Navegando por Palavras-chave "epidemic nephritis"

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    Epidemic glomerulonephritis due to Streptococcus zooepidemicus in Nova Serrana, Brazil
    (Blackwell Publishing, 2005-08-01) Sesso, Ricardo de Castro Cintra [UNIFESP]; Pinto, Sergio Wyton Lima; Universidade Federal de São Paulo (UNIFESP); Hosp Sao Joao de Deus
    Background. in 1998, there was a large outbreak of acute glomerulonephritis in Nova Serrana, Brazil, caused by group C Streptococcus zooepidemicus. This article reviews the characteristics of the outbreak and some aspects of the patients' follow-up.Methods. We describe clinical characteristics of patients with acute nephritis. Using case-control studies, we identified the source of infection. Cultures of oropharyngeal swabs from patients were performed. of 135 patients identified in 1998, available patients were reexamined in a prospective study after 2 and 5 years.Results. Lancefield group C S. zooepidemicus was identified as the causative organism and linked to the consumption of cheese produced from unpasteurized milk. of the original group of 134 patients, 4 died in the acute phase and 5 (3.7%) required chronic dialysis. After 2 years, of the 69 cases reevaluated, 94% were adults (mean +/- standard error age: 39 +/- 2 years); we found arterial hypertension in 42% (N = 27/64) of the patients, reduced creatinine clearance (< 80 mL/min/1.73 m(2)) in 30% (N = 20/67), and increased microalbuminuria (> 20 mu g/min) in 34% (N = 22/65). Preliminary data at 5-year follow-up suggest that the percentage of patients with creatinine clearance lower than 60 mL/min increased from 9% to 15%.Conclusion. This article highlights the dangers of consuming unpasteurized dairy products. Follow-up of patients with epidemic poststreptococcal glomerulonephritis due to S. zooepidemicus show that a considerable proportion present hypertension, reduced renal function, and increased microalbuminuria.
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    Five-year follow-up of patients with epidemic glomerulonephritis due to Streptococcus zooepidemicus
    (Oxford Univ Press, 2005-09-01) Sesso, Ricardo [UNIFESP]; Pinto, SWL; Universidade Federal de São Paulo (UNIFESP); Hosp Sao Joao Deus
    Background. in 1998 there was a large outbreak of acute glomerulonephritis in Nova Serrana, Brazil, caused by group C Streptococcus zooepidemicus. This study describes the follow-up of these patients, after a mean time of 5.4 years of the acute episode.Methods. of 135 cases identified in 1998, 56 were re-examined in a prospective study and had measurements of blood pressure, creatinine clearance (estimated by the Cockcroft and Gault formula), microalbuminuria (radioimmunoassay), urine sediment analysis and a protein dipstick test.Results. of the original group of 135 subjects, 3 died in the acute phase and 5 (3.7 %) required chronic dialysis. of the 56 cases re-evaluated, 54 (96 %) were adults (mean +/- SD age, 43 +/- 17 years) and 36 (64 %) females. At the follow-up examination, we found arterial hypertension in 30 % (n = 17/56) of the subjects, reduced creatinine clearance (<80ml/min) in 49 % (n = 26/53) and increased microalbuminuria (> 20 mu g/min) in 22 % (n=11/51). Compared to the evaluation carried out 3 years before, the number of cases with creatinine clearance lower than 80ml/min increased from 20 to 26 (of 53 cases). Increased microalbuminuria and/or reduced creatinine clearance were detected in 57 % (n = 32/56) of the subjects. Patients with reduced creatinine clearance were older than those without reduced renal function (54 +/- 15 vs 34 +/- 12 years, P < 0.001).Conclusions. After a mean time of 5.4 years, a relatively high proportion of patients with epidemic poststreptococcal glomerulonephritis due to S.zooepidemicus present hypertension, reduced renal function and increased microalbuminuria.
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    Follow-up of patients with epidemic poststreptococcal glomerulonephritis
    (W B Saunders Co, 2001-08-01) Pinto, SWL; Sesso, R.; Vasconcelos, E.; Watanabe, Y. J.; Pansute, A. M.; Universidade Federal de São Paulo (UNIFESP)
    In 1998 there was a large outbreak of acute glomerulonephritis (GN) in Nova Serrana, Brazil, caused by group C Streptococcus zooepidemicus and linked to the consumption of contaminated cheese produced with unpasteurized milk. This study describes the follow-up of these patients after a mean of 2 years following the acute episode. of 134 patients identified in 1998, 69 patients were reexamined and underwent measurements of blood pressure, 24-hour creatinine clearance, microalbuminuria (radioimmunoassay), and urine sediment analysis. of the original group of 134 patients, 3 patients died in the acute phase and 5 patients (3.7%) required chronic dialysis. of 69 patients reevaluated, 65 patients (94%) were adults (mean age, 39 +/- 2 [SE] years) and 47 patients (68%) were women. At the follow-up examination, we found arterial hypertension in 42% of subjects (27 of 64 subjects), serum creatinine levels greater than 1.2 mg/dL in 12% (10 of 68 subjects), reduced creatinine clearance (>80 mL/min/1.73 m(2)) in 30% (20 of 67 subjects, 2 of them on chronic dialysis therapy), and increased microalbuminuria (> 20 mug/min) in 34% (22 of 65 subjects). Increased microalbuminuria and/or reduced creatinine clearance were detected in 48% of the subjects (31 of 65 subjects). Patients with microalbuminuria had greater diastolic blood pressure than those without microalbuminuria (mean, 98 +/- 4 versus 88 +/- 2 mm Hg; P = 0.02). in conclusion, after a mean of 2 years, patients with epidemic poststreptococcal GN caused by S zooepidemicus present a high rate of hypertension and frequent abnormalities of renal function, with some having reached end-stage renal disease. Longer follow-up will be important to define the prognosis of these patients. (C) 2001 by the National Kidney Foundation, Inc.