S Suzuki

Fukushima Medical University, Hukusima, Fukushima, Japan

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Publications (21)75.55 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Clinicopathological features were investigated to clarify the ultimate prognosis and prognostic indicators for patients with IgA nephropathy in Japanese children. We evaluated the outcomes of 181 patients in whom IgA nephropathy was diagnosed before the age of 15 years since September 1979 and followed-up at least for three years with regard to clinical data at the onset of symptoms and renal histologic data. After mean follow-up of 7.3 years from onset, 91 patients of 181 (50.3%) were in clinical remission at the last examination, 24 (13.2%) had isolated hematuria, 59 (32.6%) had hematuria and proteinuria. Eighteen of 59 (9.9%) had proteinuria more than 1 g per 24 hours. Hypertension was observed in 12 cases and 7 (3.9%) developed end-stage renal disease. Except 7, no patient had reduced renal function and elevated serum creatinine at the final follow-up. Predicted renal survival rate from onset was 92.3% at 10 years and 89.1% at 20 years. In multivariable analysis, age at onset and chronic changes of tubulointerstitium were associated with poor outcome. Of 181 children with IgA nephropathy, 50% regressed, remaining 46% had hematuria and/or proteinuria and 4% of patients lapsed into end-stage renal disease. Our results indicate that childhood IgA nephropathy has a benign course and the risk for end-stage renal disease is lower than that of adults. Age at onset and tubulointerstitial lesions were the strong predictors of a progressive course of childhood IgA nephropathy.
    Clinical nephrology 10/2005; 64(3):171-9. · 1.29 Impact Factor
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    ABSTRACT: A 10-year-old female patient was found positive for urine protein and occult blood on Japanese school urinary screening. Examination of the blood was normal except low values of the complement system with CH50 13.5 U/ml, C3 45 mg/dl and C4 3 mg/dl. Renal biopsy demonstrated a focal membranoproliferative glomerulonephritis (MPGN). As for the activity of each component of the complement in the early stage of the disease, the C4 activity was markedly declined and the activity of classical pathway component was also decreased, but the activity of alternative pathway component was normal. On the HLA examination, the patient demonstrated a C4 double null haplotype (C4A2, Q0, BQ0 phenotype). A null C4 gene at both the C4A and C4B loci was found in her mother, aunt and grandfather on the mother's side and C4B null allele in her father and her grandmother on the mother's side. The development of the disease is found in 1 case and not in the other, although both have the genetic defect and the mechanism by which the complement is activated remains unknown. Thus, there appear to be many subjects to be studied as to the relationship between the defect of C4 gene and immune competence.
    Clinical nephrology 11/2003; 60(4):279-83. · 1.29 Impact Factor
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    ABSTRACT: To clarify the risk factors related to prognosis in patients with Henoch-Schoenlein purpura nephritis (HSPN), we investigated the cases with HSPN on long-term observation. We enrolled 114 patients who had been diagnosed with HSPN from 1974-1997. These patients were divided into 2 groups based upon features at last follow-up. One group, designated "favorable", consisted of 69 patients with normal urine and 25 patients with minor urinary abnormalities, and the second group, designated "unfavorable", consisted of 15 patients with active renal disease and 5 patients with renal failure. The clinical features, laboratory data and pathological findings were investigated in 2 groups. Nephrotic syndrome, decreased factor XIII activity, hypertension and renal failure at onset were more frequent in "unfavorable" than in "favorable". The rate of glomeruli with crescents, macrophage infiltrations, tubulointerstitial changes and acute exacerbation in "unfavorable" were higher than those in "favorable". There were 5 cases with renal insufficiency, and renal survival rate was 95.6% for over 15 years. These results suggest that the above mentioned risk factors play an important role in prognosis of the patients with active renal disease and renal failure.
