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)

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

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 46-year-old male chromium plating worker visited our hospital due to rhinorrhea, sneezing and cough with blood-tinged sputum for more than 10 years. He also had skin ulceration and chronic dermatitis on both hands Medical therapy was inefficient. Physical examinations revealed nasal septum perforation, severe inflammation of the nasopharynx cavity, and eczema of both hands. Laboratory investigations showed significant tubule proteinuria, enzymuria, hypercalciuria, etc. It is evident that renal tube damage was present in this patient. The blood chromium level was 25 ng/mL, and the 24-hour urine chromium excretion level was 2.8 mg/day. A pulmonary function test showed reduced functional residual capacity (FRC), which may be due to either long-term smoking or chromate acid exposure. To our knowledge this is the first case of renal tubal damage induced by chronic chromate intoxication Taiwan. Further evaluation of the occupational safety and health of chromium plating workers is needed on this island.
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PMID:[Chronic chromate intoxication with renal tubular damage--report of a case]. 135 17

A pooled estimate of the magnitude of the benefit and side effects of injectable gold salts in rheumatoid arthritis was computed using meta-analysis based upon available evidence in the literature. Active joint count, grip strength, functional capacity, hemoglobin concentration and erythrocyte sedimentation rate (ESR) were pooled. The change in percentage in favor of gold (adjusted for placebo) was as follows: active joint count 30.1%, (p less than 0.00001), grip strength 13.7% (p less than 0.013), functional capacity 13% (p less than 0.0005), hemoglobin concentration 5.3% (p less than 0.02), and ESR 19.6% (p less than 0.02). Pooling of side effects gave the following results: side effect withdrawals were 11% (p less than 0.01), dermatitis occurred in 15% and proteinuria in 0.7% more patients than in the placebo group.
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PMID:Meta-analysis of injectable gold in rheumatoid arthritis. 266 67

A 76-year-old woman with a chronic leg ulcer for the last thirty-seven years was hospitalized in our institution for chronic diarrhea and terminal kidney failure with proteinuria. The diagnosis of secondary amyloidosis due to persistent skin inflammation was confirmed by aspiration of subcutaneous abdominal fat and by kidney biopsy which showed AA type systemic amyloidosis. This appears to be a rare complication of chronic leg ulcers as there have been only eight publications covering eleven cases in the literature.
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PMID:[Leg ulcer complicated by secondary amyloidosis]. 267 48

Seven female patients with classical rheumatoid arthritis (RA), treated successfully with injectable gold salts (Fosfocrisolo ICI, 0.10 g/week, with a serum gold concentration of 200-400 mcg/dl), experienced severe gold side-effects after 3 to 20 months of therapy, requiring their withdrawal from gold despite the good results in both clinical and laboratory findings. Four patients showed mucocutaneous side-effects (2 dermatitis and 2 stomatitis) and three a moderate or severe proteinuria. Renal biopsy was performed in these patients, with a histological picture of membranous glomerulonephritis referable to gold therapy. Remission inducing drug (R.I.D.) therapy being mandatory in patients with a chronic progressive disease, and in view of the previous efficacy of gold salts, the patients were put on oral gold, Auranofin being administered 3 mg b.i.d. Both the mucocutaneous side-effects and the proteinuria ameliorated within 2 to 6 months, and the remission of the disease was maintained. The chemical and pharmacokinetic differences between the above two gold compounds are discussed.
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PMID:Injectable gold dermatitis and proteinuria: retreatment with auranofin. 293 99

