cryoglobulins, but no ati-DNA activity was found. It is concluded that circulating dsDNA-anti-dsDNA complexes are present in SLE, but some patients have SLE without these complexes. Our failure to find dsDNA-anti-dsDNA complexes in nephritis not due to SLE indicates the specificity of such complexes for SLE.
Proc Eur Dial Transplant Assoc 1980
PMID:Circulating DNA-anti-DNA complexes in lupus nephritis and idiopathic nephritis. 678 85


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