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At least 793 records · Page 44Linked to original sources
PubMed2005

[Familial summer-type hypersensitivity pneumonitis--case report and review of literature].

A 37-year-old-woman was admitted to our hospital because of chest bilateral reticular shadow with fever, cough, general malaise and exertional dyspnea in the summer. A diagnosis of summer-type hypersensitivity pneumonitis (SHP) was made by radiological, serological and histological examinations. Her 10-year-old daughter had chest reticular shadows and similar symptoms. These two patients were positive for serum anti-Trichosporon cutaneum (T. asahii, T. mucoides) antibodies and T. asahii was identified from cultured samples obtained from their house. They recovered spontaneously after hospitalization or isolation from the antigen. We reviewed the clinical features in sixteen families with familial SHP reported in Japan. Children aged under 15 years old accounted for 34% and there was no gender difference among patients. This finding differs from the conventionally defined features of patients with SHP. Measurements of serum KL-6, SP-D and SP-A seem to be useful for auxiliary diagnosis and monitoring the disease activity of SHP, especially in pediatric cases who cannot undergo invasive evaluation.

Adult↗
PubMed1991

[Infection as the precipitating factor in Schönlein-Henoch purpura].

Shönlein-Henoch's purpura (SHP) is a form of generalized vasculitis. SHP is characterized by a haemorrhagic eruption, colicky abdominal pain, renal involvement with haematuria and proteinuria, arthralgia and cerebral symptoms in the form of headache and seizures. Retrospective investigations have revealed that infection with microorganisms may precipitate SHP. The authors were able to support this observation by means of a prospective investigation. 2/3 of the 26 children in the investigation had symptoms of infection one to two weeks prior to the onset of symptoms of SHP. Ten children had definite positive signs of prior infection. The course of the sedimentation rate and leukocyte counts also support the assumption of previous infection.

Bacterial Infections↗
PubMedDate not supplied

Schönlein-Henoch vasculitis and chronic Helicobacter pylori associated gastritis and duodenal ulcer: a case report.

We describe the case of a child with Schönlein-Henoch purpura (SHP), bleeding duodenal ulcer and Helicobacter pylori (H. pylori) associated gastritis. 5-year-old girl was hospitalized with typical symptoms of SHP. On the third day, the child has several episodes of hematemesis with bright red blood, accompanied by increased pain of the epigastric region. Gastroduodenal endoscopy revealed signs of atrophic gastritis in the antrum, duodenitis with diffuse petechiae, small erosions and bleeding ulcer. The gastric biopsy showed a moderately severe chronic gastritis with activity and H. pylori was detected. The therapy with ranitidine, metronidazole and amoxycillin was introduced for a period of 30 days. At follow-up 2 months later, clinical examination and routine laboratory tests were normal. A repeated endoscopy revealed no evidence of lesions and H. pylori negative gastric biopsy. In our case, the associated chronic antral gastritis and H. pylori infection may well have aggravated the gastrointestinal symptoms of SHP. We feel it would be useful to check for H. pylori in patients with gastrointestinal manifestations of SHP, such as bleeding and important epigastric pain.

Amoxicillin↗
PubMed1984

Rapid alterations in substrate profiles after partial hepatectomy in the rat.

We compared alterations in circulating levels of insulin and glucagon and metabolic fuels in response to partial (70%) hepatectomy (HP) and sham hepatectomy (SHP) in fasting rats and in unanesthetized, fasting control rats. Within 15 minutes, animals in the HP group were hypoglycemic compared with the SHP and control groups. After 30 minutes, the insulin concentration and the insulin-glucagon molar ratio (IGR) rose in the HP group. After four hours, animals in the HP group were hyperglycemic compared with the SHP and control animals. Comparison of the lipid and amino acid profiles suggested use of these substrates by eight hours. The levels of branched-chain amino acids, although depressed early after HP, were markedly elevated later, when the IGR in the HP group had normalized. The acute loss of hepatic mass by limiting gluconeogenesis may be the cause of hypoglycemia and also could alter the plasma IGR because of the different hepatic clearance rates of these hormones. A switch to lipid and protein as metabolic fuels appears to follow these early changes.

Amino Acids↗
PubMed2000

BLNK is associated with the CD72/SHP-1/Grb2 complex in the WEHI231 cell line after membrane IgM cross-linking.

