Document Detail


Drug-associated glomerulopathies.
MedLine Citation:
PMID:  2940667     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The renal glomeruli are vulnerable to injury by a number of drugs and other toxic agents. These agents may lead to damage by one of two basic mechanisms: direct, dose-related toxic injury; indirect, immunologically mediated injury, largely dose-independent. Proteinuria is the simplest and most important functional indicator of glomerular injury. It occurs almost immediately in direct toxic injury, but there is a latent period of weeks to months with immunologically mediated processes. Of the two mechanisms, the second is by far the more common in clinical settings. The best studied experimental agent causing direct toxic injury is the aminonucleoside of puromycin. Clinically, perhaps the most important agent is Cyclosporine A. Although this agent is usually thought of primarily as a tubular toxin, it is capable of giving rise to a microangiopathic glomerular lesion similar to that in the hemolytic uremic syndrome. The classic model for immunologic glomerular lesion is Heymann nephritis, which produces a membranous glomerulopathy. Clinically, most drug mediated glomerulopathies also take the form of a membranous nephropathy, usually with a frank nephrotic syndrome. Among the more common offenders are penicillamine, gold salts used in rheumatoid arthritis, and captopril used in hypertension. The other common type of drug-related glomerulopathy occurs as part of a lupus-like syndrome induced by a variety of drugs, including hydralazine, procainamide, and penicillamine. All of these give rise to a variety of antibodies, most prominently antinuclear antibodies, and in the more severe cases there may be lupus-like glomerular lesions as well.
Authors:
G S Hill
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Toxicologic pathology     Volume:  14     ISSN:  0192-6233     ISO Abbreviation:  Toxicol Pathol     Publication Date:  1986  
Date Detail:
Created Date:  1986-07-07     Completed Date:  1986-07-07     Revised Date:  2009-07-01    
Medline Journal Info:
Nlm Unique ID:  7905907     Medline TA:  Toxicol Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  37-44     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Amyloidosis / chemically induced,  pathology
Animals
Captopril / adverse effects
Cyclosporins / adverse effects
Disease Models, Animal
Gold / adverse effects
Heroin Dependence / complications
Humans
Hydrocarbons / adverse effects
Immune Complex Diseases
Kidney Diseases / chemically induced*,  immunology
Kidney Glomerulus / drug effects
Lupus Erythematosus, Systemic / chemically induced
Mercury / adverse effects
Nephrotic Syndrome / chemically induced
Penicillamine / adverse effects
Puromycin Aminonucleoside
Serum Sickness / complications
Solvents / adverse effects
Tetradecanoylphorbol Acetate
Chemical
Reg. No./Substance:
0/Cyclosporins; 0/Hydrocarbons; 0/Solvents; 16561-29-8/Tetradecanoylphorbol Acetate; 52-67-5/Penicillamine; 58-60-6/Puromycin Aminonucleoside; 62571-86-2/Captopril; 7439-97-6/Mercury; 7440-57-5/Gold

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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