• Title/Summary/Keyword: nephritis

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A Case of Henoch-Schönlein Purpura with Fulminant Complications and Its Long-term Outcome

  • Lee, Dong Hyun;LEE, Eun-So;Hong, Jeong;Park, Kwang-Hwa;Pai, Ki Soo
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.128-133
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    • 2019
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic vasculitis characterized by purpura, arthritis, abdominal pain, and nephritis. Gastrointestinal involvement can manifest as pain, intussusception, intestinal bleeding, and intestinal perforation. We report a case of fulminant HSP at an age of eight in 1994, with multiple complications of intra-thoracic bleeding, massive intestinal perforation, nephritis, and various skin rashes. The brisk bleeding findings of intestinal on Technetium-99m-labeled red blood cell scan ($^{99m}Tc$ RBC scan) were well matched to those of the emergency laparotomy and the resected intestine. The patient's abdominal conditions improved gradually but nodular skin eruptions developed newly apart from improving preexisting lower limb rashes and the urine findings continued abnormal, so skin and kidney biopsy were done for the diagnosis. After cyclosporine therapy, skin eruptions and urine findings returned to normal gradually. On a follow-up after 25 years in 2019, the patient is 33-year-old, healthy without any abnormality on blood chemistries and urine examination.

Clinical Comparison of $Henoch-Sch\"{o}nlein$ Purpura Nephritis in Children and Adults (소아와 성인 $Henoch-Sch\"{o}nlein$ Purpura(HSP) 신염의 임상적 비교)

  • Kim Ki-Eun;Shin Youn-Ho;Shin Jae-Il;Park Jee-Min;Jeong Hyeon-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.157-165
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    • 2003
  • Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is a systemic vasculitis that involves multiple organs, especially the kidney, which is the most important organ in determining the prognosis of the disease. The morbidity of HSP nephritis in adults is low and there have been little research done on its clinical course so far. Therefore, we have compared the clinical course of HSP nephritis in children and adults in Korea. Methods : We retrospectively analyzed 81 cases of HSP nephritis in children younger than 15 years of age, and 25 cases of adults older than 15 years of age who were admitted to Yonsei University Medical College Severance Hospital from Jan. 1986 to May 2003. Results : The male to female ratio was 1.5 : 1 in children and 1.3 : 1 in adults. The incidence of HSP nephritis for both age groups was found to be increased during the autumn and winter. Infection was the predisposing factor in 39 cases(48.1%) of children, 16 cases(64.0%) of adults, and drugs were the predisposing factor in 8 cases(9.9%) of children and 4 cases (16.0%) of adults. All patients initially presented with microscopic hematuria. Thirteen cases (16.0%) of children and 7 cases(28.0%) of adults initially showed proteinuria of nephrotic range. Thirty four cases(42.0%) of children and 4 cases(16.0%) of adults showed normal urinalysis after treatment. Asymptomatic urinary abnormalities were found in 41 cases(50.6%) of children and 18 cases(72.0%) of adults. Complications such as nephrotic syndrome and hypertension were found in 3 cases(3.7%) of children and 2 cases(8.0%) of adults. Three children(3.7%) and 1(4.0%) adult required dialysis or renal transplantation. Follow-up renal biopsies were performed on 21 children, of whom 10 cases(47.6%) did not show any histologic change, 9 cases(42.9%) showed low grade changes, and 2 cases(9.5%) showed high grade changes. Prognosis was gloomy when proteinuria of nephrotic range and high grade of abnormal histology were present at diagnosis, and there was no significant difference between the two groups(P<0.05) Conclusion : This study showed that there was no difference in terms of the clinical features and courses between the children and adults with HSP nephritis. Proteinuria of nephrotic range and the severity of abnormal histologic changes at diagnosis were found to be associated with a bad prognosis, therefore we recommend that patients with these features require long term follow-up and management.

