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)

Case reports are presented on 2 patients to show the importance of following up apparently false positive results of pregnancy tests. In case 1, a 25-year-old woman was admitted to the hospital with severe breathlessness in September 1987. After she had stopped using oral contraceptives (OCs) in 1985 her periods were irregular and on 4 occasions the results of pregnancy tests bought over the counter were positive. She was twice referred for ultrasound examinations, but the uterus was empty each time. In April 1987, dysfunctional uterine bleeding was diagnosed; she was treated with clomiphene. She then experienced intermittent pleuritic chest pain and breathlessness on exertion. In early September she was admitted with acute breathlessness and chest pain. A further pregnancy test was positive; results of laparoscopy of the pelvis were normal. A radioisotope ventilation-perfusion lung scan showed multiple filling defects in the left lung and no perfusion to the right. A presumptive diagnosis of choriocarcinoma was made with the syndrome of tumor growing in the pulmonary arteries. In case 2, a 32-year-old woman was admitted to the hospital in March 1988 with acute lower abdominal pain. A pregnancy test was positive, and she underwent laparoscopy for suspected ectopic pregnancy. A macroscopic tumor was found on the surface of the right ovary and a right salpingo-oophorectomy was performed. A subsequent histological examination showed choriocarcinoma. The 2 cases reported show the importance of seeking a definitive explanation for a false positive result of a pregnancy test. If the test has been performed correctly and proteinuria and drug interference, for instance, are ruled out, then a raised human chorionic gonadotropin concentration, particularly in young women, is virtually certain. In most cases this will be due to a pregnancy that ends in a 1st trimester abortion, but in a small minority it will be due to the hormone producing a tumor such as choriocarcinoma.
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PMID:Don't ignore a positive pregnancy test. 284 5

An international multicentre study of adverse reactions to D-penicillamine was undertaken on 2879 patients exposed to the drug--1491 of them a prospective sample. The majority of patients were being treated for rheumatoid arthritis. Over a period of 18 months, 319 (21%) of patients in the prospective sample developed adverse reactions necessitating drug withdrawal; two thirds of these occurred during the first 3 months of treatment. The most frequently-occurring adverse reactions involved skin (6%), kidneys (4%), gastro-intestinal tract (4%) and haemopoiesis (3%). Adverse effects, considered to be serious by the reporting physician, included fever and leucopenia during the early weeks of treatment and, after some months of drug exposure, proteinuria, myasthenia gravis, dyspnoea and pemphigus. Two patients died, one of fulminating septicaemia and the other was found at autopsy to have had multiple lung abscesses following unexplained anaemia and hemiparesis.
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PMID:European League against Rheumatism study of adverse reactions to D-penicillamine. 293 13

1. Female Wistar rats received a single subnephrotoxic dose of guinea pig anti-glomerular basement membrane (GBM) IgG1, 2.5 mg, followed by infusion of preformed immune complexes (BSA, 5.0 mg/rabbit anti-BSA, 6 mg), 10 X antigen excess. Control groups received guinea-pig IgG1 anti-GBM, or preformed immune complexes alone, or isotonic saline. Systemic reactions were observed clinically during the first 24 h, and 24 h urine was collected for the measurement of proteinuria and hematuria. 2. Blood was collected before and 2 h after the above treatment for the determination of complement (50% hemolytic assay), kininogen (isolated guinea pig assay of released bradykinin-like spasmogenic activity) and activated partial thromboplastin time (APTT). Kidney and lung tissue was examined by light microscopy, immunofluorescence and electron microscopy. 3. Rats treated with guinea pig anti-GBM IgG1 followed by BSA immune complex presented a severe systemic picture, with macroscopic hematuria (9/14), several deaths (8/14), slight proteinuria (24.6 +/- 5.2 mg/day), marked complement consumption (delta = 49.4 +/- 2.4 UCH50/ml), intravascular coagulation and severe diffuse interstitial pneumonia, obliteration of glomerular capillary walls by edema of endothelial cells, without deposition of immune complexes in kidneys or lungs. The control groups showed no signs of systemic reaction (isotonic saline alone) or slight dyspnea (guinea pig anti-GBM IgG1 or immune complexes alone), without proteinuria or macroscopic hematuria, and with foci of interstitial pneumonia. 4. Complement consumption was significant in rats receiving immune complexes alone (delta = 31.1 +/- 1.3 UCH50/ml) and even higher when associated with infusion of guinea pig anti-GBM IgG1 (delta = 49.3 +/- 2.4 UCH50/ml). APTT was significantly lengthened only for the group treated with guinea pig anti-GBM IgG1 plus immune complexes (delta = 18.5 +/- 1.9 s), with no alterations in the other groups. Kininogen consumption was demonstrable for all groups except the saline control and was more extensive in rats which received immune complexes alone or preceded by guinea pig IgG1. 5. These data show that previous infusion of a subnephrotoxic dose of guinea pig IgG1 anti-GBM aggravated the pathological effects of preformed immune complexes by promoting marked complement consumption and activation of the coagulation system, rather than by enhancing tissue deposition.
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PMID:Potentiation of immune complex injury in rats by pretreatment with subnephrotoxic doses of guinea pig anti-glomerular basement membrane IgG1. 296 89

