ISSN:0250-8095    

DOI:10.1159/000166849

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

We report immunopathologic findings observed in renal biopsies of 18 patients with diabetic glomerulosclerosis and associated glomerulonephritis. 10 patients had nodular and 8 patients diffuse diabetic glomerulosclerosis. Focal proliferative glomerulonephritis (4 patients), membranous glomerulonephritis (3 patients), postinfectious glomerulonephritis, Henoch-Schönlein nephritis, IgA nephropathy of Berger (1 patient each), and mesangiopathic glomerulonephritis (8 patients) were the superimposed conditions. In patients with diabetic renal disease, a rapid loss of renal function or an atypical urinalysis could be the expression of a superimposed immune complex disease. Because of functional and biochemical alterations, the glomeruli of diabetic patients may be more susceptible to immune-mediated injury

ISSN:0250-8095    

DOI:10.1159/000166850

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

During long-term captopril administration to hypertensive patients on maintenance hemodialysis, a decrease in hemoglobin, hematocrit, and red blood cell count was observed in 9 out of 12 cases. The maximum decrease in hemoglobin, on the average, was detected after 10.9 months of captopril treatment, when the average decrease was 20.5%. The average daily dose of the drug was 27.6 mg/day throughout the observation period. Mean corpuscular constants, reticulocyte count, serum iron, and total iron-binding capacity did not change significantly. Coombs’ test was negative. Neither serum total protein nor body weight changed significantly. Fever, skin rashes, leukopenia, and eosinophilia were not observed. There was no significant correlation between the degree of decrease in hematological indices and the dose of captopril. After discontinuation of captopril administration, anemia improved to pretreatment levels. In 2 of the 3 patients who did not show worsening of anemia, an anabolic steroid was administered in association with captopril. It is suggested that captopril should be used with caution in hemodialysis patient

ISSN:0250-8095    

DOI:10.1159/000166851

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

We examined whether antibody-coated bacteria (ACB) reflect local immune response or passive adsorption of immune globulins (Ig). For this purpose, bacterial subcultures from infected urines and third-party bacteria were incubated with Ig preparations. These were obtained from infected urine either by removal of Ig from ACB (dissociation in alpha-methylmannoside, 0.1 M glycine-HCl, or 3 M NaSCN) or by staphylococcal protein A affinity chromatography from the supernatant of infected urine. Coincubation of either Ig preparation with bacterial sub-strains of the original urine and with third-party strains (Pseudomonas aeruginosa, Proteus mirabilis, several Escherichia coli strains, enterococci, Serratia marcescens, Klebsiella pneumoniae, Staphylococcus aureus) caused coating of the bacterial surface with Ig. Coating was not measurably influenced by coincubation with various carbohydrates or by preincubation of bacteria with glucosidases. Adsorption of Ig was observed after heat denaturation and formalin treatment of bacteria and was independent of bacterial growth phase. Coating was observed both with intact IgG and with F(ab)2 fragments. We further examined the proportion of bacteria coated with IgA, IgG, and IgM in urines of 200 bacteriuric women with symptomatic urinary tract infection. The frequency histogram plot showed a continuous nonlinear unimodal distribution. Consequently, any selection of a ‘normal range’ is arbitrary. It is concluded that coating of the bacterial surface with Ig may not necessarily reflect local immune response. A major problem of the ACB test is definition of the normal ra

ISSN:0250-8095    

DOI:10.1159/000166852

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000166853

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000166854

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A 54-year-old patient with fracturing dialysis osteomalacia and dementia demonstrated rapid deterioration following parathyroidectomy which was performed for sustained hypercalcemia. Reduction of the total body aluminum burden was attempted using desferrioxamine (DFO) as a chelating agent. After 6 months, DFO infusion resulted in sustained clinical remission of both neurological and skeletal symptoms, associated with an improvement in the EEG and improved mineralization of bone. A reduction in total body aluminum burden was reflected by reduced skeletal aluminum content, quantitated histochemically in iliac crest bone biopsies before and after DFO therapy. Dramatic increases in serum aluminum levels were documented in the initial weeks of DFO therapy leading to increased removal of aluminum during dialysis; in vitro studies indicated that the ultrafiltrable fraction of serum aluminum increased from 17 to more than 60% after initiating DFO treatment. However, after 6 months of therapy, serum aluminum levels remained unchanged after DFO infusion. These findings suggest that the serum aluminum response to DFO infusion might be a useful reflection of the total-body aluminum burden and also a reflection of the adequacy of a chelation program designed to reduce whole-body aluminum content.

ISSN:0250-8095    

DOI:10.1159/000166855

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Glomerulonephritis is a very unusual feature of relapsing polychondritis. A 16-year-old woman presented with microscopic hematuria and severe renal insufficiency during the course of relapsing polychondritis. A renal biopsy specimen disclosed focal segmental proliferative glomerulonephritis with necrotizing lesions and crescent formation. Immunofluorescent studies suggested immune complex mediated glomerular injury. The renal involvement appeared during high-dose steroid therapy. Subsequently, she was treated by adding plasmapheresis and cyclophosphamide during 6 weeks, with sustained improvement. A regimen of plasmapheresis and immunosuppression warrants consideration for use in cases of relapsing polychondritis with glomerulonephritis.

ISSN:0250-8095    

DOI:10.1159/000166856

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000166857

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Interstitial nephritis consequent to rifampin was associated with potassium wasting, an acidifying defect, high fractional uric acid excretion, and glucosuria, indicating a multiplicity of renal tubular transport abnormalities. Enlarged kidneys on sonogram and proteinuria were also observed.

ISSN:0250-8095    

DOI:10.1159/000166858

出版商:S. Karger AG    

年代:1984

数据来源: Karger