scholarly journals Late-onset rheumatoid arthritis in a patient with successfully treated IgA nephropathy

2017 ◽  
Vol 89 (8) ◽  
pp. 77-79
Author(s):  
N V Chebotareva ◽  
I N Bobkova ◽  
S V Gulyaev
Keyword(s):  
Rheumatoid Arthritis ◽  
Renal Function ◽  
Iga Nephropathy ◽  
Clinical Case ◽  
Late Onset ◽  
Systemic Diseases ◽  
Radiological Patterns ◽  
The Common ◽  
Reduced Renal Function

The paper describes a rare clinical case of rheumatoid arthritis (RA) that developed in a patient 9 years after diagnosing IgA nephropathy. Kidney disease was characterized by a stable course with moderate urinary syndrome, hypertension, and reduced renal function. Immunosuppressive therapy using glucocorticosteroids and then mycophenolic acid led to remission of nephritis and recovery of renal function. However, the absence of nephritis activity and discontinuation of immunosuppressants was responsible for articular syndrome. The diagnosis of RA is based on its characteristic radiological patterns and immunological characteristics after ruling out a number of systemic diseases and infections. The common pathogenetic components of IgA nephropathy and RA, including the role of rheumatoid factor IgA, are discussed.

Parenteral Hydration in Patients with Advanced Cancer (DRAFT)

2018 ◽  
Author(s):  
Carlos Eduardo Paiva ◽  
Bianca Sakamoto Ribeiro Paiva
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Clinical Case ◽  
Fluid Intake ◽  
Hospice Care ◽  
Important Study ◽  
The Common ◽  
To Receive

There has been much debate about the role of parenteral hydration in the last weeks and days of life. In this important study, 129 patients with advanced cancer receiving hospice care with mild to moderate dehydration who were no longer able to maintain adequate fluid intake were randomized to receive parenteral hydration of either 1 L or 100 ml of normal saline per day subcutaneously. Parenteral hydration did not significantly improve the symptoms related to dehydration, the occurrence of delirium, fatigue, quality of life, and overall survival. At the end of the chapter, a clinical case leads readers to consider the common practice of parenteral hydration.

Onset of IgA nephropathy in a patient treated with infliximab for ankylosing spondylitis

2021 ◽  
Vol 14 (1) ◽  
pp. e237713
Author(s):  
Charlotte Anne Baert ◽  
Selda Aydin ◽  
Philippe Leroy ◽  
Patrick Durez
Keyword(s):  
Renal Function ◽  
Ankylosing Spondylitis ◽  
Kidney Disease ◽  
Iga Nephropathy ◽  
Clinical Case ◽  
Urine Analysis ◽  
Immune Dysregulation ◽  
Puncture Biopsy ◽  
Necrosis Factor

We report the case of a 43-year-old man, suffering from ankylosing spondylitis and treated with Infliximab 5 mg/kg every 2 months, with an excellent disease control. During a follow-up consultation, an incipient renal insufficiency is detected. A urine analysis showed haematuria and proteinuria and a renal puncture-biopsy revealed an image of IgA nephropathy.Several cases of IgA nephropathy have been reported in the literature associated with ankylosing spondylitis. Some of them occur in patients treated with antitumour necrosis factor, but it is unclear whether this pathology is caused by the treatment or whether treatment failed to prevent its occurrence.Our clinical case highlights the importance of regular monitoring of renal function in patients with ankylosing spondylitis, as well as urinary spotting.The question of whether the disease itself, the treatment or other factors such as immune dysregulation could be held responsible for kidney disease will be addressed in the discussion.

scholarly journals Expression of MicroRNAs in the Urinary Sediment of Patients with IgA Nephropathy

2010 ◽  
Vol 28 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Gang Wang ◽  
Bonnie Ching-Ha Kwan ◽  
Fernand Mac-Moune Lai ◽  
Kai-Ming Chow ◽  
Philip Kam-Tao Li ◽  
...  
Keyword(s):  
Renal Function ◽  
Iga Nephropathy ◽  
Vimentin Expression ◽  
Protein Coding ◽  
Urinary Sediment ◽  
Non Invasive ◽  
Micro Rnas ◽  
Wide Range ◽  
Mirna Species

