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G Giraudo

Publications and source records attributed to G Giraudo.

At least 19 recordsLinked to original sources
PubMed2006

Outcome of antegrade continence enema procedures for faecal incontinence in adults.

BACKGROUND: Faecal incontinence has major consequences. Colostomy has been the mainstay of therapy when other options fail. Operations such as the Malone procedure have been proposed as an alternative. The aim of this study was to evaluate the outcomes and quality of life of patients having a Malone procedure for the treatment of faecal incontinence. METHODS: Charts of patients who had had a Malone procedure or equivalent between 1998 and 2004 were reviewed. The patients completed a Short Form (SF) 36 quality of life questionnaire. RESULTS: The study included 25 patients (17 female; median age 47 years). In seven, the appendix was used; an ileoneoappendicostomy was performed in the other 18. Three patients were lost to follow-up; the remaining 22 were followed for a median (range) of 21 (1-61) months. Five patients had a cutaneous stenosis; another had the appendicostomy removed and replaced by a colostomy. Four patients no longer used the stoma for irrigation. All other patients were completely clean except one, who reported occasional night-time seepage. The mean SF-36 showed a good physical recovery (43.9) but persisting psychological distress (36.0). CONCLUSION: The Malone procedure or equivalent achieves good results in the management of faecal incontinence, although psychological distress persists after surgery.

Adolescent↗
PubMed2005

Laparoscopic versus open surgery for extraperitoneal rectal cancer: a prospective comparative study.

BACKGROUND: The role of laparoscopic resection (LR) in the management of extraperitoneal rectal cancer still is unclear. This study aimed to compare perioperative and long-term results of laparoscopic and open resection (OR) for low and midrectal cancer. METHODS: A prospective nonrandomized trial comparing patients submitted to OR or LR for low and midrectal cancer at a single institution was conducted. RESULTS: The study included 191 consecutive patients: 98 patients who underwent LR and 93 who underwent OR. The mean follow-up period was 46.3 months for LR and 49.7 months for OR. The conversion rate for LR was 18.4%. With the use of LR, the mean time for complete patient mobilization was shorter (1.7 vs 3.3 days; p < 0.001) and patients were earlier in passing flatus (2.6 vs 3.9 days; p < 0.001) and stools (3.8 vs 4.7 days; p < 0.01), and in resuming oral intake (3.4 vs 4.8 days; p < 0.001). The mean hospital stay was shorter for LR, but the difference did not reach significance (11.4 vs 13 days). Morbidity and mortality rates were similar: LR (24.4% and 1%) and OR (23.6% and 2.2%). Laparoscopic patients presented a higher rate of anastomotic fistulas (13.5% vs 5.1%) and reoperations (6.1% vs 3.2%) but the difference was statistically nonsignificant. Laparoscopic resection presented a significantly lower local recurrence rate (3.2% vs 12.6%; p < 0.05). The cumulative survival and disease-free rates at 5 years were, respectively, 80% and 65.4% after LR and 68.9% and 58.9% after OR (nonsignificant difference). Stage-by-stage comparison showed prolonged cumulative survival for stages III and IV cancer in LR (82.5% vs 40.5%; p = 0.006 and 15.8% vs 0%; p = 0.013, respectively) and a reduced rate of cancer-related death for stage III in LR (11.4% vs 51.9%; p = 0.001). CONCLUSIONS: As compared with conventional open surgery, LR for low and midrectal cancer is characterized by a faster recovery and similar overall morbidity (but a higher rate of anastomotic leakages), and does not present any adverse oncologic effect.

Adult↗
PubMed2005

Laparoscopic total mesorectal excision-the Turin experience.

