Biomedical subjects
Publications and source records attributed to A Date.
A study of the immune system in 11 patients with chyluria showed lymphocytopenia, decrease in T cells, a low serum IgA concentration and suppression of delayed hypersensitivity responses to intradermally injected antigens. The similarity of chyluria to intestinal lymphangiectasia and thoracic duct fistula suggests that the immune deficiency may be due to loss of lymph in the urine.
Electron microscopic examination of biopsy material from two patients with renal cortical necrosis following Russell's viper bite, showed extensive destruction of glomerular and tubular cells with haemorrhage into the glomerular urinary space and tubules. The non-selective cell destruction seen suggests an ischaemic aetiology and the presence of fibrin in the glomeruli indicates that the ischaemia may be due to intravascular coagulation.
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A case is reported of Bancroftian filariasis and acute immune complex glomerulonephritis in a 44-year-old man. Renal biopsy showed microfilariae and large numbers of eosinophils in the glomeruli (eosinophilic glomerulonephritis). The absence of other aetiological factors suggests that the glomerulonephritis may have been of filarial origin.
An 18-year-old man developed skin lesions and anuria following exposure to sap of the marking-nut tree (Semecarpus anacardium). Renal biopsy showed diffuse cortical necrosis. The mechanism of nephrotoxicity of the sap is unknown but may be due to its phenolic constituents.
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Shigella dysentery caused 65% of all cases of acute renal failure (ARF) seen in children treated at the Christian Medical College Hospital, Vellore, during the 33 months ending September 1977. In the 40 children with ARF secondary to shigella dysentery, haematological findings suggested that they were suffering from the haemolytic-uraemic syndrome, and glomerular hypercellularity and fibrin deposition were present in all 12 patients whose renal histology could be studied. Peritoneal dialysis was the main element of treatment: 43% of children who underwent dialysis improved, compared with only 25% of those who did not undergo dialysis. The haemolytic-uraemic syndrome precipitated by bacillary dystentery is therefore the most important cause of ARF in children aged under 5 years in Tamil Nadu and the adjoining area of Andhra Pradesh.
Differential counts of glomerular eosinophils and neutrophils were performed on renal biopsies from 16 patients with diffuse proliferative and exudative glomerulonephritis. The results indicate that eosinophils and neutrophils are present in the glomerular exudate in the same proportion as in the peripheral blood. The eosinophilia present in some of the cases could not be etiologically related to the acute nephritis and probably represented a chance association, showing how a well known histological entity can sometimes be modified in a tropical environment. The functional effects, if any, of this modification require further study.
Clinical, hematological, and renal biopsy findings in 19 unselected patients with renal failure following snake bite, including eight bitten by Russell's viper, are presented. Hematological findings were variable and did not influence treatment. Renal histology was a good guide to prognosis; patients with normal histology recovered with conservative management, those with tubular necrosis responded well to dialysis, while those with cortical necrosis responded only partially. Peritoneal dialysis was found to be an adequate form of treatment in the majority of patients.
Electron microscopic examination of renal biopsies from 19 patients with leprosy who had edema, proteinuria, or hematuria showed a proliferative glomerulonephritis in 12, amyloidosis in 2, and no lesion in 5. The proliferative glomerulonephritis was of different patterns: diffuse with or without exudation, focal, or mesangial. Subendothelial and/or subepithelial deposits were seen in five biopsies. Of the patients with glomerulonephritis, 3 had a reduced total serum complement level, 5 had erythema nodosum leprosum, 5 had evidence of recent streptococcal infection, and 2 had microfilariae in the peripheral blood. The significance of these findings is discussed.
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