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

We are reporting findings in 13 patients who presented with glomerulonephritis without evidence of systemic disease, but who were found to have positive antinuclear antibody results and immunoglobulin and/or complement deposits at the dermal-epidermal junction of normal skin not exposed to light. There was no evidence of other organ involvement, and serologic tests for systemic lupus erythematosus (SLE) gave negative results. The renal disease is characterized by severe proteinuria, focal or diffuse proliferative glomerular lesions on biopsy, with variable patterns of immunoglobulin deposits. No clinical manifestations or serologic results typical of SLE have developed during prolonged observation. HLA phenotyping carried out in eight of the 13 patients revealed DR2 or DR3 alloantigens or both in seven of the eight patients, an incidence similar to that in patients with overt SLE. Because of the specificity of the skin biopsy immunofluorescence, the similarity of HLA-DR antigens, and a favorable response of the renal disease to therapy, we believe that these patients have a variant of SLE.
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PMID:Triad of glomerulonephritis, antinuclear antibodies, and positive skin immunofluorescence. Variant of systemic lupus erythematosus. 633 92

Acute glomerulonephritis is a syndrome characterized by the abrupt onset of hematuria often accompanied by proteinuria, hypertension, edema, and renal dysfunction. Acute glomerulonephritis can be subdivided into primary glomerular disease, postinfectious glomerulonephritis, and glomerulonephritis associated with systemic disease. With few exceptions, the underlying mechanism of acute glomerulonephritis is an immunologic one. To differentiate clinically the specific etiology of the glomerulonephritis, attention must be focused on the presence of signs or symptoms of systemic disease, changes in the environment of the patient, family history of renal disease, and recent history of infectious disease.
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PMID:Acute glomerulonephritis. A clinical overview. 636 24

Hypertension may occur during pregnancy under different clinical circumstances. One cause is toxemia, a systemic disease unique to pregnant women, in which hypertension is associated with proteinuria, CNS irritability, hepatic and renal functional abnormalities, and, in fulminant disease, a consumptive coagulopathy. Since it is clear in the non-pregnant population that the vascular complications of hypertension can be prevented with antihypertensive therapy and since toxemia is the most common cause of maternal mortality, there is no reason not to treat pregnant women with hypertension.
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PMID:How should hypertension during pregnancy be managed? An internist's approach. 636 37

A review of 430 renal biopsies from patients with various nephropathies processed by light microscopy, immunofluorescence and in part by electron microscopy revealed 82 cases with diffuse mesangial IgA deposition. Sixty-three cases appearing without signs of systemic disease were included in this study. The glomerular changes consisted of mesangial increase (31 cases mild, and 32 cases severe) and segmental-focal glomerular lesions (40 cases). Immunofluorescence revealed granular deposits of immunoglobulins and complement within the mesangium (IgG 9, IgM 25, IgA 63, C3 27, C1q 0) as well as segmentally in the wall of capillary loops (IgG 4/26, IgM 20/26, IgA 0/26, C3 16/26, C1q 7/26). Electron microscopic studies (40 cases) showed electron dense deposits in the mesangial region in all biopsies and deposits either electron dense (11 cases) or radiolucent (26 cases) at various sites along the basement membrane of capillary loops. Comparison between morphological findings and clinical data showed a significant correlation between segmental-focal glomerular lesion on the one hand, and proteinuria (p less than 0.01), immune deposits along the capillary basement membrane (p less than 0.01), and the increased mesangium (p less than 0.001) on the other. Considering the macromolecular mesangial clearing function, the segmental-focal glomerular lesions may be due to newly arrived, infection related immune complexes which may not be cleared promptly by the mesangium, because its clearing function is impaired due to IgA deposition.
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PMID:IGA mesangial glomerulonephritis; significance and pathogenesis of segmental-focal glomerular lesions. 641 53

Clinical, laboratory and renal biopsy data on 50 adult patients investigated in Jamaica because of proteinuria of more than 1 g/day were reviewed. Primary glomerular disease was present in 23 cases and the most common histological pattern was mesangial proliferation. Proteinuria was part of a systemic disease in 27 patients of whom 19 had systemic lupus erythematosus (SLE). Urinary protein excretion was less in patients with systemic diseases than in those with primary glomerulonephritis, but hypoalbuminemia, renal function and presence of edema were not helpful in distinguishing types and causes of renal disease. By comparison with other countries SLE and mesangial proliferative glomerulonephritis are common causes of proteinuria and nephrotic syndrome in Jamaica whereas idiopathic membranous glomerulonephropathy appears to be rare.
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PMID:Proteinuria and glomerular disease in Jamaica. 673 87

