American family physician
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Immunologically mediated renal diseases include Goodpasture's syndrome, systemic lupus erythematosus, membranoproliferative glomerulonephritis, membranous nephropathy, poststreptococcal glomerulonephritis, IgA-IgG nephropathy and anaphylactoid purpura. In Goodpasture's syndrome, antibodies are directed against the glomerular capillary basement membrane. The other disorders appear to result from circulating immune complexes which deposit in glomerular capillary walls or in the glomerular mesangium. Treatment with steroids and/or immunosuppressives is effective in lupus nephritis; in other diseases, the results are less certain.
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Fractures about the elbow are common in children. In addition to the more frequent humeral supracondylar type, fractures of the lateral humeral condyle, the medial humeral epicondyle and the proximal radius often occur. Fortunately, these latter types are rarely associated with neurovascular compromise, as seen with the supracondylar type. However, accurate anatomic reduction is required to permit appropriate growth at these epiphyseal sites and to prevent complications.