Improved local control and survival rates in the treatment of rectal cancer have been reported after total mesorectal excision (TME). We performed an analysis of TME for rectal cancer by laparoscopic approach during a prospective nonrandomized trial. A prospective consecutive series of 98 laparoscopic total mesorectal excision (LTME) procedures for low and mid-rectal tumors. All patients had a sphincter-saving procedure. Case selection, surgical technique, and clinical and oncological results were reviewed. The distal limit of rectal neoplasm was on average 5.4 cm (range 3-12) from the anal verge. The mean operative time was 192.5 min (range 125-360). The conversion rate was 18.4%. The mean postoperative stay was 11.6 days (range 4-61). The 30-day mortality rate was 1% (1/98) and the overall postoperative morbidity was 18.4% including 10 anastomotic leakages. Concerning long-term oncological results, we evaluated 93 (94.8%) patients with a median follow-up of 46.3 months (range 12-132). During this period, 15.1% (14/93) died of cancer and 7.5% (7/93) are alive with metastatic disease. The port-site metastases rate was 2.1% (2/93). The locoregional pelvic recurrence rate was 2.1% (2/93): 1 stage II at 12 months and 1 stage III at 18 postoperative months, respectively. LTME is a feasible but technically demanding procedure (18.4% conversion rate). Our series confirms the safety of the procedure, while oncological results are at present comparable to the open published series with the limitation of a short follow-up period. Further studies and possibly randomized series will be necessary to evaluate long-term clinical outcome in cancer patients.

Adult↗
PubMed2004

Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial.

BACKGROUND: The aim of this study was to assess the benefits and disadvantages of robot-assisted laparoscopic surgery for disorders of the adrenal gland in terms of feasibility, safety, and length of hospitalization. METHODS: Twenty consecutive patients with benign lesions of adrenal gland were randomized into two groups: Patients in the laparoscopic group underwent traditional laparoscopic adrenalectomy (LAP), whereas those in the robotic group underwent robot-assisted adrenalectomy (ROBOT) using the da Vinci robotic system. RESULTS: There was no significant difference between the groups in terms of age, sex, body mass index, and size or locations of lesions. Operative times were significant longer in the ROBOT group (total operative time, 169.2 min [range, 136-215] vs 115.3 min (range, 95-155) p < 0.001. Skin-to-skin time was 107 m (range, 77-154) vs 82.1 min (range, 55-120) (p < 0.001). There were no conversions to open surgery. However, conversion to standard laparoscopic surgery was necessary in four of 10 ROBOT patients (40%; left, one right). Perioperative morbidity was higher in the ROBOT group (20% vs 0%). There was no difference in length of hospital stay. In the following ROBOT group, hospital stay was 5.7 days (range, 4-9) vs 5.4 days (range, 4-8) in the LAP group (p = NS). The total cost of the ROBOT procedure ($3,467) was significantly higher than that for LAP ($2,737) (p < 0.01). CONCLUSION: Laparoscopic adrenalectomy is superior to robot-assisted adrenalectomy in terms of feasibility, morbidity, and cost.

Adrenal Gland Diseases↗
PubMed2004

[Laparoscopic adrenalectomy in multiple endocrine tumors, in secreting and non-secreting lesions].

AIM: Personal experience in laparoscopic adrenalectomies (LA) for secreting and non-secreting tumors is presented. METHODS: Between March 1995 and December 2001 a total of 111 LA (58 left, 49 right and 4 bilateral) were performed in 60 females and 51 males, mean age 47.5 (range 8-81) years, for: 38 Conn diseases, 24 incidentalomas, 15 pheochromocytomas, 13 Cushing diseases, 4 kysts, 3 angiomyolipomas, 1 adreno-genital syndrome, 1 hydatidosis, 1 hyperplasia, 1 ganglioneuroma, 1 oncocyte adenoma, 1 adrenal fibrous tumor, 4 cortical carcinomas and 4 metastases (from renal carcinoma, breast carcinoma, leiomyosarcoma and rabdoid sarcoma, respectively). In all cases LA was transabdominal with a lateral flank approach. RESULTS: Mean global operative time was 88.6 minutes (range 35-240). Conversion rate was 1.8% (2/111). There was low postoperative pain. Mean hospital stay was 4.3 days (range 2-13). There were 0.9% (1/111) 30-day mortality and 4.5% (5/111) morbidity. During a mean follow-up of 41 months (range 1-81), the 67 secreting patients were disease-free. Concerning 8 malignant cases, mean follow-up was 40.5 months (range 9-72) with 3 cortical carcinomas disease-free and 1 dead for stroke, 2 metastases (1 leiomyosarcoma and 1 breast carcinoma) dead for disease and 2 disease-free. There was no port-site metastases. CONCLUSIONS: LA seems safe and effective when performed in experienced Centers on endocrine surgery and laparoscopy.

