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

The paper presents the data confirming the hypothesis on the involvement of the congenital enteroviral infection in etiology of chronic nephropathy manifesting in children in the presence of influenza-like and acute respiratory infections diseases. 100 relevant children were examined. Family history indicated a high risk of enteroviruses inheritance from mothers who were chronic carriers in 19 out of 20 children with pyelonephritis or interstitial nephritis (95%), in 17 out of 23 children with transitory nephropathy (73.9%) and 16 out of 57 patients without nephropathy (28.1%). Coxsackie enteroviruses (A and B) occurred in the urinary sediment in 82.3, 68.4, 29.5% of the patients from the groups under comparison, respectively. In children free of nephropathy the viruses manifested primarily in the seasons with the highest prevalence of the enteroviral diseases, in those with nephropathy Coxsackie viruses detection rate was not season-related. Recognition of enteroviruses (Coxsackie B, as a rule) was significantly related to the risk of the transmission from the mother. Persistence of the viruses in the cells of the urinary system of children with congenital viral infection seems to run subclinically for a long time. Influenza and other acute respiratory diseases promoted activation of the endogenic infection which resulted in transitory nephropathy or interstitial nephritides.
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PMID:[The significance of a congenital enterovirus infection in the pathogenesis of transient intrainfectious nephropathy and interstitial nephritis detected in children with influenza-like and acute respiratory diseases]. 175 18

Xanthogranulomatous pyelonephritis is a special variant of interstitial nephritis, when an inflammatory infiltration contains xanthomatous cells. Its diagnosis is difficult and possible only on the basis of a histologic analysis of a surgically removed kidney. A case of xanthogranulomatous pyelonephritis combined with retroperitoneal xanthogranuloma is presented. Kidney carcinoma was suspected and in the course of operation the biopsy of kidney was taken. In the authors' opinion a histologic express diagnosis is recommended during the operation.
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PMID:[Xanthogranulomatous pyelonephritis combined with retroperitoneal xanthogranuloma, simulating kidney tumor]. 185 86

A comparative study was made of 25 patients (Group 2, control) with documented pyelonephritis and 55 patients (Group 1) who had a morphological picture of chronic interstitial inflammation without signs of abnormal urodynamics, bacteriuria, urographic and sonographic evidence of pyelonephritis. All the patients underwent life-time morphological study, their immunological spectrum (IgA, IgG, IgM, IgE) was explored. They had a test for sensitization of a peripheral blood mononuclear fraction to one or several drugs which had been given to the patients. The patients from Group 1 displayed significantly elevated IgE levels and a regularly detected sensitization of mononuclears to one or several drugs. Morphologically, there were signs of congenital renal tissue dysplasia in the presence of diffuse interstitial inflammation. Positive immunofluorescence findings were seen in the tubular wall of 10 (18%) patients. The findings made it possible to define diagnostic criteria for interstitial nephritis, a nosological entity.
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PMID:[Once more about interstitial nephritis]. 187 47

Eosinophiluria is considered a useful marker of drug-induced acute interstitial nephritis. However, recognition of eosinophiluria by Wright's staining is technically difficult, and the spectrum of disorders causing eosinophiluria is not completely defined. We have adapted Hansel's stain for the examination of urinary sediment. Whereas there was a variable uptake of Wright's stain by eosinophils in the urine, such eosinophils were readily recognized with Hansel's stain by the presence of bright red granules. The prevalence of eosinophiluria in acute interstitial nephritis was 10 of 11 patients, in acute tubular necrosis none of 30, in acute pyelonephritis none of 10, in acute cystitis 1 of 15, in postinfectious glomerulonephritis 1 of 6, in rapidly progressive glomerulonephritis 4 of 10, and in acute prostatitis 6 of 10. Eosinophiluria in acute interstitial nephritis was demonstrated by Hansel's stain in 10 of 11 patients but by Wright's stain in only 2 of 11 patients. We conclude that Hansel's stain substantially improves the recognition of eosinophiluria as compared with Wright's stain. Eosinophiluria is useful in distinguishing acute interstitial nephritis from acute tubular necrosis. The clinical spectrum of eosinophiluria also includes rapidly progressive glomerulonephritis, acute prostatitis, and occasionally, acute cystitis or postinfectious glomerulonephritis.
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PMID:Eosinophiluria--a new method of detection and definition of the clinical spectrum. 1842 May 15