Background:Micro-RNAs (miRNAs) regulate one-third of all protein-coding genes and are fundamental in the pathophysiology of a wide range of diseases. We studied the expression of several miRNA species (miR-200 family, miR-205 and miR-192) in the urinary sediment of patients with IgA nephropathy (IgAN).Methods:We studied 43 patients with biopsy-proven IgAN. Urinary expression of miRNAs was determined and compared to that from 13 healthy controls.Results:The levels of urinary miR-200a, miR-200b and miR-429, but not miR-200c, miR-141, miR-205, or miR-192, were down-regulated in patients with IgAN. Proteinuria significantly correlated with urinary expression of miR-200a (r= −0.483,P< 0.001), miR-200b (r= −0.448,P= 0.001) and miR-429 (r= −0.466,P= 0.001). Baseline renal function significantly correlated with urinary expression of miR-200b (r= 0.512,P< 0.001) and miR-429 (r= 0.425, P = 0.005). Urinary gene expression of ZEB2 inversely correlated with miR-200b (r= −0.321,P= 0.017); and vimentin expression inversely correlated with that of miR-200a (r= −0.360,P= 0.007), miR-200b (r= −0.416,P= 0.002) and miR-429 (r= −0.375,P= 0.005). After 33.4 ± 12.6 months, the rate of renal function decline significantly correlated with urinary expression of miR-200b (r= 0.316,P= 0.034).Conclusions:Urinary expression of miR-200a, miR-200b and miR-429 were down-regulated in patients with IgAN, and the degree of reduction correlated with disease severity and rate of progression. The results suggested that these miRNA species might play important roles in the pathophysiology of IgAN. Further studies are needed to clarify the role of urinary miRNA repression as a non-invasive marker of IgAN.

scholarly journals AB0053 THE ROLE OF ANGIOPOIETIN-LIKE PROTEINS TYPES 3 AND 4 IN THE DEVELOPMENT OF RENAL DYSFUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1059.1-1059
Author(s):  
V. Aleksandrov ◽  
L. Shilova ◽  
A. Aleksandrov
Keyword(s):  
Rheumatoid Arthritis ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Filtration Rate ◽  
Serum Concentrations ◽  
Group Iii ◽  
Group I

Background:Rheumatoid arthritis (RA) often contributes to the development of kidney disease. Angiopoietin-like proteins can be target markers for studying cardiorenal complications of RA [1].Objectives:Assessment of the correlation of serum concentrations of angiopoietin-like proteins types 3 and 4 (ANGPTL 3 and 4) with the progression of renal dysfunction in RA patients.Methods:114 patients with reliable RA (90.4% of women, 9.6% of men) aged 21 to 80 years (mean age 55.4 ± 11.2 years old), disease duration - 11.18 ± 9.03 years, positive for rheumatoid factor (RF-IgM) - 63.2%, positive for anti-citrullinated protein antibody (ACPA) - 59.7%) were examined. The laboratory examination included the determination of serum concentrations of angiopoietin-like protein type 3 (Human Angiopoietin-like Protein 3 ELISA, Bio Vendor, Czech Republic) and type 4 (RayBio Human ANGPTL4 ELISA Kit; RayBiotech, USA). To assess renal function in RA patients we used the calculated glomerular filtration rate (GFR) according to the CKD-EPI formula [2], taking into account the height and weight of a particular patient without indexing by body surface area. GFR values <60 ml / min / 1.73 m2 were regarded as a certain decrease, and GFR values from 60 to 89 ml / min / 1.73 m2 - as a slight decrease in global kidney function.Results:The concentration of ANGPTL3 in the blood serum of RA patients (n = 158) was 641.9 ± 224.5 ng / ml, and that of ANGPTL4 (n = 158) - 3.15 [0.77; 12.1] ng / ml. 74.7% (n = 118) were considered positive for the presence of ANGPTL3; 49.4% (n = 78) of RA patients were recognized as positive for the presence of ANGPTL4. The average glomerular filtration rate in RA patients was 74.0 ± 18.6 ml / min. More than а half of the examined RA patients had GFR ranging from 89 to 60 ml / min / 1.73 m2 (C1 - 21.5%; C2 - 58.9%; C3 - 19.6%). No sharp reduce of renal function (GFR <30 ml / min / 1.73 m2) corresponding to CKD C4-5 stages was recorded. Negative correlations of average strength were found between GFR and the level of ANGPTL 3 (r = -0.32, p <0.001) and ANGPTL 4 (rS = -0.31, p <0.001), as well as with age (rS = -0.28, p <0.001), the duration of RA (rS = -0.22, p = 0.005) and blood pressure increase (rS = -0.25, p = 0.001). On the basis of GFR measurements, patients were divided into three groups: group I - optimal renal function (> 90 ml / min); group II - a slight decrease in renal function (89-60 ml / min); group III - reduced renal function (<59 ml / min).Table 1.Content of ANGPTL 3 and 4 in RA patients with different GFR, ng / mlGroup I (n=34)Group II (n=93)Group III (n=31)ANGPTL 3533,4±161,7 I-III650,0±223,9733,2±244,1ANGPTL 40,77 [0,28;3,6] I-II, I-III3,3 [0,93;12,1]6,48 [1,52;19,3]Note: upper case indicates intergroup differences at p <0.05.There was a significant difference in the content of ANGPTL3 in patients of the first group and the patients of the third group (H-test = 6.55, p = 0.032) and ANGPTL4 in the group of patients with normal renal function (group I) and groups of RA patients with decreased GFR (group I- II: H-test = 10.7, p = 0.001; groups I-III: H-test = 20.1, p <0.001). ANGPTL4 indices also had intergroup differences (groups II-III: H-test = 7.2, p = 0.007) with GFR less than 90 ml / min.Conclusion:Chronic rheumatoid inflammation potentiates the development of renal dysfunction according to our data in 78.5% of patients. It is also accompanied by an increase in the content of ANGPTL types 3 and 4 in the blood of RA patients. A better understanding of the actions and mechanisms of ANGPTL may be of paramount importance for the development of effective ways of treatment for cardiorenal complications in RA.References:[1]Aleksandrov A., Aleksandrov V., Shilova L. Study of the role of angiopoietin-like protein type 4 in metabolic disorders caused by inflammation in rheumatoid arthritis. Ann Rheum Dis. 2020;79(s1):1341. doi: 10.1136/annrheumdis-2020-eular.4558.[2]KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1–150.Disclosure of Interests:None declared