Adolescent↗
PubMed2002

Abdominal wall recurrences after colorectal resection for cancer: results of the Italian registry of laparoscopic colorectal surgery.

PURPOSE: The purpose of the present study was to evaluate prospectively the abdominal wall recurrence rate after laparoscopic resection for colorectal cancer, to analyze the impact of the learning curve on abdominal wall recurrence, and to assess the outcome of those patients. METHODS: The Italian Registry of Laparoscopic Colorectal Surgery database was analyzed to obtain data on cancer patients with abdominal wall recurrence, concomitant local or distant metastases, and interval between initial surgery and diagnosis of trocar site or minilaparotomy recurrences. The records of the initial procedures and the technique of specimen removal were reviewed. RESULTS: From January 1992 to July 2000, 2,583 patients (1,753 cases of carcinomas and 830 cases of benign diseases) were recorded. The malignant lesions were located on the right colon in 19 percent, the left colon in 48.8 percent, and rectum in 32.2 percent. Sixteen patients with histologic evidence of colorectal adenocarcinoma recurrences at the abdominal wall were observed (0.9 percent). Ten patients presented an advanced stage (III for 7 patients and IV for 3 patients). Eleven cases occurred during the learning curve period (the first 50 consecutive cases). The median survival time after abdominal wall recurrence diagnosis was 16 (range, 12-60) months. By July 2000 only two patients were alive. CONCLUSIONS: The results of the Italian prospective Registry of Laparoscopic Colorectal Surgery confirm that the incidence of abdominal wall recurrences is similar to that reported in open studies (<1 percent). Most abdominal wall recurrences occurred in the learning curve period, suggesting that surgical experience may play a role in the development of this outcome. The prognosis of these patients is very poor.

Abdominal Muscles↗
PubMed2002

Does adrenal mass size really affect safety and effectiveness of laparoscopic adrenalectomy?

OBJECTIVES: To evaluate the effectiveness and safety of laparoscopic adrenalectomy with regard to adrenal mass size, as well as to consider its clinical and pathologic patterns. Laparoscopy is today considered the first-choice treatment of many adrenal diseases, although its use is still controversial for large adrenal masses and incidentally found adrenal cortical carcinoma. METHODS: A total of 125 patients underwent lateral transperitoneal laparoscopic adrenalectomy. The indications were either functioning or nonfunctioning adrenal masses, without any radiologic evidence of involvement of the surrounding structures. The correlation between the size and the operative times, estimated blood loss, incidence of intraoperative and postoperative complications, and length of hospital stay were studied with Pearson's correlation coefficient, Fisher's exact test, and the chi-square test. The analysis of variance test was used to evaluate any possible correlation between the size and clinicopathologic features and the results. RESULTS: A slight correlation was observed between the size and operative time (P = 0.004), but no correlation was observed between the size and the other parameters. Statistical analysis showed a significant correlation between the clinicopathologic patterns (nonfunctioning benign adrenal masses, Conn's adenoma, Cushing's adenoma, pheochromocytoma, adrenal cortical cancer, and other tumor metastasis) and the operative time (P = 0.011), but not with the other parameters. CONCLUSIONS: Laparoscopic adrenalectomy is also effective and safe for large lesions. The results of our series confirms that the risk of encountering an incidental adrenal cortical cancer is significantly increased for large lesions, and therefore, in these cases, additional attention is required to observe oncologic surgical principles.

Adolescent↗
PubMed2001

Gasless laparoscopy could avoid alterations in hepatic function.

