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  • 1
    Electronic Resource
    Electronic Resource
    Immunological factors in organ transplantation (1989)
    Springer
    Intensive care medicine 15 (1989), S. S61 
    Details
    ISSN: 1432-1238
    Keywords: Organ transplantation ; Cyclosporin ; Monoclonal antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Several immunological factors affect the outcome of human kidney transplants. HLA-A,-B and-DR matching improves kidney graft survival rate, especially matching for HLA-DR antigens. The beneficial effect of pretransplant blood transfusion has been confirmed although the mechanisms of the beneficial effect are not clear. Donor specific transfusion prior to living related donor kidney transplantation improve graft survival but some 30% of potential recipients become sensitized to the donor during the transfusion process. Major improvements in the results of organ transplantation have been achieved during the past few years with the use of new immunosuppressive agents, namely cyclosporin and monoclonal antibodies reacting with T lymphocytes. Both agents act selectively on T lymphocytes. However, nephrotoxicity of cyclosporin may limit its use.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00260890
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Treatment of lupus nephritis in children (2000)
    Springer
    Pediatric nephrology 14 (2000), S. 158-166 
    Details
    ISSN: 1432-198X
    Keywords: Key words Lupus nephritis ; Pulse methylprednisolone ; Oral prednisone ; Cyclophosphamide ; Azathioprine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In children, systemic lupus erythematosus (SLE) is often more severe than in adults. Renal disease is very common in SLE, with clinical symptoms of renal involvement occurring in 30%–70% of patients. In the absence of appropriate treatment the child may die from the disease or progress rapidly to renal failure. However, aggressive treatment regimens, in particular corticosteroids, carry the risk of growth retardation, accelerated atherosclerosis, and severe infectious complications. Lupus nephritis is classified into six groups depending on the severity of the histological lesions. The most-appropriate treatment for optimal efficacy with minimal side-effects depends on the disease severity. Mild lesions (class I or II) require only careful follow-up to identify any disease progression. Patients with class III nephropathy (focal and segmental glomerulonephritis) may have mild clinical symptoms, in which case no specific therapy is indicated, or more-severe symptoms of the nephrotic syndrome, hypertension, and sometimes moderate renal insufficiency. These patients require the same aggressive therapy as those with class IV disease (diffuse proliferative glomerulonephritis). Our current protocol starts with three methylprednisolone pulses followed by 1.5 mg/kg per day oral prednisone and six monthly pulses of cyclophosphamide. After a second renal biopsy the patient may be maintained on azathioprine while the prednisone dosage is slowly tapered. In children with milder disease we use lower doses of oral prednisone (1–1.5 mg/kg per day). Patients with membranous glomerulonephritis (class V) require no specific therapy if they have pure membranous nephropathy, but require aggressive therapy if they have the nephrotic syndrome. In those patients who progress to end-stage renal disease, clinical and serological remission is common and renal transplantation can be performed, as recurrence in the transplant is very rare.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004670050034
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Renal Granulomatous sarcoidosis in childhood: a report of 11 cases and a review of the literature (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 154-159 
    Details
    ISSN: 1432-1076
    Keywords: Key words Sarcoidosis ; Child ; Granulomatous interstitial nephropathy ; Renal failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We analysed retrospectively 11 children with renal granulomatous sarcoidosis confirmed by renal histology in order to describe the course and prognosis of the disease. Symptomatic sarcoidosis was diagnosed at a mean age of 10.1 years. Nine children had renal involvement at the time of diagnosis. In the course of the disease, nine patients developed renal failure and mild proteinuria, seven had transient sterile leucocyturia, four showed microscopic haematuria, seven had a urinary concentrating defect, and enlarged kidneys were seen in three patients. One child had hypercalcaemia and hypercalciuria, none had hypertension. Light microscopy of the kidney showed interstitial infiltration by mononuclear cells in all children, interstitial fibrosis in nine patients, epithelioid granulomas in seven, tubular involvement in eight, and mild glomerular involvement in seven patients. Renal immunofluorescence was negative. Ten children received prednisone for 1–11 years. After a mean follow up of 5.5 years, three patients had entered end-stage renal failure and one had chronic insufficiency after interruption of medical supervision and prednisone therapy. Conclusion Renal failure, proteinuria, leucocyturia, haematuria, and concentration defect are the prominent features of renal granulomatous sarcoidosis in children. Steroid therapy, adjusted according to disease activity, may prevent end-stage renal failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051038
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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