Secondary Glomerular Disease

Appel, Gerald B.; D’Agati, Vivette D.

doi:10.1016/b978-1-4160-6193-9.10032-6

Cited by 45 publications

(120 citation statements)

References 1,063 publications

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“…Accumulation of lipid components is a characteristic feature of the renal lesions in FLD, and it occurs in both intracellular and extracellular sites. 12 The GBM is considered to be injured by these lipids, resulting in proteinuria. 12 In addition, a variable form cell infiltration was frequently observed in the glomerular capillary lumina.…”

Section: Discussionmentioning

confidence: 99%

“…12 The GBM is considered to be injured by these lipids, resulting in proteinuria. 12 In addition, a variable form cell infiltration was frequently observed in the glomerular capillary lumina. 9 Foam cells are considered to be derived from monocytes or macrophages, which take up LDL and undergo phenotypic transformation into foam cells.…”

Section: Discussionmentioning

confidence: 99%

“…18 Plasma infusions improved the lipid profiles in a short-term study; however, their long-term benefits are yet to be demonstrated. 12 Recently, enzyme replacement therapy was shown to be effective for certain lysosomal diseases. 19 FLD could be an attractive candidate for enzyme replacement therapy, because LCAT acts in the plasma compartment, without any organspecific distribution.…”

Section: Discussionmentioning

confidence: 99%

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Nephrotic Syndrome Caused by Immune-Mediated Acquired LCAT Deficiency

Takahashi

Hiromura²,

Tsukida³

et al. 2013

Journal of the American Society of Nephrology

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Lecithin-cholesterol acyltransferase (LCAT) is an enzyme involved in maintaining cholesterol homeostasis. In familial LCAT deficiency (FLD), abnormal lipid deposition causes renal injury and nephrotic syndrome, frequently progressing to ESRD. Here, we describe a 63-year-old Japanese woman with no family history of renal disease who presented with nephrotic syndrome. The laboratory data revealed an extremely low level of serum HDL and undetectable serum LCAT activity. Renal biopsy showed glomerular lipid deposition with prominent accumulation of foam cells, similar to the histologic findings of FLD. In addition, she had subepithelial electron-dense deposits compatible with membranous nephropathy, which are not typical of FLD. A mixing test and coimmunoprecipitation study demonstrated the presence of an inhibitory anti-LCAT antibody in the patient's serum. Immunohistochemistry and immunofluorescence detected LCAT along parts of the glomerular capillary walls, suggesting that LCAT was an antigen responsible for the membranous nephropathy. Treatment with steroids resulted in complete remission of the nephrotic syndrome, normalization of serum LCAT activity and HDL level, and disappearance of foam cell accumulation in renal tissue. In summary, inhibitory anti-LCAT antibody can lead to glomerular lesions similar to those observed in FLD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nephrotic Syndrome Caused by Immune-Mediated Acquired LCAT Deficiency

Takahashi

Hiromura²,

Tsukida³

et al. 2013

Journal of the American Society of Nephrology

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“…[1][2][3][4] Secondary amyloidosis can arise as a complication of any kind of chronic inflammatory, infectious, and neoplastic diseases such as rheumatoid arthritis, familial Mediterranean fever (FMF), or inflammatory bowel disease. Renal involvement is a cause of major morbidity for patients having amyloidosis.…”

Section: Introductionmentioning

confidence: 99%

Functional evaluation of secondary renal amyloidosis with diffusion-weighted MR imaging

et al. 2016

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Objectives This study evaluated whether diffusion-weighted magnetic resonance imaging (DW-MRI) can be used to diagnose secondary renal amyloidosis looking specifically at the diagnostic efficacy of two apparent diffusion coefficient (ADC) measurement methods as they were used with DW-MRI. Methods The study included 24 amyloid nephropathy (AN) patients, 20 chronic kidney disease (CKD) patients, and 20 healthy volunteers (HV). ADC values were measured using two different methods: 1) the method of the region of interest indicators (ROIs) and 2) the method of drawing whole renal parenchyma (WP). The correlation between the two methods was evaluated.Results ROIs could differentiate AN-CKD (p ¼ 0.007). ROIs and WP could differentiate AN-HV (p50.05). However, none of the methods could differentiate CKD-HV (p40.05). The sensitivity and specificity of the ROIs method in differentiating AN from CKD patients for 1.8 Â 10À3 cutoff ADC values were 79% and 60% and for AN-HV patients 79% and 70%. ADC values of AN patients with GFR460 mL/min were lower than that of HV (p50.01). Conclusion DW-MRI is a useful and noninvasive diagnostic tool in diagnosing secondary renal amyloidosis and differentiating renal amyloidosis from other CKDs. ROIs had the highest sensitivity and specificity for assessing the involvement of renal amyloidosis. MRI diagnosis of AN may obviate a renal biopsy for diagnosis. ARTICLE HISTORY

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“…Renal disease develops in more than half of SLE patients, and represents the first clinical manifestation of SLE in 15%-20% (2,3). The role of the renal biopsy in diagnosis, treatment, management, and follow-up of lupus nephritis (LN) is critical.…”

Section: Introductionmentioning

confidence: 99%

Lupus Nephritis

Giannico

Fogo

2013

Clinical Journal of the American Society of Nephrology

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SummaryMost patients with SLE develop kidney disease related to this systemic underlying disease process. Lupus nephritis is an important cause of morbidity and even mortality in patients with systemic lupus erythematosus. Lupus nephritis has diverse morphologic manifestations with varying clinical presentations and consequences. The pathogeneses involve immune complexes, which can deposit anywhere in the kidney, and other mechanisms, including endothelial injury, podocytopathy, and tubulointerstitial injury. Treatment and prognosis accordingly range from excellent even with only observation with minimal mesangial deposits, to kidney failure despite aggressive immunosuppression in patients with severe proliferative disease. Renal biopsy plays a crucial role in the diagnosis of the specific form of lupus nephritis in any patient. However, the role of the renal biopsy in prediction of outcome, treatment, and prognosis has been controversial. We will review the current classification of lupus nephritis and the value of renal biopsy in the management of these patients.

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Secondary Glomerular Disease

Cited by 45 publications

References 1,063 publications

Nephrotic Syndrome Caused by Immune-Mediated Acquired LCAT Deficiency

Nephrotic Syndrome Caused by Immune-Mediated Acquired LCAT Deficiency

Functional evaluation of secondary renal amyloidosis with diffusion-weighted MR imaging

Lupus Nephritis

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