Myohemoglobinuria

Yuile, Charles L.; Clark, William F.

doi:10.1084/jem.74.3.187

Cited by 48 publications

(3 citation statements)

References 8 publications

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“…with water. This gave satisfactory recoveries at plasma dilutions of [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] (b) Continuous infusion method: A small plastic catheter was placed in the femoral vein and 30 ml. of priming solution, containing usually 1 gm.…”

Section: Preparation Of the Grass Polysaccharidementioning

confidence: 99%

“…This assumption is based on the concept of glomerular porosity proposed by Yuile (7), and his demonstration that hemoglobin (molecular weight 68,000) in dogs passes through 3 per cent of the glomerular surface and myoglobin (molecular weight 16,400) through 20 per cent (8). Similarly, Marshall and Deutsch (9) have shown recently a rough correspondence between the molecular size of proteins and their clearances relative to creatinine in dogs.…”

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confidence: 99%

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Renal Clearances of Grass Polysaccharide: Observations on Glomerular Porosity and on the Relation of This Function to Proteinuria in Renal Disease

Beattie¹,

Corcoran²

1952

J. Clin. Invest.

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bridge, drew our attention in 1948 to a fructosan polysaccharide (levan) prepared from Italian rye grass. It is readily soluble in cold water, yields levulose on acid hydrolysis and is not metabolized. At that time, the fructosan was believed to be a homogeneous substance with a molecular weight somewhat greater than that of inulin, so that the suggestion was made that it might replace inulin in the measurement of glomerular filtration rate. It has since (see below) been shown to be inhomogeneous. Samples of blood and urine were collected at intervals, at first of five and 10 minutes and then at longer intervals over four to six hours. Plasma concentrations were calculated by interpolation to the mid point of each period of urine collection from a semilogarithmic graph of the determined concentrations, and these estimates were used in the calculation of plasma clearances.(b) Continuous infusion method: A small plastic catheter was placed in the femoral vein and 30 ml. of priming solution, containing usually 1 gm. each of polysaccharide and creatinine and 4 gm. of mannitol, were injected rapidly. This was followed by a sustaining solution containing saline and given at a rate of about 1 ml. per minute. The bladder was rinsed with saline 15 minutes after completion of the priming injection; this was noted as zero time. Urine samples were collected at intervals of 10 to 15 minutes and combined with the saline bladder rinses (30-50 ml.). Samples of venous blood were collected near the mid points of each urine collection. This routine was varied in detail (concentration of polysaccharide, rate of infusion and intervals of collection) in some experiments. Clearance techniques in human subjectsThe methods, except for addition of polysaccharide to the priming and sustaining media in amounts of 3 and 5 gm., respectively, are those described elsewhere (4) for the determination of plasma clearances of mannitol (Cm) and p-aminohippurate (CPAR). Some of the observations in patients include only the three periods of urine collection used in the measurement of PAH clearance at low plasma levels. PAH was omitted from most of the infusions used in normal subjects.

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Section: Preparation Of the Grass Polysaccharidementioning

confidence: 99%

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confidence: 99%

Renal Clearances of Grass Polysaccharide: Observations on Glomerular Porosity and on the Relation of This Function to Proteinuria in Renal Disease

Beattie¹,

Corcoran²

1952

J. Clin. Invest.

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“…Like polyfructosan or p2-microglobulin, myoglobin is not bound to plasma proteins or complexed to a significant degree [30]. How ever, in contrast to the free glomerular filtration of inulin/polyfructosan [16][17][18] and prmicroglobulin [5,6], the glomerular sieving coefficient of myoglobin has been determined at 0.75 [31], and, consequently, the renal ex traction ratio of myoglobin would be expected to be lower than that of polyfructosan. One may, therefore, speculate whether a minor degree of peritubular elimina tion exists for this protein as well.…”

Section: Discussionmentioning

confidence: 99%

Renal Elimination of Beta-2-Microglobulin and Myoglobin in Patients with Normal and Impaired Renal Function

