1/23. alpha-Interferon therapy for HBV-related glomerulonephritis.We report a case of a patient with hepatitis b virus (HBV)-related membranous glomerulonephritis (MGN) who showed improvement after interferon-alpha (IFN-alpha) therapy. A 35-year-old man with nephrotic syndrome and HBV antigens received a 24-week course of IFN-alpha. At the end of therapy there was an elevation in the level of plasma aminotransferase and an increase in proteinuria, which were followed by antigen/antibody seroconversion. This "flare-up" before seroconversion suggests an increase in disease activity in the liver and kidney, demonstrating in vivo HBV involvement in MGN.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/23. Pleural mesothelioma and membranous nephropathy.Underlying malignancy has been thought to be responsible for 5-10% of the cases of membranous nephropathy in adults, with the risk being highest in patients over the age of 60 years. Solid tumors such as carcinomas of lung or colon, are most often involved. It is presumed that tumor antigens are deposited in the glomeruli; this is followed by antibody deposition and complement activation, leading to epithelial cell and basement membrane injury and proteinuria due to the associated increase in glomerular permeability. We describe a patient with a resistant nephrotic syndrome and massive proteinuria due to membranous nephropathy associated with pleural mesothelioma.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
3/23. 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 = 5keywords = antigen (Clic here for more details about this article) |
4/23. Glomerular vasculopathy after unrelated cord blood transplantation.A 1-year-old boy with hemophagocytic lymphohistiocytosis exhibited proteinuria 1 month after unrelated cord blood cell transplantation, which persisted without hematuria. Laboratory study showed an increase of factor viii-related antigen and total plasminogen activator inhibitor, suggesting endothelial injury. Histological examination of autopsy materials showed increased mesangial matrices and double-contoured basement membranes, and ultrastructurally, swelling of the endothelial cells and widening of the subendothelial space with mesangial interposition. thrombosis was not observed at any of the sites. This case may be vasculopathy distinct from thrombotic microangiopathy (TMA) or a variant form of TMA following blood stem cell transplantation (BSCT). This vasculopathy should be considered in the differential diagnosis of proteinuria in the early stages after BSCT.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
5/23. gold nephropathy: serologic data suggesting an immune complex disease.Servlogical tests preformed on a patient with gold-induced nephropathy revealed a multitude of immunological phenomena preceding the onset of proteinuria. These included formtaion of tissue antibodies, rheumatoid factors and circulating immune complexes. An antigen sharing immunological determinants with DOC-extractable tissue antigens was released into circulation before and during proteinuria. Precipitating antibodies against this circulating antigen were found in one serum sample obtained 6 weeks before the complication was diagnosed. In this serum specimen, antibodies were also found which combined with saline extracts, DOC extracts containing the ubiquitous tissue antigen (UTA), and preparations obtained from various human organs by extraction at 100 degrees C followed by precipitation at 71% ethanol concentration (BE preparations). Most of the activities disappeared before the onset of proteinuria. The possible significance of these phenomena in the pathogenesis of nephropathy is discussed.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
6/23. Post-MRSA infection glomerulonephritis with marked Staphylococcus aureus cell envelope antigen deposition in glomeruli.A 48-year-old male developed massive proteinuria and renal dysfunction after pneumonia caused by methicillin-resistant staphylococcus aureus (MRSA) infection. Examination of a renal biopsy specimen by light microscopy showed severe mesangiocapillary proliferative glomerulonephritis with fibrocellular crescents. Immunofluorescence microscopy showed weak linear staining for immunoglobulin g (IgG), while both the peripheral and mesangial lesions stained for IgA and C3. Immunostaining for a possible antigen related to post-MRSA infection glomerulonephritis, using monoclonal antibody S1D6, revealed marked deposition of S.aureus cell envelope antigen in the glomeruli. Electron-dense deposits were observed in both the subendothelial and the mesangial areas. Focal subendothelial widening accompanied with monocytes or foam cell infiltration was also seen. The findings reflect a typical post-MRSA infection glomerulonephritis caused by S.aureus cell envelope antigen.- - - - - - - - - - ranking = 3.5keywords = antigen (Clic here for more details about this article) |
7/23. Transient massive proteinuria associated with mycoplasma pneumoniae infection.A 5-year-old girl presented with mycoplasma pneumoniae infection, which was associated with eyelid edema and massive proteinuria. Her clinical manifestations were similar to those of nephrotic syndrome, except for the absence of hypoproteinemia. light microscopy of renal biopsy tissue showed minor glomerular abnormalities, with no tubulointerstitial changes. Electron microscopy showed sparse fusion of the foot processes, regular nonthickened glomerular basement membrane, and no electron-dense deposits. Immunofluorescent staining of the glomeruli for immunoglobulins (IgG, IgA, IgM) and complement (C3, C4) was negative. Mycoplasma antigen was not detected by indirect immunofluorescence. These findings suggest a causal relationship between M pneumoniae infection and transient renal injury.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
8/23. 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 = 0.5keywords = antigen (Clic here for more details about this article) |
9/23. Renal consequences of narcotic abuse.heroin addiction is associated with several severe and occasionally fatal renal complications. Acute renal failure consequent to rhabdomyolysis and myoglobinuria, when treated supportively, carries a good prognosis. Staphylococcal or other bacterial septicemia may in itself prove fatal and is associated with a proliferative immune complex, acute glomerulonephritis, which generally follows the course and prognosis of septicemia. The necrotizing angiitis reported in heroin addicts still is largely undefined. Focal and segmental glomerular sclerosis is the most common pathologic finding in the syndrome of heroin-associated nephropathy (HAN). Typically, HAN presents with massive proteinuria and progresses rapidly to renal failure. Presumptive evidence supports the premise that heroin or its vehicles elicits immunologically mediated renal damage. The antigen still is unidentified. Removing the antigenic challenge by stopping heroin injection apparently interdicts the progression of renal disease. Renal transplantation can be effectively accomplished in patients with HAN without early recurrence if patients discontinue the use of heroin.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/23. A distinctive glomerular lesion complicating placental site trophoblastic tumor: report of two cases.Renal disease with distinctive pathologic features developed in two young women who had placental site trophoblastic tumors. The renal abnormalities were manifested by proteinuria in both cases and by hematuria in one case; blood pressure was elevated in one of the patients. Pathologic examination of the kidneys showed distinctive glomerular abnormalities, characterized mainly by the presence of occlusive eosinophilic deposits in many of the glomerular capillary lumina, most of which stained for fibrinogen-related antigens and IgM by immunohistochemical techniques. Ultrastructural examination showed the deposits to consist mainly of granular material that contained packets of fibrillar material with the appearance of fibrin. The uterine tumors were composed of mononucleated and multinucleated cells with abundant cytoplasm that infiltrated between the muscle bundles of the myometrium; in both tumors there was prominent deposition of eosinophilic material that had the tinctorial properties of fibrin and that stained for fibrinogen and IgM in immunoperoxidase studies. The renal abnormalities disappeared after hysterectomy in one case; the other patient, who was receiving chemotherapy and had disseminated intravascular coagulation, died with leukopenia and sepsis. The clinical and pathologic features in these cases suggest that the renal abnormalities were related to the uterine tumors and that the production of immune complexes and/or the activation of intravascular coagulation by the tumors were pathogenetic mechanisms.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
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