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Biomedical subjects

F Arnalich

Publications and source records attributed to F Arnalich.

At least 91 records · Page 5Linked to original sources
PubMed1981

[Classical panarteritis nodosa: a clearly defined entity. Analysis of 20 cases (author's transl)].

The clinical, biological, and immunological alterations of 20 patients with histologically confirmed classical panarteritis nodosa have been studied. Characteristic angiographic changes were present in 14 cases. There were 14 males and six females, with a mean age of 50 years. The main clinical manifestations were: fever (90%), peripheral nervous system involvement (80%), renal involvement (65%), arterial hypertension (60%), arthropathy (80%), and cutaneous lesions (45%). In most cases there was elevated VSG and alpha 2-globulin, anemia and leukocytosis. HBsAg positivity was found in five patients. The immunological study revealed a polyclonal immunoglobulin increase, changes in the complement components, and a quantitative and qualitative decrease of T lymphocytes. Steroids and immunosuppressive treatment were given to eight patients, and steroids along to 11 patients. The clinical evolution of 17 patients was followed; four patients died, all of them belonging to the group treated with steroid alone.

Adolescent↗
PubMed1981

[Monoclonal IgG lambda paraprotein, Fanconi's syndrome of the adult, and osteomalacia (author's transl)].

The case here reported of 72 year-old female with osteomalacia in whom an adult's Fanconi's syndrome with distal tubular involvement and a monoclonal IgG-lambda paraprotein were discovered. There was urinary excretion of lambda light chains without evidence of myeloma or amyloidosis. Such apparently unrelated entities might be subject to an unitary pathophysiological approach: the nephrotoxicity of light chains could cause a Fanconi's syndrome, which in turn would give rise to osteomalacia through phosphate depletion. It is noteworthy that in this patient the urinary excretion of light chains was of the lambda type, in contrast to similar cases described in the literature which presented mostly kappa chains. The likelihood of this patient developing myeloma or amyloidosis at a later stage is discussed.

Aged↗
PubMed1981

[Paraneoplastic hypouricemia in Hodgkin's lymphoma secondary to a renal tubular reabsorption defect of uric acid (author's transl)].

A patient is reported with stage IV-B Hodgkin's lymphoma, lymphocyte depletion type, and associated hypouricemia (1,7 mg/dl). In the few cases described of this association hypouricemia was secondary to a high renal clearance of urate, but in no case was the involved tubular level precisely delimited. In the present case the pyrazinamide and the probenecid tests were performed, disclosing the existence of a possible defect in the postsecretory reabsorptive phase which was improved by therapy. The different pathogenetic mechanisms described to explain this transitory tubular defect are reviewed.

Adult↗
PubMed1981

[Transformation of a rib plasmocytoma into an amyloid tumor (author's transl)].

The appearance of amyloidosis during the course of multiple myeloma is a well known fact and has an overall incidence of 6 to 15%. However, the total transformation of a plasmocytoma into a voluminous amyloid tumor is a very rare event. A female patient was diagnosed of lambda light chain disease after developing a conspicuous rib plasmocytoma over the same region where a pathological fracture had appeared three years before. She was treated with discontinuous courses of melphalan and methyl-prednisolone, and developed a reversible nephrotic syndrome and a pathological fracture of the right clavicle. At necropsy there was generalized amyloidosis and complete substitution of the rib plasmocytoma by amyloid substance, with another important accumulation of amyloid in the region of the clavicular fracture. The present concepts on amyloidogenesis in multiple myeloma are reviewed, and the peculiarities of the present case together with the possible role of initiating factors and the effects of therapy are discussed. The case herein reported appears to represent a human model of focal amyloidogenesis in myeloma.

Aged↗
PubMed1981

[Tubular function and renal acidifying in juvenile diabetes mellitus of short evolution].

The fractional excretion of uric acid, calcium, phosphorus, magnesium and other ions, and the urinary acidifying capacity were studied in then patients with juvenile diabetes of short evolution and in a control group matched for age, sex, and body surface. The diabetic patients showed a hyperexcretion of uric acid, sodium, potassium, chloride and ammonium which was unrelated to the increment of glomerular filtration rate or to glucosuria, and could not be ascribed to diet. The pathophysiologic interpretation of these findings is discussed, concluding that they might be the result of an increase in the filtered load and the behaviour of the tubules in front of the glomerular hyperfunction or metabolic disturbance inherent to the diabetic condition.

Adolescent↗
PubMed1981

Relation of kidney size to kidney function in early insulin-dependent diabetes.

