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Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with systemic brucellosis due to Brucella melitensis had severe renal involvement. Clinical features included hypertension, macroscopic haematuria, massive proteinuria of 10 g per 24 hours and azotaemia. Following treatment with antibiotics, the azotaemia resolved and proteinuria decreased to less than 0.5 g per 24 hours, but microscopic haematuria and hypertension persisted. Renal biopsy during recovery revealed IgA nephropathy with minimal mesangial changes, suggesting a causal relation between brucellosis and IgA nephropathy with a reversible nephrotic syndrome.
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PMID:Brucellosis with nephrotic syndrome, nephritis and IgA nephropathy. 146 59

Associations between hypertension and cardiovascular complications of diabetes mellitus in Nigerians, were examined in a cross-sectional study. 20 hypertensive-diabetic patients, 16 hypertensive patients, 10 non-hypertensive diabetic patients and 10 age- and sex-matched healthy controls, underwent M-mode and cross-sectional echocardiography, and Bruce-protocol treadmill exercise performance. Left ventricular (LV) mass indices (+/- SD) were significantly higher in hypertensive patients (164 +/- 12gm-2), diabetic (158 +/- 17gm-2) and hypertensive diabetic patients (125 +/- 129gm-2) compared with normal controls (111 +/- 17gm-2) p < 0.01. However, the LV mass index in the hypertensive-diabetic patients was significantly less than in hypertensive (p < 0.05) or normotensive diabetic patients (p < 0.05). Systolic cardiac contractility measured as fractional fibre shortening, was preserved in the hypertensive patients (24 +/- 4%) compared with the healthy controls (23 +/- 4%), but was depressed in diabetic patients (19 +/- 3%) and to a greater extent in the hypertensive-diabetic patients (15 +/- 4% p < 0.01). Treadmill exercise tolerance time was reduced independently in hypertension (309 +/- 73 seconds) or diabetes (321 +/- 119 seconds), p < 0.05, but was further impaired in hypertensive-diabetic patients (289 +/- 110 seconds) p < 0.01 compared to the healthy controls (490 +/- 156 seconds). The patients with hypertension and diabetes had a greater degree of proteinuria (p < 0.001) and a higher frequency of retinopathy (p < 0.001), in comparison to those with hypertension or diabetes alone.
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PMID:A cross-sectional study of echocardiographic indices, treadmill exercise capacity and microvascular complications in Nigerian patients with hypertension associated with diabetes mellitus. 147 33

Familial Mediterranean fever was diagnosed in a 34-year-old Turkish patient with severe nephrotic oedema. Immunohistochemical classification of a biopsy specimen showed amyloidosis of the AA-type. There was a definite increase of serum amyloid-A-protein (SAA). The typical recurrent fever, attacks of abdominal pain with symptoms of subileus and joint swelling could be treated successfully with colchicine, the oedema with diuretics. The progression of renal failure and proteinuria as indicator of the degree of amyloid-induced renal damage remained unaffected by this treatment. With dimethyl-sulfoxide (DMSO) a marked improvement in renal function and a lowering of the SAA level could be achieved. Thus this treatment inhibits the progression of amyloidosis of the AA-type in Mediterranean fever and may be considered for other forms of AA-type amyloidoses. It is possible that the lowering of the SAA-serum concentration and the improvement of renal function is due to an antiphlogistic effect of DMSO, the mechanism of action of which is so far unknown.
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PMID:[Familial Mediterranean fever with amyloidosis. Recent pathogenetic and therapeutic aspects]. 682 96

Renal involvement during Brucella infections has been known for several years, and its real frequency appears to be higher than initially suspected. This case report deals with a patient with positive blood cultures and seroagglutination to Brucella mellitensis who presented transitory renal failure, proteinuria, and macroscopic hematuria. Renal histopathology disclosed the existence of acute tubular necrosis, and the immunofluorescence study revealed the presence of mesangial deposits of immunoglobulins and complement. Electron microscopy demonstrated the presence of electron-dense paramesangial deposits. These data suggest that immunological mechanisms are implicated in the glomerular involvement of Brucella infections.
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PMID:[Renal disease with glomerular involvement during Brucella infection (author's transl)]. 701 97

Brucellosis is an anthropozoonosis caused by a Gram negative bacillus of the Brucella gender. Skin manifestations have been reported in 1.5 to 11 p. 100 of the cases. Allergic vasculitis is rare. Recently a 24-year-old man was hospitalized for signs of infection. He had been treated with tetracycline. The clinical picture was suggestive of brucellosis and the Wright test was positive at 1/1,280. There were violet and purpuric papulae on the limbs, arthritis of the knee and ankle joints and renal involvement (haematuria, proteinuria). Histology revealed fibrinoid and leukocytoclastic vasculitis of the small veinules of the subpapillary plexus. Outcome was favourable with rifampicin, doxycycline and adjuvant dapsone, together with bed rest. Several types of skin manifestations have been reported in brucellosis although cases of allergic vasculitis are rare.
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PMID:[Allergic vasculitis in brucellosis]. 783 53

