Characteristics of the course of nephritis associated with Iga-vasculitis Henoch-Schoenlein in children

2020 ◽  
Vol 24 (3) ◽  
pp. 64-71
Author(s):  
A. V. Sukalo ◽  
I. A. Kazyra
Keyword(s):  
Clinical Laboratory ◽  
Morphological Changes ◽  
Pediatric Nephrology ◽  
Morphological Characteristics ◽  
Lymphocyte Activation ◽  
Renal Tissue ◽  
Kidney Damage ◽  
Iga Vasculitis ◽  
Factors Affecting ◽  
Treatment Regimens

INTRODUCTION. Among systemic vasopathies in children, IgA vasculitis Henoch Schoenlein (HS) is the most common, according to various authors, kidney damage is noted in 25-80 % and usually determines the prognosis of the disease.THE AIM of the study was to analyze clinical, laboratory, immunological, morphological characteristics, features of the course and treatment of nephritis associated with IgA vasculitis HS in children, as well as factors affecting the prognosis.PATIENTS AND METHODS. The study included 31 patients with morphologically verified nephritis due to IgA vasculitis HS (18 – boys, 13 – girls) aged 3 to 17 years, who were monitored at the Nephrology Department of the "2nd Children's City Clinical Hospital" of the National Center for Pediatric Nephrology and Renal Replacement therapy in Minsk from 2010 to 2019 yrs.The following parameters were analyzed: the clinical variant of kidney damage, laboratory tests (including the study of BAFF, RANTES lymphocyte activation molecules, pro-inflammatory IL1β, caspase1, TNFα, growth factors VEGF, TGF), 24 hours monitoring and office blood pressure measurements, ECHO cardiography with indicescalculation, ultrasound of the carotid arteries with the thickness of intima-media complex, morphological changes in the renal tissue, as well as treatment regimens.RESULTS. The contribution of deGal-IgA1, markers of T and B lymphocytes activation, pro-inflammatory and profibrotic molecules in the development of the disease is shown. Arterial hypertension was registered in 42 % of children, signs of heart remodeling according to the calculated indices in 19,3 %. Decrease level of adiponectin, vitamin D, leptin, increase concentration of obestatin, Pro-BNP, hs-CRP, and TSAT indicator classify patients with nephritis due to IgA vasculitis HS at moderate risk for the developmentof cardio-vascular disorders, which suggests the need for timely correction.CONCLUSION. In most cases, nephritis with IgA vasculitis HS has a benign course with rare relapses and progression to the end stage of chronic kidney disease (6,5 %).

scholarly journals ASSESSMENT OF RISK FACTORS AND RATE OF PROGRESSION OF PRIMARY GLOMERULOPATHIES

2021 ◽  
pp. 47-55
Author(s):  
I.A. Kozyro ◽  
◽  
A.V. Sukalo ◽  
A.P. Mirilenko ◽  
Keyword(s):  
Risk Factors ◽  
B Lymphocyte ◽  
Predictive Accuracy ◽  
Clinical Laboratory ◽  
Morphological Changes ◽  
Pediatric Nephrology ◽  
Lymphocyte Activation ◽  
Rate Of Progression ◽  
B Lymphocyte Activation ◽  
Group 2

Purpose of the study: to determine the rate of progression of primary chronic glomerulopathies (GP) in children and to establish the main risk factors for the development of this process. Materials and methods. 188 children who were under observation and treatment at the Republican Center for Pediatric Nephrology and Renal Replacement Therapy of the "2nd Children's City Clinical Hospital" in Minsk, aged 3 to 17 years, with morphologically verified kidney damage, were included in the study: group №1 - children with minimal change disease (MCD), n=53; group №2 with IgM nephropathy (IgMN), n=26; group №3 with focal segmental glomerulosclerosis (FSGS), n=55; group №4 with IgA nephropathy (IgAN), n=54.The duration of the period from the onset of the disease to reaching the 3rd stage of CKD and predictors that determine the rate of progression of GP using Kaplan-Meier method was studied. Results. Anamnestic, clinical, laboratory, immunological (blood concentration of markers of T and B lymphocyte activation RANTES and BAFF), proinflammatory (caspase 1, IL1β and TNFα), vascular (VEGF) and tissue (TGF1β) growth factors), metabolic status (adiponectin, leptin, obestatin, vitamin D 25 (OH) D), instrumental, morphological changes were analyzed. Each of the variables was considered as a likely risk factor for the progression of GP. Conclusion. A mathematical model has been developed for predicting the risk of progression of secondary GP in children, including risk factors as predictors: impaired renal function at the onset of the disease, non-compliance with therapy, and a decrease in the estimated glomerular filtration rate (eGFR) at the onset of the disease less than 87 ml/min. The predictive accuracy of the model was 90,9% (95%ДИ 79,3-100%).

