1/19. Botryoid wilms tumor: case report and review of literature.A rare case of botryoid wilms tumor is presented. The main clinical manifestations were persistent low-grade fever, malaise, and proteinuria associated with microhematuria. ultrasonography revealed an echogenic mass in the right kidney, and a contrast-enhanced mass was found in the dilated collecting system by contrast-enhanced computed tomography. The surgically resected tumor was a polypoid, light-yellow, glistening mass that occupied a large part of the renal pelvis and originated from the pelvicaliceal wall. Part of the tumor extended to the proximal ureter, resulting in hydronephrosis in the involved kidney. No parenchymal lesion was observed. Microscopic examination revealed epithelial, stromal, and blastemal components, which indicated wilms tumor. Infection had occurred in the hydronephrotic kidney, which presumably had caused the major presenting symptoms. The prognosis of our patient and previously reported cases of botryoid wilms tumor was good compared with that of typical wilms tumor, since the botryoid type can be detected at an early stage.- - - - - - - - - - ranking = 1keywords = nephrosis (Clic here for more details about this article) |
2/19. The correlation of serum carbohydrate antigen 19-9 with benign hydronephrosis.PURPOSE: High serum carbohydrate antigen 19-9 in patients with hydronephrosis but without malignant disease is reportedly rare but to our knowledge the clinical features of hydronephrosis that affect this level have not yet been clarified. We examined the correlation of serum carbohydrate antigen 19-9 with hydronephrosis status in patients with benign hydronephrosis. MATERIALS AND methods: We used 123 serum samples from 68 patients with and 55 without hydronephrosis. All patients enrolled in this study had no malignant disease. Serum carbohydrate antigen 19-9 was measured by immunoradiometric assay and that level was correlated with clinical factors. RESULTS: Serum carbohydrate antigen 19-9 in patients with hydronephrosis was significantly higher than in those without hydronephrosis (p <0.0001). The serum level was elevated to greater than 37 units per ml. in 25% of the patients with but in only 1.8% of those without hydronephrosis. In the hydronephrosis group the clinical features that significantly correlated with the increased serum level were bilateral hydronephrosis, urinary tract infection, proteinuria, increased serum blood urea nitrogen, severe urinary tract occlusion and high grade hydronephrosis. CONCLUSIONS: Serum carbohydrate antigen 19-9 was significantly elevated in patients with benign hydronephrosis. hydronephrosis causes false-positive results when screening for malignant disease by serum carbohydrate antigen 19-9 measurement.- - - - - - - - - - ranking = 17keywords = nephrosis (Clic here for more details about this article) |
3/19. Minimal change nephrotic syndrome revealing solid tumors.In 2 patients with the nephrotic syndrome, unsuspected solid tumors were found. One was a small cell lung carcinoma, accompanied with the syndrome of inappropriate ADH secretion. The other was a cancer of the breast with lymph node and bone metastases. In both, renal biopsy showed minimal change disease without immune complex deposits. There are only 14 other reported cases of paraneoplastic lipoid nephrosis complicating solid tumors. Such cases lead to the discussion on the respective roles of tumor cell gene product(s) inducing proteinuria and of lymphokine secretion by lymphocytes directed against the tumor itself. Cancer should be considered as a possible etiology of the minimal change nephrotic syndrome in the adult.- - - - - - - - - - ranking = 1keywords = nephrosis (Clic here for more details about this article) |
4/19. Corticosteroid- and furosemide-induced increase in proteinuria in nephrosis.A corticosteroid- and furosemide-induced excessive increase in proteinuria developed in a 34-year-old nephrotic patient with focal glomerulosclerosis. The concentration of urinary protein increased almost in parallel with that of urinary glucose. This finding indicates that corticosteroids and/or furosemide can promote the disturbance of the tubular reabsorption mechanism together with increases in glomerular permeability and glomerular filtration rate.- - - - - - - - - - ranking = 4keywords = nephrosis (Clic here for more details about this article) |
5/19. Acute human immunodeficiency virus infection temporally associated with rhabdomyolysis, acute renal failure, and nephrosis.A previously healthy 29-year-old homosexual man presented with a 4-day history of fever, malaise, sore throat, and bleeding gums. rhabdomyolysis, acute renal failure, and nephrotic range proteinuria were also present. The patient was found to have acute human immunodeficiency virus (hiv) infection confirmed by the presence of hiv antigen in his serum and subsequent evolution of an hiv antibody profile typical of acute seroconversion. A kidney biopsy revealed acute tubular necrosis and mesangioproliferative glomerulonephritis, with tubuloreticular inclusions. In the presence of otherwise unexplained acute renal failure, rhabdomyolysis, or new onset nephrotic syndrome, acute hiv infection should be considered in the differential diagnosis.- - - - - - - - - - ranking = 4keywords = nephrosis (Clic here for more details about this article) |
