Asunto(s)
Trasplante de Órganos , Atención Primaria de Salud , Rol , Adolescente , Niño , Preescolar , Anticoncepción , Interacciones Farmacológicas , Femenino , Rechazo de Injerto , Humanos , Inmunización , Terapia de Inmunosupresión , Cooperación del Paciente , Embarazo , Calidad de Vida , Recursos HumanosRESUMEN
Twenty children and adolescents with IgA glomerulonephritis were enrolled in a crossover trial. Each received 12 weeks of prednisone therapy and 12 weeks of placebo dosing. Urinary protein and erythrocyte excretion were monitored during both courses. There was no evidence that, under the conditions of the study, corticosteroid therapy was effective in IgA nephropathy.
Asunto(s)
Glomerulonefritis por IGA/tratamiento farmacológico , Prednisona/uso terapéutico , Adolescente , Niño , Creatinina/sangre , Método Doble Ciego , Femenino , Glomerulonefritis por IGA/sangre , Glomerulonefritis por IGA/complicaciones , Hematuria/etiología , Humanos , Masculino , Proteinuria/etiología , Resultado del TratamientoRESUMEN
The third component of complement, the central protein of the complement cascade, occurs in two principal allotypes, C3S and C3F. An excess frequency of the F allotype has been implicated in a number of disease states, including some forms of glomerulonephritis. These associations have been explained by functional differences between C3S and C3F. We examined several complement functions, using purified preparations of C3S or C3F. The C3S allotype was 1.3 times more efficient than C3F in a hemolytic assay employing sensitized sheep erythrocytes; this difference was shown to arise from a slightly more efficient deposition of C3F on the cell surface. These differences are trivial and of much less magnitude than the functional differences between C4A and C4B. There were no differences between allotypes in their ability to be converted to inactive C3b (C3bi) by complement factors H and I or by CR1 and factor I. No significant differences were seen between the allotypes and their ability to support solubilization of preformed immune complexes.
Asunto(s)
Complemento C3/genética , Polimorfismo Genético , Animales , Complejo Antígeno-Anticuerpo/genética , Proteínas Sanguíneas/análisis , Bovinos , Complemento C3/análisis , Proteínas Inactivadoras del Complemento C3b/farmacología , Complemento C4/análisis , Factor H de Complemento , Factor I de Complemento , Eritrocitos/inmunología , Hemólisis/genética , Humanos , Fenotipo , Conejos , Serina Endopeptidasas/farmacología , Ovinos , SolubilidadRESUMEN
Some children with Bartter syndrome have hypercalciuria. To determine the mechanism for this phenomenon, we studied tubular function and calcium metabolism in six such children. All patients had hypokalemic alkalosis, normotension, hyperreninemia, growth retardation, low fractional distal chloride reabsorption (4/5), and elevated urinary prostaglandin E2 excretion (5/6). In addition, all had hypercalciuria (urinary calcium 6.5 to 25.0 mg/kg/day), with evidence of nephrocalcinosis in five. None, however, had evidence of rickets or hyperparathyroidism. There was a marked elevation in the serum concentration of 1,25-dihydroxyvitamin D in all, and four patients had a response to oral calcium loading suggestive of absorptive hypercalciuria. Five children have had long-term therapy with indomethacin. They have had improvement in hypokalemia and reduced urinary prostaglandin E2 excretion as well as reductions in the serum concentration of 1,25-dihydroxyvitamin D and in urinary calcium excretion. These data suggest that hypercalciuria in some children with Bartter syndrome is associated with an excess of 1,25-dihydroxyvitamin D. The improvement in hypercalciuria with prostaglandin synthesis inhibition may result in part from correction of this vitamin D abnormality.