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 authors used monoclonal antibody (CD3, CD4, CD8) and indirect immunofluorescence technic to study peripheral blood lymphocyte surface markers in patients with chronic pyelonephritis (CPN) and in normal controls. In CPN patients, a significant decrease in CD3, a lower percentage of CD4 and significant higher percentage of CD8 leading to a decrease in the CD4/CD8 ratio were noted. No differences could be observed between Spleen-Kidney Yang deficiency and Kidney Yin deficiency. The overall picture shown by the CPN patients was compatible to a cell-mediated immune response defection. The CPN patients were then treated with Zi-Ling capsule (ZLC)/transfer factor (TF) and various antibiotics for three months, during which period the authors found a significant increase in CD3, CD4, but no significant change in CD8. Symptoms such as lumbago, fatigue, frequency of urination were improved. A significant decreased in CD4 after cessation of treatment with ZLC and TF was observed. These observations suggested that both ZLC and TF could also improve the immune function, however, they mainly affect CD4 but not CD8 cells, and the effect lasted for only a short period. In conclusion, ZLC/TF and antibiotics administered together would serve as a useful therapeutic measure to be recommended for patients with CPN.
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PMID:[Cell-mediated immunity in chronic pyelonephritis]. 197 46

Xanthogranulomatous pyelonephritis is an uncommon form of chronic aggressive infection of the kidney and surrounding tissues usually affecting middle aged women. It is rarely seen in childhood. We report the case of a female child with a history of fatigue, progressive anorexia, and fever in whom a diagnosis of pyelonephritis on a predisposing factor of lithiasis was suggested. After initial antibiotic treatment, nephrectomy was needed for an acute general deterioration. Pathology demonstrated xanthogranulomatous pyelonephritis.
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PMID:Xanthogranulomatous pyelonephritis in a child. 829 78

Xanthogranulomatous pyelonephritis is an uncommon variant of chronic pyelonephritis that predominantly affects middle-aged women. Patients usually present with fever, back or flank pain, flank mass, and the constitutional symptoms of fatigue, malaise, weight loss, and anorexia. Rarely, they may present with a draining sinus. There is usually a history of urinary tract infection, obstruction, or instrumentation. Other abnormalities include anemia, leukocytosis, abnormal liver enzymes, pyuria, and hematuria. Mild azotemia may be present, but frank renal failure is rare. Urine and renal tissue cultures are frequently positive. The most commonly isolated bacterial pathogens are P. mirabilis and E. coli, but other organisms have also been implicated. A CT scan is the best radiologic imaging technique to discover the extent of inflammation as well as any involvement of adjacent structures. Lipid-laden macrophages called xanthoma cells characterize the disease at the microscopic level. Nephrectomy is curative. Careful preoperative evaluation will guide surgical planning in choosing an approach that provides adequate exposure of the affected tissue and facilitates subsequent care of the patient.
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PMID:A middle-aged woman with back and flank pain. 881 29

Human patients with renal disease frequently develop disturbed sleep and severe fatigue. To develop a model for studying factors that contribute to these symptoms, we characterized the sleep patterns of various strains of mice after acute challenge with the fungal organism Candida albicans. After intravenous administration to mice, C. albicans typically colonizes the kidney, producing acute pyelonephritis. Various strains of inbred mice demonstrate marked variation in the temperature and sleep responses that develop after challenge, with individual strains generally showing increased or reduced somnolence in association with fever or hypothermia, respectively. C. albicans-infected mice may be a useful model for identifying the genes and mechanisms that link sleep, temperature, fatigue, and the immune response.
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PMID:Sleep and temperature responses of inbred mice with Candida albicans-induced pyelonephritis. 1694 52

We report three cases of multicentric Castleman's disease (MCD) successfully treated with anti-interleukin-6 receptor antibody (tocilizumab). Tocilizumab was administered intravenously at a dose of 8 mg/kg every 2 weeks. In each case, tocilizumab alleviated symptoms, including generalized fatigue, pyrexia, and alleviated biochemical abnormalities, including anemia, hypoalbuminemia, hypergammaglobulinemia, and increased C-reactive protein (CRP). Side effects included hypercholesterolemia, acute pyelonephritis, mild inflammation of the parotid glands, and upper respiratory system inflammation. Other severe side effects were not observed. These results indicate that tocilizumab is effective for the treatment of MCD. This is the first report on tocilizumab efficacy for Castleman's disease after approval for use for Castleman's disease.
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PMID:Anti-interleukin-6 receptor antibody (tocilizumab) treatment of multicentric Castleman's disease. 1754 Dec 33

We encountered a 49-year-old Japanese man in whom tumor-like renal lesions developed as a result of chronic Staphylococcus aureus pyelonephritis. The patient complained of general fatigue, weight loss, and anorexia for 6 months. Contrast-enhanced computed tomography (CT) of the abdomen revealed multiple low-density lesions in both kidneys and paraaortic lymphadenopathy. A strong uptake of Ga67 citrate in the lesions and elevation of serum soluble interleukin-2 receptor and thymidine kinase activity were strongly suggestive of primary renal lymphoma; however, histologic examination of renal biopsy specimens revealed severe tubulointerstitial change, consistent with chronic pyelonephritis. Following systemic antibiotic treatment, multiple tumor-like lesions regressed 4 months later. This case suggested that chronic pyelonephritis could present as bilateral renal tumors.
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PMID:Chronic pyelonephritis presenting as multiple tumor-like renal lesions. 1757 82

