ascorbic-acid and Hematuria

Scurvy is a rare disease in developed nations. In the field of pediatrics, it primarily is seen in children with developmental and behavioral issues, malabsorptive processes, or diseases involving dysphagia. We present the case of an otherwise developmentally appropriate 4-year-old boy who developed scurvy after gradual self-restriction of his diet. He initially presented with a limp and a rash and was subsequently found to have anemia and hematuria. A serum vitamin C level was undetectable, and after review of the MRI of his lower extremities, the clinical findings supported a diagnosis of scurvy. Although scurvy is rare in developed nations, this diagnosis should be considered in a patient with the clinical constellation of lower-extremity pain or arthralgias, a nonblanching rash, easy bleeding or bruising, fatigue, and anemia. This case highlights the importance of carefully assessing a child's dietary and developmental status at well-child visits, which can help avoid a more invasive workup.

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Child, Preschool; Diet; Exanthema; Hematuria; Humans; Lower Extremity; Magnetic Resonance Imaging; Male; Scurvy; Vitamin D Deficiency

Malakoplakia is an unusual acquired granulomatous disease that can affect many systems including urogenital tract. It presents a huge diagnostic challenge as it can mimic malignancy. We report a 55-year diabetic woman who presented with history of macroscopic hematuria and right flank pain. On investigations, ultrasound of kidney, ureter and bladder (KUB) showed right hydronephroureter, and CT KUB showed right moderate hydronephroureter and right ureteric stone. Endoscopic examination revealed multiple white plaques involving urinary bladder and right ureter. The diagnosis of malakoplakia was based on microscopic findings that are specific for its diagnosis.

Topics: Anti-Bacterial Agents; Ascorbic Acid; Biopsy; Cystoscopy; Female; Hematuria; Humans; Malacoplakia; Middle Aged; Tomography, X-Ray Computed; Ultrasonography; Ureter; Urinary Bladder

The protective roles of lipoic acid (LA)/vitamin C (VC) and mesna on preventing cyclophosphamide (CYP)-induced haemorrhagic cystitis (HC) were investigated. Swiss mice were divided into five groups randomly. HC was induced by a single dose of CYP injection (150-mg kg(-1) bodyweight). Group I was injected with saline (four times in total) throughout as control group. Group II received CYP and three equal doses of saline. Group III received CYP and three doses of mesna, whereas Group IV (or Group V) received CYP, mesna + two doses of VC (or LA). All injections were performed intraperitoneally. After 24 h of cystitis induction, the bladders were collected for all the experiments. Histological characterization showed that CYP injection resulted in severe HC. Reactive oxygen species (ROS) and thiobarbituric acid reactive substances' levels were increased in CYP group. The activities of antioxidant enzymes, e.g. superoxide dismutase, catalase, glutathione S-transferase and glutathione peroxidase, were inhibited significantly in CYP groups, respectively. In addition, activation of c-jun N-terminal kinases (JNK) and p38 mitogen-activated protein kinase (MAPK) may be involved in the mechanism of CYP-induced HC but not extracellular signal regulated kinases (ERK). Significant suppression of p38 phosphorylation on Group V suggests that LA and mesna may have synergistic beneficial effect. In Groups III-V, all the parameters of HC and oxidative stress were inhibited significantly. Taking together, we found that these results illustrated that ROS play an important role on CYP-induced HC and the administration of LA/VC with mesna may have therapeutic potential against CYP-induced bladder HC.

Topics: Animals; Antineoplastic Agents; Antioxidants; Ascorbic Acid; Cyclophosphamide; Cystitis; Drug Synergism; Hematuria; MAP Kinase Signaling System; Mesna; Mice; Organ Size; Phosphorylation; Protective Agents; Random Allocation; Reactive Oxygen Species; Thioctic Acid; Urinary Bladder

Positron emission tomography is increasingly used for the diagnosis of occult infection or malignancy. The altered metabolic rate of cells in areas of malignancy or infection provides a sensitive method to identify pathology that is otherwise not identified by standard imaging methods. This case report describes a patient who presented with a pyrexia of unknown origin and renal impairment. She had a positron emission tomography scan that showed intense accumulation of fluoro-deoxy-glucose in both kidneys. Subsequent renal biopsy results showed a diagnosis of malacoplakia, the treatment of which resulted in a resolution of the fever and a stabilization of renal function. This is the first report of the positron emission tomographic appearance of renal malacoplakia.