BACKGROUND: In a previous clinical study, we showed that the duration and level of pneumoperitoneum are responsible for changes in hepatic function during laparoscopic procedures. These findings encouraged us to evaluate hepatic function during laparoscopy with and without carbon dioxide (CO(2)) pneumoperitoneum in a clinical setting. METHODS: We performed 63 laparoscopic cholecystectomies and 30 non-hepatobiliary laparoscopic procedures in 93 consecutive patients with normal preoperative liver function tests. The anesthesiologic protocol was uniform, using drugs at low hepatic metabolism. We performed laparoscopic cholecystectomies in 43 patients with a pneumoperitoneum; in the remaining 20, we used a gasless technique. We randomized the 43 laparoscopic cholecystectomies into 23 performed with pneumoperitoneum at 14 mmHg and 20 performed at 10 mmHg. All non-hepatobiliary laparoscopic procedures were performed with a pneumoperitoneum of 14 mmHg. The postoperative serologic levels of AST, ALT, and bilirubin, and the prothrombin time were measured at 6, 24, 48, and 72 h. The alterations in the serologic hepatic tests were then related to the type of procedure, its duration, and the level of pneumoperitoneum. RESULTS: The study group was comprised of 93 patients, 39 male and 54 female, with a mean age of 50.5 years (range, 15-74). There were no deaths. There was no morbidity in the pneumoperitoneum group, but there was one case of accidental omental injury during the placement of the abdominal, wall retractor in the gasless group. All patients had postoperative changes in serologic hepatic tests. Slow return to normality occurred 48 or 72 h after the operation. The increase in AST and ALT was statistically significant and correlated to the level and duration of pneumoperitoneum. The serologic change in the gasless group were significantly lower than in the laparoscopic cholecystectomy group with pneumoperitoneum at 14 mmHg. There was no statistically significant difference between the gasless group and the laparoscopic cholecystectomy group with pneumoperitoneum at 10 mmHg. There was a statistically the significant increase in the non-hepatobiliary laparoscopy group over the gasless group, despite the absence of hepatobiliary injuries in the first group. No symptoms were related to these serologic hepatic changes. CONCLUSIONS: The gasless technique causes smaller alterations in serological hepatic parameters than pneumoperitoneum at 14 mmHg. By contrast, the gasless technique and low-pressure pneumoperitoneum have the same effect on hepatic function. Therefore, the use of a subcutaneous abdominal wall retractor combined with a low-pressure pneumoperitoneum is recommended for patients with severe hepatic failure. Transaminases

Adolescent↗
PubMed2001

Human CD38 and its ligand CD31 define a unique lamina propria T lymphocyte signaling pathway.

CD38, a nonlineage-restricted surface glycoprotein, is an ecto-enzyme (ADP ribosyl cyclase/cADPR hydrolase/EC 3.2.2.6) that regulates cytoplasmic Ca2+ and cell-cell interactions. The molecule also delivers trans-membrane signals, despite a structural ineptitude to the scope. To reconcile these issues in a unitarian model, we compared the effects of CD38 signaling in circulating and residential T lymphocytes, the latter represented by those colonizing the intestinal lamina propria. Results are as follows: 1) LP T cells express an enzymatically active form of CD38, characterized by a modified ratio between cyclase and hydrolase functions; 2) LP T cells do not mobilize Ca2+ upon CD38 ligation, as seen in PB T cells (this condition is due to a lack in activation of PLC- g, constantly observed in PB T lymphocytes); 3) The early steps of CD38 signaling involve activation of lck, syk, and LAT; 4) Late events include synthesis and release of IL-2, IL-4, IL-5, IL-10, IFN-g and GM-CSF; 5) The uniqueness of the CD38 pathway in LP T cells is not caused by impaired interactions with the CD31 ligand. The differences observed concern the signaling machinery that CD38 exploits for its own use and not the interplay with its ligand.

ADP-ribosyl Cyclase↗
PubMed2001

Transperitoneal laparoscopic adrenalectomy: experience in 72 procedures.