IgA nephropathy: analysis of progression in pediatric patients

2021 ◽  
Vol 25 (3) ◽  
pp. 61-67
Author(s):  
I. A. Kazyra ◽  
А. V. Sukalo
Keyword(s):  
Iga Nephropathy ◽  
B Lymphocyte ◽  
Interstitial Fibrosis ◽  
Prognostic Significance ◽  
Pediatric Nephrology ◽  
Lymphocyte Activation ◽  
Healthy Children ◽  
Tubular Atrophy ◽  
Factors Affecting ◽  
Highly Active

The aim of the study was to analyze the rate of progression of IgA nephropathy (IgAN) in childhood and factors affecting prognosis. The study included 54 children with a morphologically verified diagnosis of IgAN (36 boys, 18 girls) aged 2 to 17 years, who were under observation in the nephrology department of the "2nd Children's City Clinical Hospital" of the National Center for Pediatric Nephrology and Renal Replacement therapy in Minsk in the period from 2013 to 2020. The participation of deGal-IgA1, markers of T- and B-lymphocyte activation, pro-inflammatory and pro-fibrotic molecules in the development of the disease has been shown. AG was registered in 18 of 54 (33,3 %) children, nocturnal AG in 11/43 (23,4 %), signs of cardiac remodeling in 10/49 (20,4 %). A decrease in the level of adiponectin, vitamin D, an increase in obestatin in comparison with healthy children makes it possible to attribute patients with IgAN to the risk group for the development of cardiovascular disorders, which implies the need for timely monitoring and correction. In most cases in childhood IgAN is characterized by a benign course without signs of progression. The prognostic significance of highly active nephritis, impaired renal function at the onset of the disease, T1 (tubular atrophy / interstitial fibrosis in 25–50 %) by MEST, proteinuria over 0,8 g/24 hours as risk factors for progression was shown.

ASSESSMENT OF RISK FACTORS FOR PROGRESSION OF SECONDARY GLOMERUPATHIES IN CHILDREN

2021 ◽  
pp. 91-96
Author(s):  
I. A. Kozyro ◽  
◽  
A. V. Sukalo ◽  
A. P. Mirilenko ◽  
Keyword(s):  
Risk Factors ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Predictive Accuracy ◽  
Morphological Changes ◽  
Systemic Vasculitis ◽  
Systemic Disease ◽  
Pediatric Nephrology ◽  
Kidney Damage ◽  
Rate Of Progression