Topics: Abdominal Pain; Ascorbic Acid; Female; Fever of Unknown Origin; Fluorodeoxyglucose F18; Gastrointestinal Diseases; Hematuria; Humans; Kidney Diseases; Malacoplakia; Middle Aged; Radiopharmaceuticals; Tomography, Emission-Computed; Trimethoprim

By breeding and feeding salt to spontaneously hypertensive rats (SHR) continuously over a long period (until 60 wk old), rats with systolic blood pressures (SBP) of over 270 mmHg were prepared. It was studied whether or not supplying large amounts of vitamin C (200 mg/rat/d) over this period might bring any beneficial effect to blood pressure. Moreover, physico-chemical studies were performed to measure the components and enzymes in the blood and urine at 53 and 60 wk-old, and biochemical studies on vitamin C were also carried out in this experiment. Male (14 rats: 7 wk-old, 100-105 g) and female (15 rats: 7 wk-old, 95-100 g) SHR were divided into three groups and bred continuously for 53 wk. The A group rats were given salt (2.5 g/100 g of diet), the B group rats were given salt and vitamin C (500 mg/100 mL of drinking water), and the C group rats were controls. The results showed almost the same tendencies between male and female rats. The body weights of the SHR in groups A and B were slightly lower than group C. The amount of food intake in groups A and B was almost the same as group C. The amount of water intake was, in the order from highest to lowest, group A, B and C. The SBP of group A rats exhibited the highest value among the three groups. The SBP of group B rats given vitamin C simultaneously with the salt resulted in a low blood pressure level close to that of the controls (group C). Furthermore, the DBP (diastolic blood pressure) also reflected the antihypertensive effect of vitamin C as well. The heartbeat of the rats was highest in group A, and was comparable to the value in the rats receiving vitamin C simultaneously with salt. For the tests on occult blood and protein in the urine, group A rats showed strong positive reactions, whereas the group B and C rats had decreased results for both tests. The organ weights of the liver, stomach, spleen, adrenal gland and kidneys per 100 g rat body weight were not different among the three groups. The values for the bilirubin content, and the enzyme activities of ALT and AST in the blood showed to be the highest in the male rats of group A. The values from the group B rats decreased near to the normal value like the control group. Vitamin C was found to decrease the blood pressure in SHR, and also to work effectively to protect liver and kidney functions even under the condition of very high blood pressure, as high as 250 mmHg.

Topics: Alanine Transaminase; Animals; Ascorbic Acid; Aspartate Aminotransferases; Body Weight; Drinking; Eating; Female; Hematuria; Hypertension; Male; Organ Size; Proteinuria; Rats; Rats, Inbred SHR; Sodium Chloride, Dietary

Aution Max AX-4280, an automated urine test-strip analyser, was evaluated in three centres. Method comparison, imprecision, carry-over, linearity, detection limit and drift studies were performed for glucose, protein, blood and leukocytes using Uriflet S 9UB strips. These strips enable measurement of pH, glucose, protein, blood, leukocytes, ketones, bilirubin, urobilinogen and nitrite. Specific gravity is determined by the refractive index method. Within-run and between-day imprecision, assessed using pooled urines and quality control materials, were good. No drift over 24 h or sample carry-over was observed. Method comparison with quantitative methods for glucose, protein and specific gravity yielded good correlations. Ascorbate negatively interfered with haemoglobin, glucose and nitrite measurements. Acetylsalicylic acid lowered pH, the effect being greatest when protein was absent. During the assessment period no malfunction or breakdown was reported. The Aution Max is easy to use and needs minimal maintenance.

Topics: Ascorbic Acid; Aspirin; Chemistry, Clinical; Glucose; Hematuria; Humans; Hydrogen-Ion Concentration; Leukocytes; Multicenter Studies as Topic; Proteinuria; Reproducibility of Results; Specimen Handling; Time Factors; Urinalysis

The increased risk of atherosclerosis in nephrotic syndrome is attributable in part to the associated hyperlipidaemia. The importance of oxidation of LDL in the atherogenic process has been recognized over the last 15 years. However, there are few data on the balance of antioxidant defences and lipoprotein oxidation in nephrotic syndrome. Plasma antioxidant vitamin concentrations and indices of LDL oxidation (LDL lipid hydroperoxide content and the susceptibility of LDL to oxidation) were measured in two groups of patients; group I comprised 29 nephrotic patients and group II comprised 25 patients with haematuria. Plasma ascorbate concentration was significantly lower in group I (the nephrotic group) compared with group II (median 13.3 versus 22.2 micromol/L; P<0.001). Vitamin E concentrations were higher in group I but were not significantly different if corrected for total plasma cholesterol (6.12 versus 5.88 micromol/mmol; P=0.33). However, these changes resulted in a low ascorbate:vitamin E ratio in group I (0.19 versus 0.87; P<0.0001). Despite these changes in important antioxidant vitamin concentrations, we were unable to demonstrate any increased susceptibility to LDL oxidation in vitro or any difference in LDL lipid hydroperoxide content. These data suggest that there may be a relative defect of oxidant/antioxidant balance in nephrotic syndrome which could predispose to increased oxidative stress. However, measures of LDL oxidation were not significantly different between the two groups. LDL was protected from oxidation despite the severe hyperlipidaemia and the low circulating vitamin C concentrations.

