Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

During a 2-year period, 56 infants of less than 34 weeks gestation were delivered from 53 pregnancies complicated by severe hypertension and proteinuria. In the first part of the study 32 infants were delivered whose mothers did not receive antepartum glucocorticoids; subsequently 24 infants were born whose mothers did receive antepartum glucocorticoids. The severity of maternal disease, gestational age at delivery, birthweight and obstetric management was similar in both groups. In the group receiving glucocorticoids 88% of the infants were discharged live from the neonatal unit compared with 72% in the group who did not receive corticosteroids. It is concluded that in pregnancies complicated by severe hypertension and proteinuria requiring delivery before 34 completed weeks of pregnancy, the administration of antepartum glucocorticoids to the mother does not carry an increased risk to the fetus, and may be of benefit by reducing the risk of idiopathic respiratory distress syndrome and subsequent intraventricular haemorrhage.
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PMID:Use of glucocorticoids in pregnancies complicated by severe hypertension and proteinuria. 683 Jul 26

In order to improve the basis upon which to advise women with diabetic nephropathy about pregnancy, we studied the effect of diabetic nephropathy on the course of pregnancy, perinatal outcome, infant development and long-term outcome of the mothers. All pregnancies of women with diabetic nephropathy (defined as proteinuria > 400 mg/day (n = 26), creatinine clearance < 80 ml/min and hypertension in the first trimester (n = 10)) followed at our centre from 1982 to 1992 were identified (34 White class F and 2 White class T) and the women and their children re-examined in the spring 1993. From the first to the third trimester the percentage of women with proteinuria over 3 g/day increased from 14 to 53% and those treated with antihypertensive medication from 53 to 97%. There were no intrauterine or perinatal deaths, but one child died suddenly 4 weeks postpartum. Of 36 newborns (gestational week at birth 36(3), birth weight 2384(834) g)), 11 were born before week 34 and 8 had respiratory distress syndrome. Renal function in the first trimester, diastolic blood pressure in the third trimester and an HbA1c above normal were predictive of gestational age at delivery and low birth weight (stepwise regression analysis). At follow up of the children (n = 35, age 4.5 (0.4-10) years) the majority (n = 27) were normally developed but seven had psychomotor retardation (four of them major). One child had a severe motor retardation due to a congenital anomaly. At follow up, 21 of the 29 mothers had preserved renal function (creatinine 1.3 (0.8-4.3) mg/dl and 8 had developed end stage renal disease and required dialysis (2 of whom were White class T) within 3 (1-9) years postpartum.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pregnancies in women with diabetic nephropathy: long-term outcome for mother and child. 771 19

During three and a half years we observed 83 single pregnancies all delivered by caesarean section. All of them had a mild (systolic blood pressure > 140, diastolic > 90 and proteinuria > 0.5 g/dl) or a severe preeclampsia (systolic blood pressure > 160, diastolic > 100 and proteinuria > 3.0 g/dl). We found significantly twice as many abnormal uteroplacental blood flow velocities in the severe preeclampsia group than in the mild one. These results draw us to the conclusion that possible pathological changing of the vessels is due to preeclampsia which does not need to correlate with a placental insufficiency and fetal growth retardation. An abnormal uteroplacental blood flow velocity connected with an abnormal umbilical blood flow velocity raises the fetal morbidity and the early childhood morbidity. Fetal outcome in mild compared to severe preeclampsia definitively shows a worse prognosis for those fetuses whose mother developed a prepartal severe preeclampsia. A distinctly increased rate of cerebral haemorrhages, abnormal neurological signs, acute respiratory distress syndromes and bronchopulmonary dysplasia was found. Finally we show an additional risk for fetal outcome in absent or reverse enddiastolic flow velocity (AREDFV) in the severe preeclampsia group. We observed in the AREDFV group with severe preeclampsia in comparison to a group of AREDFV without maternal preeclampsia more than twice as many cerebral haemorrhages, abnormal neurological signs and bronchopulmonary dysplasia.
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PMID:[Fetal development in mild and severe pre-eclampsia: correlation with maternal laboratory parameters and Doppler ultrasound]. 772 64

Improvements in reproductive function invariably follow renal transplantation. The possibility of conception in women of childbearing age emphasizes the need for compassionate and comprehensive counselling. Couples who want a child should be encouraged to discuss all the implications. Therapeutic abortion is undertaken in 20% of conceptions and the spontaneous abortion rate is about 14%, the same as for the normal population. Of the conceptions that continue beyond the first trimester, 93% end successfully. In most women, renal function is augmented during pregnancy, but permanent impairment occurs in 15% of pregnancies. In others there may be transient deterioration in late pregnancy (with or without proteinuria). There is a 30% chance of developing hypertension, pre-eclampsia or both. Preterm delivery occurs in 45-60%, and intrauterine growth retardation in at least 20% of pregnancies. Despite its pelvic location, the transplanted kidney rarely produces dystocia and is not injured during vaginal delivery. Caesarean section should be reserved for obstetric reasons only. Neonatal complications include respiratory distress syndrome, leucopenia, thrombocytopenia, adrenocortical insufficiency and infection. No predominant or frequent developmental abnormalities have been described and data on infancy and childhood are encouraging. Future clinical and laboratory research needs to focus on improving prepregnancy assessment criteria, better understanding of the mechanisms of gestational renal dysfunction, proteinuria and the rare, but devastating, accelerated rejection, assessing the side-effects and implications of immunosuppression in pregnancy and learning more about the remote effects of pregnancy on both renal prognosis and the offspring.
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PMID:Pregnancy in renal allograft recipients: problems, prognosis and practicalities. 792 20

