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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A relation between kidney and inner ear disease, specifically neurosensorial hearing loss, has been established. Likewise, the role of tonsillitis in certain glomerulonephritides is well known. A case of post-streptococcal mesangial glomerulonephritis with IgA deposit (Berger's disease) and neurosensorial hearing loss is reported. The absence of any relevant family or personal history suggests an immunological origin for both disorders.
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PMID:[Berger's disease and acquired sensorineural hearing loss]. 919 66

Tonsillectomy seems to be a logical step in IgA nephropathy owing to the frequent tonsillitis before the beginning and the acute exacerbations of the disease. The usefulness of tonsillectomy is questionable because there are only few and short-term follow-up data after it. We followed up 35 kidney biopsy proven IgA nephropathy patients (25 men and 10 women) for an average of 12.2 yrs (range 7-32) after tonsillectomy. The values of endogenous creatinine clearance, serum creatinine, hematuria and proteinuria were compared at regular intervals during a follow-up with those obtained before tonsillectomy. We considered more than 12,000 data using 2 tailed t test. We found that proteinuria started to decrease significantly already 6 months after tonsillectomy (1.40 +/- 0.27 g/day before tonsillectomy vs 0.92 +/- 0.25 g/day after it, p < 0.05) and was significantly lower under follow-up. The tendency in microhematuria was similar (70.5 +/- 35.0 million RBC/12 hours before and 14.0 +/- 6.5 million RBC/12 hours 6 months after tonsillectomy, p < 0.0001). Furthermore, tonsillectomy stopped gross hematuria appearing in the acute exacerbation of the disease in more than two-thirds of patients. Creatinine clearance did not change in the first 2 years after tonsillectomy, however, from 2.5 years after it is significant slow and continual decrease started (117.0 +/- 9.8 ml/min before and 106.2 +/- 10.8 mil/min 2.5 yrs after tonsillectomy, p < 0.05). End-stage renal failure was detected only in 4 patients out of 35 after 10 years after tonsillectomy, in our non-tonsillectomised control group in 8 patients out of 40.
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PMID:[Does tonsillectomy cause any change in long-term course of IgA nephropathy?]. 925 43

I investigated several factors that can predict the effect of tonsillectomy for the prevention of renal failure in IgA nephropathy patients. Samples were obtained from 71 patients (35 male and 36 female) who were diagnosed as having IgA nephropathy by renal biopsy and the patients were followed-up for more than 5 years. Mean age at the time of renal biopsy was 28.3 years (8-58 years), and the mean follow-up period was 9 years 9 months (5-19 years). The overall remission rate of IgA nephropathy after tonsillectomy was 28.2%, and the retention rate of renal function was 90.1%, showing a considerably better prognosis than alternative therapies previously reported. Statistical analysis of multiple prognostic factors were examined including the following: sex, age-at-biopsy, renal pathological findings, renal function, serum IgA level, hypertension, past history of tonsillitis, preoperative results of tonsillar provocation test, and the period from diagnosis to tonsillectomy. A statistically significant poorer prognosis after tonsillectomy was observed in the following conditions: < or = 20-years-old when diagnosed, serum creatinine level > or = 1.3 mg/dl, urinary protein > or = 1.0 g/day, serum IgA level > or = 350 mg/dl. No other factors affected the prognosis of renal function statistically, including past history of tonsillitis or positive result of tonsillar provocation test. The present study indicates that there is a beneficial effect of tonsillectomy for mild to moderate IgA nephropathy and that this operation may be indicated for IgA nephropathy as long as the pathological grading is not advanced. On the other hand, tonsillectomy was not effective in cases with poor renal function. Although a past history of tonsillitis and positive results in tonsillar provocation tests have been widely considered as good indicators of tonsillectomy for IgA nephropathy, the present study showed no benefit to consideration of these factors preoperatively.
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PMID:[Therapeutic effects and prognostic factors of tonsillectomy for IgA nephropathy in long-term follow-up]. 1002 23

