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Query: UMLS:C0042384 (vasculitis)
 20,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The World Health Organization (WHO) classification of lupus (SLE) nephritis was published almost 20 years ago, and there is world-wide recognition of its utility in the diagnosis and treatment of SLE glomerulonephritis (GN). However, a number of problems have been recognized: The classification of severe segmental (WHO class III > or = 50%) and membranous glomerulonephritis (MGN) complicated by the lesions of severe segmental or diffuse GN (WHO classes Vc > or = 50% or Vd) is ambiguous; The implications of non-immune complex pathogenic mechanisms are not acknowledged and SLE interstitial nephritis and vasculitis are not included in the current classification. We propose a revision that retains the classes of the current WHO classification. Informed by investigations utilizing the WHO classification, it places severe segmental GN in class III (segmental GN) and mixed MGN and segmental and diffuse GN in class V (MGN). It optimizes the use of electron and fluorescence microscopy in defining controversial and ambiguous lesions. It develops subclasses based upon pathogenic insights gained since the advent of the WHO classification. Finally, it recognizes the need to include the disease specific lesions of SLE tubulointerstial nephritis and vasculitis.
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PMID:Rewriting the histological classification of lupus nephritis. 1251 69

The authors report the case of a 47-year-old woman in whom a systemic illness developed characterized by fever, malaise, abnormal liver function results, and acute renal failure after treatment for presumed urinary tract infection with levofloxacin. Because of suspicion of an allergic drug reaction, all medications were discontinued, but the patient remained febrile with renal failure for 18 days. Complete workup for presumed vasculitis, autoimmune illness, or infectious etiologies was negative, and the patient underwent both renal and liver biopsy. Liver biopsy results showed nonspecific changes. Renal biopsy disclosed extensive granulomatous interstitial nephritis with associated granulomatous vasculitis. The patient was begun on oral steroids with rapid defervescence of fever and progressive normalization of renal function. The authors discuss the association of granulomatous nephritis with drugs and review the known nephrotoxicity of fluoroquinolones.
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PMID:Levofloxacin-induced granulomatous interstitial nephritis. 1255 23

Renal involvement is common in leptospirosis. Clinical manifestations vary from urinary sediment changes to acute renal failure. Renal failure is observed in 44% to 67% of patients. Hypokalemia frequently occurs. Severe hypotension is an important warning sign for the later development of renal and pulmonary complications. Prognosis of the disease is generally good except for its association with pulmonary complications, especially pulmonary hemorrhage and acute respiratory distress syndrome. Interstitial nephritis is the basic renal lesion. Vasculitis is observed in the acute phase of the disease. Tubular necrosis and interstitial nephritis are responsible for renal failure. Glomerular changes usually are not remarkable. Hemodynamic alterations, immune response, and direct nephrotoxicity are responsible for the development of renal lesions. As in many infectious diseases, decreased renal blood flow and glomerular filtration rate play a basic role. Bacterial invasion and toxicity of outer membrane with generation of cytokines, chemokines, and cellular infiltration are important in cellular injury.
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PMID:Leptospiral nephropathy. 1256

The nomenclature of ulcerative dermatitis as used in literature is somehow confusing because on the one hand this skin disorder is associated with bacterial growth and on the other hand it is a synonym for a chronic sporadic disease of adult sows with unknown aetiology. Thus, we propose the terminus 'Porcine Ulcerative Dermatitis Syndrome (PUDS)' for the latter to distinguish between these two disease complexes. This syndrome could be identified by clinical and pathological examinations in six sows, that were submitted to the clinic. Epidermal ulcers could be found nearly all over the body, but teats were always spared. Haematological examination showed a slight anaemia but physiological leucocyte counts. However, lymphopenia (x = 44.8%), granulocytosis (x = 42.0%) and an increased number of monocytes (x = 13.1%) could be found. Histologically, a lymphoplasmacytic and granulohistiocytic infiltration in the corium was most prominent. In some cases, a moderate leucocytoclastic vasculitis and perivasculitis could be seen at the dermo-epidermal border. Additionally, a multifocal interstitial nephritis with lymphoplasmacytic infiltration was a prominent feature in all animals. Participation of an immune complex associated disorder can be assumed when regarding histological findings as skin lesions in combination with glomerulonephritis are a common feature of such diseases. Also, IgG levels were elevated two- to fourfold in all affected sows when compared with healthy control pigs. This supports the hypothesis that not only T cells, as shown previously, but also the humoral branch of the immune system is involved in the aetiology of PUDS.
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PMID:Clinical and pathological features of the Porcine Ulcerative Dermatitis Syndrome (PUDS). 1508 5