PURPOSE: To evaluate the safety and effectiveness of transperitoneal laparoscopic adrenalectomy for a variety of adrenal diseases. PATIENTS AND METHODS: Seventy-two patients underwent laparoscopic adrenalectomy from January 1995 until March 1999. The indications for the treatment were limited to either functioning or nonfunctioning adrenal masses without radiologic evidence of involvement of the surrounding tissues. The indication for bilateral adrenalectomy was Cushing's disease after the failure of other therapies or Cushing's syndrome secondary to ectopic ACTH secretion without the discovery of a primary neoplasm. RESULTS: Thirty-five of the adrenalectomies were performed on the left side and 33 on the right side, and 4 were performed bilaterally. The right-sided procedures required a mean operating time of 130 minutes (range 85-200 minutes), the left-sided procedures required a mean operating time of 140 minutes (range 95-200 minutes), and the bilateral procedures required a mean operating time of 240 minutes (range 210-290 minutes). A conversion from laparoscopy to laparotomy was necessary for 3 patients (4%). Intraoperative complications were reported in 6 patients (8%). Postoperative complications likewise occurred in six patients. CONCLUSIONS: These procedures proved to be safe and able to remove the majority of either functioning or nonfunctioning benign adrenal masses. Some controversy remains regarding the safety of laparoscopic adrenalectomy for large lesions and the safety of bilateral laparoscopic adrenalectomy because of bleeding risks, anesthetic risks, and long operative times. The effectiveness of laparoscopic adrenalectomy for nonfunctioning adrenal masses with histologic findings of carcinoma has not yet been proved.

Adolescent↗
PubMed2000

Solitary fibrous tumour of the adrenal gland associated with pregnancy.

Solitary fibrous tumour (SFT), first described as a pleural lesion, has been reported in several extrathoracic sites over the past 10 years. We describe a SFT of the left adrenal gland incidentally discovered in a 23-year-old, 22-week pregnant woman and characterised by a rapid growth during the third trimester of pregnancy. Elevated serum and urinary levels of cortisol and elevated blood levels of delta 4 androstendione and 17-OH progesterone were observed. After spontaneous delivery, the patient underwent laparoscopic resectioning of the mass and of the left adrenal gland from which the tumour was apparently originating. The kidney was not involved, and no other abdominal tumours were found. Histological and immunohistochemical features were typical of SFT of pleura and other locations. Only one case of adrenal SFT is on record, and the adrenal gland is to be added to the long list of extrathoracic locations of SFT. The association with pregnancy was a previously unrecognised event in SFT. The focal expression of progesterone receptors in the tumour cells may be related to pregnancy. This observation prompted an analysis of steroid hormone receptors in SFT of classical sites (pleura). Two of five cases had focal progesterone receptors too, a finding which deserves further investigations in a much larger series of SFTs.

Adrenal Gland Neoplasms↗
PubMed2000

Education as a clinical tool for self-dialysis.

Therapeutic compliance and patient education are presently considered crucial parts of end-stage renal disease (ESRD) therapy. In the center where Italian home and self-care dialysis treatment started, an education program was designed as multi-step pathway--following patients from chronic renal failure to dialysis and eventual graft--employing lessons, booklets, and books. Each step was validated in various subsets of patients. Lessons involved two hours of informal discussion on the main aspects of ESRD and renal replacement therapy (RRT); booklets were created from tape recordings of the lessons. Patient participation was good, with 28 of 33 patients on charge in the center for 6 months or more taking part in more than one lesson in 1999. In 16 of 16 patients who answered a questionnaire after two lessons, expressed opinion was "good" to "fair." All asked for further material. With regard to books, 500 copies of the book What does dialysis mean? were given out in the region; this book was validated in 22 patients on peritoneal dialysis (PD) and 18 on hemodialysis (HD). It helped patients to accept dialysis in 65% of cases and to comprehend it in 90%. Four thousand copies of the book Stories, containing 18 interviews on transplantation, were printed, and this book was validated in 21 patients on self-care and 35 on hospital dialysis (potential candidates for graft). Of 56 patients, 53 asked for further material; 19 changed their initial opinion (10 choose transplantation, despite initial skepticism; 9 put off transplantation, despite initial acceptance). On a local scale, the program led 12 of 18 new patients, who followed at least part of the program, to choose self-dialysis (PD, home, and self-care dialysis).

Adult↗
PubMed2000

Laparoscopic cholecystectomy in cirrhosis: contraindication or privileged indication?

Until recently, cirrhosis has been considered to be an absolute or relative contraindication of laparoscopic cholecystectomy. An evaluation of benefits and risks of laparoscopic cholecystectomy in the treatment of gall bladder lithiasis in cirrhotic patients is presented. Thirty-three consecutive laparoscopic cholecystectomies in patients with cirrhosis were performed between March 1990 and March 1997. During the same period, no open cholecystectomy was performed in patients with cirrhosis. There was no morbidity or mortality; the conversion rate was 6% (2/33). No patient received blood transfusion, and the mean hospital stay was 2.8 days. These results favorably compare with the results of open cholecystectomy. Specific advantages of laparoscopic cholecystectomy in patients with cirrhosis include the absence of wound infection and a lower rate of postoperative hepatic failure. Finally, laparoscopic surgery reduces the risk of viral contamination (the hepatitis B virus, the hepatitis C virus, or the human immunodeficiency virus) of the surgical staff.