Upper respiratory tract infection including chronic tonsillitis is considered to be involved in the onset and/or the progression of IgA nephropathy. It is well known that deterioration of urinary findings occurs after episodes of upper respiratory tract infection in patients with IgA nephropathy. We previously showed that the expression of macrophage-colony-stimulating factor (M-CSF) is increased in the glomeruli of patients with IgA nephropathy and correlated with glomerular mesangial proliferation, suggesting that M-CSF plays an important role in the progression of IgA nephropathy. In the present study, we measured the serum and urinary concentrations of M-CSF in patients with IgA nephropathy associated with chronic tonsillitis. Furthermore, we evaluated the effects of the local provocation test of tonsils (mechanical tonsil stimulation) on the serum and urinary concentrations of M-CSF in the following three groups: (1) IgA nephropathy with severe mesangial proliferation, (2) IgA nephropathy with mild mesangial proliferation, and (3) patients with chronic tonsillitis without renal disease. The serum and urinary levels of M-CSF in the groups with severe and mild IgA nephropathy were significantly higher than those in the chronic tonsillitis group. The urinary M-CSF level but not the serum M-CSF level was positively correlated with the degrees of mesangial proliferation and glomerular M-CSF expression in the renal biopsy specimens. The urinary M-CSF concentration was significantly increased after tonsillitis stimulation in both mild and severe IgA nephropathy groups. Enhanced urinary excretion of M-CSF prolonged for 7 days after tonsil stimulation in the severe IgA nephropathy group; in contrast, the urinay M-CSF level was increased for only 2 days after tonsil stimulation in the mild IgA nephropathy group. The urinary M-CSF level was not changed in the chronic tonsillitis group after tonsil stimulation. The serum concentrations of M-CSF were not changed after tonsil stimulation in these three groups. Our present results suggest that tonsil stimulation contributes to the progression of IgA nephropathy via enhancement of glomerular production of M-CSF. The urinary excretion of M-CSF may be a useful predictor to evaluate the relevance of chronic tonsillitis to the disease and the indication of tonsillectomy in patients with IgA nephropathy.
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PMID:Increased urinary excretion of macrophage-colony-stimulating factor (M-CSF) in patients with IgA nephropathy: tonsil stimulation enhances urinary M-CSF excretion. 1005 79

The frequent occurrence of tonsillitis or upper respiratory tract infections preceeding exacerbations of haematuria in IgA nephropathy (IgAN) suggests a relationship to the pathogenesis. Since it has been shown that release of type I interferon (IFN-alpha) can promote the release of BAFF which aids maturation of B lymphocytes, and IFN-alpha is released as part of innate immunity to pathogens of the upper respiratory tract, it is suggested than IFN-alpha may trigger the pathogenic process of IgAN. How cells in the tonsils contribute and whether Il-6 formation in the lungs also helps development of Th.2 lymphocytes are to be considered.
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PMID:Is IgA nephropathy induced by hyperproduction of interferon-alpha? 1505 Jan 19

Although there are many papers about IgA nephropathy (IgAN) and tonsils, respectively, reviews about the relationship between tonsils, tonsillitis, tonsillectomy, and IgAN are limited. In this review, we introduced the structure, development, and function of tonsils, difference of tonsils with and without IgAN, consistency of both tonsillar IgA and glomerular IgA, the effect of tonsil stimulation, tonsil infection, and tonsillectomy on IgAN showed some evidences in which tonsils were closely related to IgAN and polymeric IgA1 deposited in glomerular mesangium were at least in part of tonsillar origin. Tonsillectomy can improve the urinary findings, keep stable renal function, improve mesangial proliferation and IgA deposit, have a favorable effect on long-tern renal survival in some IgAN patients, and do not cause significant immune deficiency and do not increase incidence of the upper respiratory tract infections, and can be used as a potentially effective treatment. The indications of tonsillectomy in patients with IgAN include mainly the deterioration of urinary findings after tonsillar infection, mild or moderate renal damage. However, tonsillectomy may not be enough and may not change the prognosis in IgAN patients with marked renal damage.
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PMID:Relationship between tonsils and IgA nephropathy as well as indications of tonsillectomy. 1508 52

