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Biomedical subjects

S Karashima

Publications and source records attributed to S Karashima.

At least 37 records · Page 2Linked to original sources

Clinicopathological correlation of IgA nephropathy in children.

22 patients with IgA nephropathy aged 7-16 years, 15 of whom were found by mass urine screening of school children, were divided into three groups based on the degree of their proteinuria at admission: group A (n = 6) below 0.5 g/day of urine protein, group B (n = 7) between 0.6 and 3.0, and group C (n = 9) above 3.0 g/day of urine protein. The degree of proteinuria seemed to be related to the severity of pathological changes of the glomerular basement membrane; most severe in group C, moderate in group B, and minimal in group A. IgA deposits in the mesangial area were found in all groups of patients, but those in the capillary walls were most frequently found in group C. In addition to electron-dense deposits in the mesangial area, which was found in all groups of patients, the subendothelial and subepithelial deposits were the most remarkable changes found in group C. During the clinical observation period, which was between 2.0 and 7.1 years, no patient belonging to group A progressed to groups B or C. 4 cases in group C developed chronic renal failure, but none in the other groups did. The amount of urine protein might be used as a valuable parameter of the pathological damage of the glomerulus in children with IgA nephropathy.

Adolescent↗

A case of congenital nephrotic syndrome associated with partial deficiency of lecithin cholesterol acyltransferase (LCAT) and hypothyroidism.

The case of a 3 year-old boy with congenital nephrotic syndrome is reported, in whom decreased LCAT activity and hypothyroidism were also present. Renal biopsy confirmed a diffuse proliferative glomerulonephritis with a large number of foam cells in the capillary lumen of the glomerulus and the interstitium, which stained positively with acid phosphatase indicating the presence of macrophage with phagocyted lipid vacuole. The histological picture was similar to that of familial LCAT deficiency, but the reported case is one of secondary LCAT deficiency as a result of urinary loss of the enzyme. Replacement therapy with thyroid hormones resulted in improvement in growth and development.

Child, Preschool↗

Circulating immune complex in glomerulonephropathy associated with hepatitis B virus infection.

Urinary abnormalities combined with positive serum hepatitis B virus surface antigen (HBsAg) were found in 9 children. Most of these patients were found by mass urine screening of school children. Renal biopsy findings revealed 6 cases of membranous glomerulonephropathy (MGN) and 3 cases of minimal change disease. Immune deposits consisting of hepatitis B virus e antigen (HBeAg), IgG and C3 were detected in the glomerular capillary walls by immunofluorescent study in patients with MGN. Circulating immune complex was positive at a rate of 67% (6/9 cases) by the C1q-binding assay and at a rate of 56% (5/9 cases) by the protein-A precipitation test in patients with persistent urinary abnormalities and hepatic dysfunction.

Antigen-Antibody Complex↗