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      Mesangial Proliferative Glomerulonephritis with or without IgA Deposits: The Morphological Characters in Psoriasis Vulgaris

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          Abstract

          Background/Aim: Chronic glomerulonephritides associated with psoriasis vulgaris have been reported in the literature. However, because of the limited number of cases and the lack of specific histological findings, the existence of psoriatic nephropathy remains controversial. This study was performed to investigate the clinical and morphological characteristics of renal involvement in psoriasis vulgaris. Methods: We studied retrospectively 11 patients with psoriasis vulgaris. All patients had nephritic urinary sediments and underwent percutaneous renal biopsy between January 1997 and December 2006. To fulfill the criteria for the study, none of them had any other discernible chronic disease as a second cause of nephropathy, except for long-standing psoriasis vulgaris. Results: Of the 11 patients, 2 (18%) had impaired renal function and 9 (82%) presented with hematuria. Proteinuria was noted in all patients. Their mean peak ESR was 28.3 ± 29.1 mm/1st h. Renal biopsy specimens revealed common histological features of slight-to-moderate mesangial proliferative glomerulonephritis, with (73%) or without IgA depositions in the mesangial area. Inflammation and vascular lesions were unremarkable in the biopsy specimens. Conclusion: The results from this study demonstrate that mesangial proliferative glomerulonephritis with or without IgA deposits might be the major morphological pattern associated with psoriasis vulgaris.

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          Most cited references 14

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          Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of prognostic factors.

           Y Kaku,  K Nohara,  S Honda (1998)
          This study is the first report in which the relationship between the progression of renal involvement in Henoch-Schönlein purpura (HSP) and various factors was evaluated using a multivariate analysis. Sixty-five (33.5%) of 194 patients with HSP developed renal involvement from three days to 17 months after the onset of the disease. The plasma coagulation factor XIII (F XIII) activity of 97 patients was examined, and 51 (54.3%) of them showed a decreased activity. A univariate analysis showed that an age at the onset of more than seven years, persistent purpura and a decreased F XIII activity all increased the risk of developing renal involvement. A Cox regression model analysis indicated severe abdominal symptoms, persistent purpura and decreased F XIII activity to be significant risk factors and their hazard ratios were 3.26, 11.53 and 2.27, respectively. Corticosteroid treatment had a hazard ratio of 0.36 and was considered to decrease the risk of developing renal involvement. Based on these findings, patients who have the risk factors for renal involvement should be treated with corticosteroids at the onset of the disease to prevent developing renal involvement.
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            Differential activation of migration by hypoxia in keratinocytes isolated from donors of increasing age: implication for chronic wounds in the elderly.

             J Tyrone,  Y. Zhao,  T Mustoe (2000)
            Chronic wound healing conditions are often observed in elderly patients with poor tissue oxygenation. Impaired re-epithelialization is a hallmark of these wounds, which is seen in both clinical studies and in our animal models of impaired healing. To investigate the pathogenic mechanism of chronic wounds, we studied the effect of hypoxia on migration of keratinocytes isolated from human donors of increasing age. Keratinocytes from elderly donors had depressed migratory activity when exposed to hypoxia, as opposed to an increase in migration in young cells. Analysis of underlying biochemical changes demonstrated a differential activation of matrix metalloproteinases by hypoxia in keratinocytes isolated from the young and the old. Matrix metalloproteinases-1 and -9 and tissue inhibitor of matrix metalloproteinase-1 were strongly upregulated by hypoxia in young cells, whereas no induction was observed in aged cells. Furthermore, transforming growth factor-beta 1 signaling appears to be involved in the keratinocyte differential response to hypoxia, as transforming growth factor-beta type I receptor was upregulated by hypoxia in young cells, while there was no induction in aged cells. Transforming growth factor-beta neutralizing reagents blocked hypoxia-induced matrix metalloproteinase-1, matrix metalloproteinase-9 expression, and hypoxia-induced cell migration as well. Our results suggest that an age-related decrease in response to hypoxia plays a crucial part in the pathogenesis of retarded re-epithelialization in wound.
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              Glomerulonephritis.

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                Author and article information

                Journal
                NEC
                Nephron Clin Pract
                10.1159/issn.1660-2110
                Nephron Clinical Practice
                S. Karger AG
                1660-2110
                2008
                April 2008
                07 March 2008
                : 108
                : 3
                : c221-c225
                Affiliations
                Departments of aInternal Medicine and bNephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
                Article
                119716 Nephron Clin Pract 2008;108:c221
                10.1159/000119716
                18332636
                © 2008 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 2, Tables: 2, References: 32, Pages: 1
                Categories
                Original Paper

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