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Biomedical subjects

D Nochy

Publications and source records attributed to D Nochy.

At least 91 records · Page 5Linked to original sources

De novo focal glomerular sclerosis in preeclampsia.

Eleven women were selected on the presence, in postpartum renal biopsies, of focal glomerulosclerosis (FGS) superimposed to glomerular lesions of typical pregnancy-induced nephropathy. Ten out of them presented with severe preeclampsia. The renal specimens were examined by light and/or electron and/or immunofluorescence microscopy. The present study gathered clinical and morphological data suggesting that FGS might develop during preeclampsia. In these renal biopsies with FGS and lesions of pregnancy-induced nephropathy a sparse detachment of podocyte was observed at a distance from the segmental lesions by electron microscopy. The latter has also been observed in experimental models of FGS in which FGS is dependent on glomerular hemodynamic alterations. We think that the mechanism of the development of FGS in these pathological pregnancies may be analogous to these experimental models of FGS with hyperfiltration.

Adolescent↗

Glomerular matrix proteins in nodular glomerulosclerosis in association with light chain deposition disease and diabetes mellitus.

The diagnosis of light chain deposition nephropathy is based on the immunohistochemical demonstration of monoclonal light chain deposits within connective tissue matrix and on the presence at the ultrastructural level of electron-dense granular deposits along glomerular and tubular basement membranes. A nodular glomerulopathy characterized by amorphous periodic acid-Schiff-positive and argyrophilic widened mesangium and nodules is described in three patients with light chain deposition nephropathy. Light microscopic examination did not allow discrimination between the glomerular changes found in these specimens and the nodular glomerulosclerosis described in four patients with well-documented diabetes mellitus. Electron microscopic examination revealed microtubular fibrils 10 to 12 nm thick in mesangial areas in both groups. Such microfibrils could be glycoproteins. Immunofluorescence localization of matrix proteins, by staining with affinity-purified antibodies to types I, III, IV, and V (A, B) collagens, fibronectin, laminin, and heparan sulfate-containing proteoglycans, showed similar distributions in the two conditions. The mechanism of this abnormal accumulation of mesangial and glomerular basement membrane matrix proteins in two different conditions remains unknown.

Basement Membrane↗

Association light chain deposition disease (LCDD) and amyloidosis. One case.

Up to now, light chain deposition disease (L.C.D.D.) and amyloidosis have been shown to occur in different individuals. A case of association is described in a 76 year old man with terminal renal failure and normal size kidneys. Percutaneous renal biopsy showed glomerular and peritubular fixation of labeled antikappa light chain serum. Stains for amyloidosis were positive in small vessels. Kappa free chains were found in both serum and urine and the bone marrow showed predominantly kappa-containing plasma cells. By electron microscopy both electron-dense granular deposits and amyloid like fibrils were found in the wall of arterioles and small arteries.

Aged↗

Association of systemic light-chain deposition disease and amyloidosis: a report of three patients with renal involvement.

Three patients with renal involvement, plasma cell dyscrasia and systemic light chain deposition are reported in whom well characterized amyloid deposits were also found in the vessel walls. This association, not yet reported, is probably more frequent than believed and still brings nearer these two manifestations of monoclonal light chain deposition. Whether or not the finding of amyloid deposits during systemic light chain deposition is a separate entity and modifies the prognosis remains to be answered.

Adult↗

[A very unusual case of amyloidosis].

This case report describes a patient with IgG lambda myeloma and vascular amyloidosis. Remarkable is the presence of mesangial granular deposits revealed by electron microscopy and positive with anti-IgG and anti-kappa anti-serum in an immunofluorescence study. Granular dense deposits were also found at the inner side of the basement membrane of the skin and were positive with anti-kappa anti-serum in immunofluorescence study. Because no L kappa q light chain proliferation could be demonstrated, the nature and significance of these kappa deposits are not clear.

Amyloidosis↗

Abnormalities of renin-containing cells in human glomerular and vascular renal diseases.

The distribution of renin was investigated by immunofluorescence in human kidney biopsy specimens (27 patients with lipoid nephrosis, 39 with Berger disease, 17 with membranous glomerulonephritis, 5 with thrombotic microangiopathy, and 7 with malignant nephroangiosclerosis). A semiquantitative assessment was carried out. Two ratios were found significatively increased in the study groups as compared with the control group: JGA + and JGA ++ which expressed, respectively, the number of fluorescent JGA in relation to the number of glomerular sections and the number of fluorescent JGA with more than six renin-containing cells (RCC) in relation to the number of immunoreactive JGA. Highest values were observed in patients with thrombotic microangiopathy and malignant nephroangiosclerosis (P less than 0.001). The above immunomorphological parameters were correlated with clinical and laboratory data. A positive dependency was found between JGA + and JGA ++ ratios and a low sodium diet, diuretic therapy and serum creatinine. A negative dependency was seen in the albumin and hemoglobin serum levels. No correlation was found with blood pressure values. These observations suggested that decreased plasma volume and impaired renal function could be factors leading to an increased renin production in the kidney.