The study was undertaken to study the frequency, causes, and efficiency of treatment for acute renal failure (ARF) at the intensive nephrological care unit. The data on 117 patients with ARF of various etiology were studied. In them, ARF was caused by acute interstitial nephritis in 18.8%, by urosepsis in 18.8%, by non-urological sepsis in 19%, by destructive pancreatitis in 18%, in 13% rapidly progressive glomerulonephritis was present in systemic vasculitis. In 8.5% of the patients, ARF developed as a complication of severe pneumonias along with respiratory failure. Only single cases were presented with ARF of other intoxication etiology, crush syndrome, or acute vascular diseases. Renal replacement therapy was used in all cases. Its mode (intermittent or low-flow continuous) was determined by the severity of renal failure and the general condition of patients. The overall mortality was 38% in the whole group. It was 55% in sepsis, 33% in destructive pancreatis, 8.3% in urosepsis, 8% in acute interstitial nephritis, 64.7% in rapidly progressive glomerulonephritis. According to the type of therapy, there were no significant differences in mortality rates. There was also a correlation of the mortality rates and the APACHE score.
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PMID:[The structure of causes of acute renal failure and the efficacy of its treatment according to the materials of an intensive nephrological care unit]. 1593 98

Systemic vasculitis may, at times, be drug-induced and associated with antineutrophil cytoplasmic antibodies (ANCA). However, pantoprazole, a commonly used and well-tolerated proton pump inhibitor, has not previously been reported to cause ANCA-associated syndromes. We describe a patient who developed interstitial nephritis, cutaneous vasculitis, a perinuclear ANCA staining pattern (pANCA) on immunofluorescence, and anti-myeloperoxidase antibodies (MPO-ANCA) in association with pantoprazole. We review various immune-mediated syndromes reported in association with proton pump inhibitors, including one report of omeprazole associated with interstitial nephritis and the development of ANCA.
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PMID:Pantoprazole and perinuclear antineutrophil cytoplasmic antibody-associated vasculitis. 1648 42

From July 1998 to July 1999, 45 cases of acute renal failure were treated at Bir Hospital, Kathmandu. Out of which 24 were male and 21 were female. Age ranged from 11 months to 84 years with mean age being 35 years and 9 cases were below 10 years. Four cases with pre-renal azotaemia and twenty five cases of acute tubular necrosis (ATN) accounted for 64% of all cases. These were due to gastroenteritis 10, sepsis 6, post surgical 1, trauma 1 and obstretical complications 5. Multiple hornet stings were responsible for acute renal failure in 3 cases, acute urate nephropathy in 1 case and miscellaneous causes in 2 cases. Glomerulonephritis / vasculitis accounted for 17.7%, acute interstitial nephritis 4.4%, haemotytic uraemic syndrome (HUS) 6.6%, and post renal azotaemia in 6.6% of all cases. Mean serum creatinine was 8 mg/dl, mean blood urea 190 mg/dl. Eight cases were treated only conservatively, eighteen received haemodialysis, fourteen received peritoneal dialysis, three received both and two refused for dialysis. Average duration of hospital stay was 13.6 days. Out of the forty-five cases twenty-nine recovered normal renal function, ten expired, two recovered partially, two progressed to chronic renal failure and two left against medical advice. Overall mortality was 22.2%. Common causes of acute renal failure in our setting were gastroenteritis (22%) and sepsis (20%). HUS was exclusively seen in children following bacillary dysentery. Multiple hornet stings is an important cause of acute renal failure in our country.
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PMID:Acute renal failure in a tertiary care center in Nepal. 1655 67

