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)

A clinicopathological study was made on 65 patients from a small area of Nagano Prefecture, Japan, with hereditary generalized amyloidosis with polyneuropathy to clarify the clinical variety of the disease. Forty-five patients from Ogawa village showed similar clinical features. The age of onset ranged widely from 16 to 62 years. The main neurological manifestations were polyneuropathy starting in the legs and autonomic dysfunction. Lower cranial nerves were also affected in the advanced stages. Severe cardiac and renal involvement was uncommon. All these clinical features are consistent with type I familial amyloid polyneuropathy (FAP). The remaining 20 patients from five unrelated kinships showed unique clinical pictures. Two families from Ogawa village had type I FAP, but 4 out of the 5 affected patients showed marked nephropathy with heavy proteinuria from an early stage. Of the three other families, one, with 10 patients, was notable for the involvement of the central nervous system. Most of the patients showed cerebellar ataxia and pyramidal tract signs in addition to a sensorimotor and autonomic peripheral neuropathy. Another family had 2 siblings who had severe amyloid heart disease from the onset and developed polyneuropathy with autonomic features at an advanced stage. In the third family, onset occurred in the sixth decade in all 3 patients and the course was mild in 2, although the clinical features were those of typical type I FAP. Immunohistochemical study revealed that the amyloid fibril proteins in the patients with all four unusual clinical phenotypes were related to plasma prealbumin. The most common form of hereditary generalized amyloidosis in Japan is type I FAP, but the disease shows considerable variety in the age of onset and involves more systemic organs than previously recognized. The newly recognized clinical forms of hereditary generalized amyloidosis with severe amyloid heart disease or central nervous dysfunction indicate clinical heterogeneity of hereditary amyloidosis with polyneuropathy.
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PMID:Hereditary generalized amyloidosis with polyneuropathy. Clinicopathological study of 65 Japanese patients. 303 28

Nephronophthisis is a chronic interstitial nephropathy which in childhood may lead to terminal renal failure. Between January 1975 and July 1980, 41 children with terminal renal failure were seen in our service, of which 10 (21.9%) presented with nephronophthisis. Age of the patients ranged from 3.5-18 years, boys were in the majority (8/2). Three cases were isolated and 7 were familial (3 families). Onset was during the first year of life in 8 patients, and polydipsia-polyuria were the first symptoms. Retarded growth and anemia proportionate to the degree of renal failure were present in all patients. When diagnosed, 5 patients (50%) presented terminal renal failure, and the other 5 had renal failure of different degrees. Moderate proteinuria was found in 4 patients, without changes in urine sediment. Sodium depletion in urine was high in 5 cases and maximal urine osmolarity was less than 500 muOsm/l after hydropenia in all cases. Four had associated mental deficiency with cerebellar ataxia associated in two and congenital hepatic fibrosis (confirmed histologically) in one. The diagnosis was confirmed by biopsy in 8 and in two of these on frozen section during nephrectomy prior to kidney transplantation. At present, five of the patients are in maintenance hemodialysis, two died at home due to cardiovascular complications in terminal renal insufficiency and the remaining ones presented different degrees of renal insufficiency. Time elapsed between onset of the symptoms and inclusion in hemodialysis or death ranges form 6 months to 13 years (mean 6.7 years).
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PMID:[Nephronophthisis: study of 10 cases. Incidence, natural history and associated pathology (author's transl)]. 732 36

We investigated changes in various serum cytokines in a case of systemic lupus erythematosus (SLE) accompanied by hemophagocytic syndrome (HPS). The patient, a 15-year-old male, presented in December 1998 with bilateral salivary gland swelling and a history of fever continuing for more than 10 days. After admission, cerebellar ataxia and clouding of consciousness developed. Laboratory examinations revealed leukopenia, thrombocytopenia, high serum LDH and ferritin, hypercytokinemia, and prominent hemophagocytosis in the bone marrow. Given these findings and positive titers of antinuclear antibody, hypocomplementemia, proteinuria and pericarditis, a diagnosis of HPS with associated SLE was made. The patient was treated with high dose methylprednisolone followed by oral prednisolone and cyclosporine. The patient's clinical symptoms, abnormal blood and urine laboratory data consequently improved, and no recurrence of the symptoms has been documented. However, hemophagocytosis in bone marrow recurred with concomitantly increased serum levels of IL-6 and IL-1 beta. This case indicated that aberrant production of these inflammatory cytokines might be involved in HPS in autoimmune disease.
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PMID:[Systemic lupus erythematosus with bilateral salivary gland swelling and clouding of consciousness accompanied by hemophagocytic syndrome--a study of serial determination of serum cytokines]. 1246 29