Tyrosine phosphorylation of CD72 strongly correlates with B cell antigen receptor signals leading to apoptosis. We have previously shown that CD72 carrying two immunoreceptor tyrosine-based inhibition motifs (ITIM) is an in vivo substrate of SHP-1. CD72 forms a complex with SHP-1 and Grb2 via its tyrosine-phosphorylated ITIM when the WEHI231 cell line, which is representative of immature B cells, undergoes apoptosis. The CD72 complex formation was also demonstrated in normal primary B cells, suggesting that the complex formation in apoptotic B cells is a universal mechanism. In this study, we further investigated the molecular components of the CD72 complex in WEHI231 cells in order to understand the molecular mechanism involved in the signaling pathway mediated through the complex. Our experiments demonstrate that BLNK, a recently identified adaptor molecule predominantly expressed in B cells, is associated with the CD72 complex via the Src homology 3 domain(s) of Grb2 in the cell line after membrane IgM (mIgM) engagement. The results suggest that the mIgM-mediated signal strongly correlates with the formation of the CD72 / SHP-1 / Grb2 / BLNK complex.

Adaptor Proteins, Signal Transducing↗
PubMed2003

B cell defects in SLP65/BLNK-deficient mice can be partially corrected by the absence of CD22, an inhibitory coreceptor for BCR signaling.

CD22 is an inhibitory coreceptor for B cell receptor (BCR) signaling. The inhibition is most likely mediated by activation of SHP-1. We found that SLP65/BLNK reaches maximal tyrosine-phosphorylation at earlier time points in CD22(-/-) than in wild type B cells upon BCR cross-linking, suggesting that SLP65/BLNK is a substrate of SHP-1. However, in contrast to the defective Ca(2+) mobilization of SLP65/BLNK(-/-) B cells, there was a clear Ca(2+) response in SLP65/BLNKxCD22 double-deficient B cells. This implies that SLP65/BLNK is not the sole target of SHP-1 in the regulation of the Ca(2+) signaling strength. While SLP65(-/-) mice show several blocks of B cell differentiation, in SLP65/BLNK x CD22 double-deficient mice the maturation block of B cells in the spleen was partially rescued. However, the proliferative responses of B cells from both SLP65/BLNK(-/-) and double-deficient mice were defective after IgM- or CD40-stimulation. These results show that SLP65/BLNK is not absolutely essential for Ca(2+) induction in B cells, because the deficiency of this adapter can be by-passed by the additional deletion of an inhibitory receptor. Furthermore, these experiments suggest that B cell maturation in the spleen is directly dependent on the strength of BCR-derived Ca(2+) signals.

Adaptor Proteins, Signal Transducing↗
PubMed2005

Noonan syndrome type I with PTPN11 3 bp deletion: structure-function implications.

Noonan syndrome was recently reported to be caused by mutations in the PTPN11 gene in 40% of the cases. This gene encodes the nonreceptor-type protein tyrosine phosphatase SHP-2 and has been shown to be self down-regulated with the concurrency of two SH2 domains. Insertion of a specific loop (D'EF) from N-terminal SH2 domain into the SHP-2 active-site is responsible for the reversible inhibition of the phosphatase activity. Here we report the first in frame trinucleotide deletion resulting in the removal of Aspartate 61 (D61del), a key residue of the N-terminal SH2 D'EF loop. Energetic-based structural analysis and electrostatic calculations carried out on the wild-type and mutant proteins predict lower stability of the D'EF loop for the D61del variant as compared to the wild type indicating better access to the active site and most likely an enzyme activated for longer extent. Similar computations were performed on the previously functionally characterized gain-of-function D61Y mutant and similar behaviors were observed. The simulation data for the D61del and D61Y mutants suggest that both variants could yield more catalytic cycles than the wild-type molecule in the same timespan because of the opening of the active site. It also supports the notion that D61 plays a major role for proper down-regulation of the protein tyrosine phosphatase activity of SHP-2.

Adult↗
PubMed1999

p85 subunit of PI3 kinase does not bind to human Flt3 receptor, but associates with SHP2, SHIP, and a tyrosine-phosphorylated 100-kDa protein in Flt3 ligand-stimulated hematopoietic cells.