6/19. SDS-PAGE as an additional test to determine fetal kidney function prior to intrauterine diversion of urinary tract obstruction.The analysis of urine obtained from fetuses with hydronephrosis, seen on ultrasound, can give a misleading assessment of residual renal function. Additional parameters for assessment of fetal renal function would be helpful. We have used SDS-polyacrylamide gel electrophoresis to separate urinary proteins from a fetus with obstructive uropathy and severe oligohydramnios, already present at 18 weeks of gestation. The dilated urinary bladder of the fetus was successfully shunted in utero with a double pigtail catheter which worked for 17 weeks, and a boy without renal or pulmonary insufficiency was born at 36 weeks. In this case the prenatal protein analysis by electrophoresis was a better indicator of the ultimate good pregnancy outcome than the evaluation of urinary electrolytes and osmolarity alone. We therefore suggest the addition of this test to the profile of renal function studies performed on fetal urine.- - - - - - - - - - ranking = 1keywords = nephrosis (Clic here for more details about this article) |
7/19. Remission of idiopathic nephrotic syndrome after treatment with cyclosporin A.nephrotic syndrome in minimal change lipoid nephrosis and focal segmental glomerulosclerosis may be due to alteration of glomerular anionic sites by a lymphokine. Six adults with nephrotic syndrome who were resistant to treatment with corticosteroids and immunosuppressants were treated with cyclosporin A. In three patients with minimal change lipoid nephrosis who had been nephrotic for 3.5 to 23 years proteinuria resolved within 12 to 42 days. Subsequently, these patients became dependent on cyclosporin A. In three patients with focal segmental glomerulosclerosis who had been nephrotic for four to six years mean (SD) 24 hour urinary protein decreased from 14.7 (8.4) g to 3.6 (0.6) g within 20 to 25 days, serum albumin concentration rose, and oedema subsided. One patient died of myocardial infarction when still in partial remission after 11 weeks' treatment. Two patients remained proteinuric despite continuing treatment with cyclosporin A, but control of sodium balance was easy and serum albumin concentrations remained higher than without cyclosporin A. In all patients renal function improved during treatment. These preliminary results show that cyclosporin A may be effective in the treatment of patients with nephrotic syndrome that resists every other form of treatment and especially in the treatment of those with minimal change lipoid nephrosis. The results are in keeping with a T lymphocyte mediated mechanism of minimal change lipoid nephrosis and focal segmental glomerulosclerosis, but they also suggest that minimal change lipoid nephrosis and focal segmental glomerulosclerosis are separate entities.- - - - - - - - - - ranking = 5keywords = nephrosis (Clic here for more details about this article) |
8/19. recurrence of IgA nephropathy with nephrotic syndrome in renal allograft.A 59-year-old female presented with peripheral oedema in association with an upper respiratory tract infection in August 1980. On examination she was found to have nephrotic range proteinuria, haematuria, slightly decreased renal function and elevated blood pressure. Renal biopsy showed mesangial proliferative glomerulonephritis with mesangial IgA and C3 deposits. She was treated with corticosteroids and later with cyclophosphamide, but without any response. 1 year after the onset of disease, she developed terminal renal failure. In December 1981, she received a cadaveric renal allograft; thereafter renal function became normal but she remained proteinuric, and developed fulminant nephrosis within 2 years. A transplant biopsy revealed alterations in the graft, indicating recurrence of the original disease.- - - - - - - - - - ranking = 1keywords = nephrosis (Clic here for more details about this article) |
9/19. Vesicoureteral reflux, proteinuria and renal failure.We report 3 cases of proteinuria, progressive renal insufficiency and vesicoureteral reflux with no history of urinary tract infection. Renal histology showed focal segmental glomerulosclerosis. These associations are unusual during childhood but they are common in adults. Generally, vesicoureteral reflux is discovered during radiological evaluation of children with recurrent urinary tract infections. Renal parenchymal damage in children typically results from recurrent infection or progressive hydronephrosis. Development of proteinuria with vesicoureteral reflux usually indicates an irreversible glomerular lesion. Antireflux surgery in patients with vesicoureteral reflux and decreased renal function may be beneficial if performed before the onset of proteinuria. We recommend antireflux surgery for children with persistent vesicoureteral reflux or decreased renal function.- - - - - - - - - - ranking = 1keywords = nephrosis (Clic here for more details about this article) |
10/19. renin-induced massive proteinuria in man.A 30 year old man developed renovascular hypertension and extreme elevation of plasma renin activity. Daily proteinuria ranged from 13 to 31 g. There were no criteria for the diagnosis of malignant hypertension. A primary glomerulopathy was excluded by a basically normal renal biopsy from the unprotected kidney. On electron microscopy the epithelial cell foot processes were not fused, thus ruling out simultaneous lipoid nephrosis. The source of renin was removed by means of a left nephrectomy. Following the procedure the patient became normotensive, the renin values normalized and the proteinuria disappeared. The results suggest that renin can cause significant proteinuria in man.- - - - - - - - - - ranking = 1keywords = nephrosis (Clic here for more details about this article) |
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