Mild proteinuria during these renal complications in brucellosis is a common feature, however, heavy proteinuria in association with renal brucellosis has rarely been reported and it always was associated with a concomitant development of renal failure. This is the first description of heavy proteinuria as the sole renal derangement during acute infection with brucellosis.
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PMID:Acute brucellosis associated with massive proteinuria. 873 Apr 44

Although mild proteinuria is commonly observed during the course of brucellosis, biopsy-proven glomerulonephritis (GN) is quite rare. We present the first case of mesangiocapillary glomerulonephritis (MCGN) associated with brucellosis and summarize all cases of Brucella GN published to date. Our patient, who had a congenital bicuspid aortic valve, also had heart failure, fever, urinary abnormalities and proteinuria. Renal biopsy revealed MCGN. Although the clinical features raised the possibility of GN associated with endocarditis, transesophageal echocardiography did not show any vegetations.
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PMID:Brucella glomerulonephritis: review of the literature and report on the first patient with brucellosis and mesangiocapillary glomerulonephritis. 1216 Jan 81

We report the case of a 61-year-old man with nephrotic syndrome due to glomerulonephritis and chronic brucellosis complicated by dissecting aortic aneurysm. The patient worked as a veterinarian and was diagnosed for chronic but non-active brucellosis with positive serum test for Brucella melitensis in the past. Administration of cyclosporine in combination with low dose prednisone resulted at least in proteinuria reduction and partial remission for 3 years. Dissecting aortic aneurysm was treated by insertion of a stent-graft, that resulted in canalization of blood flow and retraction of aneurysm wall later in the course in our patient.
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PMID:Dissecting aneurysm of the thoracic aorta in a patient with nephrotic syndrome and brucellosis. 1731 48

A 12-year-old daughter of consanguineous Moroccan parents was diagnosed with cyclic neutropenia, based on a combination of recurrent gingivostomatitis, a fluctuating neutrophil count, and several episodes of severe neutropenia. No ELA2 gene mutations were found. At age 19 years she presented with edema of the limbs, proteinuria and renal failure. Renal amyloidosis AA was diagnosed by biopsy. Gene mutations associated with family Mediterranean fever (FMF) were sought, and a homozygous mutation (M694V) was found in the MFEV gene. This is the novel finding of FMF that masqueraded as cyclic neutropenia.
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PMID:Intermittent chronic neutropenia in a patient with familial Mediterranean fever. 1866 96

Brucellosis which is a endemic in Turkey, is a systemic infection which can affect any organ or system in the body. Since signs and symptoms of brucellosis resemble many other diseases, misdiagnosis and related increase in morbidity rate, are common. In this report, a case of brucellosis complicated with endocarditis, pyelonephritis, sacroileitis and thyroiditis, was presented. The case was a 32-years-old female patient in whom the diagnosis of brucellosis was delayed by 12 months since it was not taken into consideration during the clinical follow-up of the patient in various clinical centers. The patient was admitted to our center with the complaints of fever, headache, back pain, night sweats, fatigue, loss of appetite, weight loss, dysuria and polyuria. The patient had a history of consumption of raw milk and dairy products. Positive Brucella tube agglutination test (1/1280) and isolation of Brucella spp. in blood cultures led to the diagnosis of brucellosis. Sacroileitis was diagnosed upon pain on right hip joint movements, pain and restriction at the same joint in FABER test. The detection of vegetation during echocardiography, cardiac murmur during physical examination and the determination of increased ESR and CRP levels led to the diagnosis of endocarditis. Abdominal ultrasonography and urinalysis results (hematuria, proteinuria and pyuria) revealed pyelonephritis and increased free T3 and T4, decreased TSH and positive anti-thyroid autoantibodies (anti-TG, anti-TPO) revealed thyroiditis. Treatment was started with combination of rifampisin (1 x 600 mg/day) and doxycycline (2 x 100 mg/day). After the diagnosis of endocarditis, trimethoprim-sulfamethoxazole (3 x 960 mg/day) and streptomycin (1 x 1 g/day) were added to the treatment. Valve replacement surgery was planned, however, the patient didn't accept surgical intervention and antimicrobial treatment continued with streptomycin for 21 days and other antibiotics for six months. The patient exhibited significant improvement after the medical treatment. Although sacroileitis is a frequent complication of brucellosis, endocarditis, thyroiditis and pyelonephritis are among the rare complications. In cases of brucellosis with multiorgan involvement including endocarditis, successful results may be achieved by aggressive antimicrobial treatment. In endemic areas, brucellosis should always be taken into consideration in patients with fever of unknown origin and multisystem involvement.
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PMID:[A case of brucellosis complicated with endocarditis, pyelonephritis, sacroileitis and thyroiditis]. 1933 91


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