• Title/Summary/Keyword: proteinuria

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A case of chronic lymphocytic leukemia (CLL) in a Maltese dog

  • Lee, Ji-Yun;Hong, Eun-Sil;Kang, Byeong-Teck;Jung, Dong-in;Park, Chul;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.45 no.2
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    • pp.251-254
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    • 2005
  • An 11-year-old, 3.3 kg, male Maltese dog was referred to Veterinary Teaching Hospital of Konkuk University because of diarrhea and severe anemia. Abnormal physical examination findings included left submandibular lymph node enlargement, pale mucous membrane, cataract, and bloody diarrhea. Results of hematologic examination revealed a marked lymphocytosis resulting in leukocytosis and the markedly increased numbers of small, well-differentiated lymphocytes in the peripheral blood. Serum biochemical abnormalities consisted of elevated AST and ALP, hyperphosphatemia, hypoglycemia, and hypoalbuminemia. Radiographic examination showed cardiomegaly and hepatosplenomegaly. Results of urinalysis included bilirubinuria and proteinuria. Based on results of examination described above, chronic lymphocytic leukemia was diagnosed. Chemotherapy was initiated with cyclophosphamide ($300mg/m^2$, IV once every 2 weeks), vincristine ($0.75mg/m^2$, IV once every 2 weeks, alternating weeks with the cyclophosphamide), and plus prednisolone ($50mg/m^2$, PO, SID for a week, then $20mg/m^2$, PO every other day). The response to chemotherapy was partially present. This study first demonstrates clinicopathological findings and chemotherapeutic response of chronic lymphocytic leukemia in Korea.

A CASE REPORT OF KIMURA'S DISEASE IN THE PAROTID REGION (이하선부에 발생한 Kimura's disease에 대한 치험례)

  • Byun, Sung-Soo;Jung, Hwui-Dong;Choi, Young-Dal;Kim, Hyun-Sil;Cha, In-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.554-558
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    • 2007
  • Kimura's disease is a chronic inflammatory disorder presenting regional lymphadenopathy with painless soft tissue mass. Clinically, peripheral eosinophilia and elevated serum IgE levels are observed, and proteinuria associated with renal disease can also be present. Although its etiology is not clearly understood, it occurs predominantly in young Asian males and presents as a deep, subcutaneous mass involving salivary glands of the preauricular and submandibular regions. Spontaneous remission is very rare, and although treatments such as steroid, cytotoxic therapy and irradiation are available, chronic recurrence is very common. As such, surgical excision is regarded as the mainstay of therapy for localized lesions. Histopathologically, Kimura's disease features eosinophilic abscsesses and dense lymphoid aggregates with germinal center. Clinical differential diagnosis of Kimura's disease from other parotid diseases with accompanying lymphadenopathy is often very challenging prior to biopsy. The authors report a case of a 19-year-old male diagnosed with Kimura's disease in the parotid region who underwent surgical excision and was followed up for 6 years, along with a review of related literature.

Cadmium Inhibition of Renal Endosomal Acidification

  • Kim, Moo-Seong;Kim, Kyoung-Ryong;Ahn, Do-Whan;Park, Yang-Saeng
    • The Korean Journal of Physiology and Pharmacology
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    • v.4 no.1
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    • pp.63-72
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    • 2000
  • Chronic exposure to cadmium (Cd) results in an inhibition of protein endocytosis in the renal proximal tubule, leading to proteinuria. In order to gain insight into the mechanism by which Cd impairs the protein endocytosis, we investigated the effect of Cd on the acidification of renal cortical endocytotic vesicles (endosomes). The endosomal acidification was assessed by measuring the pH gradient-dependent fluorescence change, using acridine orange or FITC-dextran as a probe. In renal endosomes isolated from Cd-intoxicated rats, the $V_{max}$ of ATP-driven fluorescence quenching ($H^+-ATPase$ dependent intravesicular acidification) was significantly attenuated with no substantial changes in the apparent $K_m,$ indicating that the capacity of acidification was reduced. When endosomes from normal animals were directly exposed to free Cd in vitro, the $V_{max}$ was slightly reduced, whereas the $K_m$ was markedly increased, implying that the biochemical property of the $H^+-ATPase$ was altered by Cd. In endosomes exposed to free Cd in vitro, the rate of dissipation of the transmembrane pH gradient after $H^+-ATPase$ inhibition appeared to be significantly faster compared to that in normal endosomes, indicating that the $H^+-conductance$ of the membrane was increased by Cd. These results suggest that in long-term Cd-exposed animals, free Cd ions liberated in the proximal tubular cytoplasm by lysosomal degradation of cadmium-metallothionein complex (CdMT) may impair endosomal acidification 1) by reducing the $H^+-ATPase$ density in the endosomal membrane, 2) by suppressing the intrinsic $H^+-ATPase$ activity, and 3) possibly by increasing the membrane conductance to $H^+$ ion. Such effects of Cd could be responsible for the alterations of proximal tubular endocytotic activities, protein reabsorption and various transporter distributions observed in Cd-exposed cells and animals.

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A Case of Type II Membranoproliferative Glomerulonephritis Detected by School Urinary Screening Tests (학교 신체검진 상 우연히 발견된 제2형 막증식성 사구체신염 1예)

  • Kim, Hyung-Joong;Kwak, Byung-Ok;Bae, Jae-Uk;Kim, Kyo-Sun;Lim, So-Dug
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.79-83
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    • 2010
  • Type II membranoproliferative glomerulonephritis (MPGN) is characterized by thickening of the glomerular basement membrane owing to electron-dense deposits on electron microscopy. We experienced a case of type II MPGN in a child presenting with proteinuria, hematuria on school urinary screening tests. He had been treated with losartan and enalapril. This is the first case report of type II MPGN detected by school urinary screening tests in Korea. Thus we report a case of 10-years-old male with type II MPGN with a review of brief literature.