The problem of glomerular kidney damage remains relevant in pediatric nephrology due to the variety of reasons for its development and tendency to progression. According to the data of the Belarusian Center for Pediatric Nephrology and Renal Replacement Therapy, glomerulopathies (GP) occupy 2nd place in the structure of the causes of end-stage chronic kidney disease (CKD). The peculiarities of the course of GP dictate the need to search for informative predictors of the risk of adverse events, which will predict and prevent renal damage with a high degree of probability. Purpose of the study: to determine the rate of progression of secondary GP in children and to establish the main risk factors for its development. Materials and methods. 118 patients who were under observation and treatment at the Belarusian Center for Pediatric Nephrology and Renal Replacement Therapy of the "2nd Children's City Clinical Hospital" in Minsk, aged 3 to 17 years, were included in the study. We used the method of continuous targeted selection of patients with morphologically verified kidney damage due to the systemic disease. The analysis of the data of 4 study groups was carried out: 1) children with SLE, lupus nephritis (LN), retrospective group, n = 30; 2) children with SLE, LN, prospective group, n = 35; 3) patients with nephritis due to IgA vasculitis Schoenlein- Henoch (IgAV), n = 33; 4) patients with nephritis due to systemic vasculitis (SV), including ANCA-associated (AAV), n = 20. The duration of the period from the onset of the disease to reaching the 3rd stage of CKD and predictors that determine the rate of progression of GP using Kaplan-Meier method was studied. Results. Anamnestic, clinical, laboratory, immunological (blood concentration of markers of T and B lymphocyte activation RANTES and BAFF), proinflammatory (caspase 1, IL1e and TNFa), vascular (VEGF) and tissue (TGF1fi) growth factors), metabolic status (adiponectin, leptin, obestatin, vitamin D 25 (OH) D), instrumental, morphological changes were analyzed. Each of the variables was considered as a likely risk factor for the progression of GP. Conclusion. A mathematical model has been developed for predicting the risk of progression of secondary GP in children, including risk factors as predictors: anamnestic factors of kidney damage, non-compliance with therapy, persistent nephrotic proteinuria, increased serum creatinine over 200 umol/l. The predictive accuracy of the model was 93,6 % (95 % CI 84,8-100 %).

scholarly journals Clinical, laboratory, and morphological characteristics of kidney damage in lymphoproliferative disorders

2017 ◽  
Vol 12 (1) ◽  
pp. 44-54 ◽  
Author(s):  
B. T. Dzhumabaeva ◽  
L. S. Biryukova ◽  
V. A. Varshavsky ◽  
S. A. Mar’ina ◽  
L. S. Roshchina ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Morphological Characteristics ◽  
Lymphoproliferative Disorders ◽  
Kidney Damage

EVALUATION OF THE INTERRELATIONS OF BLOOD VCAM-1 LEVEL AND CLINICO-MORPHOLOGICAL CHARACTERISTICS OF CHRONIC GLOMERULONEFRITIS

2018 ◽  
Vol 22 (5) ◽  
pp. 64-70
Author(s):  
K. M. Bayaundurova ◽  
M. M. Batyushin ◽  
I. V. Sarvilina ◽  
N. V. Antipova ◽  
E. A. Sinel’nik
Keyword(s):  
Morphological Changes ◽  
Morphological Characteristics ◽  
Serum Levels ◽  
Renal Tissue ◽  
Pathological Process ◽  
Acute Stage ◽  
Chronic Glomerulonephritis ◽  
Intercellular Interaction ◽  
Microsoft Office ◽  
Cell Adhesion Molecule 1

Chronic glomerulonephritis is characterized by irreversible progression of the pathological process, which leads to the formation of terminal renal failure significantly impairing the  patient's quality of life, leading to internal dysfunction and increasing the risk of premature overall and cardiovascular mortality.  Consequently, the search for non-invasive methods for assessing the state of renal tissue, including the detection of proteins involved  in renal inflammation, fibrosis, intercellular interaction is currently important.THE AIM: To determine the serum levels of the vascular cell adhesion molecule-1 (VCAM-1) in patients with various forms of  chronic glomerulonephritis (CGN) and to clarify its relationship to the  development of morphological changes in the renal tissue.PATIENTS AND METHODS: In 80 patients (men and women), with CGN in the acute stage was carried out a detailed clinical and  laboratory examination, including determination of serum VCAM-1 by ELISA and performing puncture renal biopsy with the assessment of  morphological changes. Statistical analysis of the results was carried  out using «Microsoft Office Excel 2010» («Microsoft Corp.», USA)  and "STATISTICA 10.0" («StatSoft Inc.», USA).RESULTS. The serum level concentration of VCAM-1 was 719  [643;771] ng/ml. Obtained statistically significant interrelations with  enlargement of mesangial space, endothelial growth, capillary walls  thickening, mesangial hypercellularity, endothelial hypercellularity,  protein casts in tubules, anses capillaries union, fibrose demilunes,  podocyte necrosis, hypertrophic remodeling type of resistive type  vessels, Ig deposites, IgA deposites, IgG seposites, C3 complement  fluorescence, fibrinogen deposites. CONCLUSION: The results of the study demonstrate the important  role of VCAM-1 in the development of immunocomplex inflammation in glomerulonephritis. VCAM-1 is a marker of different morphological changes in CGN, and determining the level of VCAM-1 in serum is  informative, simple and noninvasive method which provides  evaluation of inflammatory process activity, prediction of the risk of morphological changes in the renal tissue structure in patients  with CGN.