Flt3/Flk2 belongs to class III receptor tyrosine kinases. Like other members of type III receptor tyrosine kinases, murine Flt3 induces tyrosine phosphorylation of p85 and subsequently activation of PI3 kinase upon FL binding. While p85 binds murine Flt3 at Y958 in the carboxyl terminus of the receptor, human Flt3 does not have a potential p85-binding site in the carboxyl terminus. In this study, we examined whether p85 binds to human Flt3 in Baf3/Flt3 and THP-1 cells. In contrast to murine Flt3, p85 is not tyrosine phosphorylated after FL stimulation, nor does it bind Flt3 in both cell lines. Instead p85 associates inducibly with tyrosine phosphorylated SHP-2 and constitutively with SHIP and two tyrosine phosphorylated proteins with molecular weights about 100-kDa (p100) and 120-kDa (p120) in Baf3/Flt3 cells. The p100 associates with both p85 and SHP-2. In THP-1 cells, p85 associates inducibly with tyrosine phosphorylated SHIP, p100 and p120. These results indicate that p85 does not bind human Flt3, but forms a complex with SHP-2, SHIP, p100 and p120 in hematopoietic cells.

Amino Acid Sequence↗
PubMed2001

Molecular cloning and characterization of SPAP1, an inhibitory receptor.

We have cloned a novel cell-surface protein designated SPAP1a for SH2 domain-containing phosphatase anchor protein 1a. SPAP1a belongs to the group of type I transmembrane proteins. Its extracellular domain contains a single immunoglobulin-like domain, and its intracellular segment has two immunoreceptor tyrosine-based inhibition motifs (ITIMs). We also identified two alternatively spliced products that were named SPAP1b and SPAP1c. SPAP1b contains a short intracellular part without ITIMs, while SPAP1c lacks the transmembrane segment and represents a potential soluble protein. Sequence alignment with the genomic database revealed that the SPAP1 gene contains seven exons and is localized at chromosome 1q21. PCR analyses demonstrated that SPAP1a mRNA is specifically expressed in human hematopoietic tissues including spleen, peripheral blood, and bone marrow, and it may be restricted to expression in B cells. Recombinant SPAP1a is tyrosine phosphorylated in cells upon pervanadate stimulation and tyrosine-phosphorylated SPAP1a recruits the SH2 domain containing phosphatase SHP-1, but not SHP-2. As a specific anchor protein of SHP-1, SPAP1a may have an important role in hematopoietic cell signaling.

Alternative Splicing↗
PubMed1988

A case of vasculitic cholecystitis associated with Schönlein-Henoch purpura in an adult.

A case of Schönlein-Henoch Purpura (SHP) in a 32 year-old female, showing gastrointestinal manifestations including acute vasculitic cholecystitis was reported. In the course of hospitalization urgent laparotomy was performed because of the severe abdominal pain. The gallbladder was inflamed with a brownish-red edematous wall and subserosal hemorrhage, and was resected. Histological examination of the resected gallbladder specimen revealed leucocytoclastic vasculitis. The patient was treated with prednisolone postoperatively, and symptoms abated over two weeks. Acute cholecystitis with SHP is extremely rare, and as far as the authors know this is the second case of this disorder documented by histological examination. Patients with acute abdomen associated with SHP should be managed with consideration of the complications of acute cholecystitis.

Abdomen, Acute↗
PubMed2005

Assessment of therapeutic effect in patients with secondary hyperparathyroidism using bone scintigraphy.

OBJECTIVE: The semi-quantitative method of bone scintigraphy [bone to soft tissue (B/ST) ratio] has been used in diagnosing and evaluating systemic metabolic bone diseases. The aim of this study is to evaluate of the therapeutic effect of secondary hyperparathyroidism (SHP). METHODS: The subjects were ten hemodialysis patients with SHP. Seven patients underwent parathyroidectomy (PTX), and 22-Oxacalcitoriol (derivative of 1,25-dihydroxyvitamin D3) (OCT) was given to three patients. Bone scintigraphy and blood tests [intact parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium (Ca), phosphorus (P), bone alkaline phosphatase (BALP), and deoxypridinoline (DPYD)] were performed before and after treatment. Regions of interest were drown around cranium, lumbar vertebrae, femoral neck and soft tissue of left medial thigh to calculate the B/ST ratio. RESULT: The B/ST ratios of cranium, lumbar vertebrae, and femoral neck were reduced significantly after PTX (cranium, p = 0.0079, lumbar vertebrae, p = 0.0282, femoral neck, p = 0.0252). Intact PTH, ALP, Ca, P, BALP and DPYD levels were reduced significantly after PTX (intact PTH, p = 0.003, Ca, p = 0.0005, P, p = 0.0393, ALP, p = 0.0051, DPYD, p = 0.0232, BALP, p = 0.0324). After OCT administration, the B/ST ratio of each bony region showed tendency to diminish, although not significantly. Intact PTH levels were reduced significantly, although ALP, BALP, and DPYD levels were not. Ca and P levels were increased significantly because of the medicinal action of OCT. CONCLUSION: The B/ST ratio of cranium may be non-invasive method and have potential in evaluating the therapeutic effect of SHP.