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Two Cases Suggesting the Relationship of IgA Nephropathy and Henoch-$Sch{\ddot{o}}nlein$ Purpura (IgA Nephropathy와 Henoch-$Sch{\ddot{o}}nlein$ Purpura가 동일 병인임을 시사하는 2례)

  • Jeong Dong-Ho;Song Chang-Ju;Kim Deok-Su;Ha Tae-Sun
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.59-63
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    • 2001
  • There are a considerable number of reports suggesting a common pathogenesis of IgA nephritis(IgANn) Henoch-$Sch{\ddot{o}}nlein$ Purpura(HSP). In previous reports, a patient develops IgAN after kidney transplantation for HSP nephritis, one of Identical twin boys, developed IgAN and the other HSP, and a boy with IgAN later developed HSP. We report two cases, one with IgAN who later developed HSP and the other with HSP who later developed IgAN, suggesting that IgAN and HSP have a common pathogenesis. (J. Korean Soc Pediatr Nephrol 5 : 59- 63, 2001)

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Multifocal Interstitial Nephritis of Pigs Slaughtered in Jeju

  • Yang, Hyoung-seok;Yang, Na-yeon;Kang, Wan-cheul;Kang, Sang-chul;Kang, Hong-won;Kim, Jae-hoon;Bae, Jong-hee
    • Proceedings of the Korean Society of Veterinary Pathology Conference
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    • 2003.10a
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    • pp.14-14
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    • 2003
  • Gross lesions of multifocal interstitial nephritis, often called 'white spotted kidney', can be caused by various bacterial or viral hematogenous infections [1, 2]. The purpose of this study was to determine whether there is an association between these lesions in slaughter pigs and the causative agents in Jeju. (omitted)

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A Case of Central Nervous System Toxicity Associated with Cyclosporine (Cyclosporine에 의한 중추신경계 독성 1례)

  • Lee Do-Yoon;NamGoong Mee-Kyung;Kim Hwang-Min;Lim Baek-Keun
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.179-182
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    • 1997
  • Cyclosporine is an immunosuppressant usually used to prevent renal transplantation rejection. Nephrotoxicity and hypertension are considered as the most frequent side effects of cyclosporine treatment. The neurotoxic effects of cyclosporine such as agitation, anxiety, delirium, depression and psychosis have recently been found. Methylprednisolone may increase as well plasma concentration of cyclosporine, which leads to side effects. Here we report a $Henoch-Sch\"{o}nlein$ nephritis patient treated with cyclosporine and methylprednisolone who has experienced psychosis including visual and auditory hallucination and convulsion.

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Survey on the endemic disease to improve production of pig farm in Incheon area (인천지역 양돈농가의 생산성 향상을 위한 질병 실태조사)

  • 황원무;이성모;황현순;한정희
    • Korean Journal of Veterinary Service
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    • v.27 no.2
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    • pp.121-131
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    • 2004
  • This experiment was executed to control effectively endemic disease of swine farms in Incheon metropolitan city. Mainly using PigMon program which had been developed by the College of Veterinary Medicine in the University of Minnesota(USA), we examined lesions of gastric ulcer and interstitial nephritis additionally. 446 heads of pigs shipped from 5 farms in Incheon to a slaughterhouse from June in 2003 to May in 2004 were examined. Infection rates by farms were obtained as follows; 1. Pneumonia was varied from 34.6% to 74.1% and pneumonic score was 1.47∼7.06. As for atrophic rhinitis, four farms were 100% and one farm was 89.5% and rhinitis score was 1.3∼3.2. 2. The infection rate of pericarditis and peritonitis was 1.0∼3.9% and liver white spots, papular dermatitis were observed in pigs of 9.8∼29.7%, 16.7∼51.4% respectively. 3. The outbreak rates of interstitial nephritis, lesions of ileal thickening and gastric ulcer were 15.4∼24.1%, 7.7∼13.5%, and 62.7%∼86.2% respectively.

The Effect of Hoelen Herbal-acupuncture at $KI_{10}$ on Lipopolysaccharide Induced Nephritis in Rats (음곡(陰谷) 백복령(白茯苓)약침이 Lipopolysaccharide로 유도된 흰쥐의 염증성 신(腎) 손상에 미치는 영향)

