Antiproteinuric effect of captopril in a patient with lupus nephritis and intractable nephrotic syndrome

Article Abstract:

Angiotensin converting enzyme (ACE) inhibitors reduce the production of angiotensin, a substance that constricts blood vessels and increases the production of the adrenal hormone, aldosterone. ACE inhibitors have been shown to be effective in reducing proteinuria, the abnormal presence of blood proteins in the urine, which develops in various kidney diseases. A case is described of a 22-year-old woman with lupus nephritis (inflammation of the kidney), high blood pressure, and intractable nephrotic syndrome, a condition characterized by the destruction of blood vessels in the filtering units of the kidney. Nephrotic syndrome leads to proteinuria, reduced amounts of blood proteins, and accumulation of fluids in the body. Administration of the blood protein albumin and the diuretic drug furosemide, which increase the excretion of water, were ineffective in treating this patient. The ACE inhibitor captopril, given in a dose of 62.5 milligrams per day, decreased proteinuria from 28 grams per 24 hours to 11.5 grams per 24 hours over a 10-week period, and resulted in a weight loss of 35 pounds of excess fluids. The function of the kidney was maintained. These results show that captopril should be considered for the treatment of proteinuria associated with lupus nephritis when the condition is resistant to conventional therapy or when cytotoxic agents cannot be tolerated or are ineffective. It is recommended that captopril be used only as a supplement to, rather than a substitute for, standard drug therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, ACE inhibitors, Angiotensin converting enzyme inhibitors, Lupus, Kidney diseases, Proteinuria, Captopril

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Effect of weather conditions on rheumatic patients

Article Abstract:

Changes in the symptoms of patients with various rheumatic diseases were compared with changes in weather conditions. Sixty-two patients were studied, including 16 with rheumatoid arthritis (RA), 24 with osteoarthritis (OA, a form of arthritis where bone and cartilage develop in the joints, which are degenerated), 11 with inflammatory arthritis, and 11 with fibromyalgia joint pain. Changes in the weather caused an increase in arthritic symptoms in the joints of most patients. Twenty-five percent (4 out of 16) of the patients with RA, 83 percent (20 out of 24) of the patients with OA, 64 percent (7 out of 11) of the patients with inflammatory arthritis and 77 percent (8 out of 11) of the patients with fibromyalgia were affected by a change in the weather. More pain was felt when there was a changes in barometric pressure and temperature in patients with RA and OA, when it rained in patients with OA, and with changes in barometric pressure in fibromyalgia patients. A greater percentage of women (62 percent) felt an increase in symptoms compared with men (37 percent). There was no difference in the age or weight of the people who felt more pain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Environmental aspects, Pain, Weather, Rheumatoid arthritis, Osteoarthritis, Rheumatic diseases, Fibromyalgia, Rain and rainfall, Rain, Temperature, Atmospheric pressure

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Renal vein thrombosis in Chinese patients with systemic lupus erythematosus

Article Abstract:

Chinese patients with systemic lupus erythematosus (SLE) who have nephrotic syndrome may be at increased risk for developing renal vein thrombosis (RVT). Six Chinese patients with SLE and RVT were examined. The only significant initial characteristics indicating possible RVT in these patients had been excess protein in the urine, evidence of the antiphospholipid antibody syndrome, and fluid accumulation in the extremities. Imaging scans including Doppler, sonograms, and computed tomography did not detect the RVT in all patients. Tests run on kidney tissue samples indicated varying stages of glomerulonephritis.

Risk factors, Systemic lupus erythematosus, Chinese, Chinese (Asian people), Thrombosis

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