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

The course of disease of a patient with membranoproliferative glomerulonephritis and partial lipodystrophy is described. The case is further characterized by a deficiency of C3 and C3- activator, by normal values of C4, by evidence of the nephritogenic factor, by raised fibrin degradation products and by an unselective proteinuria. The course of the glomerulonephritis runs parallel to a pronounced susceptibility to infection (at first varicella, tonsillitis and measles, later pneumonia, meningitis, encephalitis and hepatitis). On account of a nephrotic syndrome and an initative impairment of the renal function, a cytostatic treatment was begun, which although raising the C3 level did not influence the further course of the disease. As the patient has a healthy identical twin sister without lipodystrophy, who shows no reduction in C3 and no nephritogenic factor, this case proves that these diseases are acquired and not genetically determined.
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PMID:Membranoproliferative glomerulonephritis with partial lipodystrophy: discordant occurrence in identical twins. 12 86

Proteinuria of more than 500 mg/dl were present in 3% of all age groups in the village Pandhua. It is directly correlated with hypertension, scabies and recurrent history of tonsillitis. If any body suffers from hypertension, pyoderma and scabatic lesion the chances to have proteinuria is 86%.
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PMID:Study of proteinuria in a community. 184 93

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

A method of radioimmunologic quantitation of antibodies to streptococcal antigen separated from the cell wall extract of group A type T12 strain has been developed. The highest values of radioactive antigen binding were observed in acute glomerulonephritis (75%), as compared to chronic glomerulonephritis in which values of 25% to 56% were found depending on the morphology of renal changes. It was shown that none of the patients with pyelonephritis, Alport's syndrome, lupoid nephritis and polycystic renal disease had elevated antistreptococcal antibody levels. In contrast to this, all patients with tonsillitis and proteinuria exhibited increased titre of this antibody. It was shown that the antigen is related neither to M-protein nor to group A polysaccharide and that it is not type-specific because the binding of antigen T12 may be inhibited by the antigen produced from strain T5. Although the antigen is not type-specific, some differences in the response to antigens prepared from various types of streptococci in patients with different forms of chronic glomerulonephritis are observed.
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PMID:Use of radioimmunoassay for the detection of circulating antistreptococcal antibody in patients with glomerulonephritis. 703 91

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

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

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

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

We evaluated the efficacy of tonsillectomy plus pulse prednisolone, warfarin, and dipyridamole including methylprednisolone pulse (tonsillectomy plus pulse therapy), versus prednisolone, warfarin, and dipyridamole including mizoribine (PWDM) for the treatment diffuse IgA nephropathy (IgAN) in children. The patients were randomly assigned to be treated by tonsillectomy plus pulse therapy for 2 years (Group A, n=16) or PWDM for 2 years (Group B, n=16). The clinical features and pathological findings in both groups were analyzed prospectively. The mean urinary protein excretion after 6 months of treatment in both groups had decreased significantly compared with pre-therapy. The activity index (AI) in both groups was lower at the time of the second biopsy than at the time of the first biopsy. The chronicity index (CI) in Groups A and B did not differ between the first and second biopsy. At the latest follow-up examination none (0%) of the patients in either group had renal insufficiency. None of the patients in Group A, but six patients in Group B experienced an acute exacerbation of IgAN as a result of tonsillitis (P<0.05). In conclusion, although there was no untreated control group in this study, the results suggested that tonsillectomy plus pulse therapy is as effective as PWDM in ameliorating proteinuria and histological severity in IgAN patients and in preventing acute exacerbation of IgAN by tonsillitis.
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PMID:Efficacy of tonsillectomy pulse therapy versus multiple-drug therapy for IgA nephropathy. 1693 94


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