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)

Electron microscopic examination of renal biopsies from 19 patients with leprosy who had edema, proteinuria, or hematuria showed a proliferative glomerulonephritis in 12, amyloidosis in 2, and no lesion in 5. The proliferative glomerulonephritis was of different patterns: diffuse with or without exudation, focal, or mesangial. Subendothelial and/or subepithelial deposits were seen in five biopsies. Of the patients with glomerulonephritis, 3 had a reduced total serum complement level, 5 had erythema nodosum leprosum, 5 had evidence of recent streptococcal infection, and 2 had microfilariae in the peripheral blood. The significance of these findings is discussed.
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PMID:Glomerular pathology in leprosy. An electron microscopic study. 84 50

In 1971, rifampin was approved for treatment of pulmonary tuberculosis and asymptomatic carriers of Neisseria meningitidis. At present, the approved indications remain the same. However, rifampin in conjunction with at least one other antituberculous drug may be of great value in therapy of extrapulmonary tuberculosis and infections due to other susceptible mycobacteria. In addition, results of clinical trials in leprosy have been highly encouraging. Rifampin appears to induce light chain proteinuria in a majority of patients and has been implicated in suppression of both humoral and cell-mediated immune responses. However, these effects appear to have been of little consequence to treated patients. A variety of possibly immunologically mediated reactions to rifampin has been closely associated with irregular administration of the drug. These reactions and hepatic toxcity may be preventable in many patients. Rifampin or one of its congeners, alone or in combination with other antibiotics, may prove useful in treatment of various infectious, and possibly malignant, diseases.
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PMID:Rifampin. 93 28

Renal involvement in Hansen's disease was evaluated in 94 Portuguese patients, average age and duration of disease of 47.6 and 6.8 years respectively. Sixty-seven were studied retrospectively and 27 prospectively; renal biopsy was obtained in 4, fat-tissue needle aspiration for amyloidosis in 20, and tubular function was tested in ten. Mild proteinuria and/or haematuria was found in 33 patients, the severity increasing during erythema nodosum leprosum reactions, but without overt nephritic or nephrotic syndrome. Two patients had renal amyloidosis on biopsy and two more were confirmed by fat biopsy, a 10.5% incidence in those studied prospectively; all but one were of the lepromatous type, with frequent bouts of erythema nodosum leprosum. The two other renal biopsies showed mesangial glomerulonephritis, and one unexplained acute tubular necrosis; none had immune deposits by immunofluorescence. Proximal acidification was always normal, distal acidification tested by bicarbonate infusion was abnormal in one of nine patients, and six of nine patients had concentration defects. Leprosy causes frequent urinary sediment changes and concentration defects, usually without clinical expression; proteinuria and/or glomerular involvement is mainly due to amyloidosis.
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PMID:Renal involvement in leprosy. 249 59

A 17-year-old, Yemeni male patient with borderline lepromatous leprosy and erythema nodosum leprosum (ENL) developed a nephritic range proteinuria. A renal biopsy revealed mesangial proliferative glomerulonephritis and epithelioid granulomas in the interstitium. The presence of granular immunofluorescence for C3 and electron-dense deposits in the glomeruli indicated an immune complex glomerulonephritis. Clinical signs of ENL subsided rapidly under steroid treatment. The unusual combination of proliferative glomerulonephritis and epithelioid granulomas in leprosy is presented and discussed.
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PMID:Renal granuloma and mesangial proliferative glomerulonephritis in leprosy. 322 Nov 15

The study included 53 patients of untreated leprosy attending University Hospital, Banaras Hindu University during study period of 1 1/2 years. The various types of leprosy included 9,14,16 and 14 cases of tuberculoid, borderline, lepromatous and leprosy with type II reaction respectively. Majority of the patients were below the age of 49 years with male preponderance. 66.04% of patients came from the rural area. Painful micturation (dysuria) (13.20%) was the commonest urinary complaint recorded on enquiry. Specific gravity of urine did not show any change. Abnormal proteinuria was noted in 16.98%, 11.32%, 7.54% and 3.77% of patients of leprosy with reaction, lepromatous, borderline and tuberculoid group respectively. Significant haematuria, pyuria and epithelial cells were noted in all the groups. Haematuria was recorded in focal segmental Glomerulonephritis (GN), mesangioproliferative and diffuse endocapillary Glomerulonephritis (GN) incidence of which was 7.89%, 7.89% and 5.26% respectively in the biopsy tissue. Significant pyuria was noticed in all the groups except minimal change GN.
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PMID:Bedside urinalysis in untreated leprosy patients. 379 9

There is no specific therapy for primary amyloidosis, and acquired generalised amyloidosis can be treated only if the underlying disease is eliminated. In this study we have investigated the role of colchicine therapy in primary amyloidosis, and dimethylsulphoxide (DMSO) in leprosy associated secondary amyloidosis. No effect on creatinine clearance or 24 h proteinuria could be observed in the patients with primary amyloidosis. In the DMSO group renal function was considerably improved in 3 patients with moderate renal failure but not in those with severe renal impairment (creatinine clearance less than 10 ml/min). Serum SAA determinations were not particularly informative. These findings point to a beneficial effect of DMSO in human secondary amyloidosis when given at an early stage of renal involvement.
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PMID:DMSO and colchicine therapy in amyloid disease. 674 5