  • Kim, Min Sik;Kim, Byung Soo;Yim, Yun Kyoung
    • Journal of Acupuncture Research
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    • v.31 no.2
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    • pp.65-74
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    • 2014
  • Objectives : The purpose of this study is evaluating the effect of Hoelen Herbal-acupuncture (HO-HA) at $KI_{10}$(Umgok) on Lipopolysaccharide(LPS) induced nephritis in rats. Methods : The experimental rats were assigned to four groups; normal, LPS, saline, HO-HA groups. LPS(2 mg/kg) was administered to the rats in LPS, saline and HO-HA groups to induce acute inflammatory kidney damage. Saline injection and HO-HA were administered at $KI_{10}$ three times a week. Blood samples were taken from the rats for analysis of white blood cell(WBC), neutrophil, blood urea nitrogen(BUN), creatinine TNF-${\alpha}$, CINC-1. Urine samples were taken from the rats for analysis of urinal volume, creatinine and total protein. The kidney samples were taken from the rats for analysis of renal myeloperoxIdase(MPO). Results : HO-HA suppressed the increases of WBC and neutrophils in blood, BUN, creatinine, TNF-${\alpha}$ and CINC-1 in serum, and MPO in kidney of LPS-stimulated rats. In addition, HO-HA inhibited the decrease of urinary volume in LPS-stimulated rats. Conclusions : HO-HA has therapeutic effects on LPS-induced inflammatory kidney damage in rats. Further studies may be needed for clinical use of HO-HA.

Reciprocal regulation of SIRT1 and AMPK by Ginsenoside compound K impedes the conversion from plasma cells to mitigate for podocyte injury in MRL/lpr mice in a B cell-specific manner

  • Ziyu Song;Meng Jin;Shenglong Wang;Yanzuo Wu;Qi Huang;Wangda Xu;Yongsheng Fan;Fengyuan Tian
    • Journal of Ginseng Research
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    • v.48 no.2
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    • pp.190-201
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    • 2024
  • Background: Deposition of immune complexes drives podocyte injury acting in the initial phase of lupus nephritis (LN), a process mediated by B cell involvement. Accordingly, targeting B cell subsets represents a potential therapeutic approach for LN. Ginsenoside compound K (CK), a bioavailable component of ginseng, possesses nephritis benefits in lupus-prone mice; however, the underlying mechanisms involving B cell subpopulations remain elusive. Methods: Female MRL/lpr mice were administered CK (40 mg/kg) intragastrically for 10 weeks, followed by measurements of anti-dsDNA antibodies, inflammatory chemokines, and metabolite profiles on renal samples. Podocyte function and ultrastructure were detected. Publicly available single-cell RNA sequencing data and flow cytometry analysis were employed to investigate B cell subpopulations. Metabolomics analysis was adopted. SIRT1 and AMPK expression were analyzed by immunoblotting and immunofluorescence assays. Results: CK reduced proteinuria and protected podocyte ultrastructure in MRL/lpr mice by suppressing circulating anti-dsDNA antibodies and mitigating systemic inflammation. It activated B cell-specific SIRT1 and AMPK with Rhamnose accumulation, hindering the conversion of renal B cells into plasma cells. This cascade facilitated the resolution of local renal inflammation. CK facilitated the clearance of deposited immune complexes, thus reinstating podocyte morphology and mobility by normalizing the expression of nephrin and SYNPO. Conclusions: Our study reveals the synergistic interplay between SIRT1 and AMPK, orchestrating the restoration of renal B cell subsets. This process effectively mitigates immune complex deposition and preserves podocyte function. Accordingly, CK emerges as a promising therapeutic agent, potentially alleviating the hyperactivity of renal B cell subsets during LN.

The Effect of Long-term Steroid Therapy Combined with Azathioprine in Henoch-$Sch{\ddot{o}}nlein$ Nephritis (Henoch-$Sch{\ddot{o}}nlein$(HS) 신염에서 장기 스테로이드와 Azathioprine의 병합치료 효과)

  • Moon, Kyoung-Sang;Jin, So-Young;Kim, Eun-Mi
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.118-124
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    • 1998
  • Purpose : There is no specific treatment guidelines for Henoch-$Sch{\ddot{o}}nlein$(HS) nephritis. Therefore we performed this study to observe the effect of long term steroid therapy combined with azathioprine Methods : Treatment protocols; 1) Steroid pulse therapy: methylprednisolon 30 mg/kg/dose, maximum 1 gm, intravenolisly 6 times for alternate day. 2) Oral steroid was given 2 mg/kg/day for 1 month, 1 mg/kg/day for following 1 month and alternate day oral steroid combined with azathioprine 2 mg/kg/day for 2 years. Results : Time period from HSP to onset of HS nephritis was between 2 weeks to 5 months with mean $7.4{\pm}7.4$ weeks. Clinical remission were seen in 4 cases out of 5 ($80\%$). Mean time period with disappearance of proteinuria and microscopic hematuria were $5{\pm}2.4$ month and $13.3{\pm}2.9$ month respectively. On pathologic findings by ISKDC, 3 cases were grade IIIb, 2 cases were grade IV in first kidney biopsies and showed pathologic improvement in follow up tidneybiopsiesafterlyearstreatment. Conclusion : As there is no definitive treatment for HS nephritis so far, our study of long term oral steroid therapy with azathioprine was effective in clinical and histologic aspect. Therefore further study in HS nephritis with in a large group will be needed in the future.