Our study hypothesized that cytokines or chemokines induced in tonsils by infectious stimulations play an important role on the exacerbation of the glomerular injuries in patients with IgA nephropathy (IgAN). Tonsils from six patients with IgAN diagnosed by renal biopsy were studied after getting their written informed consents Tonsils from six patients with tonsil disorders with non-renal disorders were examined as controls. Tonsillar mononuclear cells (TMCs) were isolated and resuspended with RPMI 1640 with 10% FCS. These cells were incubated for 48 h with staphlococcus enterotoxin-B (SEB) or lipopolysaccaride (LPS). The levels of IL-6, IL-8, IL-12 and MCP-1 in the supernatants were measured by solid-phase enzyme-linked immunosorbent assay (ELISA) kits. The actual cytokine concentrations were calculated by determining the standard curves. The experiments were performed in duplicate, and the mean value was calculated. We found that tonsillar mononuclear cells of IgA nephropathy produced mesangial proliferative chemokines (MCP-1, IL-8) in higher amounts compared to tonsils from non-IgA nephropathy. This result suggests that upper respiratory tract infections such as tonsillitis may be one of the risk factors of the aggravation in patients with IgA nephropathy.
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PMID:Immunity of tonsil and IgA nephropathy--relationship between IgA nephropathy and tonsillitis. 1576 89

The temporal association of tonsillitis and hematuria or proteinuria in IgA nephropathy suggests that there might be a link between the physiological properties of the secondary lymphoid organ that tonsils represent and the mesangial deposition of IgA characteristic of this nephropathy. A number of clinical and ex-vivo data support this hypothesis. One of the earliest was the demonstration of the dimeric nature of mesangial IgA, composed of IgA monomers linked by a J chain, yet lacking the polyIg receptor acquired by secretory IgA during transcytosis through epithelial cells. This molecular structure is that of IgA synthesized in human tonsils, the epithelium of which lacks polyIg receptor. Moreover, tonsils from patients with IgA nephropathy display an abnormal partition of IgG and IgA producing plasma cells associated with a significantly developed web of high endothelial venules. IgA nephropathy could thus be in part related to an alteration of IgA precursors homing in tonsils. Tonsillectomy thus would present the advantage of removing an abnormally functioning source of dimeric IgA. Performed early enough in the course of the renal disease, tonsillectomy could suffice to halt the development of the nephropathy and restore the kidneys to health.
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PMID:Clinical involvement of the tonsillar immune system in IgA nephropathy. 1576 90

We have previously reported that clinical remission could be achieved by combination therapy consisting of steroid pulse therapy and tonsillectomy in patients with IgA nephropathy. However, there is no consensus as to the indications for tonsillectomy in IgA nephropathy (IgAN) patients. To clarify whether there is any correlation between characteristics of removed palatine tonsils and clinical remission rate, we evaluated the relationships between the remission rate of urinary abnormalities and characteristics of 186 IgAN patients (aged 11-65 years) with mild or moderate renal pathology and their tonsils. Remission of proteinuria was observed in 134 patients (72%) and remission of hematuria was observed in 111 patients (60%). There was no significant difference in remission rate of either proteinuria or hematuria in terms of the past history of recurrent tonsillitis, episodes of synpharyngitic gross hematuria, pus plugs in the tonsillar lacunae, size of tonsils, age and the results of tonsillar provocation tests. Our findings suggest that it is very difficult to predict the efficacy of tonsillectomy and steroid pulse therapy based on the gross appearance of tonsils, the tonsillar provocation test or clinical episodes of tonsillitis. Moreover, contraindication of tonsillectomy for aged IgAN patients is not always justified.
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PMID:Clinical observation of palatine tonsils with IgA nephropathy. 1576

Berger's disease, so called IgA nephropathy, is a mesangioproliferative glomerulonephritis characterized by recurrent episodes of gross hematuria in relation with ENT infections like tonsillitis. We report a clinical case which presented that association and make a review of the literature about the possible advantages of tonsillectomy on the evolutive course and prognosis of the nephropathy.
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PMID:[Relationship between repeating tonsillitis and Berger's disease. Report of A case and review of the literature]. 1656 97


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