Renal functional status was evaluated in 122 patients with lepromatous leprosy. Renal functions were found to be markedly impaired in patients with erythema nodosum leprosum (ENL) in the active or quiescent phases. Although uncomplicated lepromatous leprosy patients did show significant renal impairment as compared to healthy controls, the degree of impairment was less than that of the reactive cases. Diminished endogenous creatinine clearance and proteinuria were the common abnormalities detected. Serum creatinine was significantly increased only in reactive cases. Blood urea was found to be marginally increased in a few patients although not to a statistically significant degree. Renal involvement did not bear any relation to the duration of illness or to the Bacteriological Index.
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PMID:Renal functional status in lepromatous leprosy. 719 81

Renal involvement in 13 non-lepromatous and 17 lepromatous leprosy patients were assessed by routine urinalysis, detailed biochemical analysis of blood and urine and by renal histopathological studies and compared with 10 normal healthy controls. The presence of RBC and pus cells were detected in the urinary deposit of only one lepromatous leprosy patient in reactional phase. A reversal of albumin/globulin ratio was observed in 17.6% of non-lepromatous and 15.3% of lepromatous patients. 24 hours urinary excretion of sodium, potassium, chloride and aminonitrogen of the patients were within the normal range. Forth seven percent of the non-lepromatous and 46% of the lepromatous patients had proteinuria. Even though the mean serum creatinine values of the patients showed no difference from that of the normals, the creatinine clearance was low in 82.3% of the non-lepromatous and in all of the lepromatous patients. Serum phosphorus, serum uric acid, urinary phosphate excretion and the renal tubular reabsorption of phosphorus of the patients were normal. Twenty one percutaneous renal biopsy specimens showed nonspecific pathological changes such as nephritis of various varieties in 71.4% of the specimens. Among the lepromatous group renal involvement was observed in 5 out of 9 cases (55.6%) and in the non-lepromatous group 10 out of 12 cases (83.3%). No acid fast bacilli, amyloid and granuloma were seen in any of the renal tissues studied. There was no definite correlation between the type of renal pathology and biochemical changes. None of the patient showed any clinical evidence of renal involvement.
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PMID:Renal involvement in leprosy. 725 68

Two hundred and thirty-three patients with renal amyloidosis were studied in an attempt to identify the incidence and pattern of the disease in northern India. The incidence of amyloidosis was 1.01% of 6431 post-mortems and 8.4% of 1980 renal biopsies from patients who presented with clinical evidence of glomerular disease. Two hundred and three patients (87.1%) had secondary amyloidosis, 22 (9.4%) had primary amyloid and 8 patients (3.5%) had amyloidosis associated with multiple myeloma. Tuberculosis of various organs was the commonest predisposing disease accounting for 59.1% of secondary amyloidosis, followed by chronic suppurative lung disease in 24.1%. Rheumatoid arthritis, chronic osteomyelitis and lepromatous leprosy were seen in a small percentage of patients (2 to 8%). Proteinuria of varying degree was present in all the 233 patients and 12.9% of them had a daily protein excretion of more than 10 g. Post-mortem examination of 65 patients with renal amyloidosis showed that 75.3% also had amyloid deposit in the spleen, 63% in the liver, and 50.8% in the adrenals. Clinical evidence of disappearance of proteinuria was observed in 3 patients with secondary amyloidosis; in 2 of them, the regression of amyloidosis was confirmed by serial renal biopsy performed 3 and 5 years after the initial diagnosis.
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PMID:Pattern of renal amyloidosis in Indian patients. 727 20

Dapsone, a synthetic sulfone with chemical similarities to sulfapyridine, has been used for a number of years to treat leprosy and dermatitis herpetiformis. Recently, a number of prospective, randomized, double-blind trials have shown their success in the management of rheumatoid arthritis, with dapsone being superior to placebo and comparable to chloroquine and hydroxychloroquine. Its mode of anti-inflammatory actions in rheumatoid arthritis is not clearly understood, but modulation of neutrophil activity or inhibition of neutrophil inflammatory product formation or release appear to play a role. The major limiting side effect is hemolytic anemia, which may be mitigated through careful patient selection, conservative drug dosing, close monitoring, and possibly, concurrent administration of antioxidants or cytochrome P450 inhibitors. Methemoglobinemia is another common finding among patients receiving dapsone therapy, but rarely does it result in prominent symptoms other than transient pallor. Less common adverse events to dapsone include the idiosyncratic reactions of leukopenia and agranulocytosis, cutaneous eruptions, peripheral neuropathy, psychosis, toxic hepatitis, cholestatic jaundice, nephrotic syndrome, renal papillary necrosis, severe hypoalbuminemia without proteinuria, an infectious mononucleosis-like syndrome, and minor neurological and gastrointestinal complaints. In this report, two patients with advanced rheumatoid arthritis, who were safely and effectively treated with dapsone after failure with other second-line agents, are described and the literature is reviewed. We suggest that dapsone is an effective second-line agent in the treatment of rheumatoid arthritis.
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PMID:Dapsone in rheumatoid arthritis. 879 11


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