A 65-year-old man underwent left-upper lobectomy for large cell carcinoma of the lung on November 8, 1984 (pT1N0M0: Stage I a). He was treated with MMC, Futraful, CDDP and CPM as adjuvant chemotherapy. In April 1985, he was re-admitted to our hospital because of progressive dyspnea. He was diagnosed as having drug-induced interstitial pneumonia, and so steroid therapy was started. In July 1985, he suffered from anemia, thrombocytopenia, proteinuria and azotemia progressively, and died due to pulmonary hemorrhage and edema. At necropsy, no cancer recurrence was found. It thus seemed that the cause of death was microangiopathic hemolytic anemia and renal failure induced by anti-neoplastic agents.
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PMID:[Microangiopathic hemolytic anemia (MAHA) and renal failure induced by anti-neoplastic agents--a case report]. 303 22

Seventy nine cases of sporadic, community acquired legionnaires' disease have been reviewed. Annual and seasonal variation in incidence was noted. The mean age of the patients was 53 years and 50 (63%) were male. Pre-existing chronic diseases were present in only 23 (29%), including two patients receiving immunosuppressive treatment. Common symptoms included unproductive cough, dyspnoea, chest pain, headache, confusion, nausea, vomiting, and diarrhoea. Respiratory symptoms were absent, however, in 17 (22%). Localising chest signs were present in 74 (95%) cases. Frequent laboratory findings included lymphopenia, high erythrocyte sedimentation rate, hyponatraemia, raised urea and creatinine concentrations, abnormal liver function, hypophosphataemia, hypoalbuminaemia, proteinuria, and haematuria. Thirteen patients died (16%), including nine of 20 who received assisted ventilation. The mortality rate in patients treated with erythromycin (11%) was lower than in those who received other antibiotics (23%), but this difference was not statistically significant. Of the features noted on admission, only a high plasma urea concentration was significantly associated with death. Sporadic community acquired legionnaires' disease is a not uncommon disorder, which with appropriate treatment has a prognosis similar to that of other forms of community acquired pneumonia.
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PMID:Legionnaires' disease: a review of 79 community acquired cases in Nottingham. 378 45

Seven cases of diffuse interstitial lung disease (DILD) are reported with an unequivocal temporal relationship between the development of the lung disease and treatment with gold (6 cases) and penicillamine (1 case). They were characterised clinically by the sudden onset of dyspnoea and crepitations and radiologically by diffuse bilateral pulmonary shadowing. Most showed evidence of hypersensitivity such as eosinophilia, a raised serum IgE level in response to gold, proteinuria, thrombocytopenia, or an immediate postinjection reaction. DILD is a serious complication of treatment with gold and penicillamine that is commoner than generally realised.
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PMID:Relationship of gold and penicillamine therapy to diffuse interstitial lung disease. 678 83