Renal function and renal size have been studied in ten early insulin-dependent diabetic patients and in ten matched control subjects. Glomerular filtration rate, renal plasma flow and radiological kidney size were determined in each subject. Glomerular filtration rate and renal plasma flow were increased in diabetics (mean +/- SD: 169.6 +/- 16.1 and 690.1 +/- 52.6 ml/min/1.73 m2, respectively) compared with controls (120.6 +/- 9.7 and 605.9 +/- 67.2 ml/min/1.73 m2; p less than 0.001 and p less than 0.01). Calculated kidney weight corrected to 1.73 m2 of body surface area was elevated in diabetics (385.2 +/- 29.0 g) with respect to controls (277.5 +/- 17.5 g; p less than 0.001). No significant differences were found between diabetics and control subjects when glomerular filtration rate was expressed per gram calculated kidney weight, while renal plasma flow was significantly lower in diabetics than control subjects when so expressed (p less than 0.01). A positive correlation was found between glomerular filtration rate, renal plasma flow and kidney size in both controls and diabetics (p less than 0.01 in all cases). These findings support the conclusion that in the early state of diabetes glomerular hyperfunction is related to enlargement of the kidneys and augmented renal plasma flow.

Adolescent↗
PubMed1981

Renal tubular function and urinary acidification capacity in early juvenile diabetes.

Renal elimination of uric acid, calcium, phosphorus, sodium, potassium, chloride and magnesium and urinary acidification capacity were determined in ten insulin-dependent diabetics and in ten matched control subjects. The diabetics showed excessive excretion of uric acid, sodium, potassium, chloride and ammonia. Sodium, chloride and ammonia excretion fractions was also increased with respect to controls. The enhanced excretion of these substances in diabetics failed to relate to glomerular filtration rate, glycosuria or insulin requirements. These findings might be explained on the basis of glomerular filtration rate elevation, tubular response to this increment, and the underlying metabolic disturbances of diabetes.

Adolescent↗
PubMed1981

Angiographic findings in systemic necrotizing vasculitis.

Angiographic studies were carried out on 21 patients with systemic necrotizing vasculitis. Four basic arterial anomalies were found: (1) saccular microaneurysms appeared in 62% of the patients (2) arterial thrombosis was seen in 81% of patients; (3) arterial stenosis occurred in 81%; and (4) lumen irregularities occurred in 90%. Alterations in the renal vascular flow were also observed in accordance with changes in the cortical medullary differentiation, heterogeneous nephrogram, and prolonged washout. Two patients showed regression of microaneurysms after immunosuppressive therapy. We found angiography to be a low-risk technique of use for diagnosis and followup studies on vasculitis.

Adult↗
PubMed1980

[Comparative study between HBsAg positive and HBsAg negative panarteritis nodosa in a series of 25 cases (author's transl)].

Clinical symptoms, biochemical analyses, immunologic status and angiographic findings corresponding to seven HBsAg positive patients with panarteritis nodosa and to 16 HBsAg negative patients with panarteritis nodosa have been compared. HBsAg positive cases showed a statistical significant higher incidences of Raynaud's phenomenon (p less than 0.05) and cardiopathies (p les than 0.05), as well as high occurrence of blood hypertension, artropathy, liver involvement and peripheral neuropathy. Significant differences in relation to cell immunity were not found. Humoral immune disturbances were more common among HBsAg positive patients, being hypergammaglobulinemia (p less than 0.01), IgM increase and decrease of complement factors (C3, C4 and C3PA) the most frequent abnormalities recorded. Angiographic studies revealed a high incidence of microaneurisms for the HBsAg positive group.

Adolescent↗
PubMed1980

[Study of the renal tubular function in alcoholic hepatic cirrhosis (author's transl)].

The renal plasma flow (RPF), glomerular filtrate (GF), renal concentration strength and urinary acidification capacity in eight patients with alcoholic cirrhosis and five control subjects was studied. The maximum urinary acidification capacity was tested by means or arginine monochloride. In two patients, renal tubular acidosis (RTA) was observed. One patient manifested a slight decrease in RPF, GF, hyposthenuria, hyperchloremic metabolic acidosis and bicarbonaturia. The test for maintained acidification and the overload of bicarbonate indicated a mixed RTA. The other patient manifested incomplete distal RTA, which was briefly corrected with the administration of furosemide. These tubular defects were not associated with the loss of proteins, phosphates, glucose, aminoacids or renal lithiasis. Neither were they related to the serum levels of copper, globulins, or predisposition to hepatic encephalopathy. The association between hepatic cirrhosis and distal tubular acidosis is known, but until the present work, the fact that this hepatopathy can simultaneously affect the proximal and distal tubules had not been described.

Acidosis, Renal Tubular↗
PubMed1980

Complete proximal tubular acidosis (Type 2, RTA) in chronic active hepatitis.

Fifteen patients with chronic active hepatitis (CAH) were tested in order to ascertain the site of tubular dysfunction in renal tubular acidosis (RTA) associated with CAH. Renal plasma flow and GFR were reduced in the patients compared to controls (P < 0.005). Underbasal and acidification conditions, twelve patients showed normal acid-base balance and net acid excretion, while three patients had basal hyperchloremic metabolic acidosis while passing alkaline urine and showing bicarbonaturia. A sustained acidification test showed adequate urinary acidification in these three patients. Bicarbonate loading carried out in two of the three patients showed a proximal tubular acidifying defect (Type 2 RTA), Distal RTA (Type 1 RTA) complicating CAH is widely known, but these data suggest that CAH can also involve the proximal convoluted tubule in isolation.

Acid-Base Equilibrium↗