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The effect of artemisinin on the rabbit IgG accelerated nephrotoxic serum glomerulonephritis in mice (개똥쑥에서 분리(分離)된 artemisinin이 가토(家兎) IgG에 의해 유발(誘發)된 생쥐의 현독성(賢毒性) 혈청사구체현염(血淸絲球體賢炎)에 미치는 영향(影響))

  • Zhu, Quan
    • Journal of Haehwa Medicine
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    • v.4 no.2
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    • pp.335-336
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    • 1996
  • Artemisinin, a new antimalarial to treat patients infected with strains of Plasmodium jalciparum, derived from the plant Artemisia annua Linn, has immunopharmacologic actions such as enhence the PHA -induced lymphocyte transformation rate, increased the weight of spleen but reduced the weight of thymus, reduced phagocytic function of peritoneal macrophage, remarkably reduced the level of serum IgG and hemolysin fonning capacity (sentitized with SRBC), inhibited the activity of Ts cells of donor mice by supraoptimal immunuization(SOI), but enhenced activity of Ts cells of recipient mice by SOI. These results suggested that Ts cells may be the target cells of artemisinin. To the serum complement C3 level of plasmodium berghei-infeted mice, artemisinin (i. m,) could remarkly increase it. The artemisinin also obviously reduced the prostaglandin E(PGE) in the mouse hind paw swelling induced by carrageenin. Numerous studies have demonstrated that pharmacologic doses of PGE attenuate the development of immunocomplex nephritis. Some autologous immune mechanisms may be invoolved In the pathogensis of some types of glomurulonephritis. Glomerular abnormalities can be induced in animals by variety of immunological manipulations. The resulting disorder has many clinical and pathogical similarities to the disease in human. Our purpose was therefore to test the ability of the artemisinin to lessen the severity of rabbit IgG accelerated nephrotoxic serum glomerulonephritis in mice model. Mice which had treated with rabbit IgG and NTS, administrated with saline, showed Significant inceases of urinary protein, cholesterol level, and decrease of serum albumin in NS group. On the contrary, By i.g. adminstration of artemisinin at dose of 12.5, 25 and 50 mg/kg for 14 days after NTS injection, shown that artemisinin inhibited the nephritic changes in some parameters by means of urinary protein(p<0.05, p<0.01) and serum choleterol(p<0.05, p<0.01) and albumin (p<0.05, p<0.01), blood urea nitrogen (p<0.05, p<0.01), serum albumin(p<0.05, p<0.01); Cyclophosphamide(i.p. 10mg/kg for 14d) had almost same effect as the artemisinin had. Morphological studies shown that The picture of kidney from the mouse with NTS-nephritis accerated with rabbit IgG, treated with i.g. saline as the control, the mesangiocapillary were enlarged and proliferated; There were inflammatory cells infiltrating around the glomeruli; The ethelial cell were proliferated in the wall of Bowman's capsule. Histopatholological picture of kidney from the NTS-nephritis accerated with rabbit IgG mouse treated with i.p. 10mg/kg cyclophosphamide as the positive control. No siginicant histopathological evidence were found. Treaded with i.p. 12.5mg/kg artemisinine, the picture shown that mesangiocapillary were lightly proliferated; There were inflammatory cells infiltrating around the glomeruli; Treaded with i.p. 25mg/kg artemisinine, The picture shown that the mesangiocapillary were lightly proliferated; Treaded with i.p. 50mg/kg artemisinine, The picture shown that both the mesangiocapillary proliferated and the inflammatory cells infiltrating around the glomeruli are less than treated with saline, 12.5 and 25 mg/kg artemisinine. On the basis of these studies we conclude that the artemisinin can relieve pathological change caused by NTS-nephritis aacerated with rabbit IgG.

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