Adolescent↗

Immunohistochemistry of renin in human diseased kidney.

The distribution of renin in human kidney was investigated by immunofluorescence and the peroxidase-antiperoxidase (PAP) procedure at the light and ultrastructural level. In three cases of juxtaglomerular renin-secreting tumors, renin was localized within the cytoplasm of tumor cells. In kidney biopsies, a semi-quantitative assessment was carried out, taking into account the size and the number of immunostained juxtaglomerular apparatuses. In 12 cases of ischemic kidneys and 8 cases of segmental renal hypoplasia, the increase in immunostaining for renin was striking in altered areas, while spared areas remained negative. In 2 cases of Bartter's syndrome, the pattern was similar to that found in ischemic kidneys. The study was extended to a series of 133 needle kidney biopsies from patients with various glomerular and vascular diseases; the immunomorphological parameters were correlated with serum creatinine levels but not with blood pressure values. Post-embedding immunoelectronmicroscopy using the PAP procedure performed on two of the cases of renin-secreting tumors, showed renin in all types of secretory granules.

Bartter Syndrome↗

Accumulation of several basement membrane proteins in glomeruli of patients with preeclampsia and other hypertensive syndromes of pregnancy. Possible role of renal prostaglandins and fibronectin.

The glomerular lesions of preeclampsia consist of swelling of endothelial cells, interposition of mesangial cells and matrix between the endothelial cells and the glomerular basement membrane, and organization of subendothelial deposits of incompletely characterized material. Fibrin and immunoglobulins have previously been localized to these deposits. Laminin, a large basement membrane glycoprotein, type IV collagen, fibronectin, and a basement membrane proteoglycan were found in moderate amounts in the mesangium and prominently in the thickened glomerular capillary walls of patients with preeclampsia or other hypertensive syndromes of pregnancy. Fibrin showed the same pattern of distribution as that of fibronectin. The material deposited in the subendothelial layer of the capillary loops thus consists not only of plasma-derived proteins but also structural components of the glomerular basement membrane and of the mesangial matrix. Type I collagen deposits were demonstrated only in mesangium of pregnant patients with chronic or recurrent hypertension. Glomerular epithelial and mesangial cells synthesize in vitro the basement membrane proteins that accumulate in glomeruli of pregnant hypertensive patients. We have tested the influence of some of the pathophysiologic changes occurring during preeclampsia on the biosynthesis of collagen by rat glomerular epithelial and mesangial cells. Addition of indomethacin to the cultures transiently inhibited the synthesis of prostaglandins (PGE2) and of collagen. Addition of exogenous fibronectin to the media stimulated the production of collagen by mesangial and epithelial cells. Alterations in the metabolism of prostaglandins and the increased deposition of fibronectin observed during preeclampsia could thus play a pathogenic role in the accumulation of basement membrane proteins in glomeruli of these patients.

Basement Membrane↗

Nephrotic syndrome, linear glomerular IgG deposits, and minimal glomerular changes. Report of a case.

A young adult patient had an unusual acute idiopathic nephrotic syndrome. This nephrotic syndrome was remarkable for (1) association with acute renal failure and hypertension, (2) finding of minimal glomerular changes with a linear fixation of the anti-human IgG conjugate along the glomerular capillary wall without demonstrable antiglomerular basement membrane antibodies, and (3) complete recovery, including disappearance of the linear staining, after treatment with prednisone, cyclophosphamide, and plasmapheresis.

Acute Disease↗

Renal lesions in the hypertensive syndromes of pregnancy: immunomorphological and ultrastructural studies in 114 cases.

One hundred and fourteen women presenting during pregnancy with an abnormally high blood pressure and/or proteinuria had a renal biopsy usually on the 8th day following delivery. The pathological specimens were examined by light and/or electron and/or immunofluorescence microscopy. Forty-one cases were studied with all three techniques. The patients could be allocated to six groups on the basis of clinical criteria. The first two groups (52 patients) showed the typical clinical and pathological features of classical preeclampsia. The remaining 62 women (four groups) had isolated hypertension, and, of these, 42 had a renal pathological pattern similar to that of preeclampsia. These 42 patients also had persistent hyperuricemia. Thus in pregnancy, hypertension and persistently elevated uric acid levels are indicative of glomerular lesions of "pregnancy induced nephropathy".

Adult↗

[Glomerulopathies during hepatic disease (author's transl)].

Glomerular lesions essentially characterized by IgA deposits are very frequent in the course of alcoholic hepatopathies. Such glomerular lesions might be due to the deposition of the circulating immune complexes. Portal hypertension, by altering the epuration function of the liver could be one determining factor. The presence of similar glomerular lesions in other non alcoholic hepatopathies with portal hypertension and in experimental portal hypertension support such an hypothesis. In other circumstances where the liver disease is directly related to a viral or a parasitic agent glomerular lesion of the type seen in circulating immune complexes disease are also encountered. However in such a situation there is no evidence that the hepatic disease bears any influence on the renal disease.

Glomerulonephritis↗