Adult↗
PubMed1998

Negative regulation of antigen receptor signaling in lymphocytes.

The negative regulation of antigen receptor signal transduction is essential for the maintenance of thresholds for activation in lymphocytes. CD45 and SHP-1 are tyrosine phosphatases that are important in maintaining the proper level of tyrosine phosphorylation. Regulation of the src family of tyrosine kinases is mediated by the coordinated action of the tyrosine kinase Csk and the tyrosine phosphatase CD45. B cell receptor signaling is negatively regulated by the recruitment of SHP-1 to bind the B cell transmembrane proteins CD22 and FcgammaRIIb1. SHP-1 also functions to negatively regulate T cell receptor signaling by dephosphorylating and inactivating tyrosine kinases.

Animals↗
PubMed2005

A randomised study on a new cost-effective algorithm of quick intraoperative intact parathyroid hormone assay in secondary hyperparathyroidism.

BACKGROUND AND AIMS: The use of intraoperative intact parathyroid hormone (iPTH) assay in secondary renal hyperparathyroidism (SHP) has been limited by the relatively low cost effectiveness of the assay in improving the success rate for primary bilateral neck exploration. The study aimed at determining, in a prospective, randomised trial, the cost effectiveness and impact of the routine employment of a "six-sample" versus "two-sample" algorithm of the intraoperative iPTH assay during surgery for SHP on intraoperative decision making and surgical success rate. PATIENTS AND METHODS: One hundred and two consecutive patients with severe SHP and qualified for subtotal parathyroidectomy were randomly allocated to two equal-sized groups: group A, in which the intraoperative iPTH serum level was determined in six consecutive samples: preoperative, pre-excision, 5, 10, 20 and 60 min, and group B, in which the intraoperative iPTH serum level was determined twice only: preoperatively and 10 min. The STAT intraoperative intact-PTH immunoassay was employed. In group B, in patients with serum iPTH decrease lower than 60% of the baseline at 10 min, an additional measurement was performed at 20-min post-excision. If a decrease of 80% or more of the baseline was not obtained, the exploration was extended in search of remaining hyperfunctioning parathyroid tissue. RESULTS: The surgical success rate was 96.1% and 98.0% (in group A and B, respectively). The impact of the intraoperative iPTH assay on surgical decision making was demonstrated in 13.7% and 15.7% (in group A and B, respectively). The assay was helpful in identifying patients with supranumerary hyperfunctioning parathyroid tissue (5.9% vs 7.8% in group A and B, respectively), patients with fewer than four parathyroid glands (3.9% vs 5.9% in group A and B, respectively) and patients with remaining hyperfunctioning parathyroid tissue suspected to be located within the mediastinum in cases of negative bilateral neck exploration who benefit from transcervical thymectomy. The diagnostic accuracy of the intraoperative iPTH assay was 100% in both groups. The accuracy of two-sample algorithm increased from 96% to 100% if an additional serum iPTH determination was performed in borderline cases with an iPTH drop lower than 60% of the baseline at 10 min. The cost-effectiveness analysis showed significant savings in group B, equal to Euro 87.6 per patient, with the unchanged diagnostic accuracy of the two-sample algorithm. CONCLUSIONS: The intraoperative iPTH assay in patients operated on for secondary hyperparathyroidism offers support in surgical decision making in the majority of patients, allowing for correct identification of patients with supranumerary ectopic hyperfunctioning parathyroid glands, and in patients with fewer than four parathyroid glands. It also correctly identifies patients who do not benefit from blind thymectomy. The two-sample algorithm, extended to include three determinations in selected cases, has the same 100% diagnostic accuracy as the six-sample algorithm, the former being a much more cost-effective procedure.

Adult↗
PubMed2003

IL-6 signal transduction and its physiological roles: the signal orchestration model.

