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M Praga

Publications and source records attributed to M Praga.

129 records · Page 8Linked to original sources
PubMedDate not supplied

[Diagnostic and clinical course features of lupus membranous glomerulonephritis].

BACKGROUND: Lupus membranous glomerulonephritis (LMG) is sometimes difficult to distinguish from idiopathic membranous glomerulonephritis (IMG) and little is known about its natural history. METHODS: We have performed a retrospective study of 16 patients with LMG, types Va ("pure" LMG) (8 patients) and Vb (mesangial proliferation) (8 patients). Analytical and clinical characteristics were analyzed in each case at the onset of the disease and during follow-up. RESULTS: At the time of diagnosis, 7 patients (43%) did not present any extrarenal manifestations of systemic lupus erythematosus (SLE). Nephrotic syndrome was the most common clinical presentation (81%). 14 patients (87%) showed positive antinuclear antibodies (ANA), but at low titres (< 1/300); anti-DNA antibodies were positive only in 3 cases (18%) and hypocomplementemia was observed in 2 (12%). The most relevant histological findings were the presence of Clq deposits (83%) and subendothelial and mesangial deposits. Treatment consisted of corticosteroids, adding immunosuppression when no response was obtained in 2-3 months. In recent years, an angiotensin-converting enzyme inhibitor (ACEI) was added before immunosuppression. At the end of the study, 6 patients (42%) developed chronic renal insufficiency and 8 (58%) renainea with normal renal function. Actuarial renal survival was 100% at 5 years and 75% at 10 years. The evolution towards a non-nephrotic range proteinuria throughout the follow-up was the only parameter significantly associated with a good prognosis. CONCLUSIONS: LMG can present without extra-renal symptoms of SLE and even with very poor expression of its serological markers. Almost half of the patients (42%) developed chronic renal insufficiency. The evolution towards a non-nephrotic range proteinuria correlated with the maintenance of a normal renal function.

Adult↗
PubMedDate not supplied

[Hypercalciuria and hyperuricosuria causing hematuria in the absence of nephrolithiasis].

A prospective study was made of 38 adult patients (15 male and 23 female, age 30.5 +/- 10.8 years) with isolated hematuria of unknown etiology in which presence of hypercalciuria and/or hyperuricosuria without lithiasis was observed. Eighteen patients also referred episodes of macroscopic hematuria. Twenty-six patients had hypercalciuria (5.1 +/- 1.4 mg/kg/day), 29 hyperuricosuria (1053 +/- 198 mg/day) and 17 presented both alterations. A four months treatment was instituted with thiazides in patients with hypercalciuria and allopurinol in those with hyperuricosuria. From the first months and throughout the whole therapy, urinary excretion of calcium an uric acid became normalized in all cases. In 22 patients (57.8%) (Group I: Respondents) hematuria disappeared coinciding with normalization of calcium and uric acid values in urine and was maintained during the follow-up months. In the remaining 16 patients (Group II: Non-Respondents) the hematuria condition persisted in spite of such normalization, in most cases other causes for hematuria becoming clear later. No differences with regard to age, relationship male/female nor basal calciuria and uricosuria values were seen between both Groups. Group I had a greater incidence of macroscopic hematuria episodes (64% vs 12% in Group II, p less than 0.01) and of family nephrolithiasis (64 vs 25% in Group II, p less than 0.05). We conclude that hypercalciuria and hyperuticosuria are potentially reversible causes of hematuria in adults. Therefore, urinary determination of calcium and uric acid should be included in urinary evaluation of patients with hematuria even though they do not present renal lithiasis.

Allopurinol↗