Slowing the Progression of Chronic Kidney Disease in Children and Adolescents (소아 청소년 만성 콩팥병의 진행 억제)

  • Ha, Il-Soo;Choi, Yong
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.1-9
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    • 2010
  • Slowing the progression of chronic kidney disease is much more important in children and adolescents with a relatively longer remaining life span. A practical way to assess the rate of progression of chronic kidney disease is to measure the change of GFR estimated by formulae. To slow the progression, hypertension and proteinuria have to be controlled strictly, and hypoplastic anemia must be treated with erythropoietin. If not contraindicated, ACE inhibitor or angiotensin receptor blocker is recommended with monitoring of the side effects. Trials to slow the progression should be commenced as soon as the chronic kidney disease is confirmed and needs to be continued until renal transplantation as long as residual renal function remains. An online system, the Korean Pediatric Chronic Kidney Disease Registry (http://pedcrf.or.kr/), provides tools that are useful in evaluation and management of the children and adolescents with chronic kidney diseases.

Renoprotective Effect of Plantago major Against Proteinuria and Apoptosis Induced by Adriamycin in Rat

  • Yazd, Zohreh Naji Ebrahimi;Noshahr, Zahra Samadi;Hosseinian, Sara;Shafei, Mohammad Naser;Bideskan, Alireza Ebrahimzadeh;Mohebbati, Reza;Heravi, Nazanin Entezari;Shahraki, Samira;Mahzari, Somayeh;Rad, Abolfazl Khajavi
    • Journal of Pharmacopuncture
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    • v.22 no.1
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    • pp.35-40
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    • 2019
  • Objective: Adriamycin (ADR) is an important anti-cancer drug which can cause renal toxicity. Given the known anti-inflammatory and antioxidant effects of Plantago major (P. major), the aim of this study was to determine the effects of hydroalcoholic extract of P. major on ADR- induced nephropathy in rats. Methods: Fifty male Wistar albino rats were randomly divided into 5 groups including: control, ADR (5 mg/kg), ADR + P. major (600 and 1200 mg/kg) and P. major (1200 mg/kg). The animals were treated with P. major extract for 5 consecutive weeks and ADR was intravenously injected on the 7th day of the study. Urine and serum samples were collected on days 0, 14, 21, 28, and 35 for the measurement of serum cholesterol and albumin levels and urine protein excretion rate. At the end of the study, the left kidneys were removed for apoptosis assessment. Results: Administration of ADR significantly decreased serum albumin level and increased serum cholesterol and urine protein excretion rate as well as, apoptotic cell numbers compared to the control group (P < 0.001) while had no effect on glomerular filtration rate (P > 0.05). Treatment with P. major, in both 600 and 1200 mg/kg doses, increased serum albumin level and decreased serum cholesterol concentration, urine protein excretion rate and as well as the number of apoptotic cell compared to the ADR group (P < 0.001). Conclusion: Our results showed that the P. major extract effectively protects against ADR- induced nephropathy by reducing kidney apoptosis and improving renal functioning in rats.

Postinfectious Glomerulonephritis Associated with Pneumococcus and Influenza A Virus Infection in a Child: a Case Report and Literature Review

  • Huh, Homin;Lee, Joon Kee;Yun, Ki Wook;Kang, Hee Gyung;Cheong, Hae Il
    • Pediatric Infection and Vaccine
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    • v.26 no.2
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    • pp.118-123
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    • 2019
  • Postinfectious glomerulonephritis (PIGN) is most commonly caused by Streptococcus pyogenes in children, but PIGN associated with other pathogens has been described in the literature. A previously healthy 6-year-old boy was admitted with complaints of cough, fever, and right chest pain. The patient was diagnosed with pneumococcal bacteremia and influenza A virus infection and treated with antibiotics and antiviral agent. During hospitalization, generalized edema, hematuria, proteinuria, and increased blood pressure were observed; therefore, we started administering diuretics. The boy was discharged with gross hematuria, and even microscopic hematuria disappeared 14 weeks after discharge. We report a case of PIGN associated with bacteremic pneumococcal pneumonia and influenza A virus infection in children. A urine test and blood pressure measurement should be considered for the early detection of PIGN in children with pneumococcal or influenza A virus infection when they present with nephritic symptoms.

A Case of Renal Cortical Necrosis in a 15-year-old Boy with Acute Kidney Injury

  • Lee, Mi-ji;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.23 no.1
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    • pp.53-57
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    • 2019
  • Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.

Severe SARS-CoV-2 Infection With Multiorgan Involvement Followed by MIS-C in an Adolescent

  • Bomi Lim;Su-Mi Shin;Mi Seon Han
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.155-160
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    • 2022
  • Children and adolescents with coronavirus disease 2019 (COVID-19) generally have mild symptoms. Severe infection due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) involving multiorgan dysfunction is rare in this population. Herein, we present an unusual case of severe SARS-CoV-2 infection with multiorgan involvement followed by multisystem inflammatory syndrome in children (MIS-C) in a vaccinated 16-year-old boy. The patient was unconscious on initial presentation, and had severe paralytic ileus. On laboratory examination, there was severe metabolic acidosis, lymphocytopenia, thrombocytopenia, elevated inflammatory markers, elevated liver enzymes, and evidence of acute kidney injury with proteinuria and hematuria. His symptoms improved with the administration of remdesivir and dexamethasone. The patient briefly experienced MIS-C 2 weeks after the diagnosis of COVID-19, but the patient was discharged without any complications.

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.