Interleukin (IL)-6 is a pleiotropic cytokine that not only affects the immune system, but also acts in other biological systems and many physiological events in various organs. In a target cell, IL-6 can simultaneously generate functionally distinct or sometimes contradictory signals through its receptor complex, IL-6Ralpha and gp130. One good illustration is derived from the in vitro observations that IL-6 promotes the growth arrest and differentiation of M1 cells through gp130-mediated STAT3 activation, whereas the Y759/SHP-2-mediated cascade by gp130 stimulation has growth-enhancing effects. The final physiological output can be thought of as a consequence of the orchestration of the diverse signaling pathways generated by a given ligand. This concept, the signal orchestration model, may explain how IL-6 can elicit proinflammatory or anti-inflammatory effects, depending on the in vivo environmental circumstances. Elucidation of the molecular mechanisms underlying this issue is a challenging subject for future research. Intriguingly, recent in vivo studies indicated that the SHP-2-binding site- and YXXQ-mediated pathways through gp130 are not mutually exclusive but affect each other: a mutation at the SHP-2-binding site prolongs STAT3 activation, and a loss of STAT activation by gp130 truncation leads to sustained SHP-2/ERK MAPK phosphorylation. Although IL-6/gp130 signaling is a promising target for drug discovery for many human diseases, the interdependence of each signaling pathway may be an obstacle to the development of a nonpeptide orally active small molecule to inhibit one of these IL-6 signaling cascades, because it would disturb the signal orchestration. In mice, a consequence of the imbalanced signals causes unexpected results such as gastrointestinal disorders, autoimmune diseases, and/or chronic inflammatory proliferative diseases. However, lessons learned from IL-6 KO mice indicate that IL-6 is not essential for vital biological processes, but a significant impact on disease progression in many experimental models for human disorders. Thus, IL-6/gp130 signaling will become a more attractive therapeutic target for human inflammatory diseases when a better understanding of IL-6 signaling, including the identification of the conductor for gp130 signal transduction, is achieved.

Acute-Phase Reaction↗
PubMed2006

Incidence and risk factors of coronary heart disease in elderly patients on chronic hemodialysis.

AIM: To determine the incidence of coronary heart disease (CHD) in patients (pts) over 65 years (y) and its relation to common risk factors. METHODS: We retrospectively studied 128 hemodialysis (HD) pts (80 M and 48 F), mean age 73+/-6.5 years, mean time on HD 44.4+/-26.4 months and BMI 25.4+/-3 kg/m2. They were evaluated for: age, sex, smoking, diabetes, hypertension, left ventricular hypertrophy, secondary hyperparathyroidism (SHP), inflammation, as evidence by elevated level of hsCRP, hyperhomocysteinemia (HOC), time on HD, fluid overload and adequacy of HD. Forty-eight pts (37%) had CAD diagnosed by coronary angiography in 22 (46%) and (201)TL-chloride dipyridamole stress test in 26 (54%). RESULTS: There was a statistically significant correlation between CAD and increasing age (p<0.0001). The relative risk was significantly increased concerning: (1) male over female pts (RR: 1.95, p<0.01), (2) diabetic vs. non diabetic pts (RR: 2.09, p<0.001), (3) patients with SHP over pts with iPTH values<250 pg/ml (RR: 2.16, p<0.001), (4) hypertensive vs. non hypertensive pts (RR: 2.26, p=0.002), (5) smokers vs. non smokers (RR: 1.69, p<0.05), (6) pts with HOC over pts with normal homocysteine values (RR: 2.09, p<0.05), (7) pts with increased CRP levels over pts with normal CRP levels (RR: 1.8, p<0.01), (8) pts undergoing HD for 36 vs. 12 months (RR: 1.71, p=0.03), (9) between pts with inadequate or adequate HD (RR: 1.73, p=0.02). No significant correlation existed between CAD incidence and the other risk factors. CONCLUSIONS: Coronary heart disease incidence in elderly HD patients increases with age, male sex, diabetes, SHP, hypertension, increased CRP levels, HOC, smoking, time on HD and inadequacy of HD.

Aged↗
PubMed2006

Role of SPECT/CT in the preoperative assessment of hyperparathyroid patients.

