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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pyelonephritis xanthogranulomatosa is a peculiar manifestation of destructive interstitial nephritis which can be differentiated from other types of pyonephrosis exclusively by microscopic examination. Clinical symptomatology often points towards the existence of a renal tumor. The author analyses the clinical and radiological symptomatology of seven patients treated by him. The angiographic picture presented by pyelonephritis xanthogranulomatosa differs according to the character and extension of the inflammatory tissue lesion. The angiographic picture of the circumscribed and diffuse granular proliferative types resembles that of a poorly vascularised malignoma, whereas the destructive type resembles hydropyonephrosis.
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PMID:[A contribution to radiological diagnostics of xanthogranulomatous pyelonephritis (author's transl)]. 9 1

Kidneys obtained by nephrectomy from 85 patients with chronic nephropathy were examined by bacterial culture and by immunofluorescence for a content of E. coli antigen. A panel of 10 E. coli 0-antisera, representing the strains most commonly causing urinary tract infection, and antiserum against common enterobacterial antigen (CA), were used. Bacteria could be cultured from the nephrectomy specimens in 24 cases, mainly in cases of obstructive chronic pyelonephritis, analgesic nephropathy and congenital renal disease. By immunofluorescence, type-specific 0-antigen was found in whole bacteria and amorphously in macrophages, CA only in whole bacteria. Whole bacteria could be visualized in 12 cases, macrophages only in two cases. Amorphous bacterial antigen was no observed outside phagocytizing cells. On the basis of these results, it seems unlikely that progression of the renal lesions in chronic renal disease is due to persistant bacterial antigen in the absence of viable bacteria. Chronic pyelonephritis, defined as an interstitial nephritis due to the effects of bacterial infection in the renal parenchyma and pelvic mucosa, appears always to be a secondary manifestation following obstruction or primary renal disease, such as analgesic nephropathy or congenital renal disease.
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PMID:Bacteria and bacterial antigen in the kidney in human chronic renal disease. Bacteriological and immunofluorescence Studies. 34 94

Lipid A injected into the temporarily occluded renal pelvis of adult dogs, persisted in the kidney tissue and induced an abacterial interstitial nephritis with positive anti-lipid A titers. This reaction was increased by a single dose of lipid A vaccine, reduced by four consecutive immunisations prior to the lipid A injection and absent in puppies. The presence of IgG, IgM and complement complexes in the kidney was demonstrated by immunofluoroscopy. Lipid A antibody titers were measured by the passive hemolysis test in 349 humans. In two out of 20 healthy adults and 16 out of 18 children with recurrent urinary tract infection anti-lipid A antibodies were present. In contrast, no titers were found in 23 newborn babies. In a group of 156 patients with acute urinary tract infection, 28% revealed positive titers, whereas in a group of 132 patients with recurrent urinary tract infection titers occurred in 81%. Selected from this group of 132 patients 61 suffered from an acute infection of the upper tract. 59 oft these (96%) showed definite titers. There was no difference in the development of anti-lipid A antibodies between men and women and the height of the titers did not correlate with the clinical picture of the disease (acute or chronic). The combination of proteinuria and anti-lipid A antibodies indicates the pressure of reccurrent urinary tract infection or chronic pyelonephritis with about 90% accuracy. The titers are caused by immunogenically active lipid A in the body. Since lipid A has the ability to remain in the renal tissue for a long period of time and thereby to maintain the inflammatory response, long-term antimicrobial prophylaxis (six months) should be given to patients with a high risk of recurrent urinary tract infection.
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PMID:[Lipoid A, a factor in the pathogenesis of chronic pyelonephritis. Experimental and clinical studies of a lipoid A dependent pathological immune reaction]. 37 74

Several virulence factors, such as O and K antigens and capacity to attach to uroepithelial cells, seem to be required for Escheria coli to cause acute pyelonephritis. These factors induce an immune response, however, which can modify the course and clinical expression of the infection. During acute pyelonephritis, autoantibodies to the Tamm-Horsfall protein increase. These antibodies, which probably are evoked by a cross-reaction noted between structures of E. coli LPS and the Tamm-Horsfall protein, may add to the renal tissue engagement in interstitial nephritis caused by bacterial pyelonephritis.
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PMID:Immunological aspects of pyelonephritis. 38 Aug 97

