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

Schistosomiasis is a parasitic disease of the tropics which is estimated to affect up to 300 million people worldwide. In endemic areas the childhood age group has the highest prevalence and intensity of infection. There are several distinct species of schistosomes. The principal organ system involved in Schistosoma haematobium infection is the urinary tract since parasite eggs penetrate the bladder and are excreted in the urine. Hematuria, proteinuria, leukocyturia and symptoms like dysuria or nocturia are the most common clinical presentations. Heavily infected patients show obstructive uropathy of different severity which may lead to renal failure. Intestinal schistosomiasis is caused by Schistosoma mansoni infection. Initial symptoms can be diarrhea and blood-tinged stool. Chronic infection is characterized by fibrotic involvement of the liver and consecutive portal hypertension. The diagnosis of schistosomiasis depends on the demonstration of schistosome eggs in human excreta or biopsy material. Imported cases of schistosomiasis to Europe show an increasing tendency due to expanding international travel. Furthermore imported cases are usually not diagnosed until years after the patients have left an endemic area. The treatment of choice is a single dose of praziquantel 40 m/kg bodyweight resulting in cure rates of around 90% and considerable reversibility of pathological abnormalities due to schistosome infections.
 ...
PMID:Schistosomiasis in childhood. 327 25

Egg output, proteinuria, erythrocyturia, and leukocyturia were quantitatively assessed in six schoolchildren with urinary schistosomiasis due to Schistosoma haematobium on 5 days before and 1-35 and 61-65 days after administration of praziquantel (40 mg/kg). Twenty days after therapy, egg output had decreased from a median of 310 before therapy to less than one egg per 10 ml of urine. This decrease was paralleled by a reduction in proteinuria (1.01 g/liter), erythrocyturia (2,142/microliter), and leukocyturia (803/microliter) to normal values. Between days 31-35 and 61-65, five of the six patients had no detectable viable eggs on five consecutive days. Thickening of the bladder wall and vesical polyps detected by ultrasonography returned to a normal appearance one month after treatment. However, dilatation of the renal collecting system showed no significant reduction.
 ...
PMID:Reduction of pathological findings in urine and bladder lesions in infection with Schistosoma haematobium after treatment with praziquantel. 393 Jun 20

Quantitative parasitological assessment and quantitative analysis of proteinuria, hematuria, and leukocyturia were carried out in 182 Sudanese schoolboys with mixed urinary and intestinal schistosomiasis. Pathological proteinuria was found in 73% of patients (median = 380, 95% confidence limits = 200 to 500 mg/liter). The median protein/creatinine ratio was 0.54. SDS polyacrylamide gel electrophoresis showed an excretion of albumin, transferrin, and IgG consistent with a postrenal pattern of proteinuria. Pathological erythrocyturia occurred in 84% of patients (median = 255, 95% CL = 95 to 629 cells/microliter) and leukocyturia in 77% of patients (median = 148, 95% CL = 93 to 246 cells/microliter). Phase contrast microscopy revealed intact erythrocytes, suggestive of postrenal hemorrhage. Proteinuria, erythrocyturia, and leukocyturia correlated significantly with the ova excretion in the urine, but not with egg excretion in the stool. Oxamniquine reduced ova excretion in the stool but did not influence pathological urine findings. In patients treated effectively with Praziquantel or Metrifonate, pathological PU, EU, and LU decreased markedly 1 month post treatment. PU in severely proteinuric patients reached physiological values 5 months post therapy. We suggest that the proteinuria, erythrocyturia, and leukocyturia in mixed schistosomiasis were of postrenal origin.
 ...
PMID:Proteinuria, hematuria, and leukocyturia in children with mixed urinary and intestinal schistosomiasis. 393 51

213 patients with urinary schistosomiasis were investigated under field conditions in the Peoples Republic of Congo by quantitative parasitological examination, urine analysis and abdominal ultrasonography. The study group consisted mainly of children. Disease related pathological ultrasonographical findings were dependent on the intensity of infection. Sixty patients had bladder wall thickening and 55 patients had vesical polyps. Those with multiple vesical polyps were the only patients with urinary retention and they had a significantly higher proteinuria than those with a singular polyp. Obstructive uropathy of different degrees was encountered in 50 cases. Of these, 21 patients had moderate to severe urinary tract obstruction and in all cases except one also presented concomitant vesical abnormalities. Nine patients revealed bilateral obstructive uropathy. Lesions of the lower urinary tract were a predisposing factor in the development of urinary tract obstruction. Morbidity of study patients was considered to be substantial. A proteinuria of more than one gramme per litre in spontaneously voided midday urine indicated a high probability for the presence of urinary tract obstruction and was considered an urgent indication for antischistosomal treatment.
 ...
PMID:Morbidity in urinary schistosomiasis: relation between sonographical lesions and pathological urine findings. 393 56

