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Biomedical subjects

J Feehally

Publications and source records attributed to J Feehally.

At least 127 records · Page 7Linked to original sources
PubMed1987

Response of circulating immune complexes to food challenge in relapsing IgA nephropathy.

The response of circulating immune complexes (CIC) to food challenge was assessed in 15 subjects with IgA nephropathy (IgAN) and recurrent macroscopic haematuria. CIC were measured by solid-phase C1q binding assay (SP-C1q), immunoglobulin class-specific polyethylene glycol (PEG) precipitation assays (PEG-G, PEG-A, PEG-M) and by an antigen (ovalbumin)-specific radioimmunoassay after acid dissociation (OA-IC). CIC were measured when the subjects were fasting and hourly for 6 h after a test meal containing eggs. All 15 subjects were tested while clinically quiescent (remission) and 6 were tested again during episodes of macroscopic haematuria (relapse). The PEG-A CIC response to food challenge was significantly exaggerated in IgAN remission compared with controls at 3-6 h after food. There were also non-significant increases in PEG-G, though not in PEG-M. Paired data showed further exaggeration of PEG-G, PEG-A and PEG-M responses to food during IgAN relapse, but significance was not attained if the findings in 1 subject were separated. In this individual a florid clinical relapse with transient decline in renal function was associated with very high levels of PEG-IC, and only in this patient in relapse was OA-IC detectable, confirming that some PEG-precipitated material represented antigen-antibody complexes containing food antigen.

Adolescent↗
PubMed1987

Recurrent acute renal failure with interstitial nephritis due to D-penicillamine.

A 60-year-old man with rheumatoid arthritis, who developed acute reversible renal failure with nephrotic syndrome and tubulointerstitial nephritis in association with multiple-drug therapy, is described. The episode was ascribed to the nonsteroidal anti-inflammatory agent fenbufen, and the patient was reexposed to D-penicillamine within 6 months, reproducing the same renal lesion. There was no evidence of the glomerular lesions characteristically associated with D-penicillamine nephrotoxicity. D-penicillamine was the only drug therapy common to both episodes and it is concluded that it may cause tubulointerstitial nephritis with nephrotic syndrome.

Acute Kidney Injury↗
PubMed1986

Is chronic renal transplant rejection a non-immunological phenomenon?

Five patients with chronic renal transplant rejection were subjected to dietary protein restriction (0.6 g/kg ideal body weight daily) with no change in immunosuppressive therapy. In all five patients the slope of the curve of reciprocal serum creatinine and time decreased (mean -46.0 +/- 11.8 before diet fell to -11.7 +/- 9.4; p less than 0.01). These findings support the hypothesis that non-immune mechanisms are dominant is chronic renal transplant failure.

Chronic Disease↗
PubMed1986

Sequential study of the IgA system in relapsing IgA nephropathy.

Cellular and immunochemical parameters of the IgA system were studied in 15 subjects with IgA nephropathy (IgAN) and 15 agematched controls. In IgAN remission no abnormalities of the IgA system were detectable by the methods used. In IgAN relapse, [macroscopic hematuria associated with upper respiratory tract infection (URTI) (N = 6)] there were rises in IgA-bearing B-lymphocytes (three of six), T helper/suppressor cell ratio (six of six) and pokeweed mitogen-induced IgA production (four of six). Total serum and salivary IgA were unchanged. Serum IgA profile (HPLC-ELISA) showed increases in polymer IgA (three of six). No such changes were found during URTI in controls. These findings support the view that an exaggerated IgA response to mucosal antigen challenge initiates glomerular damage and hematuria in IgAN.

Adolescent↗
PubMed1986

Impaired IgG response to tetanus toxoid in human membranous nephropathy: association with HLA-DR3.

