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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 60 (1982), S. 1115-1125 
    ISSN: 1432-1440
    Keywords: Long-term management ; Inherited renal tubular disorders ; Fanconi syndrome ; Pharmacotherapy ; Langzeitbetreuung ; Tubulopathien ; Fanconi-Syndrom ; Pharmakotherapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Hereditäre Tubulopathien mit isolierten tubulären Funktionsstörungen erfordern oft keine oder nur eine einfache, aber wirksame ärztliche Behandlung. Bei einigen angeborenen Stoffwechselerkrankungen mit komplexen tubulären Störungen gibt es eine spezifische Form der Behandlung, wie z.B. die galaktosefreie Diät bei der Galaktosämie oder die Entleerung der Kupferspeicher bei der Wilson'schen Erkrankung. Bei Patienten mit idiopathischem Fanconi-Syndrom, Zystinose, oculo-cerebro-renalem Syndrom oder Glykogenose Fanconi-Bickel hat die symptomatische Substitutionsbehandlung mit Flüssigkeit, Elektrolyten und Wasser die Lebenserwartung in den letzten 20 Jahren deutlich erhöht. Die Substitutionsbehandlung scheint jedoch keinen Einfluß auf die Entwicklung einer chronischen Niereninsuffizienz zu haben. Die Langzeitbetreuung von Patienten mit angeborenen Tubulopathien sollte sowohl die Behandlung der Tubulopathie, der chronischen Niereninsuffizienz und der mitbetroffenen Organe als auch die genetische Beratung und Hilfestellungen bei der sozialen Eingliederung beinhalten.
    Notes: Summary In inherited renal tubular disorders with isolated defects of tubular transport medical treatment is usually either not indicated or is simple and effective. In some inherited metabolic disorders with complex defects of renal tubular transport a specific therapy is known. For example, in galactosemia and hereditary fructose intolerance crude products may be restricted or in cases of Wilson's disease copper stores may be reduced. In idiopathic Fanconi syndrome, cystinosis, oculocerebrorenal syndrome and glycogenosis Fanconi-Bickel, a symptomatic replacement treatment based on supplementation of water, electrolytes and vitamin D has improved the non-uremic survival of these patients considerably within the last 20 years. For long-term management of inherited renal tubular disorders, treatment of tubular dysfunction, chronic renal failure, and involved extrarenal organs must be supported by genetic counseling and assistance for social integration.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 394 (1982), S. 235-254 
    ISSN: 1432-2307
    Keywords: Nephronophthisis ; Chronic sclerosing tubulo-interstitial nephropathy ; Associated defect
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The clinical and morphological findings are described in 27 children with nephronophthisis. Seventeen children were considered as sporadic cases. In 10 familial cases the presumed mode of inheritance was autosomal recessive. The clinical picture was rather uniform: polyuria-polydipsia, hyposthenuria, anemia, growth retardation, and azotemia with progressive renal failure. Six patients presented with tapeto-retinal degeneration. In a further seven children other ocular changes were detected. Two female siblings showed additional non-renal manifestations: mental retardation, pulmonary emphysema, skeletal anomalies, and congenital hepatic fibrosis. Renal histology displayed a chronic sclerosing tubulo-interstitial nephropathy with extensive tubular atrophy and dedifferentiation. Medullary cysts were frequently found in end-stage kidneys. Immunofluorescence was either non-specific or completely negative. On electron microscopy, the tubular basement membrane changes predominated: thickening, lamellation, splitting, and deposition of microfibrils within the increased basement membrane substance. Detailed light- and electron microscopic findings were non-specific but the overall morphologic picture was characteristic and even diagnostic in conjunction with the clinical presentation. A recurrence of nephronophthisis in transplanted kidneys has not been observed. The pathogenesis of nephronophthisis is obscure but with respect to the morphologic findings a primary or secondary tubular basement membrane defect seems very likely. Our experience suggests that nephronophthisis is a frequent cause of chronic renal failure in children and commonly associated with non-renal abnormalities. To avoid the separation of different syndromes presenting with a uniform renal disease but various non-renal manifestations, we suggest that the term “nephronopthisis complex” be used.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 397 (1982), S. 193-202 
    ISSN: 1432-2307
    Keywords: Minimal change nephrotic syndrome ; Children ; Morphometry ; Mesangial hypercellularity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Renal biopsies from 25 children with steroid-sensitive minimal change nephrotic syndrome were evaluated retrospectively to determine whether there is any relation between the morphological changes and the frequency of relapses. Biopsy material was examined by light-, immunofluorescence-, and electron microscopy, and by morphometric methods. The patients were divided in a group of 15 children with frequent relapses (FR) and another group of 10 children with an absence of, or only infrequent, relapses (NR/IR). Semiquantitative evaluation of biopsy specimens disclosed no significant differences between groups, but morphometric measurements performed on toluidine stained semithin sections showed a significant increase of mesangial nuclei in FR compared with NR/IR (P〈0.01). Furthermore, the mean area of mesangial nuclei was decreased and the relative frequency of smaller nuclear profiles was higher in patients with FR compared to NR/IR (p〈0.01). These findings suggest mesangial cell activation in FR which may be related to a longer course of the disease prior to renal biopsy (mean 4.0 years in FR vs. 1.4 years in NR/IR). In our opinion, morphometric assessment of discrete mesangial alterations is a promising method for exploring clinicopathological correlations in minimal change nephrotic syndrome.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 138 (1982), S. 354-357 
    ISSN: 1432-1076
    Keywords: Adolescent cystinosis ; Renal function ; Renal morphology ; Renal transport of amino acids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Morphological and functional investigations of the kidney were performed in an adolescent with cystinosis. The late onset and the gradual development of moderate complex tubular dysfunction was documented. Whereas in patients with infantile cystinosis tubulo-intersitial lesions and tubular dysfunction are pronounced, this patient with adolescent cystinosis show a predominance of glomerular lesions and glomerular dysfunction.
    Type of Medium: Electronic Resource
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