scholarly journals A Pandemic Early Warning System Decision Analysis Concept Utilizing a Distributed Network of Air Samplers via Electrostatic Air Precipitation

2021 ◽  
Vol 11 (11) ◽  
pp. 5308
Author(s):  
Joseph J. Bango ◽  
Sophia A. Agostinelli ◽  
Makayla Maroney ◽  
Michael Dziekan ◽  
Ruba Deeb ◽  
...  
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Pathogen Detection ◽  
Clinical Laboratory ◽  
Culture Media ◽  
Morphological Characteristics ◽  
Warning System ◽  
Ambient Air ◽  
Aerosol Sampling ◽  
Distributed Network

The COVID-19 pandemic has highlighted the need for improved airborne infectious disease monitoring capability. A key challenge is to develop a technology that captures pathogens for identification from ambient air. While pathogenic species vary significantly in size and shape, for effective airborne pathogen detection the target species must be selectively captured from aerosolized droplets. Captured pathogens must then be separated from the remaining aerosolized droplet content and characterized in real-time. While improvements have been made with clinical laboratory automated sorting in culture media based on morphological characteristics of cells, this application has not extended to aerosol samples containing bacteria, viruses, spores, or prions. This manuscript presents a strategy and a model for the development of an airborne pandemic early warning system using aerosol sampling. 

Factors predicting length of stay in patients hospitalized for acute parotitis

2020 ◽  
pp. jim-2020-001506
Author(s):  
Avinoam Markovich ◽  
Ohad Ronen
Keyword(s):  
Clinical Laboratory ◽  
Medical Center ◽  
White Cell Count ◽  
Acute Infection ◽  
Retrospective Chart Review ◽  
Significant Treatment ◽  
Patient Age ◽  
Factors Affecting ◽  
Patient Âgé ◽  
Length Of Hospitalization

Acute suppurative parotitis (ASP) is an acute infection of the parotid gland that necessitates hospitalization in some patients. The aim of this study was to evaluate clinical laboratory values including hydration, nutritional status, inflammatory markers and age, and to compare them with duration of hospitalization of patients with ASP. This is a retrospective chart review in a tertiary academic center. We investigated the factors affecting length of hospitalization in patients admitted to Galilee Medical Center with a diagnosis of ASP between 2010 and 2018. Of the 60 patients with ASP included in the study, 24 were male. The average age of patients was 60, ranging from 18 to 99. We found statistically significant correlations between length of hospitalization and patient age (r=0.3), C reactive protein (r=0.3), white cell count (WCC) at presentation (r=0.3), blood urea nitrogen to creatinine ratio (BUN:Cr) (r=0.2), and platelet levels at discharge (r=0.4). Examination of these factors on multivariate analysis found hospitalization duration was exclusively affected by patients’ level of dehydration as represented by BUN:Cr. Patient age, WCC levels at presentation, and platelet levels were not found to be statistically significant. Treatment and interventions should be planned accordingly.

scholarly journals Myxomatous Mitral Valve Disease with Mitral Valve Prolapse and Mitral Annular Disjunction: Clinical and Functional Significance of the Coincidence

2021 ◽  
Vol 8 (2) ◽  
pp. 9
Author(s):  
Nina C. Wunderlich ◽  
Siew Yen Ho ◽  
Nir Flint ◽  
Robert J. Siegel
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Disease ◽  
Morphological Changes ◽  
Morphological Characteristics ◽  
Mitral Annulus ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Valve Disease ◽  
Left Ventricular Myocardium ◽  
Basal Portion