Typing for antigens HLA-A,B,C and DR was performed on 165 rheumatoid arthritis patients (14 black, 151 white) who had received gold therapy to determine the relationship between HLA antigens and gold dermatitis, stomatitis, thrombocytopenia, and proteinuria. Dermatitis and stomatitis occurred in both black and white patients. Thrombocytopenia and proteinuria occurred only among the white patients studied. The absence of thrombocytopenia and proteinuria among the black patients was not statistically significant. Antigen HLA-DR7 was uncommon among black and white subjects with dermatitis (0 of 6 blacks, 4 of 48 whites), but this decrease in frequency was not statistically significant. Antigen HLA-DR3 was an important risk factor for thrombocytopenia (relative risk = 11.8, P = .0043) and proteinuria (RR = 5.8, P = .032). These results are consistent with previous studies of HLA-DR3 and gold toxicity. The only black patient with stomatitis possessed the A1B8DR3 phenotype. Future studies should examine whether the same HLA antigen confers risk of different gold toxicities in different racial groups, and whether there are HLA antigens that provide a protective effect.
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PMID:Immunogenetic and racial determinants of gold toxicity in rheumatoid arthritis. 297 88

The association between HLA antigens and adverse drug reactions (ADR), (e.g. proteinuria, haematological abnormalities, stomatitis, diarrhoea and dermatitis) in rheumatoid arthritis (RA) to sodium aurothiomalate (gold) and to D-penicillamine (PA) were studied in 32 patients. Thirty-eight RA patients treated with gold and PA, and with no ADR to these drugs, were used as controls. The frequency of HLA B8 was significantly (p less than 0.05) increased among RA patients with ADR compared to plasma donors. DR3 was also significantly increased (p less than 0.05) in RA patients with haematological ADR compared to plasma donors. Haematological ADR occurred significantly (p less than 0.05) more often in DR3 positive patients (55%) than among DR3 negative RA patients (27%).
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PMID:HLA antigens and adverse drug reactions to sodium aurothiomalate and D-penicillamine in patients with rheumatoid arthritis. 315 29

MRL lpr/lpr (MRL/l) mice exhibit a disease similar to systemic lupus erythematosus (SLE) in humans. To investigate the influence of antihypertensive treatment on this disease, four groups of MRL/l mice were treated with the angiotensin-converting enzyme inhibitor captopril (n = 25), with the sympathetic blocker bretylium (n = 15), and with cyclophosphamide (n = 10). Thirty-five mice did not receive any treatment and served as controls. Survival rate, blood pressure, incidence of proteinuria and hematuria, renal pathology, lymphoid hyperplasia and dermatitis were studied. The survival at the age of 36 weeks was significantly improved by captopril as compared to controls (60 vs. 25%, p = 0.035). The cyclophosphamide group showed no mortality at that time and the bretylium group did not differ from the control group. Captopril and bretylium reduced systolic blood pressure significantly while cyclophosphamide was without effect. Captopril and cyclophosphamide diminished significantly the glomerular damage with less proliferative changes and a decreased incidence of proteinuria. The bretylium-treated animals also exhibited an improved renal pathology index but they did not differ from the controls with respect to proteinuria and hematuria. Lymphoid hyperplasia and dermatitis were decreased only by captopril and cyclophosphamide. It is concluded that captopril improves survival in SLE disease of MRL/l mice, counteracting lymphoid hyperplasia, renal disease, dermatitis and decreasing arterial blood pressure.
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PMID:Beneficial effect of captopril on systemic lupus erythematosus-like disease in MRL lpr/lpr mice. 328 May 1

Auranofin (triethylphosphine gold), an oral gold preparation, has recently been made available, and along with injectable gold preparations, is of therapeutic value for rheumatoid arthritis. Serious gold toxicity is uncommon, and drug-related deaths rare. Many potential adverse reactions are similar, including dermatitis, stomatitis, thrombocytopenia, leucopenia, and proteinuria, generally with increased incidence in the injectable gold-treated patients. Oral gold is associated with benign lower gastrointestinal side effects, including diarrhoea, loose stools and abdominal cramps that are often dose-related and resolve spontaneously. The incidence of severe reactions such as thrombocytopenia, aplastic anaemia and exfoliative dermatitis is lower with oral gold than injectable preparations, and contributes to a superior risk-benefit ratio. The treatment of gold toxicity depends on the type and extent of organ involvement.
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PMID:Adverse reactions with oral and parenteral gold preparations. 329 22


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