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)

This study was carried out in two parts. Part 1 consisted of an epidemiological survey of 1011 subjects aged 3-65 yrs from 2 adjoining villages hyper-endemic for Onchocerciasis and 890 subjects in a control area, relatively free from this infection but otherwise with a similar parasitological profile. There was a significantly higher prevalence of proteinuria in subjects from the onchocercal zone than in controls (observed difference greater than 5 1/2 times its standard error). Part 2 comprised detailed investigations, including renal biopsy, of 63 consecutive patients admitted into hospital with severe proteinuria and/or renal failure from a caption area extending into the onchocercal zone. There were a variety of causative factors, but in 9 cases filarial antigen was demonstrable in the immune-complex deposits in the kidney. A plenum of renal histopathological changes were seen in patients with onchocerciasis. The significance of these findings is discussed.
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PMID:Nephropathy in Cameroon: evidence for filarial derived immune-complex pathogenesis in some cases. 386 88

In a double-blind controlled clinical trial comparing the safety and efficacy of oral diethylcarbamazine citrate (DEC) with topical DEC for the treatment of onchocerciasis twenty men with moderate skin-snip microfilarial counts received daily therapy for 1 week, then weekly therapy for the rest of 6 months. The number of microfilariae per skin snip dropped quickly to 2% of initial levels and remained at low levels in those receiving oral DEC, and to 20% of initial levels in patients treated with DEC lotion. Side-effects in both groups included lymphadenopathy, fever, pruritus, rash, proteinuria, and chorioretinitis; they were commoner with topical DEC.
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PMID:Controlled clinical trial of oral and topical diethylcarbamazine in treatment of onchocerciasis. 610 99

In the last ten years ivermectin appeared an efficient and safe alternative to diethylcarbamazine which is known to induce severe adverse reactions in loiasis, including encephalitis. After these results, large scale ivermectin treatments against onchocerciasis were carried out in Central Africa where loiasis is also endemic; and seven cases of severe reaction were reported in Cameroon since 1991, during these mass ivermectin treatments. In order to study adverse reactions in patients harbouring high load of Loa loa microfilariae (mf), we realized careful hospital based treatment in 112 patients with more than 3,000 mf/ml (ml) blood. Patients received once 200 micrograms ivermectin per kilogram at day 0 (D0). Clinical examination was made daily during the four following days (D1 to D4). Blood and urine samples were analysed before treatment and at D1 and D3. Lumbar puncture was made at D1 for 39 patients with more than 10,000 mf/ml; at D3 for the 49 following patients without consideration for the level of parasitaemia, and at D0 and D3 for ten voluntary patients. For analysis the patients were distributed in 3 groups according to initial parasitaemia: the first group included 50% out of the patients, those whose parasitaemia was fewer than 15,000 mf/ml blood; the second group included 25% patients whose parasitaemia was between 15,000 and 30,000 mf/ml; the third group included the last 25% patients whose parasitaemia was higher than 30,000 mf per ml blood. Adverse reactions were observed in 71% out of the patients. Symptoms described were fever, pruritus, headache, arthralgia. Most symptoms appeared 24 to 36 hours after treatment. Temperature increased significantly in group 3. Microfilaraemia decreased by 85% in the 3 groups during the 4 days following treatment. C-reactive-protein increased dramatically after treatment in all patients (p < 10(-4)). Some patients presented blood in urine in three groups but haematuria reached 35% of patients in group 3. Proteinuria is noted among 33% of all patients but 20% in group 1 and 2 versus 70% in group 3. Loa loa mf were observed in urine of half the patients, but in low amounts (< 10 mf per 50 ml urine). In cerebro-spinal fluid (CSF), some mf appeared at D1 or D3 in people heavily infected with Loa loa, reaching 80% of the patients of group 3. LP made at D0 in ten patients with parasitaemia higher than 30,000 mf/ml blood confirmed that CSF was naturally microfilaria free before treatment. One patient presented severe troubles with fever, asthenia and conscience troubles beginning at D3, reactive coma at D4, renal impairment with transitory anuria; progressive improvement in 2 weeks and complete recovery at D22; he presented 102 mf/ml CSF at D6. The study confirmed that ivermectin treatment is generally well tolerated. Among people with high Loa loa parasitaemia the symptoms after treatment are frequent but mild. However severe cases with conscience troubles are possible, and may occur in about 1% of subjects with more than 3,000 mf/ml blood. Severity of adverse reactions was linked to level of parasitaemia before treatment. The critical parasitaemia level which could lead to expect serious adverse effects seems to be 30,000 ml/ml blood. These informations should induce carefulness to carry out large scale treatments against filariosis in endemic areas of Loa loa.
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PMID:[Secondary effects of the treatment of hypermicrofilaremic loiasis using ivermectin]. 855 62

The occurrence of renal abnormalities was investigated in patients with onchocerciasis in comparison to individuals without onchocerciasis in Guinea. Serum creatinine levels, excretion of urinary marker proteins, and kidney size by ultrasound were determined. A high prevalence of glomerular as well as tubular dysfunctions was observed; however, no association with onchocerciasis could be detected. We also hypothesized that patients with hyperreactive onchocerciasis might be prone to develop immune-mediated glomerular disorders; however, this could not be verified. Following treatment with ivermectin, a slight but significant increase in the excretion of urinary albumin and alpha1-microglobulin was seen five days after treatment in all treated patients, whereas levels of proteinuria were significantly higher five days after treatment only in patients with high microfilarial densities. Our results indicate that ivermectin can cause glomerular and tubular disturbances in patients with onchocerciasis; however, these are minor and do not seem to be clinically relevant.
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PMID:Analysis of renal function in onchocerciasis patients before and after therapy. 1040 31

The present study was aimed at determining the prevalence of onchocerciasis and proteinuria as well as the association between manifestations of heavy chronic onchocerciasis (HCO) and proteinuria among patients in Cameroon. Of the 482 (277: 57.5% females and 205: 42.5% males) subjects recruited from an area with an ivermectin treatment coverage rate of 77.8%, the average prevalence of microfilaridermia by skin snip (mf/ss) was 31.9%, the community microfilaria load was 9.3 mf/ss and the overall prevalence of proteinuria was 4.4%. There was no statistically significant difference in the prevalence of symptoms of HCO when subjects were matched in the presence and absence of proteinuria with regard to positive ss (P = 0.0860), presence of nodules (P = 0.5000), depigmentation (P = 0.1459), visual impairment (P = 0.5000) and recent ingestion of ivermectin (P = 0.6366). Fourteen (66.6%) of the 21 subjects with protein to creatinine ratios (P/CR) > or = 0.2 had HCO, while 15 (71.4%) of the 21 subjects with P/CR < 0.2 had HCO. This gives an odd ratio of 0.8 and a P value of 0.62. However, there is need to carry out studies with a larger sample size before firm conclusions can be drawn about the association between onchocerciasis and proteinuria.
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PMID:Proteinuria and onchocerciasis in an endemic area in Cameroon under community-based treatment with ivermectin. 1771 3