Of 58 patients treated with captopril, 3 have now received the drug for more than 2 years and 22 for more than one year. This study concerns 38 patients treated for 6 months, captopril having been given alone during the first 2 months. They all had severe hypertension (diastolic BP Greater Than 110 mmHg) which had resisted previous treatments in normally effective doses, including at least one beta-blocker, dihydralazine and a diuretic. After 6 months blood pressure levels were normal in 53% of the patients, reduced in 31% and unchanged in 16%. Clinical improvement was habitual with, in particular, disappearance or decrease of tiredness and dyspnoea. Since some side-effects of the drug, such as granulopenia, proteinuria and ageusia, are mainly observed with high dosage, captopril is usually administered in doses lower or equal to 400 mg/day. In resistant or malignant hypertension it must be used in combination with salt-free diet, a beta-blocker and/or prazosin. Clinical, haematological and renal surveillance is necessary during treatment. When these precautions are observed, captopril constitutes a very useful drug for the treatment of patients with severe resistant hypertension.
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PMID:[Treatment of severe resistant arterial hypertension with captopril. 58 patients, including 38 treated for more than 6 months (author's transl)]. 702 47

The coexistence of systemic lupus erythematosus (SLE) and thymoma is rare. We describe 2 female patients with this combination. A 48-year-old woman presented with dyspnea due to a left pleural effusion. Her past history revealed over the previous 3 years the development of anemia, thrombocytopenia, alopecia, pericardial effusion and proteinuria. Four months prior to this hospitalization, the patient was first admitted due to purpura. At that time, laboratory tests revealed an elevated sedimentation rate, elevated titers of ANA and anti-DNA. Chest X-ray demonstrated a widened mediastinum, and upon operation an encapsulated thymoma was excised. Four months following the thymectomy, the patient is unresponsive despite high dose steroid therapy. Another patient, a 30-year-old woman, presented with SLE (cutaneous, arthritis, anemia, positive ANA and high titers of anti-DNA) and thymoma simultaneously. Six years after thymectomy the patient is in SLE remission. Thymectomy in mice prone to autoimmunity (NZB/W mice) has been shown to accelerate the autoimmune manifestations. Conversely, the opposite effect is seen in MRL/lpr mice. The immunological effect of adult thymectomy on the course of human SLE remains to be established, on a larger series of patients. It seems that the heterogenicity of human patients is exemplified by the contrasting effects of thymectomy for thymoma in SLE patients.
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PMID:Systemic lupus erythematosus and thymoma--a double-edged sword. 764 92

We report a case of renal vein thrombosis (RVT) and pulmonary embolism associated with diffuse membranous glomerulonephritis. A 44-year-old Japanese male was referred to the Nephrology Department with heavy proteinuria. Renal biopsy revealed diffuse membranous glomerulonephritis and we administered PSL 30mg/day and dipyridamole 300mg/day. Three weeks later, he was admitted with severe chest pain, dyspnea and massive proteinuria. RVT and pulmonary embolism were detected on CT scan and perfusion lung scan. After a few days of continuous intravenous unfractionated heparin (UFH) therapy, we used 72 U (anti-FXa)/kg of intravenous low-molecular-weight heparin (LMWH) every 12 hours for 10 days. He also received urokinase at the dose of 120,000 U/day for 4 weeks and long-term therapy with warfarin potassium at the dose of 3 mg/day. One month later, the thrombi in the pulmonary arteries and inferior vena cava disappeared on CT scan and perfusion lung scan. LMWHs have a longer biological half-life and a lower bleeding tendency than UFH for an equivalent antithrombotic effect. This case indicates that intermittent intravenous LMWH administration combined with urokinase is effective against RVT and pulmonary embolism without any side effect.
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PMID:[A case of renal vein thrombosis and pulmonary embolism associated with diffuse membranous glomerulonephritis: the usefulness of low-molecular-weight heparin and urokinase therapy]. 769 54

Two dogs were seen at the University Veterinary Teaching Hospital, Nairobi, Kenya, both having histories of dyspnoea, progressively enlarging abdomens, anasarca, ascites, pleural and pericardial effusion, and pulmonary oedema. One of the dogs had a mild neutrophilic leucocytosis, elevated levels of alkaline phosphatase, alanine aminotransferase, lactate dehydrogenase and proteinuria. Histopathological examination of the myocardium revealed some damage to myocytes and a mononuclear cellular infiltration involving the myocardium, liver and kidneys. The two dogs had a fondness for avocado fruits and, as the presenting syndrome is identical to that seen in goats, sheep and horses poisoned by avocados, a comparison is made and the probable manifestation of this poisoning presented.
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PMID:Putative avocado toxicity in two dogs. 789 92


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