Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Acquired Immunodeficiency Syndrome (AIDS) has involved the pediatric age group and is especially prevalent in babies born of mothers who are intravenous drug abusers or prostitutes. Approximately 30% of children born to mothers who are seropositive for the human immunodeficiency virus (HIV) will develop HIV infection. There are several important differences in children and adults with AIDS. The incubation period of the disease is shorter, and initial clinical manifestations occur earlier in children. In addition, certain infections are more common in children, and the different types of malignancy, especially Kaposi's sarcoma, are unusual in the pediatric age group. The altered immune system involves both T cells and humoral immunity and increases susceptibility to a variety of infections, particularly opportunistic organisms. In this publication the complications of pediatric AIDS involving the lungs, cardiovascular system, gastrointestinal tract, genitourinary system, and neurological system are described. The most common pulmonary complications in our experience are Pneumocystis carinii pneumonia and pulmonary lymphoid hyperplasia. The spectrum of cardiovascular involvement in pediatric AIDS includes myocarditis, pericarditis, and infectious endocarditis. Gastrointestinal tract involvement is usually due to opportunistic organisms that produce esophagitis, gastritis, and colitis. Abdominal lymphadenopathy is a common finding either due to disseminating Mycobacterium avium-intracellulare infection or nonspecific lymphadenopathy. Although cholangitis is more commonly seen in adults, it may occur in children with AIDS and, in most cases, is due to related opportunistic infections. Genitourinary infections may be the first evidence of HIV disease. Cystitis, pyelonephritis, renal abscesses, and nephropathy with renal insufficiency are complications of pediatric AIDS. A variety of neurological abnormalities may occur in pediatric AIDS. The most common cause of neurological dysfunction in children with AIDS is HIV neuropathy. We present the many complications of AIDS in children demonstrated by a variety of imaging modalities, emphasizing the importance of diagnostic imaging in children with this disease.
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PMID:Radiology of AIDS in the pediatric patient. 157 31

A 37-year-old female patient reported marked weight loss, prolonged alopecia, recurrent infections and watery diarrhoea. Examination revealed Salmonella infection, candidiasis and immunological signs of previous toxoplasmosis. Between 1978 and 1981, the patient had had close sexual relations to a patient with haemophilia A. Due to this fact, AIDS was suspected. Serological tests for HIV were not available at the time. The findings in DNA image cytometry (nuclear DNA inclusion bodies, polyploid lymphocyte nuclei and binuclear lymphocytes) suggested a viral infection of the lymphoid cells. Electron microscopy revealed in hepatocytes and cerebral cells intranuclear inclusion bodies whose size and contents were not compatible with an infection caused by cytomegalovirus, herpes virus or Epstein-Barr virus. In autopsy, infections of various organ systems such as pneumonia, tracheobronchitis, urocystitis, pyelonephritis, Candida oesophagitis and enteritis were found.
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PMID:[AIDS in a woman having had sexual relations with a patient with hemophilia A. Characteristic findings in DNA image cytometry]. 379 20

In the Swiss Study "HIV and pregnancy" we observed 153 singleton pregnancies of HIV-positive women. 23 (15%) of those ended with a premature delivery. For drug addicts (n = 100), the incidence of prematurity, 20%, significantly higher than in those free of drugs (n = 53) with 5.6%. The most frequent cause of prematurity was premature labor or rupture of the membranes (n = 13), followed by maternal illness (n = 8) and fetal complications (n = 2). Women with premature delivery tended to have lower CD4 cell counts than those with term delivery (29.4% vs 12.0% with < 200 CD4 cells/microliters). Low CD4 cell counts and drug consumption are two independent but cumulative risks for severe infections. 16 of the 153 women (12 with, 4 without drug consumption) had severe infections during pregnancy; in 4 cases (25%), this led to prematurity. The most common infection was pneumonia (14/16), further one case of pyelonephritis and one of cerebral toxoplasmosis. Two of these 16 infants (12.5%) were HIV-positive. We could not confirm a relationship between prematurity and vertical HIV transmission. Of the HIV-classified children, 3/18 (16.7%) premature infants and 16/74 (21.6%) term infants were infected.
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PMID:[Premature labor in HIV infected women. Swiss "HIV and Pregnancy" Study Group]. 778 79