We report a case of hypocomplementemic urticarial vasculitis syndrome (HUVS) with membranous glomerulopathy in a 62-year-old man who had a 2-month history of secondary iritis. He was transferred to our hospital because of uncontrollable edema and respiratory dysfunction. Physical examination revealed anasarca, pulmonary edema, hypertension and urticaria-like eruption on his arms. Urinalysis, blood chemistry and serological studies showed massive proteinuria (10.5g/day) with numerous granular casts, hypoalbuminemia (1.5g/dl), renal dysfunction (creatinine; 1.6mg/dl, BUN; 86mg/dl), hypercholesterolemia (total cholesterol; 455mg/dl), positive results for antinuclear factor, microsome test, thyroid test, lupus anticoaglant, antithyroglobulin test and rheumatoid factor, but LE cell or double-strand anti DNA antibody was negative. Serum complement levels were persistently low as CH50 of 13 U/ml and Clq of 6.0 micrograms/dl. The patient serum precipitated with normal human Clq by immunodiffusion analysis, indicating the presence of anti-Clq antibody. Renal biopsy revealed membranous glomerulopathy with prominent fine granular deposition of Clq along the glomerular basement membrane by immunofluorescent study and subepithelial dense deposit by electron microscopy. Corticosteroid treatment was ineffective for hypocomplementemia and nephrotic syndrome. Acute subendocardial infarction occurred on the 25th hospital day and he died of acute respiratory distress syndrome on the 45th hospital day. Autopsy revealed leucocytoclastic vasculitis in the alveolar wall. HUVS was confirmed by clinical symptoms, such as iritis and urticaria-like eruption, serum anti-Clq antibody, the absence of any specific autoantibody for systemic lupus erythematosus (SLE) and leucocytoclastic vasculitis in the alveolar wall.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Nephrotic syndrome due to membranous glomerulopathy in hypocomplementemic urticarial vasculitis syndrome;--a case report]. 807 26

Hantavirus activity in rodents and human beings in Argentina has been known since the 1980's. In this study, we retrospectively investigated hantavirus infections among Argentine Hemorrhagic Fever (AHF) cases notified between 1987 and 1994, without virological confirmation. IgG and IgM antibodies to hantavirus were tested by ELISA. Among 1028 patients included in the study, we found 13 recent infections (1.26%) and 13 remote infections (1.26%). IgG antibodies determined in 745 healthy persons living in the same localities of recent infection cases, gave only one positive result (0.13%). Nine of the 13 recent infections had the clinical presentation of Hemorrhagic Fever with Renal Syndrome (HFRS) while the other four were in the form of Hantavirus Pulmonary Syndrome (HPS). We performed a clinical and epidemiological comparison between the nine patients with FHSR and two paired control groups: one with confirmed AHF and the other with Febrile Syndrome of Undetermined Etiology (FSUE), which were negative for hantavirus, Junin and LCM. There were no differences between clinical signs or symptoms. Nevertheless, normal or high leucocyte counts, with thrombocytopenia, hemoconcentration, high creatinine levels and proteinuria in HFRS cases resulted useful for differential diagnosis. These results showed the coexistence of Junin virus and hantaviruses in the endemic area of AHF, and indicate the importance of including the infection with these viruses in the differential diagnosis of hemorrhagic fevers and respiratory distress syndromes of unknown etiology. The clinical variability found could be related to the presence of more than one hantavirus serotype in our country.
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PMID:[Retrospective detection of hantavirus clinical infections in Argentina]. 873 23

Eclampsia is defined as the occurrence of seizures in pregnancy or within 10 days of delivery, accompanied by at least two of the following features documented within 24 hours of the seizure: hypertension, proteinuria, thrombocytopenia or raised aspartate amino transferase. Eclampsia complicates approximately one in 2,000 pregnancies in the United Kingdom and it remains one of the main causes of maternal death. Up to 38% of cases of eclampsia can occur without premonitory signs or symptoms of pre-eclampsia-that is, hypertension, proteinuria, and oedema. Only 38% of eclamptic seizures occur antepartum; 18% occur during labour and a further 44% occur postpartum. Rare cases of eclampsia have occurred over a week after delivery. Outcome is poor for mother and child. Almost one in 50 women suffering eclamptic seizures die, 23% will require ventilation and 35% will have at least one major complication including pulmonary oedema, renal failure, disseminated intravascular coagulation, HELLP syndrome, acute respiratory distress syndrome, stroke, or cardiac arrest. Stillbirth or neonatal death occurs in approximately one in 14 cases of eclampsia. Up to one third of eclamptic seizures occur out of hospital. For this reason, initial management may involve accident and emergency departments. Early involvement of senior obstetric staff is crucial. Optimal emergency management of seizures, hypertension, fluid balance and subsequent safe transfer is essential to minimise morbidity and mortality.
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PMID:Management of eclampsia in the accident and emergency department. 1065 82