    Clinical nephrology 10/2003; 60(3):153-60. · 1.29 Impact Factor
  • Pediatrics 04/2003; 111(4):785-789. · 5.12 Impact Factor
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    ABSTRACT: We describe a 12-year-old girl with systemic lupus erythematosus (SLE) who first presented with an atypical hemolytic uremic syndrome (HUS) associated with hypocomplementemia, and compare the clinical manifestations and prognosis between SLE patients with HUS and thrombotic thrombocytopenic purpura in the reported literature. Diagnoses were based on renal failure, hemolytic anemia, and thrombocytonemia, including the observation of fragmented red blood cells, hypocomplementemia and on the American College of Rheumatology criteria for SLE. Cocktail therapy may have been effective against the pathological condition of SLE. In 4 patients with SLE and HUS, prednisolone and immunosuppressive drugs were administered, and none of the patients suffered from chronic renal insufficiency. The prognosis for SLE patients with HUS is good. These findings suggest that SLE should be suspected in any HUS patient presenting with hemolytic anemia, thrombocytopenia, acute renal failure and hypocomplementemia, and the therapeutic response and prognosis for SLE with HUS are good.
    American Journal of Nephrology 01/2002; 22(5-6):576-80. · 2.62 Impact Factor
  • Pediatrics International 09/2001; 43(4):417-9. · 0.88 Impact Factor
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    ABSTRACT: Activator protein-2 (AP-2) is an important transcription factor for activation of growth- and inflammatory-associated genes. To detect AP-2 in the mesangium, the expression level of AP-2 was examined in cultured mesangial cells in response to various cytokines and prostaglandins. The level was also observed in kidney tissue samples obtained from patients with proteinuria and from a rat nephrosis model. AP-2 was immunohistochemically detected with a specific antibody. The expression level was analyzed by immunoblotting. Human tissue samples were obtained from patients with proteinuria. Kidney samples were also obtained from rats with puromycin aminonucleoside-induced nephrosis. Pro-inflammatory cytokines, such as IL-6, IL-1 and IL-2, but not TNF-alpha, induced AP-2 expression in a time- and dose-dependent manner in cultured mesangial cells. PGE(2) and PGI(2) also induced AP-2 expression, while PGF(2 alpha) failed to induce this protein. High expression levels of AP-2 were observed in different cell types including mesangial cells of kidney samples from patients with proteinuria. Similar results were obtained from the rat nephrosis model. These findings demonstrate that the primary cytokines induce AP-2 protein in mesangial cells. AP-2 may act as a transcription factor to produce additional cytokines and growth-associated gene products, suggesting an important role for AP-2 for the function of mesangial cells in glomerular disorders.
    American Journal of Nephrology 01/2001; 21(4):307-14. · 2.62 Impact Factor
  • Pediatrics International 07/2000; 42(3):316-8. · 0.88 Impact Factor
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    ABSTRACT: In Japanese patients idiopathic tubular proteinuria presents mainly as asymptomatic tubular low molecular weight proteinuria. This disease has recently been shown to resemble Dent's disease which is characterized by tubular proteinuria, hypercalciuria, rickets and eventual renal failure. We report on 4 children with idiopathic tubular proteinuria. Although they had normal renal function, as evidenced by serum creatinine or creatinine clearance, they had very poor renal accumulation of 99mTc-DMSA and the presence of large amounts of tracer in the bladder. Additionally, the patient with the largest amounts of tubular proteinuria had the poorest renal accumulation of the 4 patients. The renal accumulation of tracer decreased with time from a maximum at 10 min after injection. These findings demonstrate that the tracer, once taken to be confined to the proximal tubular cells, is immediately excreted to the tubular lumen. We suggest that poor renal accumulation of 99mTc-DMSA is very important in elucidating the mechanism of idiopathic tubular proteinuria, and that 99mTc-DMSA renoscintigraphy is useful in the evaluation of the patient's renal function over time.