The IgG response to tetanus toxoid (TT) immunization was quantitated by by radioimmunoassay in patients with membranous nephropathy (MN) and healthy controls. Variation in subclass (ELISA) and electrical charge (isoelectric focussing, immunofixation & autoradiography) of the IgG response were also assessed. Total IgG and igG subclass responses were impaired in MN compared to controls, although this was only significant for IgG-3 (P less than 0 X 05). Non responders to TT were more common in MN, and response was independent of disease activity. No distinctive pattern of IgG subclass response or IgG spectrotype was seen in MN. Impaired response to TT was associated with HLA-DR3 among controls, and in MN (88 X 8% of whom were DR3) markedly depressed responses occurred in apparent DR3 homozygotes.

Antibodies, Bacterial↗
PubMed1986

High risk acute renal failure.

Acute renal failure carries a high mortality and little change in survival rate over the last three decades has been seen. Patients requiring intensive care, most of whom have developed acute renal failure following trauma or surgery, have a worse prognosis. The survival in this series of 100 consecutive patients admitted to one intensive care unit between 1976 and 1985 was 35 per cent. The only factors which differed significantly between the surviving and non-surviving patients were age, requirement for mechanical ventilation and maximum serum creatinine level before the first dialysis. It is difficult to predict outcome for an individual patient at the start of treatment and an aggressive approach to management is advocated.

Acute Kidney Injury↗
PubMed1985

High incidence of minimal change nephrotic syndrome in Asians.

Between 1973 and 1982 there was a significantly higher incidence of minimal change nephrotic syndrome among Asian compared with non-Asian children in Leicestershire. Most Asians in Leicestershire are Gujarati-speaking Hindus, but Sikhs and Muslims are also represented; no group of Asians (defined by religion, language, or birthplace) was at special risk of developing nephrotic syndrome. Nephrotic syndrome was more preponderant in Asian children living within the city of Leicester, and there was an unusually low incidence in non-Asian children within the city. Both racial and environmental factors may be important in the increased susceptibility to minimal change nephrotic syndrome in Asian children.

Adolescent↗
PubMed1984

Modulation of cellular immune function by cyclophosphamide in children with minimal-change nephropathy.

Cyclophosphamide is widely used to induce a remission of minimal-change nephropathy, but concerns have been raised about whether its effects on cellular immunity persist after treatment is discontinued. We studied functional and numerical measures of cellular immunity in children who had minimal-change nephropathy with frequent steroid-responsive relapses and were receiving cyclophosphamide (2.5 mg per kilogram of body weight per day for eight weeks). Sequential studies during such treatment showed that cyclophosphamide caused lymphopenia, particularly among T helper cells, resulting in a significant fall in the immunoregulatory (helper/suppressor) cell ratio. This change persisted 1 to 3 months after cyclophosphamide was discontinued, but measures of immune function reverted to normal after 6 to 12 months. Children with minimal-change nephropathy in long-term remission had no difference in T-cell subpopulations, lymphocyte responses to mitogens, or suppressor-cell function that could be attributed to the disease itself or to the previous use of cyclophosphamide.

Child↗
PubMed1984

Primary tuberculosis of the esophagus.

A case of primary tuberculosis of the esophagus is presented in an Asian patient. This is a rare site for tuberculosis and mimicked the appearance of a carcinoma.

Adult↗
PubMed1983

Predictors of renal function in diabetic and non-diabetic renal disease.

Forty-two patients with renal disease due to diabetic nephropathy (14 patients), tubulointerstitial disease (14 patients) and glomerular disease (14 patients) underwent measurement of glomerular filtration rate (GFR) by the 51Cr-EDTA 'one-shot' method and simultaneous serum beta 2-microglobulin, serum creatinine and creatinine clearance estimation. Serum creatinine was a significantly better predictor of GFR than serum beta 2-microglobulin in patients with diabetic nephropathy, whereas both methods were equally useful predictors of GFR in non-diabetic renal disease. Serum creatinine measurement remains the best method for detecting early reduction of GFR on a serum sample.

Adult↗