Sayuri Okushin

Remnant-Like Particle Cholesterol May Indicate Atherogenic Risk in Patients on Chronic Hemodialysis

Recently, involvement of remnant-like particle cholesterol (RLP-C) in atherosclerosis was reported, but this parameter has not been adequately investigated in hemodialysis (HD) patients. The present study investigated the relationship between the RLP-C level and total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), lipid peroxides (malone dialdehyde, MDA), apolipoprotein (Apo) A-I, and ApoB. In addition, the fractions of very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), LDL, and HDL in serum lipoproteins were determined by disk polyacrylamide gel electrophoresis. The relationship between the RLP-C level and three atherogenic indices was also studied. The RLP-C level in HD patients (8.2 +/- 6.7 mg/dl) was significantly higher than that in normal controls (2.7 +/- 1.3 mg/dl). The RLP-C level showed a significant positive correlation with the levels of TC, TG, LDL-C, MDA, ApoB, VLDL(%), and IDL(%), as well as a negative correlation with HDL(%). However, there was no correlation with age or the duration of HD. RLP-C also showed significant positive correlations with the (TC -HDL-C)/HDL-C ratio and the (VLDL + LDL)/HDL ratio, as well as a negative correlation with the ApoA-I/ApoB ratio. These results suggest that RLP-C may be a potential indicator of atherogenic risk in HD patients.

PARENT AND CHILD CASES OF IGA NEPHROPATHY ASSOCIATED WITH VON RECKLINGHAUSEN'S DISEASE

Yoshihiko Taniguchi, MD, Second Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-Ku, Hirsohima City 734 (Japan) Table 1. Serological typing for HLA-A, -B, -C, -DR, and -DQ antigens Dear Sir, We present parent and child cases of IgA nephropathy associated with von Recklinghausen’s disease. Case 1: In April 1987, a 41-year-old woman was referred to our department because of episodes of proteinuria and occult hematuria concomitant with febrile upper respiratory tract infections. A renal biopsy done at this time revealed IgA nephropathy, moderate degree. In 1988, she was diagnosed as having von Recklinghausen’s disease at the Dermatology Department of our hospital. In 1995, her renal function deteriorated gradually, so she was admitted for a second renal biopsy. Physical examination revealed multiple soft, small tumoral masses, which were pathologically diagnosed as being fibro-mas, along with café-au-lait spots and diffuse freckles. Her extremities were also slightly edematous. Abnormal laboratory findings were: urinary protein 2+, occult hematuria 3+, urinary protein excretion 0.8 g/day, BUN 19 mg/dl, serum creatinine 0.89 mg/dl, uric acid 6.0 mg/dl, creatinine clearance 58.5 ml/min, and serum ß2microglobulin 2.79 μg/ml. Her serum IgA level was normal. Microscopic examination of her renal biopsy tissues revealed sclerotic lesions such as global sclerosis or adhesions of Bowman’s capsule, and marked tubulointerstitial lesions were found. Immunofluorescent findings revealed IgA and C3 mesangial deposits. Electron microscopic examination showed slight dense deposits in the mesangial areas. Case 2: A 24-year-old man, the son of case 1 ‚ was referred to our hospital in January 1989 because of episodes of proteinuria and occult hematuria concomitant with upper respiratory tract infections. He was also diagnosed as having von Recklinghausen’s disease at the Dermatology Department of our hospital in 19 8 9. He was admitted to our hospital in September

Usefulness of immunoadsorption therapy for systemic lupus erythematosus associated with transverse myelitis. A case report.

Transverse myelitis (TM) is a very rare complication of systemic lupus erythematosus (SLE) and its prognosis is poor. It therefore needs to be treated aggressively. We describe a patient suffering from SLE associated with TM, who responded well to a combination of immunoadsorption therapy and steroid mini-pulse therapy. His serum interleukin 6 levels as well as clinical indicators fell to normal after this treatment.

HLA typing of a family with nephronophthisis-medullary cystic disease complex

A 25-year-old man developed renal dysfunction and his family showed autosomal dominant inheritance of endstage renal disease. The proband had trace albuminuria and a slightly raised serum creatinine level. Renal biopsy showed tubulointerstitial nephritis, which was compatible with the nephronophthisis-medullary cystic disease complex (N-MCD). His older brother (aged 31 years) had progressed to endstage renal failure by the age of 23 years after renal biopsy revealed N-MCD when he was 20 years old. Human leukocyte-associated (HLA) antigen typing was performed for the proband, the older brother, the mother (who showed endstage renal failure at the age of 50 years), and the sister (who showed no signs of renal disease at the age of 28 years). The HLA loci A24(9), B62(15), and DR2 were common to all 4 family members, while Cw1 was only found in the 3 with renal disease. These findings suggested the possible participation of the Cw1 locus in autosomal dominant N-MCD.

Study of the effects of pravastatin in patients with glomerulonephritis associated with hyperlipidemia

Abstract Pravastatin was administered at a dosage of 10 mg/d for 24 weeks to 21 outpatients with glomerulonephritis with accompanying hyperlipidemia who presented with total serum cholesterol levels of ≥220 mg/dL. As a result, significant reductions in total serum cholesterol, low-density lipoprotein cholesterol (LDL-C), and apolipoprotein (apo) B levels were observed at 12 and 24 weeks after drug administration when compared with the levels observed before treatment (total cholesterol, 308.7 ± 52.3 mg/dL vs 250.8 ± 40.8 mg/dL vs 238.4 ± 34.5 mg/dL; LDL-C, 215.0 ± 47.8 mg/dL vs 158.5 ± 38.4 mg/dL vs 153.0 ± 33.5 mg/dL; and apo B, 143.2 ± 28.3 mg/dL vs 111.3 ± 18.0 mg/dL vs 112.1 ± 19.7 mg/dL; P P