Urine samples from five boys (7 to 9 years) with urinary schistosomiasis were collected at 6 A.M. and thereafter at 3-hr intervals until 9 P.M. on 5 consecutive days. Ova excretion in the urine, proteinuria (PU), erythrocyturia (EU), and leucocyturia (LU) were assessed quantitatively. Egg excretion followed a circadian rhythm with a peak at 12 noon and was paralleled closely by pathological PU. Maximal erythrocyturia occurred at 6 P.M., whereas leucocyturia revealed two distinct peak times. Taking the congruent patterns of egg excretion and PU together with the results of qualitative urinary protein analysis into account, it was concluded that PU was linked causally to ova excretion and could be explained by bleeding and exudation of serum proteins during penetration of ova through the bladder mucosa. In contrast, EU and LU seemed to be caused by different pathological mechanisms. EU followed a time-delayed circadian rhythm, possibly induced by persistent bleeding, whereas LU may have indicated a concomitant inflammatory component of the bladder.
 ...
PMID:Circadian variation of ova excretion, proteinuria, hematuria, and leukocyturia in urinary schistosomiasis. 404 Jan 88

The glomerular lesions induced in 10 chimpanzees infected with variable numbers of Schistosoma japonicum cercariae were studied by means of light and electron microscopy and fluorescent antibody technic. Ten animals served as controls; 5 were uninfected and 5 were only lightly infected. The animals were observed for periods ranging from 3 to 17 months, and by the time of sacrifice, all had developed advanced liver fibrosis. In general, the degree of glomerular injury was related to infection intensity and degree and duration of portal liver fibrosis. Some animals had terminal BUN elevation and slight proteinuria. By light and electron microscopy, in the initial stages, only part of the glomeruli were involved and exhibited mesangial matrix expansion and mesangial cell proliferation with intracellular hyaline droplets. At later stages, a larger number of glomeruli were affected and exhibited diffuse hypercellularity, glomerular basement thickening, mesangial sclerosis and less often, focal necrosis, crescent formation, synechiae and global hyalinization. In addition, there were discrete electron-dense deposits localized in the mesangial area in some glomeruli. Immunofluorescent studies utilizing antisera to chimpanzee gamma-globulin and complement (C3) and to human properdin disclosed only faint deposits of C3, apparently in mesangial areas. The association of hepatosplenic schistosomiasis and nephropathy, the possible role of schistosomal antigen and the mechanism(s) of such glomerular injuries are reviewed and compared with the disease in humans and other host species infected with Schistosoma.
 ...
PMID:The nephropathy of experimental hepatosplenic schistosomiasis. 413 91

Epidemiologically, the incidence of renal pathology in patients with chronic parasitic infections is higher than expected. In particular, schistosomiasis may have an association with renal failure. 24 New Zealand White rabbits were, therefore infected with 250 or 500 Schistosoma japonicum cercariae of the Philippine-Leyte strain and studied for eight months to determine if rabbits with long-term infections were suitable hosts for the study of schistosomal nephropathy. Clinical evidence for renal disease consisted of proteinuria, haematuria, and casts. Of the 18 surviving infected animals, six had trace amounts of protein in their urine, three had significant proteinuria ranging from 100 to 300 mg%, four exhibited haematuria and 14 were positive for the presence of proteinaceous cast formation. The clinical findings correlated with the histological data. Periodic open renal biopsies on a subgroup of the animals revealed no changes until about the sixth month. At eight months after infection, five (28%) of the 18 rabbits had amyloid deposits and 15 (83%) had some degree of renal change which included mild focal, diffuse intracapillary, and crescentic glomerulonephritis with mesangial and subendothelial complex trapping. Periodic-acid Schiff staining graphically demonstrated wire loops and tubular casts. Immunofluorescence showed that 15 (83%) of the infected animals exhibited diffuse mesangial and peripheral capillary wall deposition of IgG while 14 contained IgM (78%). The third component of complement was found in only five (28%) of the infected rabbits. Parasite antigen could not be detected in the glomeruli of any of the animals. Kidneys from age-matched controls were within normal limits. Electron microscopy of glomeruli from several animals demonstrated the presence of subendothelial and mesangial immune complex deposition similar to that seen in systemic lupus erythematosus. These findings show that schistosomiasis japonica in the rabbit offers an excellent model system for studying not only the renal pathology associated with human schistosomiasis but also the pathogenesis of amyloidosis which is a frequent sequela observed in a variety of chronic inflammatory infections.
 ...
PMID:Immune complex glomerulonephritis and amyloidosis in Schistosoma japonicum infected rabbits. 621 73

