1/6. Successful transplantation of a cadaveric kidney with post-infectious glomerulonephritis.This report describes a successful renal Tx in a patient with chronic renal failure, caused by dysplastic kidneys, who received a cadaveric kidney with post-infectious glomerulonephritis. Sequential renal biopsies were performed at 12 h before Tx, and at 1 h and on days 8 and 58 post-Tx. Post-operative hematuria disappeared on day 9 and proteinuria on day 13. Normal graft function was observed within 1 month, with histologic resolution. Our study suggests that while the donor kidney facilitates deposition of certain immune reactants, this is a host (environmental) problem and when transplanted into a new host (new environment), the problem is no longer sustained.- - - - - - - - - - ranking = 1keywords = kidney (Clic here for more details about this article) |
2/6. infection with human herpesvirus 6 after kidney-pancreas transplant.We describe the first known case of symptomatic infection resulting from human herpesvirus-6 (HHV-6) in simultaneous pancreas-kidney transplant recipients. The role of HHV-6 in solid-organ transplant recipients is not well defined. In hematopoietic stem cell transplantation (SCT) HHV-6 may cause fever, rash, myelosuppression, interstitial pneumonitis, and encephalitis.- - - - - - - - - - ranking = 0.71428571428571keywords = kidney (Clic here for more details about this article) |
3/6. Young's syndrome accompanied by medullary sponge kidney.A 33-year-old man was admitted to our division for further evaluation of repeated fever and purulent sputa of more than 10 years duration. Based on clinical symptoms, chest roentgenograms, bronchograms, seminal examination, testicular biopsy specimen and electron micrograph of cilia from the left main bronchial mucosa, the diagnosis of Young's syndrome was made. A drip infusion myelogram, which was performed because of a persistent hematuria, revealed bilateral medullary sponge kidney, suggesting the involvement of this hereditary disorder in Young's syndrome.- - - - - - - - - - ranking = 0.71428571428571keywords = kidney (Clic here for more details about this article) |
4/6. Acute cryoglobulinemic renal failure after intravenous infusion of gamma globulin.A 39-year-old woman had mixed IgM/IgG cryoglobulinemia, but was later found to have a lymphoma that produced an IgM kappa paraprotein with rheumatoid factor activity. With intermittent chlorambucil and prednisone therapy, the lymphoma was controlled for five years and she had no evidence of cryoglobulinemia. Because of the presence of intractable pulmonary infection and hypogammaglobulinemia G, she was given an intravenous infusion of gamma globulin. Within 72 hours, renal failure and a sustained decrease in serum concentrations of IgM and IgG began concurrently. A kidney biopsy specimen obtained five days after the infusion showed hyaline "thrombi" in numerous glomerular capillaries and glomerular necrosis, consistent with acute, severe mixed cryoglobulinemic nephropathy. Immunostaining showed strong positivity for IgM, IgG, and light chains in glomerular capillary lumina and subendothelial sites; immunostaining with a monoclonal antiidiotypic antibody specific for the patient's paraprotein established the presence of the rheumatoid factor paraprotein in the deposits. These observations strongly suggest that complexes consisting of IgM kappa rheumatoid factor, IgG, and complement initiated the renal damage. Therefore, demonstrable serum rheumatoid factor activity in patients with B cell neoplasms should be considered a contraindication to the administration of intravenous gamma globulin.- - - - - - - - - - ranking = 0.14285714285714keywords = kidney (Clic here for more details about this article) |
5/6. Postinfectious glomerulonephritis. Subtypes, clinico-pathological correlations, and follow-up studies.APGN (WHO: diffuse endocapillary proliferative glomerulonephritis) has long been considered one of the best described kidney afflictions, clinically characterized by the sudden development of a nephritic syndrome after a latency period following a nasopharyngeal infection or pyoderma. Proliferation of mesangial and endothelial cells in the endocapillary space, aggregation of polymorphonuclear granulocytes in the capillary lumina, and deposition of predominantly subepithelial immune complexes on the glomerular basement membrane (so-called "humps") are to the present day considered characteristic of renal morphology. However, the nature of the antigen (or antigens) as well as the determining mechanisms in the pathogenesis of APGN still are unclear. Considerable disagreement also exists regarding the prognosis. An analysis of APGN is once again presented to elucidate whether the morphological picture of APGN is really as uniform as has been generally assumed. A large number of kidney biopsies was examined and subjected to the triad of light microscopy (LM), immunofluorescence microscopy (IFM) and electron microscopy (EM). The findings, which were recorded at an early stage of APGN in all cases (i.e. during the first 9 weeks), were related to clinical data, age (childhood or adulthood), and etiology (e.g. streptococci, staphylococci). In addition, clinical and morphological follow-up over a period of up to 10 years in those cases, which had been carefully documented in the early stages, afforded an insight into the dynamics and the prognosis of APGN. light microscopy of APGN showed a certain spectrum of variation even during the rather limited period of 9 weeks, due to the varying number of granulocytes and a varying degree of cell proliferation, as we could show semiquantitatively. With the triad of methods, especially by IFM and EM, three separate morphological patterns were distinguishable: the starry sky pattern, the garland pattern and the mesangial pattern. Based on clinico-pathological correlations, these patterns were shown to permit the nosological subdivision of APGN. The following features merit special emphasis: The starry sky pattern occurred most often during the first few weeks, the mesangial pattern increased in frequency after the 3rd week, and the garland pattern could occur at any time. In the starry sky and garland patterns immunoglobulins (mainly IgG) generally appeared in combination with C 3. The mesangial pattern was characterized by C 3 appearing alone. These three immunohistological patterns, which also showed transitional and combined forms, had certain characteristic features by electron microscopy.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 0.28571428571429keywords = kidney (Clic here for more details about this article) |
6/6. Persistent fever in a patient with polycystic kidney and liver diseases and bilateral hip prostheses.Persistent fever in a 60-yr-old man with polycystic kidney and liver diseases and bilateral hip prostheses was presented in this study. Multiple diagnostic tests failed to localize a source of infection. Subsequently, a combination of a 111In-oxine labeled WBC and 99mTc-sulfur colloid scans (and computer subtraction) demonstrated abnormally increased WBC activity in the left lobe of the liver, thus, diagnosis of an infected cyst (or cysts) was made. The patient responded to the treatment with antibiotics. This article discusses the clinical features of polycystic disease of the liver and kidneys. infection in cysts are discussed as well as radiographic and scintigraphic investigations that can be used to diagnose and localize infection in a cyst.- - - - - - - - - - ranking = 157.48135489376keywords = polycystic kidney, polycystic, kidney (Clic here for more details about this article) |