PURPOSE: Our purpose was to assess the clinical value and additional benefit of fusion single-photon computed tomography (SPECT) and computed tomography (CT) images in locating the parathyroids in a selected group of patients affected by primary (PHP) and secondary hyperparathyroidism (SHP). MATERIALS AND METHODS: Sixteen patients (11 women and five men; age range 35-80 years) with severe hyperparathyroidism (HP) (ten PHP, six SHP) were studied by ultrasound (US), and, after i.v. injection of 370 MBq of 99mTc-sestamibi, by planar parathyroid scintigraphy, SPECT and SPECT/CT using a dual-detector scintillation camera GE Infinia Hawkeye. All patients underwent parathyroidectomy. RESULTS: US findings were inconclusive in 12/16 patients affected by multinodular goitre, and two probable eutopic parathyroid glands were identified. "Double phase" parathyroid scintigraphy identified 14 probable parathyroid glands, SPECT 23 (14 ectopic and nine eutopic) and SPECT/CT confirmed all 23 probable parathyroid lesions, offering more precise localisation and an evident improvement in diagnostic accuracy. Sixteen of these foci of increased uptake were hyperplastic parathyroid glands, six were adenomas, one was a parathyroid carcinoma and one was a thyroid follicular carcinoma. Surgical detection of the 23 sestamibi-positive lesions was correctly matched with 100% of SPECT/CT images and 61% of SPECT data alone. Hybrid imaging thus provided additional data in 39% of lesions, and in three patients with retrotracheal glands, it modified the surgical approach. CONCLUSIONS: We believe 99mTc-sestamibi SPECT/CT to be a more reliable presurgical method to study a patient subgroup affected by PHP or SHP in whom conventional US and other scintigraphic methods have failed for intrinsic reasons due to the concomitant presence of multinodular goitre or ectopic parathyroid gland. The additional practical benefit derived from this methodology was evident. In fact, anatomical information provided by CT enables precise localisation of the functional abnormalities highlighted by SPECT, and both are essential to a correct surgical approach.

Adult↗
PubMedDate not supplied

Influence of hydrolysis procedures on the urinary concentrations of codeine and morphine in relation to doping analysis.

A method is described for the GC-NPD determination of urinary codeine and morphine after derivatization with trifluoroacetic anhydride. The lower limit for accurate quantitative determination was 0.05 microgram ml-1. After the oral administration of Bisolvon Griblettes corresponding to 30 mg codeine phosphate to seven subjects maximum codeine concentrations were obtained after 1-2 h and codeine remained detectable generally 24 h post dosing. The mean maximum level was 5.1 +/- 2.8 micrograms ml-1 found after enzymatic hydrolysis with Suc Helix pomatia juice (SHP). Based on these and previous results (mean 6.3 +/- 3.4 micrograms ml-1) a threshold level for codeine of 16 micrograms ml-1 is proposed. Significant differences were noticed between urinary codeine concentrations found after enzymatic hydrolysis with SHP, beta-glucuronidase from Patella vulgata and acid hydrolysis, respectively. Generally, highest values were obtained after SHP, while beta-glucuronidase and especially acid hydrolysis resulted in much lower levels. No morphine could be detected after acid hydrolysis. Concerning doping analysis, in particular the uniformity of methods and interpretation of the results, it is recommended that the hydrolysis method should be specified in the rules of those sporting federations allowing codeine and/or morphine.

Acetic Anhydrides↗
PubMed1990

Primary IgA nephropathies in children.

With the worldwide use of immunofluorescence microscopy, idiopathic IgA nephropathy (Berger's disease) has been recognized as a distinct form of primary glomerular disease. IgA nephropathy is the most common form of GN in many parts of the world. However, since the criteria for diagnosis are exclusively based on the findings of predominant IgA in the mesangium, the boundaries of this "entity" are not well delineated and it has become clear that several different clinical conditions share this common immunopathology. IgA nephropathy should, therefore be regarded as a syndrome. Schönlein-Henoch purpura (SHP) and Berger's disease represent the primary form of this syndrome. The clinical features of both diseases in children are reviewed. Although the clinical symptoms may appear different there is a close relationship between SHP and IgA nephropathy. They share the same pathology, the same pathogenesis, and they may both recur on a transplanted kidney. Moreover, both diseases can occur in a single family. When pathologic mechanisms are more defined, SHP may prove to be 1 end of a spectrum of diseases associated with microvascular immune deposits in which IgA is the predominant immunoglobulin seen, the other end being Berger's disease.

Child↗