This study was undertaken to attempt to identify correlations between microsporidial seroprevalence data in man, clinical diseases and groups of people at the risk of HIV/AIDS infection. Groups of patients were selected according to the predilection of members of the genus Encephalitozoon for nervous and kidney tissue. Female prostitutes and alcohol and intravenous drug abusers were selected as groups at risk of HIV/AIDS infections. A total of 401 samples of human sera were examined for the presence of antimicrosporidial IgG antibodies by ELISA test with a titre of 600 considered borderline positivity. The highest occurrence of antimicrosporidial antibodies was found in the groups of alcohol abusers (16% from 43 patients), intravenous drug abusers (11% from 9 patients) and prostitutes (10% from 80 women) for E. cuniculi antigen and in the groups of psychiatric patients (14% from 44 patients), malaria patients (11% from 38 patients) and alcohol abusers (7% from 43 patients) for E. hellem antigen. The occurrence of specific antibodies of the six examined diagnostic units (glomerulonephritis chronica, pyelonephritis chronica, schizophrenia, dementia, multiple sclerosis and cerebral stroke) was statistically significant only in patients with pyelonephritis chronica and dementia (p < 0.05). No cases of microsporidial infection were found among the female prostitutes by parasitological examination, although one case of giardiasis was identified. Sera of patients with high anti-E. cuniculi and anti-E. hellem antibodies (titres in ELISA of 600 and above) were confirmed by Western blot using E. cuniculi and E. hellem polypeptides, respectively. These results suggest that the examined patients could show residual antibodies from past or latent infections.
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PMID:The serological surveillance of several groups of patients using antigens of Encephalitozoon hellem and E. cuniculi antibodies to microsporidia in patients. 968 20

Clinically, it is important to detect mycoplasmas because these organisms have been implicated in gastric and ovarian cancer, pneumonia, postabortal fever, pelvic inflammatory disease, pyelonephritis, endometritis, urethritis, perinatal mortality, arthritis, spontaneous abortion, infertility and interference with sperm development and they act as cofactors catalyzing the HIV disease state. Recently, the combined polymerase chain reaction and enzyme-linked immunosorbent assay method targeting the consensus DNA of over 15 species of mycoplasmas was shown to be superior for the detection of mycoplasmas. The objective was to determine if there was an association between mycoplasmas and cervical neoplasia. Cervical tissues, histopathologically categorized by cervical intraepithelial neoplasia (CIN) grade, flat or exophytic, and acanthosis or koilocytotic, were used. The results showed that mycoplasmas DNA were present in 21.4% of the condyloma tissues and in 33.3% of condyloma tissues with CIN. In contrast, mycoplasmas DNA were not detected when there were no CIN. The presence or absence of human papillomavirus (HPV) did not make a difference. Mycoplasmas DNA were present in 40.0 and 12.5% of the exophytic and flat condylomas, respectively. A higher percentage of cervical tissues graded with slight koilocytosis had (P = 0.05) mycoplasmas DNA compared with tissues graded with moderate koilocytosis. The detection of mycoplasmas DNA in archived cervical condyloma tissues with CIN corroborated previous reports of an association between mycoplasmas and CIN. However, the association between mycoplasmas and the presence of HPV could not be made in this study.
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PMID:Assessment of archived paraffin-embedded cervical condyloma tissues for mycoplasma-conserved DNA using sensitive PCR-ELISA. 982 68

To study the role in AIDS pathogenesis of the human immunodeficiency virus type 1 (HIV-1) Tat protein, a transactivator of viral and cellular genes, we generated transgenic mice with a recombinant DNA containing BK virus (BKV) early region and the HIV-1 tat gene, directed by its own promoter-enhancer. DNA hybridization revealed that the transgene is stably maintained in all organs of transgenic mice as a tandem insertion in a number of copies ranging from 5 to 20 per cell. In addition, tat and BKV RNA were expressed in all tissues. Transgenic mice developed three types of lesions: 1) tumors, 2) hyperplastic and dysplastic lesions, and 3) non-neoplastic lesions. Tumors of different histotypes, such as lymphomas, adenocarcinomas of skin glands, leiomyosarcomas, skin squamous cell carcinomas, hepatomas, hepatocarcinomas, and cavernous liver hemangiomas, developed in 29% of transgenic animals. The majority of tumors were malignant, invasive, and producing metastases. Conversely, tumors of only two histotypes (lymphomas and adenocarcinomas of skin glands) appeared in control mice. Hyperplastic and dysplastic lesions were more frequent in transgenic than in control mice and involved the skin or its adnexes, the liver and the rectum, indicating multiple targets for the activity of the transgene. Pyelonephritis, frequently complicated with hydronephrosis, inflammatory eye lesions, and amyloid depositions represented the most frequent non-neoplastic lesions detected in transgenic mice. Many of the pathological findings observed in this animal model are comparable to similar lesions appearing in AIDS patients, suggesting a relevant role for Tat in the pathogenesis of such lesions during the course of AIDS.
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PMID:Morphological, histochemical, immunohistochemical, and ultrastructural characterization of tumors and dysplastic and non-neoplastic lesions arising in BK virus/tat transgenic mice. 1023 61

