Comparison of lupus patients with early and late onset nephritis: a study in 71 patients from a single referral center

Abstract Background: Nephritis occurs frequently in systemic lupus erythematosus (SLE) and may worsen disease morbidity and mortality. Knowing all characteristics of this manifestation helps to a prompt recognition and treatment. Aim: To compare the differences in clinical data, serological profile and treatment response of nephritis of early and late onset. Methods: Retrospective study of 71 SLE patients with biopsy proven nephritis divided in early nephritis group (diagnosis of nephritis in the first 5 years of the disease) and late nephritis (diagnosis of nephritis after 5 years). Epidemiological, serological, clinical and treatment data were collected from charts and compared. Results: In this sample, 70. 4% had early onset nephritis and 29.6% had late onset. No differences were noted in epidemiological, clinical, serological profile, SLICC and SLEDAI, except that late onset nephritis patients were older at nephritis diagnosis (p = 0.01). Regarding renal biopsy classification, C3 and C4 levels, serum creatinine, 24 h proteinuria and response rate to treatment the two groups were similar (p = NS). Patients with early onset had lower levels of hemoglobin at nephritis onset than those of late onset (p = 0.02). Conclusions: Most of SLE patients had nephritis in the first 5 years of disease. No major differences were noted when disease profile or treatment outcome of early and late onset nephritis were compared.(AU)

Cutaneous vasculitis and renal involvement in Mycoplasma pneumoniae infection

No abstract available.

Nefritis aguda focal: caso clínico / Focal acute nephritis: a case report

Focal acute nephritis (FAN) or acute lobar nephronia is a rare clinical picture characterized by an infection localized in the kidney, with an inflammatory mass without liquefaction. Of variable clinical manifestations, diagnosis is achieved through CT scanning. Histologically, unlike acute pyelonephritis, it does not present a diffuse infíltrate. Objective: Case report of FAN in a pediatric patient. Case Report: Ten year old male complaining of abdominal pain, presents painful percussion in the right lumbar fossa. Urinary analysis and culture were negative, renal sonogram was negative. Abdominal CT sean showed múltiple hypodense renal foci. He responded well to cephotaxim, being discharged in the third day of hospitalization with completion of treatment as outpatient. Differential diagnosis with Acute Pyelonephritis is very important, as it requires controlled and opportune treatment to prevent renal absceses. Diagnosis of this pathology must be pursued despite a normal UA.

La nefritis aguda focal o nefronia lobar aguda constituye un cuadro poco común caracterizado por una infección localizada en el riñon, la que corresponde a una masa inflamatoria sin licuefacción. Posee una clínica variable, siendo la tomograña computada (TAC) la prueba más sensible y específica para el diagnóstico de esta enfermedad. Esta patología se diferencia histológicamente de la pielonefritis aguda por no presentar un infiltrado inflamatorio difuso. Objetivo: presentar un caso de nefronia aguda multifocal en un paciente pediátrico. Caso clínico: Escolar de 10 años que consultó por dolor abdominal, al examen destacaba la presencia de percusión dolorosa en fosa lumbar. Los exámenes de orina y urocultivo fueron negativos. Al ingreso no se detectó cambios renales ecográficamente evidenciables. Se realizó un TAC de abdomen que mostraba múltiples focos renales hipodensos. Respondió favorablemente a terapia antibiótica con cefotaxima siendo dado de alta al tercer día, completando terapia en forma ambulatoria. La diferenciación de este cuadro de otros procesos renales como la pielonefritis aguda (PNA) es muy importante, ya que precisa un tratamiento oportuno y controlado por el riesgo de evolucionar a absceso renal. El diagnóstico de esta patología debe ser buscado a pesar de contar con exámenes de orina negativos.

[ comparative study on uterus and kidney inflammation and their treatments described in the book [Hidayat al-Muta'allimin fit-Tib] with modern medicine]

[Hidayat al-Muta'allimin fit-Tib] [A Guide to Students of Medicine] is one of the oldest Persian medical books written in Persian by Akhawayni around llth century in Bukhara. In this book, each disease is described as a separate monograph including signs and symptoms as well as treatment orders. Two of the well explained monographs are concerned to inflammation of uterus and kidney. The purpose of this study was to compare the signs, symptoms, and treatment procedures written in the above mentioned book with what written in modern medical texts for Pelvic Inflammatory Disease [PID] and kidney abscess. For this purpose, a comparative study on signs, symptoms, and treatment procedures of these diseases with modern medicine was done. According to this study, the inflammation of uterus in primary stage showed some similarities with PID and in final stage with tubo- ovarian abscess. The inflammation of kidney at its first stage had a lot of resemblance with pyelonephritis, in advanced stage with interarenal or perinephric abscess, and in final stage with renal failure. The treatment procedures in the old traditional medicine were originally based on herbal treatments that are completely different with modern antibiotic therapy. However, the anti-inflammatory and anti-infective herbal drugs used in this book are in support of the antimicrobial and anti-inflammatory data reported for the most of these herbs in scientific literatures. The results point out that the ancient Iranian physicians had a reasonable concept of the infective diseases. The herbs used by traditional physicians have ethnopharmacological potential for further research to develop new antibacterial and anti-inflammatory agents from these plants

Nefritis colagena / Collagen nephritis

En los últimos años se ha descripto un nuevo tipo de glomerulopatía primaria, denomminada nefritis colágena, caracterizada por la acumulación masiva de colágeno fibrilar en mesangio y membrana basal glomerular sin asociación con patología osteoarticular. Se comunica aquí el primer caso en nuestro medio. Se trata de una paciente de 26 años con síndrome nefrótico y progressiva caída del filtrado cuya biopsia renal mostró una esclerosis focal y segmentaria en la microscopia óptica. La evaluación ultraestructural reveló acúmulos en membrana basal y mesangio de colágeno fibrilar que permitió el diagnóstico de esta entidad.