Urticarial skin lesions may occur in patients as a manifestation of necrotizing vasculitis. We describe a series of forty patients with idiopathic chronic urticaria and histologic features of necrotizing vasculitis. On the basis of clinical evaluation, we have classified urticarial vasculitis into two major groups: (1) hypocomplementemic (sixteen patients, ten of whom had evidence of renal disease) and (2) normocomplementemic (twelve patients with systemic disease and twelve with only cutaneous involvement). Most patients with hypocomplementemia presented with arthritis, and some had abdominal pain or airway compromise. Although patients with normocomplementemia and systemic disease had a less severe clinical course, four exhibited renal disease that was characterized by microhematuria and proteinuria. Direct immunofluorescence microscopy of the skin aids in assessing renal involvement in some cases of hypocomplementemic urticarial vasculitis, particularly when IgG and IgM are deposited at the basement membrane. There seems to be a spectrum of disease in urticarial vasculitis, ranging from benign cutaneous lesions to systemic disease.
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PMID:The clinical and histopathologic spectrums of urticarial vasculitis: study of forty cases. 675 76

Type 2 mixed cryoglobulinemia is a relatively common although rarely recognized consequence of chronic hepatitis C virus infection. Its detection should be pursued in individuals with lower extremity vasculitis which occurs in association with other signs of systemic disease such as proteinuria or a peripheral neuropathy. Importantly, HCV-associated cryoglobulinemia can occur in individuals with clinical evidence for cryoglobulinemia but without any evidence of detectable liver injury. Two cases recently seen in Oklahoma demonstrating these points are reported.
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PMID:Type 2 cryoglobulinemia and hepatitis C virus: its recognition and treatment. 779 10

Amyloidosis occurs in association with many diseases and can also be idiopathic. It is usually a systemic disease with variable presentations. The diagnosis should be suspected in patients with unexplained proteinuria, cardiomyopathy, congestive heart failure, peripheral neuropathy, carpal tunnel syndrome, macroglossia, or hepatosplenomegaly. Amyloidosis generally has a poor prognosis and responds poorly to therapy. Much needs to be learned about its pathogenesis and treatment possibilities.
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PMID:The many guises of amyloidosis. Clinical presentations and disease associations. 793 10

In order to ascertain to prevalence of glomerulopathies in our patient population, all renal biopsies performed on patients older than 14 years of age presenting to a single military hospital from 1983 to 1992 were reviewed. Two hundred and eighty-five patients were included in the study. Indications for renal biopsy included evaluation for the nephrotic syndrome, asymptomatic proteinuria, hematuria/proteinuria, isolated hematuria or systemic disease. Fifty-one percent of the patients were white and 44 percent were black. The male/female ratio was 3.2:1. The most common etiology of the nephrotic syndrome or asymptomatic proteinuria was focal glomerular sclerosis, and was found predominantly in black males. IgA nephropathy was the most common cause of combined hematuria and proteinuria, and was not found in any black patients in 126 biopsies. Isolated hematuria was secondary to either IgA nephropathy or thin basement membrane disease in 70 percent of the biopsies. This is the first study to demonstrate such differences in glomerular disease in an American population on the basis of race and sex in a single center.
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PMID:Racial differences in the prevalence and presentation of glomerular disease in adults. 795 82

Despite the availability of different classifications for rapidly progressive glomerulonephritis (RPGN), patients with "idiopathic crescentic GN" have not been yet inserted as a precisely defined subgroup, pointing to their probable heterogenicity. Trying to better define their characteristic, we retrospectively analyzed the clinical, histological and immunopathological features of 41 patients diagnostically labelled "idiopathic RPGN" because they had no evidence of systemic disease (including systemic vasculitis), no anti-GBM mediated glomerulonephritis and no clearly defined primary glomerulopathy. Starting by a thorough morphological review, 2 subgroups were defined: group I (25 patients) with variable degrees of intraglomerular necrosis, and group II (16 patients) with no intracapillary necrotizing lesions. Group I showed no or minimal endocapillary proliferation, intense interstitial infiltrates with periglomerular localization, frequent ruptures of Bowman's capsule and mild degree of glomerular and/or interstitial sclerosis. 16 patients in this group (64%) had irregular deposits of complement C3 at immunofluorescence while the remaining 9 (36%) had no immune deposits. Clinically they had no previous history of preceding urinary abnormalities, had a mean of 1.8 g/day proteinuria and a positivity for ANCA in 92% (12/13). In group II there was frequently marked mesangial proliferation, scarce interstitial infiltrates, no ruptures of Bowman's capsule and marked degrees of glomerulosclerosis and interstitial fibrosis. All patients in this group had clearly defined immune deposits of C3 and/or IgG. Clinically 50% of these patients had a history of recurrent microhematuria and/or proteinuria, a mean of 4.5 g/day proteinuria and negativity for ANCA in all 8 patients tested.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Critical re-evaluation of 41 cases of "idiopathic" crescentic glomerulonephritis. 813 64


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