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)

Since the introduction of ibuprofen as a nonprescription drug in the US, there have been reports of significant toxicity associated with large ingestions (> 400 mg/kg) in both children and adults. Acute renal insufficiency is a rare, reversible effect of ibuprofen overdose documented in adults, but we could find no published pediatric cases. We report a case of a healthy two-year-old boy, without a previous history of renal problems, who developed reversible acute renal insufficiency after a toxic ingestion of approximately 640 mg/kg ibuprofen. By 11 hours, his initially normal creatinine began to rise, reaching a peak value of 181 mmol/L (2.1 mg/dl) by 27 hours. His urinalysis showed moderate microscopic hematuria without the presence of casts or proteinuria. No problems arose with fluid management. Normalization of his renal function occurred by 72 hours. A serum ibuprofen concentration obtained by high-performance liquid chromatography and drawn approximately four hours after ingestion was 1724 mumol (therapeutic serum concentration, 50-250 mumol). This case demonstrates that acute, reversible renal insufficiency can occur in healthy children after a severe overdose of ibuprofen; hence, renal function should be monitored in such instances.
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PMID:Acute renal insufficiency in ibuprofen overdose. 759 69

Acute renal insufficiency developed in four idiopathic nephrotic patients with minimal change or mild proliferative glomerulonephritis. The reduction in glomerular filtration rate (CInulin) was not in proportion to the renal plasma flow (CPAH) as evidenced by a low filtration fraction. Diuretic therapy failed to reverse renal insufficiency, and renal biopsy showed no evidence of interstitial nephritis, acute tubular necrosis or interstitial edema. Corticosteroid therapy induced a recovery of renal function with a decrease in proteinuria. These observations suggest that acute renal insufficiency in the idiopathic nephrotic syndrome might be caused by impaired glomerular permeability.
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PMID:Reversible acute renal failure in idiopathic nephrotic syndrome. 849 41

Acute renal insufficiency associated with chronic lymphocytic leukemia (CLL) has a variety of causes. An extremely rare cause of renal dysfunction is dense leukemic infiltrate in the renal interstitium. This report describes a patient with CLL who developed acute renal failure secondary to leukemic infiltration and who had a partial response to chemotherapy. This diagnosis should always be considered when a patient with CLL, regardless of the clinical stage, presents with renal insufficiency because it appears to respond reasonably well to a variety of therapies. The finding of enlarged kidneys on renal ultrasound is suggestive of infiltrative disease, but is not always present. Proteinuria is generally mild. The literature is reviewed.
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PMID:Acute renal failure secondary to chronic lymphocytic leukemia: a case report. 1844 51

The use of human intravenous immunoglobulins (IVIg) in systemic lupus erythematosus (SLE) currently relies on evidence from small case series and is mainly regarded as an off-label strategy in cases that are refractory to conventional therapies or poorly controlled with high doses of corticosteroids. Standard dosage regimens typically entail the administration of a total amount of 2 g/kg of IVIg divided into five consecutive days in order to minimize the risk of severe adverse events. We herein describe the case of a 28-year-old woman with a known history of antiphospholipid syndrome (APS) who was admitted to our hospital following fulminant onset of SLE in spite of ongoing immunosuppressive therapy. Acute renal insufficiency with nephrotic-range proteinuria, central nervous system involvement, severe thrombocytopenia, malar rash, pancreatic injury and moderate-severe aortic valve steno-insufficiency were the most prominent clinical manifestations, along with high titres of anti-dsDNA antibodies. Pulses of methyl-prednisolone followed by high-dose corticosteroids proved ineffective. Strikingly, IVIg therapy delivered at unconventional doses (1.2 g/kg) due to the presence of multiple risk factors for adverse events resulted in a significant, comprehensive clinical improvement. Although large-scale randomized double-blind studies are needed, the use of IVIg might constitute a valuable therapeutic modality as a last-resort strategy in cases of fulminant SLE. The total dose of immunoglobulins should be dictated by the clinical response as well as the presence of pre-existing risk factors for adverse events.
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PMID:Use of Intravenous Immunoglobulin Therapy at Unconventional Doses in Refractory Fulminant Systemic Lupus Erythematosus. 3075 66