Ninety-eight Zimbabweans with glomerulonephritis characterised by nephrotic proteinuria were studied. There was no evidence to implicate Schistosoma mansoni or S. haemotobium in the aetiology, although schistosomiasis was diagnosed in 54 patients in the series. Similarly, Plasmodium malariae proved unimportant as a cause of the nephrotic syndrome, only one patient showing focal segmental glomerulosclerosis which was associated with subclinical quartan malarial infection. Nevertheless, infections were shown to play a major role in the genesis of glomerulonephritis which was associated with beta-haemolytic streptococcal, hepatitis B and syphilitic infection in 45 patients in the series. The major patterns of disease in childhood proved to be membranous glomerulopathy associated with hepatitis B antigenaemia. In young adults post-streptococcal proliferative glomerulonephritis constituted the commonest disease pattern. In older adult patients a miscellany of primary and secondary glomerulonephritides was encountered but proliferative glomerulonephritis, which was both idiopathic and streptococcus-related, predominated.
 ...
PMID:Patterns of glomerulonephritis in Zimbabwe: survey of disease characterised by nephrotic proteinuria. 636 74

The reliability of using urinalysis reagent strips, which semi-quantitatively measure hematuria and proteinuria, to correctly select urine specimens found by microscopy to have Schistosoma haematobium eggs was studied in 359 previously unscreened Kenyan primary school children. The presence of and degree of hematuria and proteinuria were highly correlated with the presence of S. haematobium eggs and with egg counts in urine specimens. Hematuria was more strongly correlated with S. haematobium egg counts than was proteinuria. The ability of presence of hematuria or proteinuria, or both, to select all microscopically positive cases of urinary schistosomiasis for treatment was tested using sensitivity (ST) and specificity (SP) analysis. Selection of cases using 1) presence of hematuria alone, and 2) presence of either hematuria or proteinuria had the highest combined ST and SP (88% ST, 97% SP; 91% ST, 92% SP, respectively). Most of the few cases detected by microscopy but not by reagent strips had low egg counts. The presence of hematuria alone failed to detect only 12% of S. haematobium-positive cases (mostly low egg counts), and only 3% of S. haematobium-negative persons had urinary blood and would have received unnecessary treatment. Preliminary studies on the use of reagent strips to screen previously infected children 6 months after treatment, and the effects of seasonal variations in temperature and humidity on urine specimen volume, egg counts, and reagent strip results are also presented. The practical field use and cost of reagent strips in S. haematobium control programs are discussed.
 ...
PMID:Sensitivity and specificity of reagent strips in screening of Kenyan children for Schistosoma haematobium infection. 648 95

Trichlorfon (metrifonate) was given intermittently to 37 schoolboys with urinary schistosomiasis living in a hyperendemic area of the Sudan. Patients were followed up for three years. Initially, 10 mg of trichlorfon/kg of body weight was administered; this dosage was repeated 14 days and 16 months later. Patients still excreting eggs after 24 months received a fourth dose. At month 24, 61% and at month 36, 56% of the patients had no detectable egg excretion; the others showed severe reduction of egg output. The number of ova excreted was always paralleled by a combined scale of hematuria, leukocyturia , and proteinuria, as assessed by urine analysis reagent strips. Quantitative urine analysis at month 36 revealed pathological findings in only eight individuals. Thus, trichlorfon given three or four times in a dose of 10 mg/kg of body weight spaced over a period of two years was highly effective in reducing parasite load and disease in children living under hyperendemic conditions.
 ...
PMID:Intermittent chemotherapy with trichlorfon (metrifonate) reverses proteinuria, hematuria, and leukocyturia in urinary schistosomiasis: results of a three-year field study. 672 93


<< Previous 1 2 3 4 5 6 7 8 Next >>