SummaryBackground and objectives The cross-reactive antigen(s) of tubulointerstitial nephritis and uveitis (TINU) syndrome from renal tubulointerstitia and ocular tissue remain unidentified. The authors' recent study demonstrated that the presence of serum IgG autoantibodies against modified C-reactive protein (mCRP) was closely associated with the intensity of tubulointerstitial lesions in lupus nephritis. The study presented here investigates the possible role of IgG autoantibodies against mCRP in patients with TINU syndrome.Design, setting, participants, & measurements mCRP autoantibodies were screened by ELISA with purified human C-reactive protein in 9 patients with TINU syndrome, 11 with drug-associated acute interstitial nephritis, 20 with IgA nephropathy, 19 with minimal change disease, 20 with ANCA-associated vasculitis, 6 with Sjogren's syndrome, and 12 with amyloidosis. mCRP expression was analyzed by immunohistochemistry in renal biopsy specimens from the 9 patients with TINU syndrome and 40 from disease controls. Frozen normal human kidney and iris were used to demonstrate co-localization of human IgG and mCRP from patients with TINU syndrome with laser scanning confocal microscopy. ResultsThe mCRP autoantibodies were detected in all nine patients with TINU syndrome, significantly higher than that of those with disease controls (P Ͻ 0.05). The renal histologic score of mCRP in TINU syndrome was significantly higher than that in disease controls (P Ͻ 0.05). The staining of mCRP and human IgG were co-localized in renal and ocular tissues. ConclusionsIt is concluded that mCRP might be a target autoantigen in TINU syndrome.
BackgroundRabies is very common in People’s Republic of China. Henan province, in the central portion of China, is one of the most densely populated provinces in the entire country. With the new rabies epidemic trend noted in northern and western China, it is necessary to investigate the characteristics of human rabies in this area and control the disease.MethodsWe chose patients in hospital isolation in 18 municipalities in Henan province as the investigation subjects. Data were collected through systematic reporting from these hospitals, whereas a questionnaire was applied to the relatives of patients.ResultsA total of 1022 rabies cases were reported. The incidence of human rabies in Henan has increased rapidly since 2005, having peaked in 2007, and maintained a high level in the remaining years. The cases were found mainly in rural areas in the south and east of the province. Rabies was often noted in summer and with the highest number in August. Most cases were noted in males and often in farmers. The patients aged between 40 and 60 years accounted for 36.8 % of all the cases. The wound treatment rate (12.2 %) and vaccination rate (2.6 %) of rabies cases after exposure were relatively low, while the rabies immunoglobulin utilization rate was only 2.8 %.ConclusionsRabies epidemic cases at the county level overall were increasing in Henan province during the period of 2005–2013; the epidemic has spread quickly. The data in this study imply that the disease could be better managed by more integrated surveillance across human health and veterinary sectors, improved education and better government policies.
Anti-glomerular basement membrane (anti-GBM) disease is characterized by autoantibodies against antigenic site on type IV collagen of the GBM. The coexistence of anti-GBM disease and other immune complex mediated glomerulonephritis is common. Herein, we describe a patient presented with rapidly progressive glomerulonephritis, who was diagnosed as IgA-mediated nephropathy and was found to have abundant serum anti-glomerular basement membrane IgG antibodies. The patient's renal function improved considerably with intensive immunosuppressive therapy.
BackgroundRabies is very common in People’s Republic of China. Each year thousands of people die because of this disease, but rabies diagnosed in pregnancy is very rare.Case PresentationIn this study, we report the case of a pregnant woman who was infected with the rabies virus after a dog bite. The symptoms of rabies appeared in labor and she died after pregnancy. Her baby and husband did not develop the disease.ConclusionThe phenomenon that the newborn infant was healthy may be related to the protective role of placenta in resisting the invasion of the rabies virus or the absence of systemic viremia. The prompt administration of vaccines and anti-rabies immunoglobulin to the infant may have also contributed to his survival.
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