1/7. Poststreptococcal glomerulonephritis presenting as impending airway obstruction.The presence of poststreptococcal glomerulonephritis in the pediatric patient remains a diagnostic challenge to the emergency physician. The variability of both patient presentation and laboratory parameters often obscures the diagnosis. We describe a child who presented to the emergency department with subglottic edema and the possibility of impending airway compromise. The child was admitted to the hospital under close observation, and several days later, the diagnosis of poststreptococcal glomerulonephritis was made.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Fibrillary glomerulonephritis.The occurrence of fibrillary glomerulonephritis is unusual in taiwan, whereas it occurs in approximately 1% of renal biopsy specimens taken in the united states of American. This disease is characterized by extracellular randomly arranged non-branching congo red-negative microfibrils within glomeruli. The microfibrils are less than 30 nm in diameter, and electron microscopy is essential for diagnosis. Differential diagnosis of the deposition of extracellular non-branching microfibrils within glomeruli is important because discrete diseases have different therapeutic and prognostic implications. The report will discuss two cases of biopsy-proved fibrillary glomerulonephritis who presented with proteinuria, hematuria, renal insufficiency, and hypertension. It is noteworthy that the renal function persistently went downhill, even though the physician treated the patients with corticosteroids, pulse treatment and immunosuppressive agents.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. autoantibodies and the spectrum of sjogren's syndrome.In studies reported recently, the sera of patients with sjogren's syndrome were found to contain precipitating antibodies to nuclear antigens that can be identified by immunodiffusion analysis. These precipitating autoantibodies have been termed SS-A and SS-B antibodies. We show that identification of these autoantibodies helped in establishing the diagnosis of sjogren's syndrome in 12 of 30 patients in whom the diagnosis had not been considered at the time of the physician's initial examination. The reasons for this were related to lack of spontaneous complaints of keratoconjunctivitis sicca and xerostomia and prominence of symptoms associated with arthritis, myalgia, pulmonary fibrosis, and cardiac disease. This study re-emphasizes the importance of multisystem disease in sjogren's syndrome and shows that specific serologic assays for autoantibodies aided in diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Poststreptococcal glomerulonephritis: a rare complication in pregnancy.streptococcus pyogenes rarely causes glomerulonephritis in pregnant women. The family physician must consider this nonsuppurative cause, however, in the differential diagnosis of a pregnant patient with edema, abnormal urinalysis, and declining renal function, as this case study demonstrates.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Evaluation of gross and microscopic hematuria.In summary, hematuria, either gross or microscopic and with or without any accompanying symptoms, should always alert the clinician to the possibility of serious urologic disease and should virtually always trigger a thorough urologic investigation. This can be done by immediate referral to the urologist, or it can be done by the primary care physician initiating the diagnostic work-up in children by obtaining studies for acute poststreptococcal glomerulonephritis and in adults by obtaining excretory urograms with physiologic voiding films and also by urine cytologic studies and urine cultures. Appropriate referral to a urologist can then be made for additional studies that might be indicated, such as cystoscopy and cystourethroscopy and for meticulous follow-up of any abnormal findings. The physician who delays or defers a careful investigation into the cause of a given patient's hematuria (gross or microscopic) does the patient a disservice at best and, at worst, may inadvertently permit a significant disease process to become more extensive.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
6/7. urinalysis and clinical renal disease.urinalysis is a simple, efficient, and accurate guide in the diagnosis of renal disease. By determining a patient's history and obtaining a physical examination, the physician is very often able to diagnose a patient's renal lesion. Heavy proteinuria and a microscopic sediment containing red cells and red cell casts strongly suggest acute glomerulonephritis. The causes of this nephropathy are legion. On the other hand, mild proteinuria and a lack of microscopic findings suggest nephrosclerosis, interstitial nephritis, or acute tubular necrosis in the proper clinical setting. When glomerular disease produces nephrotic syndrome, the various types of glomerular disease can be diagnosed accurately without biopsy in a high percentage of cases.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Acute rheumatic fever and poststreptococcal acute glomerulonephritis caused by T serotype 12 Streptococcus.We present a rare case of a 10 year old Japanese boy with acute rheumatic fever accompanied with poststreptococcal acute glomerulonephritis. We isolated group A Streptococcus serotype T 12, a strain that was thought to be nephritogenic but not rheumatogenic, from throat culture. Although rare, physicians should be aware that acute renal disease may accompany rheumatic fever.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |