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Biomedical subjects

A Tarantino

Publications and source records attributed to A Tarantino.

At least 91 records · Page 5Linked to original sources
PubMed1983

Intravenous methylprednisolone pulse therapy in essential mixed cryoglobulinemia nephropathy.

In 15 patients with essential mixed cryoglobulinemia, 24 exacerbations of renal disease, characterized by an increase in plasma creatinine (13 episodes) and/or proteinuria (18 episodes), were treated by 3 intravenous pulses of methylprednisolone (1 g each), followed by oral prednisone (0.5 mg/kg/day). Plasma creatinine levels fell within a week (P less than 0.025), while a significant decrease in urinary protein excretion was observed only after one month (P less than 0.05). After therapy, plasma creatinine levels remained stable in 8/10 patients for 3 to 60 months. These beneficial results suggest that MP pulses may be useful in the treatment of cryoglobulinemic nephropathy.

Adult↗
PubMed1982

Glomerular localization of circulating antiglobulin activity in essential mixed cryoglobulinemia with glomerulonephritis.

Kidney biopsy samples from 27 patients with essential mixed cryoglobulinemia of the IgG-IgM(k) type and glomerulonephritis were studied to assess whether glomerular immunodeposits display antiglobulin (AG) activity similar to that of serum cryo-IgM. A preparation of heat-aggregated human IgG (FAIgG) was used to search for tissue AG activity, and blocking tests and reactivity tests were carried out to define the nature of this activity. Glomerular localization of FAIgG was observed in 17 out of 27 kidney specimens, the positive findings being always associated with IgM deposits. Prior exposure of tissue sections to anti-IgM serum blocked the FAIgG reaction, but no such effect was produced by the pretreatment with other antisera. The positive FAIgG tissue specimens yielded a similar fluorescence pattern with aggregated alkylated-reduced IgG, but did not react at all with the aggregated F(ab')2 or aggregated albumin. The IgM recovered in the eluate of a kidney biopsy specimen displayed AG activity. Patients with AG deposits showed more severe histologic changes and a greater renal functional impairment than did those without. The data support the notion that circulating cryo-IgM anti-IgG participates in the formation of glomerular immunodeposits and in the genesis of renal damage.

Adult↗
PubMed1981

Factor VIII/von Willebrand factor in glomerular nephropathies.

Levels of factor VIII/von Willebrand factor were measured in 105 patients affected by glomerulonephritis either of primary origin or associated with systemic diseases. The median plasma concentration of factor VIII-related antigen was significantly higher in the patients than in healthy controls. Amongst patients with primary glomerulonephritis, higher levels were observed in minimal change nephropathy than in other types. In patients with secondary glomerulonephritis, plasma factor VIII-related antigen was particularly elevated in lupus nephritis and in renal amyloidosis. Altogether, patients with the nephrotic syndrome showed higher levels than patients with lesser degrees of proteinuria. A negative correlation was found between the plasma concentration of factor VIII-related antigen and that of serum albumin but no correlation was observed with the extent of proteinuria. In 48 patients, plasma factor-VIII procoagulant activity was also measured and found to be elevated to the same extent as factor VIII-related antigen in the majority of cases. The urinary excretion of factor VIII-related antigen, evaluated in 72 patients, was found in variable amounts in 31 cases without any correlation with proteinuria. Glomerular deposits of factor VIII-related antigen were an uncommon finding. After 24 months, there was no clear evidence of an unfavourable association between increased plasma levels of factor VIII-related antigen and the course of the disease. Our findings suggest that the measurement of levels of factor VIII/von Willebrand factor in plasma or urine must be interpreted with caution in predicting the clinical course of patients affected by glomerular disease.

Antigens↗
PubMed1981

Renal lesions in essential mixed IgG-IgM cryoglobulinemia. Study of 48 cases.

56 renal biopsies in 48 patients affected by essential mixed IgG-IgM cryoglobulinemia have been examined by light microscopy and immunofluorescence. Patients were classified in four groups: 1) minimal lesions (4 patients); 2) pure proliferative mesangial lesions (9 patients); 3) membranoproliferative glomerulonephritis (23 patients); 4)proliferative glomerulonephritis with prominent intraluminal thrombi (12 patients). In this last group large intraluminal thrombi intensely fixing anti-IgG and IgM antisera were present; unlike the preceding groups, few deposits on capillary walls were seen. These four groups differed in renal clinical syndrome at presentation: in particular, proteinuria or nephrotic syndrome was the predominant manifestation in group 3, acute nephritic syndrome in group 4. In the latter, reversal of renal failure and regression of lesions could be observed. Various morphological aspects tend to show that in this disease more than one mechanism is operating in producing renal damage, including local trapping of abnormal circulating proteins.

Cryoglobulinemia↗
PubMed1981

Renal disease in essential mixed cryoglobulinaemia. Long-term follow-up of 44 patients.

