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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pattern of renal disease and its basic principles of management are essentially the same in the tropics as in the temperate environment. Glomerulonephritis and pyelonephritis with concomitant hypertension account for most cases of renal failure. Malaria is now well recognised as a cause of the nephrotic syndrome. Economic and manpower factors dictate a conservative approach to therapy. Maintenance haemodialysis and renal transplantation are not realistic in the present context, having regard to the order of priorities in health care delivery.
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PMID:Nephrology in the tropical setting. 37 Jun 31

A study of renal biopsy specimens obtained in Senegal from 24 children and six adults with nephrotic syndrome showed two unusual varieties of nephropathy--namely, an extramembranous glomerulonephritis associated with hypocomplementaemia (four cases), a combination previously described only in systemic lupus erythematosus, and a "tropical nephropathy" (16 cases). The latter, though lacking the diffuse glomerular deposits of immunoglobulin described in quartan malarial nephropathy (Q.M.N.), showed a curious progressive and segmental glomerulosclerosis, characterized by a "flaking" or fibrillary splitting of the glomerular capillary wall, seen in Q.M.N. Serological evidence of malaria was lacking in a third of the childhood cases.
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PMID:"Topical nephropathy" and "tropical extramembranous glomerulonephritis" of unknown aetiology in Senegal. 109 12

Plasmodium brasilianum causes chronic quartan malaria in the common marmoset Callithrix jacchus, whereas Epstein-Barr virus (EBV) infection is followed by an infectious mononucleosis-like syndrome that resolves. We infected weanling marmosets with one or both of these pathogens. Timing of the infections influenced outcome. Six animals were simultaneously infected with both agents; four became seriously ill (with accompanying proteinuria and edema) and either died or were killed. Histopathology indicated that glomerulonephritis had developed. The two survivors had more-prolonged parasitemia than did animals infected with P. brasilianum alone, as did animals infected with EBV before P. brasilianum. Five of the six simultaneously infected animals had absent or low titers of antibody to Epstein-Barr viral capsid antigens when compared with the other EBV-infected animals. Our results suggest that combined infection may be part of the etiology of quartan malarial nephropathy.
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PMID:Glomerulonephritis in common marmosets infected with Plasmodium brasilianum and Epstein-Barr virus. 284 17

Clinicians have long suspected a relationship between malaria and nephritis in Africa. The results of tests made several years ago suggested that the relationship might be an immunological one. This memorandum discusses clinical, epidemiological, morphological, and immunopathological aspects of malaria-associated nephropathy, will special emphasis on immunological investigations. Immunofluorescence studies on renal biopsies from patients with the nephrotic syndrome and Plasmodium malariae parasitaemia have shown the presence of immunoglobulin (Ig) deposits with certain complement components on glomerular basement membranes. IgG with anti-P. malariae specificity has been found in eluates of kidney tissue from such patients and P. malariae antigen was identified in the glomerular basement membrane by immunofluorescence studies. These observations support the view that the nephropathy associated with P. malariae infections is a form of immune complex nephritis initiated by circulating P. malariae antigens and anti-P. malariae antibodies. Additional support is obtained from electron microscope studies, which show that electron-dense material is associated with the glomerular basement membrane in certain diseases of the kidney in which immune complexes have been detected in glomeruli by immunofluorescence methods. The view that malarial nephritis is a form of immune complex disease should be useful in stimulating new approaches to the study of the pathogenesis of both the initiating and the perpetuating immunopathological lesion.
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PMID:Immunopathology of nephritis in Africa. 455 7

A comparative study of the serum levels of an immune-adherence inhibiting factor was carried out on serum samples from eighty-seven nephrotic syndrome children, twenty-eight nephrotic adults, 202 normal school children, 116 blood donors, twenty-five falciparum malaria children and 172 patients with miscellaneous diseases. Low titres (1/32 and below) of the factor were present in sera from 63.2% of the nephrotic children 60.7% of nephrotic adults and 60.0% of children malaria, as compared with 30.7% of the normal children, 25.5% of the patients with miscellaneous diseases and 41.4% of the blood donors. There is a significant difference between nephrotic children and normal children with low titres (P less than 0.05). Furthermore, 36.8% of the nephrotic children had serum titres of 1/4 or less, as compared with 6.4% of normal children. The serum factor is tentatively referred to as 'C3b-inase'. Its similarity to conglutinogen-activating factor (KAF) and its possible role in the pathogenesis of the immune-complex nephropathy of childhood nephrotic syndrome associated with malaria are discussed.
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PMID:Studies on the immunopathology of the nephrotic syndrome associated with Plasmodium malariae. 1. Serum levels of an immune adherence inhibitor. 628 85

