Glomerulonephritis

Hematologic diseases autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, pernicous anemia Kidney disease Goodpasture syndrom, lipoid nephroses, minimal change glomerulonephritis Diseases of the gastrointestinal tract autoimmune chronic active hepatitis, autoimmune atrophic gastritis, Crohn s disease, ulcerative colitis... 

In the pathogenesis of many chronic inflammatory diseases (e.g., rheumatoid arthritis, glomerulonephritis, colitis ulcerosa, Morbus Crohn, atopic dermatitis, psoriasis) autoimmune processes play an important role, too. Although first of all nonsteroidal antiinflammatory agents or glucocorticoids should be applied, immunosuppressive agents may also be indicated. 

Brown, muddy granular casts (highly indicative of ATN) Proteinuria (glomerulonephritis or allergic interstitial nephritis) Eosinophiluria (acute interstitial nephritis)... 

The three most common causes of CKD in the United States are diabetes mellitus, hypertension, and glomerulonephritis. Together these account for about 75% of the cases of CKD (37% for diabetes, 24% for hypertension, and 14% for glomerulonephritis).2 These are discussed in further detail below. 

The goals of therapy for streptococcal pharyngitis are to eradicate infection in order to prevent complications, shorten the disease course, and reduce infectivity and spread to close contacts. Sequelae that can be prevented by antibiotic use are peritonsillar or retropharyngeal abscess, cervical lymphadenitis, and rheumatic fever. There is no evidence that antibiotic use has an impact on the incidence of poststreptococcal glomerulonephritis. 

The primary goal of therapy for impetigo is resolution of infection. A secondary goal is prevention of glomerulonephritis (although extremely rare) secondary to group A Streptococcus (GAS). 

Immunologic phenomena glomerulonephritis, Osier s nodes, Roth s spots, and rheumatoid factor... 

CHF Congestive heart failure chronic heart failure DPGN Diffuse proliferative glomerulonephritis... 

GN Glomerulonephritis graduate nurse IDDM Insulin-dependent diabetes mellitus... 

Glomerulonephritis Glomerular lesions that are characterized by inflammation of the capillary loops of the glomerulus. These lesions are generally caused by immunologic, vascular, or other idiopathic diseases. Glomerulonephritis can lead to high blood pressure and loss of kidney function. 

Chen S, Bacon KB, Li L, et al. In vivo inhibition of CC and CX3C chemokine-induced leukocyte infiltration and attenuation of glomerulonephritis in Wistar-Kyoto (WKY) rats by vMIP-II. J Exp Med 1998 188 193-8. 

Barber DF, Bartolome A, Hernandez C, et al. PI3Kgamma inhibition blocks glomerulonephritis and extends lifespan in a mouse model of systemic lupus. Nat Med 2005 11(9) 933—935. 

Wada T, Tomosugi N, Naito T, et al. Prevention of proteinuria by the administration of anti-interleukin 8 antibody in experimental acute immune complex-induced glomerulonephritis. J Exp Med 1994 180 1135-1140. 

Feng L, Chen S, Garcia GE, et al. Prevention of crescentic glomerulonephritis by immunoneutralization of the fractalkine receptor CX3CR1 rapid communication. Kidney Int 1999 56 612-620. 

Anders HJ, Frink M, Linde Y, et al. CC chemokine ligand 5/RANTES chemokine antagonists aggravate glomerulonephritis despite reduction of glomerular leukocyte infiltration. J Immunol 2003 170 5658-5666. 

Segerer S, Regele H, Mack M, et al. The duffy antigen receptor for chemokines is up-regulated during acute renal transplant rejection and crescentic glomerulonephritis. Kidney Int 2000 58 1546-1556. 

Suggested Alternatives for Differential Diagnosis Acute poststreptococcal glomerulonephritis, spotted fevers, typhus, malaria, hepatitis, Colorado tick fever, septicemia, heat stroke, disseminated intravascular coagulation, leptospirosis, hemolytic uremic syndrome. 

Penicillamine onset may be seen in 1 to 3 months, and most responses occur within 6 months. Early adverse effects include skin rash, metallic taste, hypogeusia, stomatitis, anorexia, nausea, vomiting, and dyspepsia. Glomerulonephritis may occur, which manifests as proteinuria and hematuria. Penicillamine is usually reserved for patients who are resistant to other therapies because of the rare but potentially serious induction of autoimmune diseases (e.g., Goodpasture s syndrome, myasthenia gravis). 

Secondary hypertension is much more common in children than in adults. Kidney disease (e.g., pyelonephritis, glomerulonephritis) is the most common cause of secondary hypertension in children. Coarctation of the aorta can also produce secondary hypertension. Medical or surgical management of the underlying disorder usually restores normal BP. 

Nonsuppurative complications such as acute rheumatic fever, acute glomerulonephritis, and reactive arthritis may occur as a result of pharyngitis with Group A Streptococcus. 

Glomerular damage Accelerated hypertension Systemic lupus erythematosus Poststreptococcal glomerulonephritis Antiglomerular basement membrane disease... 

Glomerulonephritis, pyelonephritis, renal infarction, papillary necrosis, renal tumors, kidney stones Pyelonephritis, interstitial nephritis... 

Pyelonephritis, interstitial nephritis Glomerulonephritis, renal infard, lupus nephritis, vasculitis... 

A number of studies in humans show that PUFAs can generate significant immunomodulatory effects. Generally, these studies have utilized considerably lower amounts of fish oil to treat subjects than found in most animal studies. Numerous clinical trials have examined the effects of fish oil on rheumatoid arthritis and many have reported statistically significant benefits such as decreased morning stiffness and numbers of tender joints [57]. Several other studies have reported that PUFAs can provide therapeutic benefits for patients with IgA nephropathy, the most common primary human glomerulonephritis... 

Gregorini, G. et al., Association between silica exposure and necrotizing crescentic glomerulonephritis with p-ANCA and anti-MPO antibodies A hospital-based case-control study, Adv. Exp. Med. Biol. 336, 435, 1993. 

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