Methylprednisolone pulse therapy was performed for 8 patients of childhood nephrotic syndrome who showed resistance to conventional prednisolone therapy of 4 to 8 weeks. The pathological diagnosis of the patients were: 1 case of membranous nephropathy, membrano-proliferative glomerulonephritis, Menbranoproliferative glomerulonephritis with epithelial crescent (70%), sclerosing glomerulonephritis, mesangial proliferative glomerulonephritis, focal and global glomerulonephritis, and 2 cases of focal and segmental glonerulosclerosis. Creatinine clearance was above 50% of the normal in 7 cases, and less than 20% in crescentic glomerulonephritis. 20% in crescentic glomerulonephritis. 30gm/kg/D. of methylprednisolone was administered intravenously over 1~2hours, which was repeated 2 to 9 times on every other day. Thereafter, alternate day prednisolone therapy was continued. The results were as follows: Remission was attained in membranous nephropathy and MPGN, within 9 weeks and 13 weeks respectively. Marked improvement was noted in crescentic glomerulonephritis. Ccr increased from 18.5ml/min/1.73mm(2) to 59.1ml/min/1.73mm(2) 10 days later after pulse? Sclerosing glomerulonephritis showed significant improvement in clinical finding and serum albumin. There was no improvement in mesangial proliferative glomerulonephritis, focal and global glomerulonephritis, and 2 cases of focal and segmental glomerulosclerosis. These findings suggest that methylprednisolone pulse?therapy may benefit the childhood nephrotic syndrome with resistance to conventional prednisolone therapy.
Creatinine ; Diagnosis ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Humans ; Methylprednisolone ; Nephrotic Syndrome* ; Prednisolone* ; Serum Albumin

Child ; Glomerulonephritis ; classification ; diagnosis ; therapy ; Humans

BACKGROUND: Since the introduction of cyclosporine, the short-term renal allograft survival has significantly improved. However, the long-term success is still limited by the development of chronic rejection and recurrent disease. Post-transplant glomerulonephritis (post-Tx GN) including recurrent disease is becoming an important cause of graft dysfunction. METHODS: From November 1988 to June 2004, a total of 629 renal transplants involving 588 patients were performed at our medical center. RESULTS: The prevalence rate of post-Tx GN was 11.9% in 629 renal transplant. Among 75 transplants diagnosed as post-Tx GN, IgA nephropathy (62.7%) was the most common histologic diagnosis, followed by focal segmental glomerulosclerosis (26.7 %), membranous glomerulonephritis (8.0%), membranoproliferative glomerulonephritis (1.3%) and diabetic nephropathy (1.3%). Documented histologic recurrence occurred in only 24.2% of patients with prior biopsy-proven glomerulonephritis of their native kidneys. The actuarial allograft survival at 5 and 10 years posttransplantation with post-Tx GN was 80.5 % and 27.9%, respectively; and the corresponding graft survival for patients without post-Tx GN was 74.9% and 52.3%, respectively (p<0.05). However, there was no significant difference in the graft survival according to type of post-Tx GN. The 5 and 10 year graft survival for patients with proteinuria over than 3.5 g/24 hr were 62.5% and 0%, which is significantly lower compared with 85.3% and 28.7% for patients with proteinuria less than 3.5 g/24 hr (p<0.01). CONCLUSION: In conclusion, post-Tx GN is associated with decreased long-term graft survival and nephrotic range proteinuria is most important prognostic factor for graft survival. A prospective study with rigorous efforts to make pretransplant diagnosis and standardized criteria for allograft biopsy will more accurately characterize the natural history of post-Tx GN and may provide insight regarding treatment.
Allografts* ; Biopsy ; Cyclosporine ; Diabetic Nephropathies ; Diagnosis ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Graft Survival ; Humans ; Kidney ; Natural History ; Prevalence ; Proteinuria ; Recurrence ; Transplants

BACKGROUND: Immunoglogulin A(IgA) nephropathy is the most common primary glomerular disease throughout the world. 30-50% of patients with IgA nephropathy(IgAN) have high serum IgA concentrations. However, we do not know if the degree of elevation in IgA level increases the likelihood of having IgAN. Neither do we know if the IgA level has any association with pathological findings of IgAN. METHODS: We analyzed the relationships between IgAN and the levels of serum IgA which has been a routine part of the study in all patients with glomerulonephritis in our institution for the last 4 years. We reviewed 270 patients in whom the pathological diagnosis and the results of their IgA levels were both available. RESULTS: Of 80 patients who were IgA nephropathy, 26 patients(32.5%) had higher than normal cut- off value of serum IgA(385 mg/dL). In contrast, 8.9 % of patients with other types of glomerulonephropathies showed the values above normal(p<0.0001). The risk ratio for an increase of one unit of the IgA level was 1.0025(logistic regression, p=0.0043), which was increased to 1.0079 when patients with low complement levels were excluded from the analysis. The data were also analyzed according to the immunofluorescence microscopic findings of IgAN, which were found to have no significant correlation with IgA concentrations. CONCLUSION: The IgA level is a risk factor for IgAN throughout the whole range. However, it does not correlate with the IgA deposition in the renal tissue. We believe that this study will help understanding the interpretation of IgA levels in patients with IgAN.
Complement System Proteins ; Diagnosis ; Fluorescent Antibody Technique ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Odds Ratio ; Risk Factors

