Theodore Ehrenreich

Treatment of Idiopathic Membranous Nephropathy

In a retrospective study of the effect of treatment in biopsy-proved idiopathic membranous nephropathy, 91 adults and 12 children were followed for periods up to 29 years after clinical onset (mean, 6.5 years). Forty-four were treated with corticosteroids, 15 with corticosteroids and immunosuppressants; 44 had no treatment and served as a control group. Clinical cure and improvement were significantly greater in the treated than in the nontreated group (P less than 0.01). The recurrence rate, occurrence of renal failure and probability of death were significantly greater in the nontreated group, although some of these patients eventually showed improvement. Prognosis was better in patients who responded to therapy. These data strongly suggest that steroid therapy is beneficial in patients with membranous nephropathy.

Nephropathy Induced by D-Penicillamine

Abstract Two patients given D-penicillamine for rheumatoid arthritis and scleroderma developed renal damage. In one patient, a renal biopsy had been obtained before treatment was begun that permitt...

Glomerular lesions in a strain of genetically diabetic mice.

Summary In a strain of genetically determined, spontaneously diabetic mice (KK mice) lesions similar to those seen in human diabetic nephropathy were found in the glomeruli. These lesions increased with age and consisted of diffuse and nodular mesangial changes, exudative lesions, and alterations of the basement membranes.

Diabetic microangiopathy in KK mice: III. Effect of prolonged glyburide treatment on glomerulosclerosis

Abstract KK mice with spontaneous hereditary diabetes and human diabetic-like glomerulosclerosis were treated with either 0.5 or 2.5 mg/kg of glyburide, a sulfonylurea compound, from 2 months of age. Both, saline and glyburide-treated mice were sacrificed at 4, 6, 9, and 12 months of age, and their kidneys were examined by light microscopy. The data indicate that early glyburide treatment is effective in ameliorating or delaying the progression of diabetic glomerulosclerosis. This effect seems to be related to the early control of hyperglycemia in KK mice.

Related Factors in the Progression of Microangiopathy in KK Mice

Publisher Summary This chapter discusses certain findings based on studies of 130 KK and 64 S1 mice equally distributed according to age and sex. To identify the glomerular lesions more precisely, a temporary histological working classification was employed. The chapter illustrates an incidence of significant glomerular lesions among KK and control mice of both sexes. The diabetic syndrome in KK mice is not only associated with a higher incidence of glomerulosclerosis at an early age but it also accelerates the development of kidney pathology. There is no correlation between the degree of impairment in tolerance to glucose and the incidence of severe glomerulopathy when the glucose area levels throughout life are employed for evaluation of the degree of glucose dysmetabolism in KK mice. Correlative studies of severe glomerulopathy and degree of intolerance to glucose, based on 2 SD, gave similar negative results.

Ultrastructure of glomerular lesions in KK mice.

Publisher Summary This chapter discusses the ultrastructure of glomerular lesions in KK mice. In an experiment described in the chapter, electron microscope examinations were made in 20 KK mice and 18 controls from a group of 320 KK and 180 control mice. All animals were maintained on an 11 % fat diet under standard laboratory conditions. Electron microscopy revealed an increase in mesangial cells and matrix which in the early phases and in young animals did not result in widening of the mesangial space. It was found that with increase in mesangium, the mesangial space may be markedly widened. Usually, the mesangial accumulation is accompanied by cells; however, in a few instances, there are small, dense accumulations of mesangial matrix without mesangial cells. As the mesangium proliferates, it grows into the capillary wall and tends to be get inserted between the basement membrane and the endothelium. In advanced cases, the capillary lumen may be partly occluded by the mass of mesangium. Collagen fibrils are found in the mesangial matrix in some instances. Electron-dense deposits are also seen in the mesangial matrix, beneath the capillary endothelium, in the basement membrane, and occasionally partly occluding the capillary lumen.

Ameloblastic adenomatoid tumor (adenoameloblastoma). Case reports and review of the literature.

Abstract Two additional cases of ameloblastic adenomatoid tumor (adenoameloblastoma) are reported, bringing the total number of recorded cases of this rare lesion to 50. The tumor occurs most frequently in patients between 12 and 20 years of age, it is located most often in the maxilla, and it has a 2:1 male: female ratio. Regardless of therapy, no recurrences have been reported after complete removal, a fact which emphasizes the need for clear differentiation from ameloblastoma. To avoid confusion, the term ameloblastic adenomatoid tumor should be utilized more widely.

Clinical Aspects of Membranous Nephropathy.

Excerpt Membranous nephropathy is a primary renal disease characterized by diffuse thickening of glomerular capillaries and massive proteinuria with nephrotic syndrome. It is also known as membrano...