Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 14 year old boy presented with recurrent attacks of macroscopic haematuria preceded by tonsillitis. Clinical examination revealed generalised vitiligo. Renal function was normal with microscopic haematuria. Percutaneous renal biopsy showed mesangial proliferation on light microscopy with deposition of IgA and IgM in a granular pattern in the mesangium and glomerular basement membrane compatible with a diagnosis of IgA nephropathy. Biochemical investigations revealed primary hypothyroidism and primary adrenocortical insufficiency with negative organ specific autoimmune screen. Renal function has not deteriorated after three years follow-up. This particular association has not been previously described to our knowledge.
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PMID:A case of IgA nephropathy associated with vitiligo, primary hypothyroidism and primary adrenocortical insufficiency. 276 33

At the onset or in the course of IgA nephropathy (IgA NP), upper respiratory tract infections and tonsillitis are often followed by periods of gross haematuria. In a search for possible abnormalities in the tonsillar IgA- and IgG-cell system, the palatine tonsils from seven patients with IgA NP and eight controls, all 15 suffering from chronic recurrent tonsillitis, were subjected to an immunohistochemical study. Compared with the controls, tonsils of NP patients contained a significantly (P less than 0.001) increased proportion of IgA-producing cells (49.6% versus 35.7%). There was also an increase (P less than 0.001) in the ratio of IgA polymer- (J-chain-positive) to monomer-producing cells in NP tonsils compared with controls (35.0% versus 18.8%). Although the tonsillar IgA cells were generally producing mainly IgA1, this subclass was even more predominant in NP tonsils (P less than 0.03). These results are compatible with the hypothesis that in some patients with IgA NP, the polymeric IgA1 deposited in the mesangium may be of tonsillar origin.
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PMID:Tonsillar distribution of IgA and IgG immunocytes and production of IgA subclasses and J chain in tonsillitis vary with the presence or absence of IgA nephropathy. 312 77

We report a dramatic response of the nephrotic syndrome to prednisolone therapy (2 mg per kg per day) in a 6-year-old boy with IgA nephropathy. He had developed massive proteinuria (22.1 gm per day) and microscopic hematuria shortly after an episode of tonsillitis. Renal biopsy two months after onset showed mild mesangial hypercellularity with typical mesangial deposition of IgA. Corticosteroid therapy resulted in a sharp cessation of proteinuria and complete resolution of the urinary abnormalities. We suggest that massive proteinuria associated with IgA nephropathy may be responsive to corticosteroid therapy when there are minimal glomerular changes.
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PMID:Dramatic response to corticosteroid therapy of nephrotic syndrome associated with IgA nephropathy. 405 39

IgA nephropathy (IgAN) is generally thought to be mediated by the glomerular deposition of circulating immune complexes containing IgA as the major antibody component. Upper respiratory infections and tonsillitis often precede IgAN, and in some cases tonsillectomy is effective for the treatment of IgAN. Thus, the tonsil seems to be a unique organ causing initial and/or progressive events to generate nephritogenic immune complexes in IgAN. In this study we focused on the analysis of immunopathological features of the palatine tonsil characteristic of IgAN patients by using an immunohistochemical technique. The IgA1 subclass was demonstrated in follicular dendritic cells (FDC) of the tonsil of IgAN patients, but not in FDC of non-IgAN controls. On the other hand, IgA2, IgG, IgM and C3 did not show any differences in distribution between the two groups. Moreover, the expression of decay-accelerating factor (DAF), an inhibitor of homologous complement activation, and transforming growth factor-beta 1 (TGF-beta 1), an inducer of antibody-producing cells to IgA class switching, in FDC and interdigitating dendritic cells of the tonsil, respectively, which was also clarified in this study for the first time, was found to be identically distributed in the two groups. These findings may support the idea that IgA1, possibly in an immune complex form, is trapped by FDC and plays an important role in the persistent activation of particular B cell repertoires responsible for the onset and/or progression of IgAN.
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PMID:Immunopathological features of palatine tonsil characteristic of IgA nephropathy: IgA1 localization in follicular dendritic cells. 750 15

IgA nephropathy (IgAN) is thought to be mediated by the glomerular deposition of circulating immune complexes containing IgA as the major antibody component. Tonsillitis often precedes IgAN, and tonsillectomy is an efficient treatment of IgAN. Thus, the tonsil may cause initial and/or progressive events leading to IgAN. To determine the pathological features of tonsillar lymphoid cells, we transferred tonsillar mononuclear cells from IgAN patients to SCID mice. Although human IgG-, IgM- and IgA-positive cells were detected in the spleens of SCID-Hu mice, they failed to reproduce the increase in serum IgA level and glomerular deposition. These results suggest that other factors are needed for the progression of IgAN.
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PMID:Reconstitution of immunological imbalance in SCID mice given tonsillar mononuclear cells from patients with IgA nephropathy. 828 38