Topics: Adult; Aged; Antioxidants; Ascorbic Acid; Cholesterol; Female; Hematuria; Humans; Lipoproteins, LDL; Male; Middle Aged; Nephrotic Syndrome; Oxidative Stress; Oxygen; Vitamin E; Vitamins

Long-term or high-dosage consumption of vitamin C may play a role in calcium oxalate kidney stone formation. The present study was undertaken to determine the biochemical and physicochemical risk factors in a male subject who developed haematuria and calcium oxalate crystalluria after ingestion of large doses of ascorbic acid for 8 consecutive days.. Twenty-four-hour urine samples were collected before and during the ascorbic acid ingestion period as well as after the detection of haematuria. A special procedure was implemented for urine collections to allow for oxalate, ascorbate and other urinalysis. Oxalate was determined in the presence of EDTA to prevent in vitro conversion to ascorbic acid, whereas ascorbate itself was determined by manual titration in a redox method using the dye dichlorophenolindophenol. Urinalysis data were used to compute calcium oxalate relative supersaturations and Tiselius risk indices, whereas scanning electron microscopy was used to examine urinary deposits.. Oxalate excretion increased by about 350% during ascorbate ingestion before haematuria. Ascorbate concentrations also increased dramatically but appeared to reach a plateau maximum. Increasing calcium excretion was accompanied by decreasing potassium and phosphate values. The calcium oxalate relative supersaturation and Tiselius risk index increased during vitamin C ingestion and large aggregates of calcium oxalate dihydrate crystals were observed by scanning electron microscopy immediately after the detection of haematuria.. High percentage metabolic conversion of ascorbate to oxalate in this subject caused relative hyperoxaluria and crystalluria, the latter manifesting itself as haematuria. Clinicians need to be alerted to the potential dangers of large dose ingestion of vitamin C in some individuals.

Topics: Adult; Ascorbic Acid; Calcium Oxalate; Crystallization; Hematuria; Humans; Hyperoxaluria; Kidney Calculi; Male; Microscopy, Electron, Scanning; Risk Factors; Time Factors

The inhibitory effect of ascorbic acid on commercial test strip reactions for haematuria is demonstrated in vitro. A new test strip containing iodate is shown to be insensitive to even high ascorbic acid concentrations in the same in vitro experiments.

Topics: Ascorbic Acid; Diagnostic Errors; Drug Interactions; Hematuria; Indicators and Reagents; Iodates; Reagent Strips

Topics: Ascorbic Acid; Diagnosis, Differential; Hematuria; Humans; Indicators and Reagents; Reagent Strips

Topics: Albuminuria; Ascorbic Acid; Bacteriuria; Glycosuria; Hematuria; Humans; Indicators and Reagents; Methods; Reagent Strips; Urine

An attempt was made, by means of test strips for leucocytes, eruthrocytes, protein, ketone bodies, nitrate and ascorbic acid to distinguish urine samples with abnormal sediments. The urinary sediment was, at the same time, quantified with the Kova system. It was demonstrated that the teststrip system can separate out nearly all samples containing significant amounts of sediment. In addition, lysed erythrocytes and leucocytes are detected. It is, therefore, suggested to restrict microscopic examination to those samples which have been positive to at least one test strip. It is important that genital cleansing is undertaken before micturition.

Topics: Ascorbic Acid; Chemical Precipitation; Hematuria; Humans; Indicators and Reagents; Ketone Bodies; Leukocytes; Nitrites; Proteinuria; Reagent Strips; Urine

Review of results of 9,620 consecutive urinalyses revealed 892 urines that contained microscopic evidence of erythrocytes and 98 for which there were discrepancies between microscopic evidence of hematuria (greater than 20 erythrocytes/high-power field) and chemical detection of blood (0 or "1+" when results should be "3+"). Eleven specimens (from ten patients) showed negative results of chemical tests for blood and greater than 40 erythrocytes/high-power field (HPF). Nine of these patients were receiving ascorbic acid supplementation. In a random sample of 20 patients with greater than 40 erythrocytes/HPF and strongly positive tests for blood, none was receiving ascorbic acid, a significant difference by chi-square analysis. In a prospective study, low levels of ascorbic acid inhibited chemical detection of blood. At 25 mg/dl ascorbic acid, 10--20 erythrocytes/HPF could not be detected; at 35 mg/dl ascorbic acid, greater than 20 erythrocytes/HPF were undetectable. For quantitation of the low level at which ascorbic acid inhibits chemical detection of blood, fresh urine specimens should be analyzed. Ascorbic acid is oxidated in vitro to products that partially inhibit detection of blood yet do not assay as ascorbic acid.

Topics: Ascorbic Acid; Erythrocytes; Hematuria; Humans

Topics: Ascorbic Acid; Hematuria; Humans

Topics: Acute Disease; Amino Acid Metabolism, Inborn Errors; Ascorbic Acid; Chronic Disease; Female; Growth Disorders; Hematuria; Humans; Infant, Newborn; Liver; Liver Diseases; Male; Methionine; Pregnancy; Tyrosine

Topics: Animals; Ascorbic Acid; Blood Pressure; Brain Diseases; Brain Edema; Dehydration; Glycerol; Hematuria; Injections, Intravenous; Intracranial Pressure; Male; Rabbits

Topics: Acid-Base Equilibrium; Albuminuria; Ascorbic Acid; Bence Jones Protein; Bile Pigments; Bilirubin; Color; Drug Antagonism; Hematuria; Hemoglobinuria; Humans; Indicators and Reagents; Ketone Bodies; Paper; Peroxidases; Phenolphthaleins; Phenols; Povidone; Proteinuria