摘要:

A 68-year-old male patient suffering from dizziness, gait instability, deafness, and visual loss showed proteinuria, hematuria, reduced creatinine clearance, and a monoclonal IgA lambda component. Renal biopsy revealed crescentic glomerulonephritis. Serum antibodies against myeloperoxidase were identified. These antibodies were IgG, not related to the IgA monoclonal component. This clinical description adds new information to the spectrum of diseases associated with glomerulonephritis and antimyeloperoxidase antibodies and illustrates that a monoclonal component cannot be directly implicated in the pathogenesis of a vasculitic process associated with antineutrophil cytoplasm antibodies.

ISSN:1660-8151    

DOI:10.1159/000188810

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

This paper reports on 3 patients on renal dialysis for crescentic glomerulonephritis associated with microscopic polyarteritis (MPA) and antineutrophil cytoplasmic autoantibodies specific for myeloperoxidase (MPO-ANCAs). They successfully underwent renal transplantation from a cadaver donor 6-63 months after the onset of the disease, despite the persistence of antibodies at high titer. A triple immunosuppressive regimen including steroids, cyclosporin and azathioprine was used. One patient underwent transplantectomy for surgical complications 3 months later, while the serum creatinine was 2.0 mg/ dl (178 μmol/l): the remainder have a well-functioning graft after 21 and 38 months, no clinical sign of disease recurrence, and a MPO titer within the normal range. We conclude that MPA patients can undergo renal transplantation even if ANCAs persist at a high titer in the circulation

ISSN:1660-8151    

DOI:10.1159/000188811

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

It has been considered unlikely that patients with insulin-dependent diabetes and diabetic nephropathy with nephrotic range proteinuria can substantially reduce proteinuria and continue for many years without further loss of renal function. We present a patient who had the diagnosis of insulin-dependent diabetes made at age 15, had his first of 6 laser treatments for proliferative and hemorrhagic retinopathy at age 27 and was found to have nephrotic range proteinuria and edema with hypertension at age 29, when results of a renal biopsy were typical of diabetic nephropathy. Ten years later, with the last 5.5 years on ACE inhibitors, proteinuria has been < 0.65 g/24 h for 2 years and recently 0.22 g, serum creatinine is unchanged at 90 to 102 μmol/l, DTPA GFR is 104 ml/min and retinopathy has remained stable without laser therapy for 7 years. Blood pressure on clinic visits has averaged 126/74 for the last 8 years. This duration of stable renal function and the major decrease in proteinuria after being in the neprotic range is very rare in reports, if not unique

ISSN:1660-8151    

DOI:10.1159/000188812

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The aim of this study was to examine whether the frequent short-time hemodiafiltration (FSHDF) could remove β2-microglobulin β2m), an amyloidogenic factor, more effectively compared with the conventional hemodiafiltration (CHDF). A uremic patient underwent FSHDF (each 90 min, 6 times/week) for 6 weeks after CHDF (each 4 h, 3 times/week) for 6 months. Pretherapeutic plasma concentrations of β2m, small molecules, electrolytes and bicarbonate were measured every Monday for 4 weeks during CHDF and for 6 weeks during FSHDF. The body weight gain during these weeks was also determined. The time average concentrations in β2m and blood urea nitrogen (TACβ2m and TACBUN) were evaluated based on their concentrations in pre-, post- and intertherapeutic plasmas frequently collected for 1 week each during CHDF and FSHDF. The quantities of total protein, albumin and β2m in the removed fluids for the same week were determined. The pretherapeutic concentration in β2m was significantly lower (18.7 ± 1.3 mg/l) during FSHDF than CHDF (32.4 ± 2.8 mg/l). The TACβ2m was decreased during FSHDF (from 23.5 to 13.7 mg/l), while the TACBUN did not change. The pretherapeutic bicarbonate concentration was higher and the gain of body weight per week was lower during FSHDF although the other parameters were not different. It is concluded that FSHDF therapy is more effective to decrease β2m concentration and correct acidosis together with an adequate urea removal and clini

ISSN:1660-8151    

DOI:10.1159/000188813

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188814

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188815

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188816

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188817

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188818

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188819

出版商:S. Karger AG    

年代:1996

数据来源: Karger