The morphological changes that occur in myxomatous mitral valve disease (MMVD) involve various components, ultimately leading to the impairment of mitral valve (MV) function. In this context, intrinsic mitral annular abnormalities are increasingly recognized, such as a mitral annular disjunction (MAD), a specific anatomical abnormality whereby there is a distinct separation between the mitral annulus and the left atrial wall and the basal portion of the posterolateral left ventricular myocardium. In recent years, several studies have suggested that MAD contributes to myxomatous degeneration of the mitral leaflets, and there is growing evidence that MAD is associated with ventricular arrhythmias and sudden cardiac death. In this review, the morphological characteristics of MAD and imaging tools for diagnosis will be described, and the clinical and functional aspects of the coincidence of MAD and myxomatous MVP will be discussed.

scholarly journals Coastal Sensitivity/Vulnerability Characterization and Adaptation Strategies: A Review

2021 ◽  
Vol 9 (1) ◽  
pp. 72 ◽  
Author(s):  
Giorgio Anfuso ◽  
Matteo Postacchini ◽  
Diana Di Luccio ◽  
Guido Benassai
Keyword(s):  
Emergency Preparedness ◽  
Morphological Characteristics ◽  
Vulnerability Index ◽  
Tidal Range ◽  
Coastal Vulnerability ◽  
Natural Habitats ◽  
Factors Affecting ◽  
Cultural Aspects ◽  
Relevant Variables ◽  
Coastal Resilience

Coastal area constitutes a vulnerable environment and requires special attention to preserve ecosystems and human activities therein. To this aim, many studies have been devoted both in past and recent years to analyzing the main factors affecting coastal vulnerability and susceptibility. Among the most used approaches, the Coastal Vulnerability Index (CVI) accounts for all relevant variables that characterize the coastal environment dealing with: (i) forcing actions (waves, tidal range, sea-level rise, etc.), (ii) morphological characteristics (geomorphology, foreshore slope, dune features, etc.), (iii) socio-economic, ecological and cultural aspects (tourism activities, natural habitats, etc.). Each variable is evaluated at each portion of the investigated coast, and associated with a vulnerability level which usually ranges from 1 (very low vulnerability), to 5 (very high vulnerability). Following a susceptibility/vulnerability analysis of a coastal stretch, specific strategies must be chosen and implemented to favor coastal resilience and adaptation, spanning from hard solutions (e.g., groins, breakwaters, etc.) to soft solutions (e.g., beach and dune nourishment projects), to the relocation option and the establishment of accommodation strategies (e.g., emergency preparedness).

scholarly journals Moraxella lacunata infection accompanied by acute glomerulonephritis

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 962-967
Author(s):  
Nami Sawada ◽  
Tamaki Morohashi ◽  
Tomokazu Mutoh ◽  
Tsukasa Kuwana ◽  
Junko Yamaguchi ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Case Reports ◽  
Laboratory Data ◽  
Inflammatory Cells ◽  
Final Diagnosis ◽  
Renal Tissue ◽  
Acute Glomerulonephritis ◽  
Pathological Findings ◽  
Complement Activity ◽  
Moraxella Lacunata

AbstractMoraxella lacunata (M. lacunata) is a Gram-negative bacterium, which rarely causes serious infection. This is a rare case report of acute glomerulonephritis diagnosed by pathological findings in a child accompanied by M. lacunata infection. The patient showed hematuria, proteinuria and hyperkalemia requiring emergency hemodialysis. After hospitalization, M. lacunata bacteremia became apparent. Pathological findings showed an increase in glomerulus inflammatory cells and glomerular C3 deposition was observed in the renal tissue biopsy. Final diagnosis was endocapillary proliferative glomerulonephritis. Clinical reports of M. lacunata infection requiring emergency hemodialysis in children are rare. Previous reports have suggested that lowered immune competency with chronic kidney disease may be a risk factor associated with serious invasive cases of M. lacunata infection. However, detailed clinical laboratory data and pathological findings have not been identified in previous case reports. Our case directly indicated complement activity and acute glomerulonephritis with M. lacunata infection. Although there are various causes for acute glomerulonephritis, infection-related glomerulonephritis (IRGN) is an important concept. M. lacunata infection might have a potential risk for IRGN with dysregulation of complement activity leading to serious and invasive clinical conditions than previously considered.

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