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  • 1
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    Nephrology 10 (2005), S. 0 
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SUMMARY:  Lupus nephritis (LN) is a prototypic autoimmune disease. Its immunopathogenesis is characterized by the loss of self-tolerance. In this article, we review our current understanding of the disease mediators of LN. There is ample evidence to suggest a pathogenic role of nephritogenic autoantibodies. These antibodies cross react with nucleosomal epitopes, and the in vivo generation of nucleosomes requires apoptosis. Furthermore, there is an intriguing and paradoxical relationship between complement and systemic lupus erythematosus (SLE). Immune complex–mediated activation of complement through the classic pathway is traditionally believed to be a major mechanism by which tissue injury occurs. In contrast, hereditary deficiencies of complement components increase the risk of SLE. Finally, the roles of reactive nitrogen and oxygen species are emphasized.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Backgrounds and Aims:  There is relatively little data on the seroprevalence of Helicobacter pylori in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). This study aims at establishing the seroprevalence of and the factors associated with H. pylori infection in Chinese CAPD patients.Methods:  All CAPD patients from a single dialysis centre were invited to participate in the study. Diagnosis of H. pylori infection was made serologically by the pylori DTect ELISA method. Dyspeptic symptoms were assessed by the Hong Kong Index of Dyspepsia (HKID) Questionnaire. Demographic, clinical and laboratory parameters were correlated with the H. pylori serology results.Results:  One hundred and thirty-six Chinese CAPD patients were included in the study. The mean age of the patients was 61.8 ± 12.5 years with a male to female ratio of 1:1.4. The mean duration of CAPD was 54 ± 42 months. Thirty-five patients (26%) have positive serology against H. pylori. Nineteen patients had a HKID score of 〉16. There was no association between H. pylori seropositivity and dyspeptic symptoms (P = 0.62). Patients who were seropositive for H. pylori were significantly older (64.9 ± 9.5 years vs 60.7 ± 13.2 years, P 〈 0.05) and had lower KT/V-values than patients who were seronegative for H. pylori (1.88 ± 0.3 vs 2.03 ± 0.3, P 〈 0.05). Patients with positive or negative H. pylori serological status did not differ in terms of demographic parameters (e.g. sex, duration of CAPD), clinical factors (e.g. bodyweight, body mass index, hepatitis status, use of H2 antagonists or proton pump inhibitors) and laboratory data (e.g. haemoglobin, serum urea, creatinine, albumin and parathyroid hormone levels).Conclusions:  The seroprevalence of H. pylori infection among Chinese CAPD patients is 26%. Helicobacter pylori seropositivity is not associated with dyspepsia. Older age and lower KT/V-values appear to be associated with the development of H. pylori seropositivity in our dialysis population.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Antiglomerular basement membrane (anti-GBM) disease is an uncommon disease, especially among Asian population. Many reports and studies on this condition in the Caucasian population are available, but little information exists on anti-GBM disease in Asians. To study the incidence and clinical characteristics of anti-GBM disease among Chinese patients, we reviewed our experience of anti-GBM disease in our hospital (Queen Mary Hospital, Hong Kong) from 1992 to 2003.Methods:  All patients who were admitted for acute renal impairment, which was caused by crescentic glomerulonephritis associated with linear immunoglobulin G (IgG) staining on immunofluorescence, were included in the analysis. Serum anti-GBM antibodies were detected by either enzyme-linked immunofluorescence or indirect immunofluorescence. Ten patients were treated for anti-GBM disease during this 11-year period, yielding an incidence of approximately 0.6 cases per million population per year.Results:  In this cohort, anti-GBM disease predominantly affected older patients (mean age: 58.6 ± 21.7 years). Eight patients were aged between 60 and 80 years and there was a female preponderance (M:F =  2:8). The 1-year renal and patient survival was 15% (95% CI 0–40%) and 70% (95% CI 42–98%), respectively. Most patients presented with non-specific symptoms as well as impaired renal function. Detection of anti-GBM antibody provided a good screening test for the disease. Antiglomerular basement membrane antibodies were not detected in two patients. All but two patients received steroid, cyclophosphamide and intensive plasmapheresis therapy. Haemoptysis occurred in four patients (40%), and usually lagged behind the renal presentation and commencement of treatment. Six patients required long-term dialysis after the acute disease. Three patients died from the disease, two died from pulmonary complications and one died suddenly after a partial recovery of renal function.Conclusion:  Antiglomerular basement membrane disease is uncommon among the Chinese population. It predominantly affects older patients, and prognosis is poor. Long-term preservation of renal function after the initial attack is unusual.
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