Floege

Wilks²,

Soose³

et al. 1990

Nephron

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Since the demonstration that β₂-microglobulin (β₂M) is an amyloidogenic protein in man, the excretion of this low-molecular-weight protein under conditions with normal and reduced renal function has received increased interest. The renal arteriovenous extraction of β₂M, polyfructosan (an inulin analogue), and a second low-molecular-weight protein, myoglobin, was measured in vivo in 16 human kidneys with normal renal function/gross morphology and in 22 kidneys with reduced function. In kidneys with normal function, the extraction of β₂M significantly exceeded that of polyfructosan (0.198 ± 0.037 vs. 0.182 ± 0.05; p = 0.04), while that of myoglobin (0.177 ± 0.068) was not different from that of polyfructosan. In kidneys with reduced function, the extraction of polyfructosan or myoglobin was not significantly altered. In contrast, the β₂M extraction decreased to 0.110 ± 0.060 (p < 0.01 vs. extraction of polyfructosan or myoglobin). This decrease was significantly correlated with the decrease of the endogenous creatinine clearance or the total or unilateral ¹³¹I-hippuran clearance. These results indicate that in normal renal function the glomerular filtration of β₂M may be supplemented by a peritubular mode of removal. The mechanism(s) underlying the selective decrease of β₂M extraction in kidneys with reduced function remain speculative. However, this decrease will lead to a further augmentation of the retention of β₂M in renal failure.

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Idiopathic Paroxysmal Myoglobinuria

Pearson¹,

Beck²,

Blahd³

1957

AMA Arch Intern Med

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The liberation of myoglobin pigment from striated muscle and its subsequent appearance in the urine is a dramatic, potentially serious, and fortunately rather rare occurrence.Many types of traumatizing damage to muscle fibers may cause a partial or complete dissolution of the muscle sarcoplasm with the release of myoglobin and probably many other of the intracellular components. Some of these substances enter the circulation, and myoglobin, at least, is excreted by the kidney. Hence, myoglobinuria is not associated specifically with any single disease process but is a sign of severe damage to a significant mass of striated muscle.In addition to the traumatic myopathies, there have been reported a number of cases of myoglobinuria, usually recurrent and unassociated with any traumatic or toxic event.About one-third of these have been associated with muscular dystrophy. The remainder of the cases, 20 in number, have been idiopathic and unassociated with any specific or at least constantly recognizable disease process. This report deals with such a case, a man who throughout all of his adult life has suffered from recurrent major and minor attacks of myoglobinuria.Although the pathophysiological mechan¬ isms underlying this disease entity are still not understood, we have been able to con-duct a number of studies not previously reported on this condition. The results, to¬ gether with some recent reports on the physical chemistry of myoglobin, allow us to formulate a fairly clear picture of a number of the events which occur during the course of this disease. To add further emphasis to the potential seriousness of the disorder, our patient, as have others, de¬ veloped acute renal shutdown following his induced acute attack. Recovery from this was fortunately most satisfactory. Report of a CaseA 57-year-old white male office worker of Scotch and American Indian ancestry was first admitted to the Wadsworth Veterans Administra¬ tion Hospital on Feb. 16, 1955, with mild symp¬ toms and chemical evidence of diabetes mellitus.History revealed that he was perfectly well and healthy until the age of 20. Muscular effort in¬ cluding strenuous wrestling in matches prior to this time cause him no discomfort. While in France, in 1918, (age 20) he began to experience aching and cramping in the calves following moderate forced marching with a light pack. On the third such occasion the cramps were so severe that he had to be carried back to the camp.After this episode he noted that any muscle or muscle group would react in the same way with pain, tenderness, and cramps following heavy physical exertion. The cramps would last up to 12 hours and the pain and tenderness up to 48 hours. The quadriceps muscles were most fre¬ quently affected. In 1922, following heavy lifting, he developed lumbar pain and muscle cramping which was followed by the passage of dark red urine for the first time. On many occasions since then he has experienced this sequence of events, and the passage of red urine has followed overexertion of any significant bulk...

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Myohemoglobinuria

Cited by 48 publications

References 8 publications

Renal Clearances of Grass Polysaccharide: Observations on Glomerular Porosity and on the Relation of This Function to Proteinuria in Renal Disease

Renal Clearances of Grass Polysaccharide: Observations on Glomerular Porosity and on the Relation of This Function to Proteinuria in Renal Disease

Renal Elimination of Beta-2-Microglobulin and Myoglobin in Patients with Normal and Impaired Renal Function

Idiopathic Paroxysmal Myoglobinuria

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