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Original Article
Effect of Estrogen on Pseudomonas Mucoidy and Exacerbations in Cystic Fibrosis
Pseudomonas aeruginosa is a gram-negative opportunistic pathogen associated with cystic fibrosis, a multisystem genetic disease characterized by defects in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, which results in recurrent infective exacerbations. Median overall…
Original Article
Familial Diarrhea Syndrome Caused by an Activating GUCY2C Mutation
Chronic diarrhea is a health problem that poses challenges with respect to both diagnosis and treatment. The irritable bowel syndrome affects 15 to 20% of adults and is a common cause of diarrhea. Other causes include inflammatory bowel disease, infections, paraneoplastic hormones, celiac disease,…
Correspondence
Pulmonary Fibrosis, Bone Marrow Failure, and Telomerase Mutation
To the Editor: Telomeres protect the ends of chromosomes from erosion; telomerase ensures their integrity. We report a case of familial idiopathic pulmonary fibrosis and bone marrow failure associated with a mutation in telomerase reverse transcriptase (TERT). The patient was a 56-year-old lifelong…
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Original Article
Brief Report: Integrin α3 Mutations with Kidney, Lung, and Skin Disease
Epithelial–mesenchymal interactions are important in the development and tissue homeostasis of many multicompartment organs, such as the kidneys, lungs, and skin. Adhesion of epithelial cells to basement membranes provides the structural and functional integrity of the organs. Cues from the…
Original Article
HLA Class II Locus and Susceptibility to Podoconiosis
Podoconiosis (endemic nonfilarial elephantiasis) is a noninfectious geochemical disease that results in bilateral swelling of the lower legs (Figure 1). It is found among subsistence farmers whose feet are exposed over many years to red-clay soil derived from volcanic rock. Podoconiosis is an…
Original Article
Effect of a Monoclonal Antibody to PCSK9 on LDL Cholesterol
In 2003, Abifadel and colleagues described two families with autosomal dominant hypercholesterolemia that was associated with gain-of-function mutations in proprotein convertase subtilisin/kexin 9 (PCSK9), one of the serine proteases. These patients had high plasma levels of low-density lipoprotein…
Correspondence
Eculizumab for the Treatment of Dense-Deposit Disease
To the Editor: Dense-deposit disease (also known as membranoproliferative glomerulonephritis type II) is a rare glomerulopathy characterized by electron-dense deposits in the glomerular basement membrane as well as the glomerular deposition of complement. Within 10 years, the disease progresses to…
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Review Article
Mechanisms of Disease: Monogenic Mitochondrial Disorders
To function normally, human cells require energy in the form of ATP. In many cell types, ATP is primarily generated by mitochondria, which are also key players in other important cellular processes, such as adaptive thermogenesis, ion homeostasis, innate immune responses, production of reactive…
Correspondence
Eculizumab and Refractory Membranoproliferative Glomerulonephritis
To the Editor: Membranoproliferative glomerulonephritis (MPGN) mainly affects children, often progresses to end-stage kidney disease, and can recur after transplantation. Primary MPGN is one of several glomerulopathies that have recently been linked to dysregulation of the complement alternative…
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Correspondence
Eculizumab in a Patient with Dense-Deposit Disease
To the Editor: In 1999, an 11-year-old girl with the nephrotic syndrome received a biopsy-confirmed diagnosis of membranoproliferative glomerulonephritis. The level of plasma complement C3 was 7 mg per deciliter (normal range, 90 to 180). Glucocorticoids, administered for 5 years, were ineffective.…
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Editorial
Lowering Plasma Cholesterol by Raising LDL Receptors — Revisited
Thirty-one years ago, Mabuchi and colleagues reported in the Journal that a statin called compactin reduced plasma low-density lipoprotein (LDL) cholesterol levels by 29% in patients with heterozygous familial hypercholesterolemia. This drug inhibits an early step in cholesterol synthesis catalyzed…
Original Article
Truncations of Titin Causing Dilated Cardiomyopathy
Gene mutation is an important cause of cardiomyopathy. Mutations in eight sarcomere-protein genes cause hypertrophic cardiomyopathy, detected in 40 to 70% of patients. Variations in more than 40 genes, most of which encode components of the sarcomere, the cytoskeleton, or the nuclear lamina, have…
Perspective
Preparing for Precision Medicine
Ms. H. is a 35-year-old woman from Japan who has had a cough for 3 weeks. Her physician sends her for an x-ray and CT scan that reveal an advanced lesion, which a biopsy confirms to be non–small-cell lung cancer. She has never smoked. Can anything be done for her? Had Ms. H.'s cancer been…
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Review Article
Mechanisms of Disease: Iron Overload in Human Disease
Iron-overload disorders are typically insidious, causing progressive and sometimes irreversible end-organ injury before clinical symptoms develop. With a high index of suspicion, however, the consequences of iron toxicity can be attenuated or prevented. Some iron-overload disorders are quite common…
- CME
Editorial
Merry Christmas for Patients with Hemophilia B
Hemophilia B (also known as Christmas disease) is due to deficiency of coagulation factor IX (FIX). In this issue of the Journal, Nathwani et al. report the first unequivocal evidence of successful gene therapy for hemophilia B — a major advance in this field. This success for hemophilia may…
Original Article
Adenovirus-Associated Virus Vector–Mediated Gene Transfer in Hemophilia B
Hemophilia B is an X-linked bleeding disorder that results from a defect in the gene encoding coagulation factor IX (FIX), a serine protease that is critical for blood clotting. Persons with severe hemophilia B have functional FIX levels that are less than 1% of normal values and have frequent…
Using techniques to target the liver, enhance gene expression, and avoid eliciting an immune response, the authors administered an adenovirus-associated virus containing the gene for factor IX (FIX) in six patients with hemophilia B. The result was either reduction or elimination of the need for FIX prophylaxis.
Correspondence
Combined C3b and Factor B Autoantibodies and MPGN Type II
To the Editor: Membranoproliferative glomerulonephritis (MPGN) type II (MPGN II), also called dense-deposit disease, is a rare glomerular disease that often progresses to end-stage renal disease. MPGN II is associated with complement because of systemic C3 activation and deposition of C3 cleavage…
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