scholarly journals Yersiniosis with a predominance of articular syndrome: challenges of outpatient admission. Clinical case

2021 ◽  
Vol 2 (5) ◽  
pp. 35-38
Author(s):  
Alexander A. Kopelev ◽  
◽  
Margarita A. Gromova ◽  
Julia B. Chervyakova ◽  
◽  
...  
Keyword(s):  
Connective Tissue ◽  
Clinical Picture ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Outpatient Basis ◽  
Systemic Diseases ◽  
The Common

The articular syndrome, although it requires, first of all, the exclusion of systemic diseases of the connective tissue, contrary to the common stereotype, is rather nonspecific. It can also be accompanied by infectious pathology, the incidence of various variants of which is quite high. On an outpatient basis, doctors of any specialty are faced with yersiniosis, the clinical manifestations of which are polymorphic and similar to those of other diseases. Below is an example of the course of yersiniosis with a predominance of articular syndrome in the clinical picture.

Effects of defibrotide treatment in patients with IgA nephropathy and reduced renal function

1996 ◽  
Vol 11 (2) ◽  
pp. 392-393 ◽  
Author(s):  
G. M. Frasca ◽  
M. Manello ◽  
E. Sestigiani ◽  
C. Canova ◽  
A. Vangelista ◽  
...  
Keyword(s):  
Renal Function ◽  
Iga Nephropathy ◽  
Reduced Renal Function

scholarly journals Tuberculosis-associated IgA nephropathy

2018 ◽  
Vol 46 (7) ◽  
pp. 2549-2557 ◽  
Author(s):  
Yamei Wang ◽  
Yuhong Tao
Keyword(s):  
Renal Function ◽  
Mycobacterium Tuberculosis ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Immunoglobulin A ◽  
Diagnostic Value ◽  
Accurate Diagnosis ◽  
Pathological Diagnosis ◽  
Immunoglobulin A Nephropathy ◽  
Reduced Renal Function

Immunoglobulin A nephropathy (IgAN) is the most frequent pathological diagnosis of tuberculosis (TB)-associated glomerulonephritis. Diagnosing TB-associated IgAN (TB-IgAN) is difficult because of its non-specific and insidious symptoms. An inaccurate diagnosis of TB-IgAN could result in the spread of TB and reduced renal function. Haematuria and proteinuria in conjunction with TB should be assessed because of the potential for diagnosis of IgAN. Renal biopsy is important in securing an accurate diagnosis prior to initiating treatment. Detection of Mycobacterium tuberculosis DNA and assessment of early secreted antigenic target of 6 kDa in renal biopsy tissues may have great potential diagnostic value in patients with TB-IgAN. Anti-TB therapy can effectively alleviate TB and TB-IgAN.

scholarly journals The role of homeostatic disorders in development of periodontal generalized inflammatory diseases in patients with β-thalassemya major

2019 ◽  
pp. 115-120
Author(s):  
R. V. Shadlinskaya
Keyword(s):  
Inflammatory Diseases ◽  
Periodontal Diseases ◽  
Thalassemia Major ◽  
Systemic Diseases ◽  
Acting Out ◽  
The Common ◽  
Direct Acting ◽  
The Way

Periodontitis as a manifestation of the systemic diseases was placed in separated part in the contemporary periodontal diseases classification. It has its own specific traits caused by features of the common pathology. The way as ß-thalassemia major is impacting to periodontium could be recognized as the indirect acting out of the side of dental and occlusal anomalies or direct acting of ß-thalassemia major to the periodontium. The range of the influence on periodontium depends on the degree of intensity of the systemic diseases.

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