Chronic pyelonephritis (c.p.) is by definition an infectious tubulo-interstitial nephritis. It has to be differentiated from other etiologic forms of tubulo-interstitial nephritis. Therefore strict morphological criteria are needed for diagnosis. The characteristic lesion is a large cortico-medullary scar overlying a dilated chronically inflammed calyx. The macroscopic aspect and the histologic survey picture are more important than histologic details. A diagnosis on renal biopsies is therefore not warranted. Vesico-renal reflux and papillary morphology play an important pathogenetic role. Beside the more common focal scar a diffuse form of scarring can be observed. A limited number of conditions only have to be considered in differential diagnosis. The Ask-Upmark kidney seems to be a special form of c.p. related to urinary tract infection and reflux in early infancy. Pelvi-calyceal lithiasis without superimposed infection causes a picture very similar to a pyelonephritic scar. A reliable differentiation between c.p. and analgesic nephropathy may cause problems in endstage kidneys with sloughed off papillae. Various mechanisms of renal damage such as bacterial infection, immunological mediated inflammation, leakage of urinary constituents into the interstitium especially Tamm-Horsfall-protein and ischemia have to be considered. Despite the frequency of urinary tract infections chronic progressive pyelonephritis is rare. Predisposing factors are needed for progression of the disease. These include congenital or acquired urinary tract obstruction, vesico-renal reflux and papillary damage with intrarenal obstruction to the urinary flow. Other important factors are focal and segmental glomerulosclerosis and hypertension.
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PMID:[Chronic pyelonephritis and its differential diagnosis. A disease changing with time]. 248 12

Fifty-five cases of primary (that is, without urinary tract abnormalities), acute pyelonephritis (PN) were studied by computed tomodensitometry (CT). There were 48 women and 7 men. All were febrile and 16 had positive blood cultures. In 7 cases, (4 diabetics and 3 malnourished alcoholics) PN was painless, diagnosis was delayed and lesions were severe. Two diabetics underwent emergency nephrectomy for sepsis. Conventional radiological techniques (IVP and ultrasonography) were poorly informative. In contrast, initial CT abnormalities were visible in 44 patients. They consisted of triangular or round hypodense images, diffuse hypodensity in a grossly swollen kidney, and/or abscesses. Hypodense images were presumably due to acute focal ischemia. Renal histology was available in five patients. It showed acute interstitial nephritis with leukocyte infiltrates, edema and hemorrhagic streaks. Pyelonephritis was due to E. coli in 48 cases (87.5%). In 27 cases E. coli isolates were studied by genotypic assays which detect the three most frequent (pap, afa and sfa) of the four operons known to encode adhesin. In all cases, at least one of these genotypic markers of uropathogenicity was found. In 27 cases, repeat CT was done shortly after treatment. It showed healing in only 12. Early cortical scar formation was visible in 2. Final evaluation in 27 cases with adequate follow-up showed that (in addition to the 2 patients who had been nephrectomized), in only 17 of 27 (63%) had the kidneys recovered a normal appearance. In two cases one kidney had undergone atrophy; renal biopsy showed subacute-chronic interstitial nephritis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Frequency of development of early cortical scarring in acute primary pyelonephritis. 265 59