    Nephron 02/1999; 81(1):49-54. · 13.26 Impact Factor
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    ABSTRACT: We treated a 13-year-old girl who developed myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-related crescentic glomerulonephritis (GN) during propylthiouracil (PTU) treatment for Graves' disease. MPO-ANCA-related crescentic GN during PTU therapy has been described previously in only one recent report of 2 children. We report this case here and describe 15 (13 adult cases) more patients with MPO-ANCA-related GN associated with PTU found in a literature review. The mean age at onset was 41.3 years, and the length of PTU administration ranged from 2 weeks to 6 years (mean 3.5 years). Clinical signs and symptoms were hematuria (100%), proteinuria (100%), arthralgia (7 of 16 cases; 43.8%), fever (4 cases; 20.0%), purpura (2 cases; 12.5%), skin ulcer (1 case; 6.3%) and dyspnea (1 case; 6.3%). These patients were treated with steroid (15 cases; 93.8%), cyclophosphamide (8 cases; 50.0%), steroid pulse therapy (4 cases; 25.0%), or plasma exchange (1 case; 6.3%), or were not treated (1 case; 6.3%). Most patients revealed crescentic GN (15 cases; 93.8%) on renal biopsy, while one exhibited mesangial proliferative GN (6.3%). For 2 of the 16 patients (12.5%) irreversible renal dysfunction persisted and hemodialysis was started. Patients with Graves' disease treated with PTU should be observed carefully by urinalysis and monitoring of the serum creatinine level.
    Nippon Jinzo Gakkai shi 12/1998; 40(8):612-7.
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    ABSTRACT: IgA nephropathy associated with thin basement membrane disease is reported in a 9-year-old female. The diagnosis of IgA nephropathy was made by means of an immunofluorescence investigation, which showed generalized diffuse mesangial deposits. Thin basement membrane disease was identified by electron-microscopic investigations, which disclosed thinning of the basement membrane of several capillary loops and prominence of the lamina densa. Her father, elder sister and younger sister were also found to have hematuria and her sisters were diagnosed as having thin basement membrane disease by renal biopsy. Patients with IgA nephropathy have focal thinning of the glomerular basement membrane, but we consider that urinalysis of the family needs to be done for the diagnosis of familial thin basement membrane disease, when diffuse thinning of the glomerular basement membrane is detected in such patients.
    American Journal of Nephrology 02/1998; 18(5):422-4. · 2.62 Impact Factor
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    ABSTRACT: The purpose of the present investigation is to study renal injury by monthly viral inoculation into mice, using several different types of strains of enterovirus. A group of mice were inoculated intravenously with five different serotypes of group B coxsackieviruses (CB1 to CB5), once a month from 1 to 5 months of age and sacrificed monthly from 6 to 12 months of age. Mesangial proliferation and PAS-positive mesangial deposits in light microscopy and electron-dense deposits in electron microscopy were observed at maximum from 6 to 7 months of age. The CB viral RNA detected by in situ hybridization were observed in the mesangial lesion. By immunofluorescence findings, positive findings for IgG and IgA were observed. These results demonstrated that intermittent intravenous inoculation with different serotypes CB in mice provoked pathological changes closely resembling those in human proliferative glomerulonephritis. Moreover, the detection of CB viral RNA in glomerular lesions suggested that renal injury was induced by immune complexes correlated with CB viral replication in renal tissues.
    Nephron 02/1997; 77(1):93-9. · 13.26 Impact Factor
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    ABSTRACT: Viruses have been suspected to be etiological agents of IgA nephropathy. Recently, viruses were detected in renal tissues from patients with IgA nephropathy. We tried to cause lesions similar to IgA nephropathy by inoculating virus into mice and to detect virus RNA in the lesion by in situ hybridization. A group of mice were inoculated intravenously with coxsackie B4 virus once a month from 1 to 5 months of age and sacrificed monthly from 6 to 12 months of age. Mesangial proliferation and deposits that stained positive with periodic acid-Schiff in light microscopy and electron-dense deposits in electron microscopy were found from 6 months of age. Positive findings for IgG and IgA deposition in the mesangium were noted and the intensity of IgA deposition was predominant after 10 months of age. The signals of coxsackie B4 virus by in situ hybridization were observed in the lesions. These observations indicate that coxsackie B4 virus inoculated repeatedly into mice induces lesions similar to IgA nephropathy. The depositions of the lesions may be immune complexes of coxsackie B4 virus and these immune complexes injure renal tissues.
