Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 34 years old white male patient suffering from a seropositive "probable" rheumatoid arthritis developed a severe hypocomplementemic mesangiocapillary glomerulnophritis. Rheumatoid factor-Latextest and Waaler-Rose-Titers and IgM have been found highly elevated in the serum. The third component of complement (C3) was markedly depressed, while the fourth component (C4) was within the normal range. The rapid progression of both diseases forced us to start an immunosuppressive drug therapy using azathioprine and steroids, 18 months after the beginning of the treatment the patient is well, has only slight proteinuria, normal levels of complement and no joint pain. The possible connections between rheumatoid arthritis and mesangiocapillary glomerulonephritis in this case as well as the therapeutic approaches are discussed.
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PMID:[Mesangiocapillary glomerulonephritis and rheumatoid arthritis. A case with diagnostic and therapeutic questions (author's transl)]. 6 Nov 63

50 patients with definite rheumatoid arthritis treated with D-penicillamine were studied every 4 weeks by disk electrophoresis of the urine to make an early record of the glomerular proteinuria of the immune complex nephritis, which has been described as a side effect of this treatment. In 30 of these patients we found, however, a tubular proteinuria which correlated well with the disease activity and which disappeared after successful basic treatment. This finding indicates interstitual renal involvement due to the basic disease.
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PMID:[Kidney complications in chronic polyarthritis]. 7 64

In a series of 100 adult patients with definite rheumatoid arthritis of at most 3 years' duration and with no previous penicillamine, gold or systemic corticosteroid treatment, 50 patients were treated with D-penicillamine and 50 with gold for one yar. The dose of penicillamine was 600 mg daily. Sodium aurothiomalate was given 50 mg weekly up to a total of 13 mg/kg and thereafter 50 mg once a month. In both treatment groups a statistically significant decrease in the number of painful and/or swollen joints, an increase in haemoglobin and a decrease in ESR, serum ceruloplasmin-, alpha1-acid glycoprotein-, IgG-, IgM- and IgA levels was observed. All the changes in these clinical and laboratory tests were of the same degree in both treatment groups. In the penicillamine group 12 out of 20 seropositive patients became seronegative and in another 5 the Waaler-Rose titre dropped clearly. In the gold group, 7 out of 16 seropositive patients became seronegative, and the Waaler-Rose titre dropped in another 5. An equal increase in the number of eroded joints in hands and toes was seen in the penicillamine and the gold group. Penicillamine was discontinued because of side effects in 13 patients (26%), and gold treatment in 15 (30%). Proteinuria and/or haematuria were the most common causes of discontinuation in the penicillamine group.
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PMID:Comparison of penicillamine and gold treatment in early rheumatoid arthritis. 10 90

The development of severe proteinuria or nephrotic syndrome as an adverse reaction to gold therapy in rheumatoid arthritis is well known. Morphologic examination reveals membranous glomerulonephritis in almost all cases. Since the beginning of 1978 there has been a striking increase in the number of such cases seen at this institute. 5 patients aged from 17 to 65 years who had been treated with sodium aurothiomalate for rheumatoid arthritis developed severe proteinuria. In all cases only minimal glomerular changes were observable by light microscopy. Electron microscopy demonstrated multiple electrondense, subepithelial deposits which were confirmed by fluorescence microscopy. In all cases characteristic lysosomes ("aurosomes") were demonstrated in the cytoplasm, mainly of the epithelial glomerular cells. This unusual accumulation of almost identical cases coincides with the introduction of a new gold preparation, Na-aurothiomalate (Tauredon), containing 46% metallic gold.
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PMID:[Conspicuous accumulation of membranous glomerulonephritis following gold therapy in chronic polyarthritis--a side effect of a new preparation?]. 10 66

Currently available techniques do not enable the clinician to identify which patients with rheumatoid arthritis will respond favorably to chrysotherapy or to predict which patients will develop gold-related complications. Gold concentrations are similar in blood, urine, feces, skin, hair and nails in gold-responders and non-responders, and in gold-toxic and non-toxic patients. However, gold toxicity is a function of dosage schedule; higher than conventional doses increase the prevalence and severity of adverse reactions. Preliminary observations suggest that the frequency of common side-effects (e.g. dermatitis, stomatitis, proteinuria) from oral gold (auranofin) is less than that incurred with intramuscular gold prepartions. The possible genetic predisposition to develop gold toxicity is under investigation.
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PMID:Gold compounds in rheumatoid arthritis: clinical-pharmacokinetic correlates. 11 49

Twenty patients with rheumatoid arthritis developing proteinuria when being treated with penicillamine have been studied. In 5 the proteinuria was mild and resolved rapidly. Eleven of the remaining patients have undergone renal biopsy. One was found to have amyloidosis, and in the other 10 there was evidence of an immune complex type of injury, manifested by a granular immunoglobulin deposition within glomerular capillary walls associated with subepithelial deposits, found on electron microscopy. The proteinuria associated with this was mild (mean 2.6 g per 24 h) and occurred on average some eight months after commencing therapy (range 6 weeks to 60 months).
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PMID:Effect of penicillamine on the kidney. 12 55

Forty patients with active rheumatoid arthritis were treated with intramuscular injections of gold salts. A significant response was shown by 67,5% of the patients. Treatment was discontinued owing to side-effects in 35%. Dermatitis and proteinuria from renal damage were the commonest complications of treatment. The method of treatment and its side-effects are discussed.
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PMID:Gold therapy in rheumatoid arthritis. 12 34

A case of severe enterocolitis which occurred on initiation of chrysotherapy for rheumatoid arthritis is reported. The patient, a male aged 50 years, suffered from dramatic diarrhea for several weeks. Biopsy specimens from the stomach, ileum and colon revealed signs of inflammation. Later, general toxicodermia, mouth ulcers, blood eosinophilia and asymptomatic proteinuria were observed. After several months all the side effects disappeared. The toxicodermia was the most persistent.
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PMID:[Toxic reactions to gold salts with severe enterocolitis in a patient with rheumatoid arthritis]. 13 87

In order to evaluate clinical efficacy of D-penicillamine (DP) a double-blind study was conducted by the Metalcaptase Research Group consisting of forty-one rheumatological centers in Japan. A total of 179 patients with rheumatoid arthritis (RA) was divided into two groups; one treated with 5 mg (control group) and the other with 100 mg (drug group) of DP in capsule form. The trial lasted 24 weeks. Global judgment by physicians revealed that improvement was found in 27% in the controls and 65% in the drug group. Adverse reactions occurred in 34% of the controls and 49% of the drug group. Skin rashes, taste disturbances, gastrointestinal upset and proteinuria were frequent in the drug group, but severe or fatal reactions could not be seen in this trial.
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PMID:Clinical evaluation of D-penicillamine by multicentric double-blind comparative study in chronic rheumatoid arthritis. 14 7

Proteinuria, with or without the nephrotic syndrome, developed in 8 patients with seronegative rheumatoid arthritis after the institution of gold therapy. Light microscope examination of renal biopsies showed normal findings in 7, and a focal increase in the mesangial matrix of one glomerulus in the eighth. In all patients immunofluorescence showed deposits of IgG and C3 along the glomerular basement membrane, indicative of immune complex nephritis. The renal biopsies of 5 patients were studied with the electron microscope and subepithelial deposits were detected in all. The Rose-Waaler test for the detection of IgM-rheumatoid factor (IgM-RF) was repeatedly negative in all patients. These results suggest that the development of gold nephropathy may be related to an absence of IgM-RF in serum.
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PMID:Gold-induced immune complex nephritis in seronegative rheumatoid arthritis. 14 32


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