Bacterial invasion of the renal parenchyma, pyelonephritis, is rarely considered as a primary cause of acute renal failure, particularly in adults. We report two cases of acute renal failure occurring in absence of hypotension, urinary tract obstruction, or nephrotoxic medications that are likely the direct consequence of pyelonephritis. The first case involved a 48-year-old HIV-positive woman who presented with 3 days of nonspecific symptoms and was noted to have acute renal failure. Due to unremitting renal dysfunction, a renal biopsy was performed confirming the diagnosis of bacterial pyelonephritis. The second case, a 33-year-old man with HIV disease, presented with fever and was found to have pyelonephritis by urine culture and ultrasonography. These cases represented initial diagnostic dilemmas for the admitting physicians and demonstrate the varied clinical presentations of acute renal failure as a direct consequence of bacterial infiltration of the renal parenchyma.
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PMID:Pyelonephritis and acute renal failure. 1531 Nov 72

We describe the first case of efavirenz-induced urolithiasis in a 47-year-old HIV-positive patient. Urinary obstruction led to pyelonephritis and septic shock, requiring emergency ureteral catheterisation. The subsequent clinical course was favourable, allowing the patient's discharge on day 5. A 7 mm, radio-translucent, non-crystalline, beige stone was extracted during catheterisation. Stone analysis by Fourier transform infrared spectrometry, liquid chromatography and mass spectrometry revealed a stone composed of efavirenz (EFV) metabolites M4, M5, M8 (as described by Mutlib et al. in 1999) and approximately 50% of unspecified proteins. EFV is a non-nucleoside reverse transcriptase inhibitor introduced to European markets in 1999. It is principally metabolised by cytochrome P450 3A4 and 2B6. Of the dose, 14-34% is excreted in the urine, 1% as unchanged drug. The patient had been taking 600 mg EFV per day for 3 years. As EFV-induced urolithiasis has not been reported so far, we would like to draw the attention of the medical community to this potentially severe complication.
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PMID:Efavirenz-induced urolithiasis. 1662 85

Renal sonography can be easily performed and provides valuable information concerning the underlying disease process, helping to decide appropriate management. This article reviews the important renal infections, such as pyelonephritis, emphysematous pyelonephritis, renal abscess, hydatid disease, renal tuberculosis, pyonephrosis, and HIV-associated nephropathy.
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PMID:Ultrasonographic evaluation of renal infections. 1714 85

With prolonged survival and aging of the HIV-infected population in the era of antiretroviral therapy, biopsy series have found a broad spectrum of HIV-related and co-morbid kidney disease in these patients. Our study describes the variety of renal pathology found in a prospective cohort of antiretroviral-experienced patients (the Manhattan HIV Brain Bank) who had consented to postmortem organ donation. Nearly one-third of 89 kidney tissue donors had chronic kidney disease, and evidence of some renal pathology was found in 75. The most common diagnoses were arterionephrosclerosis, HIV-associated nephropathy and glomerulonephritis. Other diagnoses included pyelonephritis, interstitial nephritis, diabetic nephropathy, fungal infection and amyloidosis. Excluding 2 instances of acute tubular necrosis, slightly over one-third of the cases would have been predicted using current diagnostic criteria for chronic kidney disease. Based on semi-quantitative analysis of stored specimens, pre-mortem microalbuminuria testing could have identified an additional 12 cases. Future studies are needed to evaluate the cost-effectiveness of more sensitive methods for defining chronic kidney disease, in order to identify HIV-infected patients with early kidney disease who may benefit from antiretroviral therapy and other interventions known to delay disease progression and prevent complications.
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PMID:The spectrum of kidney disease in patients with AIDS in the era of antiretroviral therapy. 1905 38


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