The mode of presentation of renal disease in 44 patients with essential mixed cryoglobulinaemia (EMC) was: acute renal failure (two patients), acute nephritic syndrome (six patients), nephrotic syndrome (eight patients), proteinuria and/or haematuria (28 patients). Renal biopsy, performed in 35 patients showed proliferative lesions in 33, while only minimal glomerular changes were seen in the remaining two. Immunofluorescence studies showed: IgG (85 per cent), IgA (36 per cent), IgM (90 per cent), C3 (90 per cent), C1q (47 per cent), and C4 (33 per cent) deposits, mainly located in subendothelial position. On electron microscopy, crystalloid structure of deposits and monocyte infiltration of capillary loops were the outstanding feature. The survival rate was 75 per cent at 10 years from the onset of clinical symptoms. Thirty-nine patients were followed for three to 146 months (mean 53.8). Twelve patients died, cardiovascular disease and infection being the commonest cause of death. Thirteen patients showed acute renal failure of acute nephritis syndrome: nine recovered completely, whereas the remaining four died during the acute renal episode. Three patients developed chronic renal failure, but only one period required chronic dialysis. The ominous significance of renal impairment in EMC should therefore be revaluated. The high prevalence of hypertension (28/44 patients) which was refractory to treatment in six, may be important to the clinical outcome.

Adult↗
PubMed1980

[Results of renal transplantation from cadavers in 200 patients].

We report our experience of 202 cadaveric renal transplant performed over a 9 year period. Actuarial patient survival rate was 87.5% at 1 year and 81% at 9 years; graft survival rate was 58.5% at 1 year and 43% at 9 years. In order to improve patient and graft survival, from September 1977 renal transplantation was performed only in patients with a previous careful clinical selection and who had received at least three blood transfusions. Out of 18 patient, actuarial patient and graft survival rate at 1 year were 100% and 76% respectively.

Adolescent↗
PubMed1980

[Prognostic significance of anuric acute rejection].

32 graft rejection episodes requiring dialysis within four days appeared in the first month after transplantation in 224 renal transplants. Our report shows that oliguric renal failure is not related to the severity of rejection but probably to the appearance of an acute tubular necrosis. Therefore graft renal failure requiring dialysis is not necessarily related to a bad prognosis.

Acute Kidney Injury↗
PubMed1979

Comparison between immunofixation and crossed immunoelectrophoresis for the detection of C3 activation products.

C3 breakdown products were measured in 51 fresh and stored sera and/or EDTA plasma samples from 18 healthy subjects, 8 patients affected by essential mixed cryoglobulinaemia, and 15 patients with miscellaneous glomerulonephritis, by simultaneous crossed immunoelectrophoresis and immunofixation. C3 splitting products, as determined by both methods compared well, and showed a highly significant correlation. The advantages and reliability of these two methods are discussed. Immunofixation seems to be the most suitable for routine use in clinical practice, being less expensive and more rapid to perform.

Complement C3↗
PubMed1979

Urinary excretion of factor VIII after renal transplantation.

The urinary excretion of factor-VIII-related antigen (VIIIRAg) was measured in 72 patients with kidney transplants and compared with that of two end-products of fibrin-fibrinogen lysis (fragments D and E) to assess their usefulness in monitoring the onset of rejection episodes. Specific and sensitive radioimmunoassays were used to measure the three proteins. Unconcentrated urine samples of 24-hour collections were obtained from 20 healthy subjects, 48 patients with stable transplants, and 24 patients with recent transplants serially followed up from the day of transplantation. Factor VIIIRAg and fragments E and D were not detectable in the urine from healthy subjects but were present in 39%, 60%, and 100% respectively of samples from patients with stable transplants. During 33 acute rejection episodes in 19 patients with recent transplants factor VIIIRAg and fragments E and D were significantly increased above the values observed in patients with stable transplants in 82%, 73%, and 64% of samples respectively; in patients with recent transplants showing no clinical sign of rejection increased excretion of these proteins was observed in 11%, 26%, and 22% of samples respectively. The presence of factor VIIIRAg in urine from patients with kidney allografts suggests that endothelial cell-factor VIII-platelet interactions might pay a key part in the pathogenesis of acute rejection. The results suggest that the assay of factor VIIIRAg in urine is more useful than assays of fragments D and E as a corroborative index of transplant rejection.

Antigens↗
PubMed1978

Serum complement pattern in essential mixed cryoglobulinaemia.

In twenty-six patients affected by essential cryoglobulinaemia, 188 determinations of serum complement components (SCC) were made. A peculiar pattern was observed which was characterized by: (a) low levels of early components (Clq, Cls and C4), (b) normal levels of C3 and high concentrations of late components (C5, C9) and (c) CH50 values significantly lower than normal. No relationship could be observed between early SCC and C3 levels. Thirty-three crossed immunoelectrophoreses were performed in thirteen patient's blood samples. The C3c peaks were not different from normal. Follow-up data (156 serum samples from twenty-four patients) during a 6-40 month period showed a non-homogeneous SCC behaviour. However, no relationship was found between the complement concentrations and clinical score. These findings suggest that SCC abnormalities are related to a complement hyposynthesis, which could be caused by a reduced C2 production or by a negative feedback effect of active components or their fragments.

Complement C3↗