Pharmacokinetic profile of pipemidic acid in normal and nephritic rats

The pharmacokinetic profile, tissue distribution and residual content of pipemidic acid were studied in normal and nephritic rats. The maximum serum concentration was reached after 1 hour in both normal and nephritic rats following oral administration of 50 mg/kg b. wt. Lower serum concentration were detected in nephritic rats at corresponding time intervals as compared with healthy ones. Following the intravenous injection of pipemidic acid, the resulting curves were best fitted to follow two compartment open model. The drug was highly distributed in all tested tissues and completely disappeared from all tissues after 9 and 15 days in healthy and nephritic rats following its oral administration in a dose of 50 mg/kg b. wt. twice daily for 5 successive days

Role of CT and ultrasound in diagnosis and management of renal and perirenal inflammatory diseases

Thirty patients with urosepsis and renal or perirenal infections were evaluated with both computed tomography and Ultrasonography. The results were identical in twenty patients. In the remaining ten cases, Ultrasonography was falsely negative in five cases, underestimated the extent of the disease in the three cases, also the extent of gaseous collection in one case of renal abscess and in another case of emphysematous pyelonephritis were better evaluated by compared tomography than Ultrasonography. From this study, we conclude that CT is more sensitive in the detection of acute renal inflammatory disease, for definition of extent of disease and helps planning of treatment

Study of renal arterial blood flow in different renal disorders using doppler ultrasonography

In thirty subjects with different renal disorders classified into three groups each group contains 10 subjects; nephritis group, renal colic group, and chronic renal failure group; and 10 subjects as healthy control group. Study of renal arterial blood flow and its relation to kidney functions in these renal disorders using Duplex-Doppler ultrasonography was done. The end diastolic flow [D] and the early peak systolic flow [S], the resistive index [RI], the pulsatility index [PI] and the D/S ratio were recorded. All the doppler indices were nearly the same as normal in the nephritis group. Resistive index values were significantly increased [P < 0.01] in the renal colic and chronic renal failure group, resistive index of 0.70 was considered the upper limit for normal kidneys. The D/S ratio was significantly decreased [P < 0.05] in renal colic and renal failure groups D/S ratio of 0.30 has considered the minimum value/or normal kidneys. Both chronic renal failure and renal colic increase the renal peripheral resistance but glomerulonephritis did not alter it, so all the doppler indices remain unchanged as long as the disease remain limited to the glomeruli. A significant correlation exists between blood urea and D/S ratio [r = 0.69], as well as between serum creatinine and D/S ratio [r = 0.75] in chronic renal failure group. In conclusion, there is an altered blood flow in renal obstruction and chronic renal failure. While no change in renal arterial blood flow in diseases limited to glomeruli. Duplex Doppler ultrasonography is a good non-invasive method for evaluation of renal functions from the pattern of renal arterial blood flow, however it can not differentiate between healthy subjects and glomerulonephritis or between renal obstruction and chronic renal failure

Presentación clínica del absceso perinéfrico, de 1980 a 1985 / Clinical presentation of perinephric abscess from 1980 to 1985

Durante el periodo comprendido entre 1980 a 1985 se diagnosticaron 10 abscesos perinéfrico en siete mujeres y tres varones. La edad promedio fue de 43.1 años. La evolución promedio de 174.7 días. Los síntomas prominentes fueron dolor (costovertebral/abdominal), calosfríos repetidos y fiebre. A la exploración física se encontró una tumoración en nueve de los diez casos. La hemoglobina promedio fue de 9.94 con un recuento total de leucocitos de 16,360. Todos los pacientes tenían alteraciones en la urografía excretora sugestivas de absceso perinéfrico. Las enterobacterias gramnegativas sensibles predominaron (siete de 10) como los agentes etiogénicos. Esta entidad se debe sospechar en mujeres/varones mayores de 40 años, con diabetes sacarina no insulinodependiente, anémicos, con duración de signos y síntomas de más de una semana, a los que se les practicó una urografía excretora

Nefritis postestreptocócica en pediatría: experiencia en 45 casos / Post-streptococcal nephritis in pediatrics: experience in 45 cases

Se analizan 45 casos de nefritis postestreptocócica observados durante 1983, destacando: a) un marcado incremento de casos concordante con el mayor número de consultas por escabiosis infectada; b) la evolución favorable del cuadro con menor permanencia hospitalaria, y c) la utilidad de la determinación de C3. Se resaltan los aspectos clínicos importantes