Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149514 (bronchitis)
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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

IgA nephropathy (IgAN) was first reported by Berger in 1968, and characterized by diffuse IgA deposition in the mesangium. Patients with IgAN have usually episodic macroscopic hematuria accompanied with pharyngitis, gastroenteritis, bronchitis, or sinusitis. These findings suggest that IgAN is an immune-complex disease resulting from a poorly controlled mucosal immune response to environmental antigens to which the patient was chronically exposed. We reported the glomerular deposition of the outer membrane of Haemophilus parainfluenzae (OMHP) antigens and the presence of IgA antibody against OMHP in the sera of patients with IgAN. These suggest that Haemophilus parainfluenzae plays a role in the aetiology of this disease. This study was conducted to determine whether OMHP antigens induced immunohistologically evident glomerular deposition of IgA and C3 in C3H/HeN mice. Female C3H/HeN mice (4 weeks old) received intraperitoneal injection (HP-IP group), and oral administration (HP-PO group) of OMHP antigens. The control group similarly received intraperitoneal injection of PBS, and oral intake of ordinary water. The mice were sacrificed at 10, 20, 30, 40, 50 weeks after the start of the experiment. The HP-IP group showed glomerular deposition of IgA, C3 and OMHP antigens, glomerular changes (Mesangial hypercellularity and increase in mesangial matrix) after 20 weeks. The HP-PO group showed only mild deposition of IgA, and mild increase in mesangial matrix. These results suggest that OMHP antigens play a role in the glomerular deposition of IgA and C3 in C3H/HeN mice. This is the first use of OMHP antigens to establish an active model of IgAN.
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PMID:[Haemophilus parainfluenzae and IgA nephropathy]. 1051 4

Henoch Schonlein purpura (HSP) is an immune mediated disease associated Immunoglobulin A (IgA) deposition within the affected organs. While the disease is commonly seen in the pediatric age group, it is rarely seen in adults. We report the case of a 93-year-old Caucasian lady who presented with nonthrombocytopenic purpuric rash and acute kidney injury after an episode of bronchitis. Rapid and progressive deterioration of renal function prompted a kidney biopsy, which showed findings consistent with IgA nephropathy confirming the diagnosis of HSP. The patient was treated with high dose intravenous methylprednisolone followed by oral prednisone; however, her kidney disease progressed to end stage renal disease requiring hemodialysis. HSP is usually a self-limiting disease in children. However, adults are at an increased risk of severe renal involvement including end stage renal disease. Purpuric skin rash with renal involvement should raise suspicion for HSP. This is the oldest known patient with HSP.
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PMID:Henoch Schonlein Purpura as a Cause of Renal Failure in an Adult. 2767 95