The authors report series of 360 cases of transthoracic fine-needle aspiration cytology (TFNA) from Oct. 1982, through Aug. 1986 at the Seoul National University Hospital. A diagnosis of neoplastic lesion was established in 50.3% of the cases. A non-neop- lastic diagnosis was made in 38.5%, nondiagnostic one in 6.5% and inadequate one in 4.7% of the total. Statistical findings on cytological diagnoses were as follows. Specificity was 100%: sensitivity, 92%; predictive value for positive, 1.0: predictive value for negative, 0.9; concordance rate, 84.2%: diagnostic accuracy in non-neoplastic lesion, 65.4%, and typing accuracy in malignant tumor, 0.77.
Biopsy, Fine-Needle ; Diagnosis ; Glomerulonephritis, IGA* ; Immunoglobulin A* ; Sensitivity and Specificity ; Seoul

PURPOSE: Postinfectious acute glomerulonephritis usually needs no renal biopsy. But atypical clinical course and laboratory results indicate a need for renal biopsy. Therefore, to investigate clinicopathological characteristics of postinfectious acute glomerulonephritis, we compared clinical manifestations of biopsy group with those of non-biopsy group. METHODS: We reviewed the records of clinical and pathological data of 20 cases diagnosed by renal biopsies and compared them with 23 cases only diagnosed clinically. RESULT: Male : female ratio was 4.8 : 1 in biopsy group and 1.2 : 1 in non-biopsy group, so the male is more predominent in number in the biopsy group. Hypertension was documented in 52.2% of cases of non-biopsy group, which is significantly high compared to incidence of hypertension (20%) in the biopsy group. Laboratory data showed that serum creatinine, cholesterol, and 24- hour urine protein losses are significantly higher in the biopsy group. In the biopsy group, tentative diagnosis on admission were acute glomerulonephritis(45.0%), nephrotic syndrome(15.0%), membranoproliferative glomerulonephritis(15.0%), pyelonephritis(10.0%) and so on. Mean time from onset of symptoms to renal biopsy was 29.3+/-24.1(7-110) days. Fifty percent of the cases showed exudative phase, 25.0% exudative-proliferative phase. In three cases over 7 weeks, two showed proliferative phases and one sclerotic phase. CONCLUSION: Our cases of postinfectious acute glomerulonephritis diagnosed by renal biopsy had a male predominence, and lower incidence of hypertension They also tended to have decrease renal function and more urinary protein loss compared to clinically diagnoses ones without renal biopsy.
Biopsy ; Cholesterol ; Creatinine ; Diagnosis ; Female ; Glomerulonephritis* ; Humans ; Hypertension ; Incidence ; Male

PURPOSE: Postinfectious acute glomerulonephritis usually needs no renal biopsy. But atypical clinical course and laboratory results indicate a need for renal biopsy. Therefore, to investigate clinicopathological characteristics of postinfectious acute glomerulonephritis, we compared clinical manifestations of biopsy group with those of non-biopsy group. METHODS: We reviewed the records of clinical and pathological data of 20 cases diagnosed by renal biopsies and compared them with 23 cases only diagnosed clinically. RESULT: Male : female ratio was 4.8 : 1 in biopsy group and 1.2 : 1 in non-biopsy group, so the male is more predominent in number in the biopsy group. Hypertension was documented in 52.2% of cases of non-biopsy group, which is significantly high compared to incidence of hypertension (20%) in the biopsy group. Laboratory data showed that serum creatinine, cholesterol, and 24- hour urine protein losses are significantly higher in the biopsy group. In the biopsy group, tentative diagnosis on admission were acute glomerulonephritis(45.0%), nephrotic syndrome(15.0%), membranoproliferative glomerulonephritis(15.0%), pyelonephritis(10.0%) and so on. Mean time from onset of symptoms to renal biopsy was 29.3+/-24.1(7-110) days. Fifty percent of the cases showed exudative phase, 25.0% exudative-proliferative phase. In three cases over 7 weeks, two showed proliferative phases and one sclerotic phase. CONCLUSION: Our cases of postinfectious acute glomerulonephritis diagnosed by renal biopsy had a male predominence, and lower incidence of hypertension They also tended to have decrease renal function and more urinary protein loss compared to clinically diagnoses ones without renal biopsy.
Biopsy ; Cholesterol ; Creatinine ; Diagnosis ; Female ; Glomerulonephritis* ; Humans ; Hypertension ; Incidence ; Male

IgA nephropathy can occur rarely as a complication of D-penicillamine treatment, but it is exact pathogenesis remains unclear. If a patients has gross or microscopic hematuria during D-penicillamine treatment, D-penicillamine induced IgA nephropathy should be suspected as a cause of hematuria. In those cases, renal biopsy should be taken for diagnosis and proper management. We experienced a case of IgA nephropathy confirmed by renal biopsy in a 39-years-old female patient with scleroderma during D-penicillamine therapy and report this case with a review of literature.
Biopsy ; Diagnosis ; Female ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Penicillamine*

Adolescent ; Child ; Female ; Glomerulonephritis, IGA ; diagnosis ; pathology ; Humans ; Male ; Prognosis

Glomerulonephritis, IGA ; diagnosis ; therapy ; Humans ; Integrative Medicine ; Risk Assessment