nephritis associated with infected indwelling shunts. The infection is usually with staphylococci (S. epidermidis) and patients present with anorexia, malaise, arthralgia, and low-grade fever. Purpura, anaemia, and hepatosplenomegaly may be found and urine analysis shows heavy proteinuria, often with a *nephrotic syndrome and haematuria. Treatment usually involves removal of the infected shunt as well as antibiotics.
A term used when a hole in the septum (internal wall) of the HEART allows blood to ?ow from the systemic circulation properly con?ned to the left side of the heart to the pulmonary circulation, con?ned to the right. The shunt is usually detected by hearing a murmur, and the diagnosis con?rmed by ECHOCARDIOGRAPHY (see also SEPTAL DEFECT).... left to right shunt
disease of the *tubulointerstitium of the kidney. Acute interstitial nephritis (AIN) represents in many cases an allergic reaction to drugs (especially ampicillin, cephalexin, NSAIDs, allopurinol, and frusemide). AIN can also be associated with acute infections and autoimmune disease. Thirst and polyuria may be prominent, and renal function severely affected. In allergic cases, the use of steroids hastens recovery after the allergen has been removed. Chronic interstitial nephritis (CIN) is associated with progressive scarring of the tubulointerstitium, often with lymphocyte infiltration. Primary causes of CIN include gout, radiation nephropathy, sarcoidosis, *analgesic nephropathy, reflux nephropathy, chronic hypokalaemia and hypercalcaemia, and *Aristolochia-associated nephropathies. Management of CIN involves removal of the precipitating cause, where identified, and control of hypertension.... interstitial nephritis
a frequent and serious complication of systemic *lupus erythematosus (SLE). The 2002 WHO/ISN/RPS classification of lupus nephritis recognizes six classes: class I is the presence of mesangial deposits (see juxtaglomerular apparatus) seen on immunofluorescence and/or electron microscopy; class II is the presence of mesangial deposits and mesangial hypercellularity; class III is focal and segmental *glomerulonephritis; class IV is diffuse segmental or global nephritis; class V is *membranous nephropathy; and class VI is advanced sclerotic glomerulonephritis. Untreated, outcomes are poor in classes III and IV, but much improved with immunosuppressant treatment.... lupus nephritis
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