A 15-year-old girl with a history of Kawasaki disease was admitted to our nephrological department due to acute renal failure. Despite antibiotic therapy because of fever and the symptoms of a pharyngitis in the last few days, the girl showed persisting fever and developed arthralgias, an exanthema and a rising serum creatinine as well as anuria. A wide variety of differential diagnoses has to be thought of because of the history of the Kawasaki disease (symptoms like fever, pharyngitis, exanthema and arthralgia), i.e. hemolytic-uremic syndrome, vasculitis, ascending infection, postinfection glomerulonephritis. In consideration of etiologically unclear "rapidly progressive renal failure" with anuria and thrombocytopenia an immediate renal biopsy was done and revealed a severe drug induced acute interstitial nephritis. Due to this diagnosis we treated the patient with corticosteroids. Within 4 weeks serum creatinine declined to 1.8 mg/dl but did not normalize.
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PMID:Exanthema and acute anuric renal failure. 1672 58

There is a broad clinical spectrum of renal involvement in snakebite. Besides the local and systemic symptoms, clinical renal manifestations vary from mild proteinuria, haematuria, pigmenturia to acute renal failure. Bites by haemotoxic snakes and myotoxic snakes are the common causes of renal involvement especially acute renal failure. Therefore, renal failure is often associated with haemorrhagic diathesis, intravascular haemolysis and rhabdomyolysis. Renal pathological changes include mesangiolysis, glomerulonephritis, vasculitis, tubular necrosis, interstitial nephritis and cortical necrosis. Tubular necrosis is an important pathological counterpart of acute renal failure. Haemodynamic alterations induced by cytokines and vasoactive mediators leading to renal ischaemia are important in the pathogenesis of acute renal failure. Haemolysis, intravascular coagulation and rhabdomyolysis are important contributing factors. Direct nephrotoxicity can be induced by the venom through metalloproteases and phosphilipase A2. Immunologic mechanism plays a minor role in the pathogenesis of the renal lesion.
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PMID:Snakebite nephropathy. 1701 59

This prospective study was undertaken to study the spectrum of renal failure and the outcome in elderly patients. Patients included in the study group were elderly (age>60 years) who either attended outpatient renal clinic and or were hospitalized. Renal failure was classified as acute renal failure (ARF), rapidly progressive renal failure (RPRF) and chronic renal failure (CRF). A total of 4255 elderly patients were seen, of these 236 (5.5%) had renal failure. Mean age was 65.1+/-4.2 years (60-86 years). CRF was the commonest, seen in 137 (58.1%) followed by ARF 69 (29.2%) and RPRF in 30 (12.7%) patients. Diabetic nephropathy was the commonest cause of CRF, seen in 58.4% followed by chronic interstitial nephritis in 9.5% and chronic glomerulonephritis in 8.7% of patients. Of 137 patients 53 (38.7%) presented in end stage renal disease (ESRD). Of these 41 (77.3%) were initiated on maintenance hemodialysis and 12 (22.6%) on continuous ambulatory peritoneal dialysis. Only 15 patients were on dialytic support at the end of 1 year. Sepsis contributed to ARF in 75.4% of cases. Forty of 69 patients (57.9%) needed dialytic support. Forty (57.9%) were critically ill, defined as presence of two or more organ system failures (excluding renal failure). Forty two patients (60.9%) died patients. Acute interstitial nephritis (AIN) was the commonest cause of RPRF seen in 10 (33.3%) patients followed by vasculitis in 7 (23.3%). Myeloma cast nephropathy contributed towards RPRF in 20% of patients. Of 30 patients, 10 (33.3%) reached ESRD at end of 3 months of follow up, 4 (13.3%) died due to sepsis. Only 2 showed complete recovery while 14 (46.6%) had partial improvement. AIN patients had a relatively better outcome.
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PMID:Spectrum of renal failure in elderly patients. 1724 50


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