Brucellosis which is a endemic in Turkey, is a systemic infection which can affect any organ or system in the body. Since signs and symptoms of brucellosis resemble many other diseases, misdiagnosis and related increase in morbidity rate, are common. In this report, a case of brucellosis complicated with endocarditis, pyelonephritis, sacroileitis and thyroiditis, was presented. The case was a 32-years-old female patient in whom the diagnosis of brucellosis was delayed by 12 months since it was not taken into consideration during the clinical follow-up of the patient in various clinical centers. The patient was admitted to our center with the complaints of fever, headache, back pain, night sweats, fatigue, loss of appetite, weight loss, dysuria and polyuria. The patient had a history of consumption of raw milk and dairy products. Positive Brucella tube agglutination test (1/1280) and isolation of Brucella spp. in blood cultures led to the diagnosis of brucellosis. Sacroileitis was diagnosed upon pain on right hip joint movements, pain and restriction at the same joint in FABER test. The detection of vegetation during echocardiography, cardiac murmur during physical examination and the determination of increased ESR and CRP levels led to the diagnosis of endocarditis. Abdominal ultrasonography and urinalysis results (hematuria, proteinuria and pyuria) revealed pyelonephritis and increased free T3 and T4, decreased TSH and positive anti-thyroid autoantibodies (anti-TG, anti-TPO) revealed thyroiditis. Treatment was started with combination of rifampisin (1 x 600 mg/day) and doxycycline (2 x 100 mg/day). After the diagnosis of endocarditis, trimethoprim-sulfamethoxazole (3 x 960 mg/day) and streptomycin (1 x 1 g/day) were added to the treatment. Valve replacement surgery was planned, however, the patient didn't accept surgical intervention and antimicrobial treatment continued with streptomycin for 21 days and other antibiotics for six months. The patient exhibited significant improvement after the medical treatment. Although sacroileitis is a frequent complication of brucellosis, endocarditis, thyroiditis and pyelonephritis are among the rare complications. In cases of brucellosis with multiorgan involvement including endocarditis, successful results may be achieved by aggressive antimicrobial treatment. In endemic areas, brucellosis should always be taken into consideration in patients with fever of unknown origin and multisystem involvement.
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PMID:[A case of brucellosis complicated with endocarditis, pyelonephritis, sacroileitis and thyroiditis]. 1933 91

A 43-year-old woman was referred to our hospital for fever, general fatigue and left flank abdominal pain during the last two weeks. A blood test showed severe inflammation, and computed tomography (CT) study of the abdomen with intravenous contrast revealed swelling and irregular enhancement in the upper left kidney. Initially, we diagnosed it as xanthogranulomatous pyelonephritis and treated it with antibiotics. A percutaneous renal biopsy was performed because the white blood cell count remained elevated after the treatment. Histopathologic examination revealed a carcinoma. Therefore, we performed left nephroureterectomy. The diagnosis was high grade urothelial carcinoma of the renal pelvis, and it stained positive by immunohistochemical staining using anti-granulocyte-colony stimulating factor (G-CSF). The serum G-CSF level was also elevated on the same day. The patient received chemotherapy but, died 9 months after surgery. A G-CSF-producing urothelial carcinoma of the renal pelvis is known to have a poor prognosis in the Japanese literature. It is important to closely monitor a G-CSF producing tumor, when a patient shows severe inflammation, but no infection.
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PMID:[Granulocyte-colony stimulating factor-producing urothelial carcinoma of the renal pelvis : a case report]. 2382 67

A 79-year-old female with diabetes mellitus had general fatigue, a high fever and vomiting. A CT revealed acute emphysematous pyelonephritis (EPN). A nephrectomy was performed on the 2(nd) hospital day. The results of the blood culture showed the presence of Citrobacter freundii infection. The patient's post-operative course was uneventful. This case is the second reported case of EPN induced by Citrobacter freundii. Bacteremia induced by Citrobacter freundii infection typically results in a high mortality rate. In this case, the early diagnosis of the EPN using CT and immediate medical treatment, including urgent elective nephrectomy, were key to the favorable outcome.
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PMID:A case of emphysematous pyelonephritis induced by Citrobacter freundii infection. 2433 64

Medical history and clinical findings | Two cases of the rarely diagnosed Streptobacillus moniliformis infection (rat bite or haverhill fever) emerged within two months in Stuttgart. The first patient presented with typical symptoms, i.e., fever and arthralgia. The second patient, however, was afebrile with severe back pain and fatigue as only symptoms. None of the patients reported rat bites or other animal contacts. Examinations | Physical examination did not reveal any focus of infection in the first patient. Further examinations could not be completed. Suspected diagnosis was therefore "unclear, most likely viral infection". In the case of the second patient, ultrasound revealed an engorged right kidney and urinary obstruction. Upon concomitant detection of Escherichia coli in the urine, pyelonephritis was suspected. Laboratory parameters were not indicative in neither case. Detection of the infectious agents was accomplished by blood cultures and subsequent identification by mass spectrometry, albeit after discharge of the patients. Treatment and course | The first patient left the hospital against the doctors' advice the day after his admission. The second patient improved under ciprofloxacin and metamizole therapy and was discharged after five days with the recommendation to continue the antibiotic therapy. Conclusion | Cases of rat bite or haverhill fever are difficult to diagnose when no rat bites are recognized. Seroprevalence data of S. moniliformis infection would be desirable to estimate how often atypical or subclinical cases of this potentially lethal infection go undiagnosed.
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PMID:[Rat-bite fever--two cases of infection with Streptobacillus moniliformis within two months]. 2597 Apr 14


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