Prophylactic drug monitoring of mefloquine and its carboxylic acid metabolite were studied in two patients with end-stage renal disease undergoing long-term hemodialysis treatment. The patients, short-term travellers to areas where malaria is endemic, took 250 mg of mefloquine (Lariam) once weekly for 2 weeks before and during their 3-week stay abroad and for one week after their return. Pre- and postdialysis blood samples were drawn before their departure and after their return. The concentration-time profiles of mefloquine and its metabolite in plasma samples taken before and after the 3- to 4-h dialysis sessions were similar. Mefloquine and its metabolite could not be detected in the dialysate. These findings show that mefloquine and its metabolite are not, or are very poorly, removed by hemodialysis. Concentrations in plasma and accumulation kinetics were similar to those reported for healthy volunteers and were associated with high prophylactic efficacy against malaria. No special dosage adjustments have to be made in patients undergoing hemodialysis treatment to achieve concentrations in plasma similar to those in healthy volunteers. The prophylactic dose of mefloquine could be given before, during, or after the hemodialysis session.
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PMID:Influence of hemodialysis on plasma concentration-time profiles of mefloquine in two patients with end-stage renal disease: a prophylactic drug monitoring study. 748 43

A patient with end-stage renal disease who acquired Plasmodium vivax infection after renal transplantation is reported. This 24-year-old male, a native of Taiwan, had chronic renal failure due to nephrotic syndrome of unknown etiology and had been maintained on regular hemodialysis. He developed a fever 18 days after receiving a blood transfusion and a renal allograft transplant from unknown donors in India, while he was taking corticosteroids, azathioprine and cyclosporine. Ring forms, schizonts and trophozoits of P. vivax were found in the patient's peripheral blood. He achieved defervescence after a three-day treatment of chloroquine. Malaria should be considered in the differential diagnosis of fever in transplant recipients who have received organs or blood products from an area of endemic malaria.
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PMID:Plasmodium vivax infection in a renal transplant recipient: report of a case. 774 46

In order to assess renal pathology, 92 clinically well-documented cases of nephrotic syndrome (NS) in adults (median age: 29) were systematically biopsied upon admission to the University Hospital of Kinshasa, between 1986 and 1989. All biopsies were paraffin embedded and histologically assessed by the routine methods of light microscopic examination. Histologic lesions were classified according to standard criteria. Focal and segmental glomerulosclerosis (FSG) was found in 41% of patients. The remaining 59% included minimal epithelial disease or minimal change nephropathy (MCN) responsive to corticosteroid therapy (14%), proliferative glomerulonephritis (PGN) (11%), membranous glomerulopathy (MGP) (10%), amyloidosis (10%), membrano-proliferative glomerulonephritis (MPGN) (8%), and "end stage kidney" (ESK) (7%). These results strikingly indicate the high prevalence of FSG. In comparison with previous findings from the same milieu, there is a seven-fold increase of this entity (41% versus 6%). The findings herein reported define a new histologic profile of NS in Zaire, characterized by the predominance of FSG. While in the past the vast majority of NS (52%) were putatively related to the intercurrent parasitic diseases, among which malaria was the chief etiology, similar associations were less important. Instead, no definite causative agent emerged for this apparently idiopathic condition. Further epidemiological and morphological intercorrelation studies, as well as the studies aimed at the relationships with AIDS, are in progress, with the purpose of identifying putative etiologies and risk factors responsible for the increase of FSG in Zaire.
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PMID:Focal and segmental glomerulosclerosis in nephrotic syndrome: a new profile of adult nephrotic syndrome in Zaire. 848 81

A patient with a filarial infection due to Loa loa, received single oral dose of ivermectin A few hours after, he has presented a severe renal impairment. Native of the Cameroons, he was also treated for malaria. A renal biopsy has been done, because of chronic proteinuria. It has showed microfilariae in glomeruli, thickening of the basement membrane and a segmental and focal mesangial hyalinosis. By immunofluorescence microscopy there were granular deposits of IgM and C3 along this membrane. Electron microscopy has showed subepithelial electron- dense deposits. This suggests that the renal disease is immunologically induced. During the therapy, adverse reactions seemed to be related with massive liberation of filarial antigens. This is well known with diethylcarbamazine but also now, sometimes with ivermectin.
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PMID:[Nephropathy and filariasis from Loa loa. Apropos of 1 case of adverse reaction to a dose of ivermectin]. 941 Feb 54

Renal disease is a common complication in malaria infection. In acute falciparum malaria renal involvement is usually mild, but in severe disease acute renal failure is a major problem. Acute renal failure has been attributed to ischaemic tubular necrosis from hypovolaemia resulting from vasodilatation due to endothelial injury. Though myositis is recorded as a common manifestation in falciparum malaria, only 1 case with myositis and myoglobinuria with acute renal failure has been documented; but no renal biopsy was performed in the patient. In the present study we examined the case of a 17-year-old man with severe falciparum malaria with myositis and myoglobinuria who developed acute renal failure requiring dialysis. Muscle biopsy revealed severe myositis with macrophages and T lymphocytes including CD4+ cells. The kidney biopsy showed scanty T cells and macrophages in the glomeruli which were only mildly hypercellular. The renal tubules showed myoglobin casts in the lumen and foci of interstitial inflammatory cells, including macrophages and T lymphocytes but no CD4+ cells. Rhabdomyolysis induced by macrophages and T cells with myoglobinuria and acute renal failure is a problem in severe falciparum malaria infection.
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PMID:Acute renal failure from myoglobinuria secondary to myositis from severe falciparum malaria. 1097 Sep 90


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