Hypertension is found among 1 to 6% of young women. Treatment aims to decrease cardiovascular risk, the magnitude of which is less dependent on the absolute level of blood pressure (BP) than on associated cardiovascular risk factors, hypertension-related target organ damage and/or concomitant disease. Lifestyle modifications are recommended for all hypertensive individuals. The threshold of BP at which antihypertensive therapy should be initiated is based on absolute cardiovascular risk. Most young women are at low risk and not in need of antihypertensive therapy. All antihypertensive agents appear to be equally efficacious; choice depends on personal preference, social circumstances and an agent's effect on cardiovascular risk factors, target organ damage and/or concomitant disease. Although most agents are appropriate for, and tolerated well by, young women, another consideration remains that of pregnancy, 50% of which are unplanned. A clinician must be aware of a woman's method of contraception and the potential of an antihypertensive agent to cause birth defects following inadvertent exposure in early pregnancy. Conversely, if an oral contraceptive is effective and well tolerated, but the woman's BP becomes mildly elevated, continuing the contraceptive and initiating antihypertensive treatment may not be contraindicated, especially if the ability to plan pregnancy is important (e.g. in type 1 diabetes mellitus). No commonly used antihypertensive is known to be teratogenic, although ACE inhibitors and angiotensin receptor antagonists should be discontinued, and any antihypertensive drugs should be continued in pregnancy only if anticipated benefits outweigh potential reproductive risk(s). The hypertensive disorders of pregnancy complicate 5 to 10% of pregnancies and are a leading cause of maternal and perinatal mortality and morbidity. Treatment aims to improve pregnancy outcome. There is consensus that severe maternal hypertension (systolic BP > or = 170mm Hg and/or diastolic BP > or = 110mm Hg) should be treated immediately to avoid maternal stroke, death and, possibly, eclampsia. Parenteral hydralazine may be associated with a higher risk of maternal hypotension, and intravenous labetalol with neonatal bradycardia. There is no consensus as to whether mild-to-moderate hypertension in pregnancy should be treated: the risks of transient severe hypertension, antenatal hospitalisation, proteinuria at delivery and neonatal respiratory distress syndrome may be decreased by therapy, but intrauterine fetal growth may also be impaired, particularly by atenolol. Methyldopa and other beta-blockers have been used most extensively. Reporting bias and the uncertainty of outcomes as defined warrant cautious interpretation of these findings and preclude treatment recommendations.
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PMID:Treating hypertension in women of child-bearing age and during pregnancy. 1136 52

Fifty per cent of pregnancies are unplanned, and 1-6% of young women have pre-existing hypertension. However, no commonly used antihypertensive agent is known to be teratogenic. ACE inhibitors (and angiotensin-receptor antagonists) should be discontinued due to fetotoxicity. Five to 10% of pregnant women have hypertension, of which pre-existing hypertension is but one type. There is consensus that severe maternal hypertension (blood pressure >or=170/110 mmHg) should be treated to minimize the risk of acute cerebrovascular complications. Parenteral hydralazine may be associated with a higher risk of maternal hypotension, and intravenous labetalol with neonatal bradycardia. There is no consensus that mild-to-moderate hypertension in pregnancy should be treated. Clinical trials indicate that transient severe hypertension, antenatal hospitalization, proteinuria at delivery and neonatal respiratory distress syndrome may be decreased by normalizing blood pressure, but intrauterine fetal growth restriction may be increased. Methodological problems with published trials warrant cautious interpretation of these findings. Methyldopa and beta-blockers have been used most extensively, although atenolol may impair fetal growth in particular and should be avoided.
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PMID:Drugs in pregnancy. Antihypertensives. 1180 May 27

A 12-year-old boy was admitted in paediatric nephrology unit of Bangabandhu Sheikh Mujib Medical University (BSMMU) with massive proteinuria, hypertension, respiratory distress and anaemia and diagnosed as nephrotic syndrome. Percutaneous needle biopsy was consistent with diffuse endocapillary proliferative glomerulonephritis and initially managed conservatively with injection methyl prednisolone, cyclophosphamide, lisinopril etc. without any improvement. Living-related renal transplantation was done successfully from paternal uncle. Two episodes of acute rejection occurred, one immediately after transplantation and another after one month. These were managed with IV methyl prednisolone for 3 days. At present, he is on oral prednisolone, cyclosporine, azathioprine and antihypertensives with normal haemoglobin and stable serum creatinine level (pre-transplant level 12.5mg/dl to post-transplant level 1.5mg/dl). He has been maintaining his normal life including schooling for last few months. It is concluded that a patient with uncommon presentation of nephrotic syndrome should be confirmed by renal biopsy and renal transplantation may be considered if conservative measures fail.
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PMID:A case of renal transplantation. 1862 62


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