To determine whether tonsillectomy is a significantly effective treatment in the clinical course of IgA nephropathy, we did a comparative study on 50 patients with IgA nephropathy and chronic tonsillitis. We divided the patients into two groups: 35 patients with and 15 without tonsillectomy (control group). With or without tonsillectomy, renal function became progressively worse during the follow-up period in most patients with a serum creatinine level of > 1.4 mg/dl at the time of renal biopsy. In patients with a serum creatinine level of < or = 1.4 mg/dl, renal function remained normal in all subjects with tonsillectomy, but worsened in 3 patients out of 13 without tonsillectomy. Improvement in proteinuria/hematuria was found more frequently in the tonsillectomized group than in the controls. Furthermore, the serum IgA level was significantly reduced after tonsillectomy, especially in patients showing improvement. From these results we conclude that tonsillectomy was effective for patients with IgA nephropathy complicated by tonsillitis when the operation was performed before deterioration of renal function.
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PMID:Chronic tonsillitis and IgA nephropathy. Clinical study of patients with and without tonsillectomy. 828 40

We designed a study to investigate the morphological expression of immune responses in the palatine tonsils from patients with IgA nephropathy. To distinguish between the histological characteristics of the tonsils in habitual tonsillitis (47 patients) and IgA nephropathy (11 patients), we studied the T nodules, B-lymphoid follicles, germinal centers, areas of mixed T and B lymphocytes, lacunar epithelium and connective tissues; then we compared patients with habitual tonsillitis and IgA nephropathy. The T nodules in patients with IgA nephropathy were enlarged, and this change was not accompanied by atrophy of B-lymphoid follicles. Morphologically, primary T nodules were predominant. In reactive lymph nodes, T nodules generally play an important role in the extra-follicular maturation of stimulated B lymphocytes into Ig-secreting plasma cells. Therefore the enlarged primary T nodules remind us that this maturation may occur more frequently in the tonsils of patients with IgA nephropathy than in those with habitual tonsillitis. This suggests that some immunoregulatory dysfunction exists in the secretory immune system of mucosa-associated lymphoid tissues in patients with IgA nephropathy.
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PMID:Expanded primary T nodules in the palatine tonsils from patients with IgA nephropathy. 828 41

Serum antibodies to whole cells of streptococci and serum immune complexes were investigated in patients with IgA nephropathy accompanied by tonsillitis and in healthy adult controls by enzyme-linked immunosorbent assay (ELISA). Serum IgA levels to Streptococcus salivarius, S. sanguis I and S. pneumoniae were higher in patients with IgA nephropathy than in healthy controls. The levels of IgG to S. pyogenes T12, S. gordonii and S. sanguis II in patients with IgA nephropathy were also higher than in healthy controls. Serum immune complexes of IgG and IgA were higher in patients with IgA nephropathy than in healthy controls. Serum levels of IgA to some strains of streptococci tended to correlate with the level of IgA immune complex in both patients and healthy controls. These results suggest that antibodies to some strains of streptococci play a role in the pathogenesis of IgA nephropathy.
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PMID:Role of serum antibodies to streptococci in patients with IgA nephropathy. 828 43

Renal biopsies of 43 patients who developed renal complications after treatment with antibiotics were studied. The treatment with antibiotics in these cases was used for many different reasons such as: bronchitis, bronchopneumonia, cystitis, tonsillitis, sepsis, peritonitis, gangrene of the foot and tuberculosis. The renal function of these patients, before the treatment with antibiotics was normal. The biopsies were studied by light, electron and immunofluorescence microscopy. In 43 cases treated with antibiotics renal changes were shown. Three types of morphologic changes were found: acute tubular necrosis (ATN) (13 cases), acute tubulo-interstitial diseases (ATID) (21 cases), focal glomerulonephritis with crescents (FGN) (9 cases). The renal pathologic changes were most commonly seen in patients treated with 2 groups of antibiotics: aminoglycosides (21 cases) and antibiotics of the penicillin group (15 cases). The most characteristic feature of aminoglycosides is their direct toxic effect leading to ATN. Antibiotics of the penicillin type more commonly caused an allergic reaction leading to ATID (secondary to cellular mechanisms) or FGN (secondary to a predominantly humoral mechanism). Renal changes in the use of other antibiotics were much less manifest and were usually due to a hypersensitivity reaction. Cephalosporins, if used in combination with other antibiotics can increase their nephrotoxicity.
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PMID:Antibiotic associated nephropathy. 870 64

Over the past 5 years, bilateral tonsillectomy has been performed in 104 patients (48 male and 56 female) with IgA nephropathy at the Department of Otolaryngology of Sendai Red Cross Hospital. We studied the relationship between remission rates as shown by urinary findings at one year after tonsillectomy and various clinical factors. Patients with mild or moderate renal pathology had higher postoperative remission rates of proteinuria than those with advanced renal pathology. There was a tendency for higher remission rates in patients with smaller tonsils. There were no significant differences relative to past history of tonsillitis, age, pus plugs in the lacunae, temporary deterioration of urinary findings after tonsillectomy, and results of provocation tests.
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PMID:Clinical study of chronic tonsillitis with IgA nephropathy treated by tonsillectomy. 908 74


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