Substances having the chromatographic behaviour and the bioassay properties of prostaglandins (PGE and PGF) were detected in the urine of 30 patients with kidney disease and 15 healthy subjects. The mean urinary PGE and PGF values in 15 patients with chronic glomerular disease or nephrosclerosis were significantly lower than those of 15 patients with chronic pyelonephritis and other forms of chronic interstitial nephritis, polycystic kidney disease, obstructive nephropathy or diuretic phase of acute renal failure, and of the mean PGE and PGF values found in the healthy subjects. It was suggested that in contrast to disease affecting primarily the renal medulla, chronic glomerular disease and nephrosclerosis are accompanied by a decrease of renal prostaglandin synthesis and/or release.
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PMID:Urinary prostaglandins in kidney disease. 55 98

Renal tissues were studied using electron microscopy (EM) and immunofluorescence microscopy (IFM) from three patients who were found to have chronic interstitial nephritis (pyelonephritis) by light microscopy (LM). By LM, 90% of the glomeruli in two patients and all glomeruli in one patient were normal. By EM, glomerular capillaries in all patients revealed generalized fusion of epithelial foot processes. In two patients, IFM for immunoglobulins, third component of complement and fibrinogen were negative. These two patients received corticosteroids for 6 to 12 weeks. In one, proteinuria markedly decreased (from 17.9 to 1.1 gm) in four weeks and in the other follow-up studies of renal histology revealed normal glomeruli and partial restoration of foot processes by LM and EM respectively. Thus, this study offers evidence for lipoid nephrosis (or minimal lesion disease) as an etiology of nephrotic syndrome in chronic interstitial nephritis (pyelonephritis). The impaired renal function in these patients is attributed to tubulo-interstitial disease rather than glomerular pathology. It remains to be determined whether the two disparate pathological conditions have coexisted or chronic interstitial nephritis had led to the appearance of lipoid nephrosis through an unidentified mechanism.
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PMID:An etiology of nephrotic syndrome in chronic interstitial nephritis (pyelonephritis); an electron microscopic study. 61 Apr 18

The x-ray findings of 727 patients with chronic interstitial nephritis are evaluated; these patients have been controlled over a period of several years: 594 suffer from chronic bacterial interstitial nephritis (pyelonephritis) and 133 patients from chronic abacterial interstitial nephritis of different etiology. The causes for the abacterial type of nephritis are phenacetin and primary gout. The radiological signs of the two forms of chronic interstitial nephritis in different degrees of involvement are pointed out. Whereas with the chronic abacterial interstitial nephritis symmetrical affection is typical, the chronic bacterial interstitial nephritis shows asymmetrical findings, especially in ascending pyelonephritis. Differentiation between the chronic bacterial nephritis and the chronic abacterial nephritis can be achieved in most cases by radiological signs, (morphological findings). The microscopic evaluation does not always allow a differentiation; because there are mixed forms and secondary bacterial infections are associated with primary chronic abacterial interstitial nephritis in the late stages. The multiple causes for chronic abacterial interstitial nephritis is radiologically reflected mostly by uniform signs during the different degrees of involvement.
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PMID:[Radiology of bacterial and abacterial interstitial nephritis (author's transl)]. 62 20

The effect of immunosuppressive agents in different glomerulopathies is reviewed and some guidelines for their use in clinical practice are proposed. The immunological aspects of pyelonephritis and interstitial nephritis are studied to evaluate future possibilities of either therapeutic immunosuppression or immunization in these diseases.
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PMID:[Certain and disputed indications of immunosuppressive therapy in kidney diseases]. 63 5

Interstitial nephritis is a common condition, which in spite of a relatively constant pathologic picture has different etiologic agents and pathogenetic mechanisms. Failure to appreciate this, particularly in the chronic group, has led to considerable confusion and has been largely responsible for the overdiagnosis of chronic pyelonephritis. Although we are still largely ignorant of the causes of interstitial nephritis, it is now possible to define many of them. While experimental studies have not made spectacular contributions to our understanding, an attempt is now being made to develop appropriate models, and we hope these will enable us to still further clarify our understanding of other entities.
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PMID:Interstitial nephritis. A brief review. 77 3

Bone formation in renal medulla arises from papillary necrosis and is observed almost exclusively following chronic pyelonephritis and chronic interstitial nephritis. Since papillary necrosis occurs in the early stage of chronic interstitial nephritis, this kind of osseous metaplasia has specific diagnostic significance. By means of a case report formal pathogenesis, experimental basis, clinical diagnostic considerations and prognosis of the bone formation in renal medullary parenchyma are discussed.
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PMID:[Osseous metaplasia of renal medulla (author's transl)]. 81 17


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