Fifty indoor patients of chronic pulmonary tuberculosis were studied for renal involvement. There were 36 (72%) males and 14 (28%) females. Age of the patients was ranging from 16 to 70 years. Most of the patients were receiving treatment for tuberculosis for more than 1 year. Frequency of micturition and dysuria were the commonest symptoms observed. Urine smear for mycobacteria was negative in all patients however culture was positive in 6% patients. Renal biopsy was attempted in all patients but was successful in 35 patients. It revealed interstitial nephritis in 28.5%; amyloidosis in 17.1%, glomerulonephritis in 17.1%, tubercular pyelonephritis in 5.6%; pyelonephritis combined with amyloidosis in 8.5% patients. Non-specific changes were observed in 14.3% patients and in 8.5% patients tissue was inadequate for biopsy study.
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PMID:Renal involvement in chronic pulmonary tuberculosis. 276 53

We report five cases of renal parenchymal malakoplakia. They represent a histologic spectrum of this uncommon inflammatory process as it involves the renal parenchyma. Only one of these five cases presented the classical histologic picture of malakoplakia ("diagnostic stage"). Two cases--although with similar cellular infiltrate--had a marked paucity of Michaelis-Gutmann bodies and thus might have been classified as megalocytic interstitial nephritis were it not for the identification of such calcific intracellular inclusions under the electron microscope. The fourth case presented a pseudosarcomatous morphology and is similar to what has been described as a late or fibrous stage in malakoplakia of the urinary bladder. The last case had a destructive, frankly granulomatous histologic picture with a preponderance of foamy histiocytes reminiscent of xanthogranulomatous pyelonephritis, but with clusters of von Kossa-positive Michaelis-Gutmann bodies. The last two forms of the disease have not been previously reported to occur in the kidney. We believe that these cases represent various stages of development of the disease.
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PMID:Renal parenchymal malakoplakia. Histologic spectrum and its relationship to megalocytic interstitial nephritis and xanthogranulomatous pyelonephritis. 291 20

A 56-year-old woman in chronic hemodialysis had been suffering from uncontrollable fever for the past 7 months. Her original disease was diagnosed as familial polycystic kidney and three of her five brothers were found to have the same disease. Her chromosome was 46,XX,21P+ and laboratory examination revealed severe anemia, malnutrition, liver dysfunction, pyuria and candidiasis of urine. Abdominal echogram and CT scan revealed polycystic kidneys and multiple liver cysts. She was admitted to our hospital and was diagnosed as having pyelonephritis of the right kidney. As her condition was not improved by conservative therapy right nephrectomy was performed. One month later, spiking fever and left tenderness reappeared. Those symptoms could not be controlled by conservative therapy and left nephrectomy was performed again. Pathological examination on nephrectomized kidneys showed interstitial nephritis, hyaline degeneration and proliferative change of glomeruli, microabscess, colloid of tubules and calcification of parts of Henle's loops. Nephrectomy has been performed in 1.6 to 10.0% of polycystic kidneys due to references since 1952. Eight of the 22 polycystic kidneys (36.3%) seen at our hospital during the past 10 years have been removed.
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PMID:[A case of polycystic kidney with bilateral nephrectomy]. 305 41

The pharmacokinetics of disopyramide was studied in 15 patients with renal dysfunction (4 with pyelonephritis, 7 with glomerular nephritis and 4 with interstitial nephritis). The elimination rate constant of unbound disopyramide was 0.094 h-1 and CLu/f (unbound clearance divided by bioavailability) was 245 ml/min. Both the unbound renal clearance (CLR) and CLu/f were highly correlated with the creatinine clearance (CLCR). The apparent unbound metabolic clearance in the patients was approximately two-fold lower than that previously reported in normal subjects. The estimated unbound metabolic clearance in the renal dysfunction patients showed a significant negative correlation with the alpha 1-acid glycoprotein (AAG) concentration and only a weak, non-significant correlation with CLCR. As AAG in the renal dysfunction subjects was increased in comparison with normal values, it is possible that AAG is a factor in the decrease in the apparent unbound metabolic clearance.
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PMID:Does alpha 1-acid glycoprotein reduce the unbound metabolic clearance of disopyramide in patients with renal impairment? 318 Dec 85


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