Clinical significance of serum and urinary muramidase activity in leukemia and other hematologic malignancies

Wiernik, Peter H.; Serpick, Arthur A.

doi:10.1016/0002-9343(69)90036-9

Cited by 100 publications

(32 citation statements)

References 21 publications

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“…Osserman and Lawlor and others have noted hypokalemia and hyperkaluria in a number of patients with mono-and myelomonocytic leukemia (7,14,15,36). Excessive excretion rates of potassium, reduced excretion of titratable acid, and glycosuria were also noted in some patients (15).…”

Section: Proteins and Rendl Function In Monocytic Leukemiasmentioning

confidence: 95%

“…Osserman has suggested that humans and rats with monocytic leukemia, as well as rats injected with exogenous lysozyme, develop "lysozyme nephropathy" (55). It has been shown that the increased concentration of the enzyme in the kidney may be associated with cytoplasmic droplet degeneration of the proximal tubular cells and distortion of the mitochondria and nuclei (16,36). Similarly, in autopsy material available to us, droplets of homogenous eosinophilic substances have been found in the proximal tubular cells in 4 of 12 cases studied.…”

Section: Proteins and Rendl Function In Monocytic Leukemiasmentioning

confidence: 99%

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Serum and urinary proteins, lysozyme (muramidase), and renal dysfunction in mono- and myelomonocytic leukemia

Pruzanski¹,

Platts²

1970

J. Clin. Invest.

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A B S T R A C T Serum levels, urinary excretion, and clearances of several proteins of different molecular weights were studied in 18 patients with mono-and myelomonocytic leukemia. Nine patients had normal renal function (group A) and nine had impaired renal function with azotemia (group B). The majority of patients in both groups had increased concentration of immunoglobulins, particularly IgG, IgA, and IgM; IgD level was normal. Serum transferrin and a2-macroglobulin were frequently reduced while the level of ceruloplasmin was often increased, especially in patients with azotemia. The activity of lysozyme in the serum was high in all patients, but was considerably higher in group B.Proteinuria was found in most patients but was more prominent in group B. Almost invariably albumin constituted less than 25% of the total protein excreted. Qualitative analysis of various urinary proteins by immunochemical techniques and clearance studies suggested the presence of glomerular as well as tubular dysfunction. Determination of urinary lysozyme frequently showed no direct correlation between the serum level of the enzyme and its concentration in the urine or its clearance by the kidney. In addition to glomerular filtration, impaired tubular reabsorption may account for the high level of lysozyme in the urine. It is postulated that the very high level of lysozyme in the glomerular filtrate and possibly hypergammaglobulinemia may play a role in the induction of tubular damage. Renal impairment has been correlated with histological changes in the kidneys. From a comparative study of various leukemias, it seems that the combined glomerular-tubular dysfunction is a manifestation unique to mono-and myelomonocytic leukemia.

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Section: Proteins and Rendl Function In Monocytic Leukemiasmentioning

confidence: 95%

Section: Proteins and Rendl Function In Monocytic Leukemiasmentioning

confidence: 99%

Serum and urinary proteins, lysozyme (muramidase), and renal dysfunction in mono- and myelomonocytic leukemia

Pruzanski¹,

Platts²

1970

J. Clin. Invest.

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“…Since very high levels are found in leukaemia it should be possible to deduce the threshold using data from leukaemic patients. In this way there have been various estimates: 45 ,ug/ml (Hayslett et al, 1968), more than 50 ,tg/ml (Perillie, Kaplan, Lefkowitz, Rogaway, and Finch, 1968), and variable butnot less than 42 ,tg/ml (Wiernik and Serpick, 1969). …”

Section: Normal Valuesmentioning

confidence: 99%

Lysozymuria and acute disorders of renal function

1973

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On the assumption that increased urinary lysozyme concentration (`lysozymuria') indicates tubular proteinuria and therefore impaired tubular function, urinary lysozyme has been estimated in acute disorders where transient disturbances of renal function might be expected, in cases diagnosed clinically as extrarenal uraemia, and in a few examples of acute renal disease. Reversible lysozymuria occurred with hypokalaemia, postoperative `collapse', electrolyte depletion, severe extrarenal infection, acute pyelonephritis, the nephrotic syndrome, after a few apparently uncomplicated surgical operations, and very transiently after ventricular fibrillation abolished by DC shock. There was no lysozymuria with severe uraemic heart failure, aspirin and paracetamol poisoning, or severe jaundice, nor in two cases of acute glomerulonephritis. Although lysozymuria may occasionally be useful in the clinical diagnosis of acutely disordered renal function, the results suggest that its value is limited; on the other hand, they have provided information on renal pathophysiology in acute disease.

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“…Wiernik and Serpick (1969) found that patients with acute myeloid leukaemia, who had elevated initial serum muramidase levels, fared worse than those with normal or low levels. Castro, Perillie and Finch (1970) came to the opposite conclusion: they reported that patients with high serum lysozyme levels live longer than those with low levels.…”

mentioning

confidence: 99%

Lysozyme: a brief review

1977

Postgraduate Medical Journal

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Summary Serum lysozyme (muramidase) estimation is a simple, convenient and useful laboratory investigation. A review of the literature shows that lysozyme has been implicated as an aetiological factor in various disorders, and credited with being a prognostic indicator in acute myeloid leukaemia, but these promises have not been fulfilled. This low molecular weight protein is found in the urine of some patients with renal tubular disorders, but some workers have emphasized its importance as a causal agent in hypokalaemia of acute myeloid leukaemia. Research should be concentrated on muramidase as an expression of cell functions rather than as an aetiological factor. Hypokalaemia in acute myeloid leukaemia may be caused by an unidentified substance of molecular weight similar to that of lysozyme.

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Clinical significance of serum and urinary muramidase activity in leukemia and other hematologic malignancies

Cited by 100 publications

References 21 publications

Serum and urinary proteins, lysozyme (muramidase), and renal dysfunction in mono- and myelomonocytic leukemia

Serum and urinary proteins, lysozyme (muramidase), and renal dysfunction in mono- and myelomonocytic leukemia

Lysozymuria and acute disorders of renal function

Lysozyme: a brief review

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