IgG4-Related Kidney Disease: A Curious Case of Interstitial Nephritis with Hypocomplementemia

IgG4-related kidney disease has been relatively newly recognized over the last two decades as a combination of an autoimmune and allergic disorder, with elevated serum IgG4 level and hypocomplementemia among its characteristic features. Here we report the case of a man with interstitial nephritis presenting with acute kidney injury and hypocomplementemia but normal serum IgG4 level and provide a literature review of IgG4-related kidney disease. This case highlights the importance of IgG4-related kidney disease as an important differential diagnosis in any patient presenting with a clinical syndrome mimicking acute interstitial nephritis with hypocomplementemia. A high index of suspicion with a low threshold for performing a native kidney biopsy would be paramount as patients do respond well to corticosteroid therapy

Lead (Pb) exposure and its effect on APP proteolysis and Abeta aggregation

Alzheimer's disease (AD) is a progressive neurodegenerative disorder with clinical manifestations appearing in old age, however, the initial stages of this disease may begin early in life. AD is characterized by the presence of excessive deposits of aggregated beta-amyloid (Abeta) peptides, which are derived from the beta-amyloid precursor protein (APP) following processing by beta-secretase and gamma-secretase. Recently, we have reported that developmental exposure of rats to Pb resulted in latent elevation of APP mRNA, APP, and Abeta in old age. Here we examined whether latent up-regulation in APP expression and Abeta levels is exacerbated by concurrent disturbances in APP processing or Abeta aggregation. Among the environmental metals tested, only Abeta solutions containing Pb promoted the formation of Abeta aggregates at nanomolar concentrations. The lifetime profiles of alpha-, beta-, and gamma-secretases remained constant in adult and aging animals, and developmental exposure to Pb did not alter them. Furthermore, the addition of various concentrations of Pb (0.1 to 50 microM) to cerebral cortical extracts derived from control animals also did not affect the proteolytic activities of these enzymes. Therefore, we propose that amyloidogenesis is promoted by a latent response to developmental reprogramming of the expression of the APP gene by early exposure to Pb, as well as enhancement of Abeta aggregation in old age. In rodents, these events occur without Pb-induced disturbances to the enzymatic processing of APP. The aforementioned results provide further evidence for the developmental basis of amyloidogenesis and late-life disturbances in AD-associated proteins by environmental agents

THU0639 AUTOMATED CAPTURE AND HIGH UPTAKE RATES OF PATIENT REPORTED OUTCOME MEASURES IN ROUTINE RHEUMATOLOGY PRACTICE

10.1136/annrheumdis-2019-eular.3872Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 201

Quality of life and its determinants in established rheumatoid arthritis

APLA

Modifiable risk factors for RA: prevention, better than cure? Rheumatology

Abstract Objective. To perform a meta-synthesis of the evidence for modifiable lifestyle risk factors for inflammatory polyarthritis (IP) and RA

Sociodemographic Factors Are Predictors of Poorer Clinical Outcome Trajectories in Early Rheumatoid Arthritis: Results from the Singapore Early Arthritis Cohort

ACR (Americal College of Rheumatology) meetin

Hospital admission risk stratification of patients with gout presenting to the emergency department

10.1007/s10067-021-05902-5Clinical Rheumatology4161801-180

Predicting Flares in Patients with Stable Systemic Lupus Erythematosus

10.1016/j.semarthrit.2019.01.001Seminars in Arthritis and Rheumatism49191-9