    American Journal of Nephrology 02/1997; 17(1):81-8. · 2.62 Impact Factor
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    ABSTRACT: We describe the effects of Sairei-to, a Chinese herbal medicine, on aminonucleoside-induced nephrotic rats (ANNR), and analyze the urinary excretion of protein and phosphatidylinositol (PI) turnover via prostaglandin E2 (PGE2) receptors in isolated glomeruli. Sairei-to suppressed urinary excretion of protein and PGE2 in ANNR, and inhibited acceleration of PI turnover in isolated nephrotic glomeruli. The affected responsiveness of the PI turnover system to PGE2 in a nephrotic state was presumed to be normalized by Sairei-to. These findings suggest that Sairei-to restores abnormal changes in the PI turnover system in ANNR kidneys, and thereby inhibit excretion of protein into the urine.
    Nephron 02/1997; 75(2):208-12. · 13.26 Impact Factor
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    ABSTRACT: In order to examine the intracellular thromboxane A2 (TXA2) signal transduction system in platelets of patients with nephrotic syndrome, we measured the levels of TXA2 metabolites in urine and blood and platelet calcium ion level as a result of STA2, an analog of STA2 (9,11-dimethylmethano-11,12-methano-TXA2) stimulation, and obtained the following results: (1) In pediatric patients with nephrotic syndrome, urinary thromboxane B2 (TXB2) and 11-dehydro-TXB2 excretion were signficantly higher in the onset and relapse groups compared to the remission and control groups. (2) The blood 11-dehydro-TXB2 level in the onset group was significantly higher than those in the remission and control groups. (3) Platelet calcium concentrations due to STA2 stimulation were significantly increased in the onset, relapse and remission groups compared to the control group. These findings suggest activation of the TXA2 signal transduction system in platelets of pediatric patients with nephrotic syndrome.
    Nephron 02/1997; 77(3):309-14. · 13.26 Impact Factor
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    ABSTRACT: A case of Sjögren's syndrome with glomerulonephritis is presented. The patient was a 13 year old male with hematuria and proteinuria discovered by urine screening of school children. Evaluation showed no evidence of any associated connective tissue disease. Kidney biopsy was consistent with membranous glomerulonephritis. Sjögren's syndrome with membranous glomerulonephritis is rare and the patient was the youngest case in the literature.
    Acta paediatrica Japonica; Overseas edition 11/1996; 38(5):533-6.
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    ABSTRACT: The aim of this study was to evaluate glomerular C3c deposits of Henoch-Schönlein purpura nephritis (HSPN) in children. Fifty-one patients aged 7-15 years (20 males and 31 females) were studied. On histological investigation, crescent formation seen under light microscopy and subepithelial electron dense deposits (EDD) under electron microscopy were found to be related to the degree of proteinuria and the duration of proteinuria and/or hematuria. A comparative clinicopathological study was performed on C3c-positive patients (n = 22) and C3c-negative patients (n = 25). Histological findings, such as crescent formation and subepithelial EDD, had no relation to glomerular C3c-deposits. At renal biopsy, C3c deposits were positive in 65 % of patients with heavy proteinuria ( > 100mg/kg/day), and in 30% of mild proteinuria patients ( < 50mg/kg/day). The difference between the two groups was statistically significant (p < 0.05). The duration of proteinuria and/or hematuria in C3c-positive patients had a tendency to persist in comparison with that in C3c-negative cases. Renal biopsies on many cases of C3c-negarive patients were performed following the lapse of three months, while the biopsies on patients showing global (+) C3c deposits (n = 15) were conducted within the three-month period. These results suggest that glomerular C3c deposits influence the clinical conditions of patients with HSPN, and complement activation is generated in the early stage of HSPN.
    Nippon Jinzo Gakkai shi 07/1996; 38(6):259-68.
  • Clinical nephrology 07/1996; 45(6):422. · 1.29 Impact Factor
  • Nippon Jinzo Gakkai shi 09/1988; 30(8):985-90.
  • Fukushima journal of medical science 07/1988; 34(1):21-5.