Adult↗
PubMed1999

Endoscopic palliative treatment of advanced pancreatic cancer: thoracoscopic splanchnicectomy and laparoscopic gastrojejunostomy.

DESIGN: Evaluation of thoracoscopic splanchnicectomy and laparoscopic gastrojejunostomy as endoscopic palliative treatment of advanced pancreatic cancer. PATIENTS AND METHODS: Between November 1993 and September 1998 we performed 16 thoracoscopic splanchnicectomies and 6 laparoscopic gastrojejunostomies in patients with an advanced pancreatic cancer admitted to the Department of Surgery of University Hospital Rotterdam-Dijkzigt. These patients either did not achieve adequate pain control with medication or presented serious problems of gastric outlet obstruction, or both. RESULTS: There were fourteen patients (9 men and 5 women) with mean age of 51.8 years (range 28-83), mean BMI of 21.1 (range 17.2-27.2), ASA score I in 2, II in 11, III in 1. We performed 2 left, 2 right and 4 bilateral thoracoscopic splanchnicectomies, 4 laparoscopic gastrojejunostomies and 2 combined endoscopic procedures (bilateral thoracoscopic splanchnicectomy and laparoscopic gastrojejunostomy). The overall average operation ("skin to skin") time was 86 minutes (range 75-100) for bilateral thoracoscopic splanchnicectomies, 63 minutes (range 60-65) for unilateral splanchnicectomies, 88 minutes (range 65-115) for laparoscopic gastrojejunostomies and 190 minutes (range 180-200) for the combined procedure. Blood loss was insignificant with a median of 50 ml (range 30-150). The conversion's rate to open surgery was 4.5%. There were no intraoperative complications. The overall average postoperative mobilization was in 1.9 days (range 1-4) and the overall median postoperative hospital stay was 7 days (range 2-24). There was no mortality at 30 days after endoscopic procedures and the morbidity rate was 21.4%. The postoperative analgesic requirement was considerably reduced with a successful rate was 83.3%. The resolution of gastric outlet obstruction has been complete in all laparoscopic gastrojejunostomies. CONCLUSIONS: Our results show the feasibility and safety of these minimally invasive approaches such as endoscopic palliative treatment of complications of advanced pancreatic cancer.

Adult↗
PubMed1998

Alterations in hepatic function during laparoscopic surgery. An experimental clinical study.

BACKGROUND: Very few studies have been done on the consequences of pneumoperitoneum on hepatic function. At present, there is no consensus on the physiopathological hepatic implications of pneumoperitoneum. The purpose of this clinical study was to evaluate the effects of pneumoperitoneum on hepatic function in 52 patients treated with laparoscopic procedures. METHODS: Thirty-two laparoscopic cholecystectomies and 20 nonhepatobiliary laparoscopic procedures were performed in 52 patients (12 men and 40 women) with a mean age of 44 years (range, 15-74). All patients had normal values on preoperative liver function tests. The anesthesiologic protocol was uniform, with drugs at low hepatic metabolism. The 32 cholecystectomies were randomized into 22 performed with pneumoperitoneum at 14 mmHg and 10 performed at 10 mmHg. All nonhepatobiliary laparoscopic procedures were performed with a pneumoperitoneum of 14 mmHg. The postoperative serologic levels of AST, ALT, bilirubin, and prothrombin time were measured at 6, 24, 48, and 72 h. The serologic changes were related to the procedure, the duration, and the level of pneumoperitoneum. RESULTS: Mortality and morbidity were nil. All 52 patients had a postoperative increase in AST, ALT, bilirubin, and lengthening in prothrombin time. Slow return to normality occurred 48 or 72 h after operation. The increase of AST and ALT was statistically significant and correlated both to the level (10 versus 14 mmHg) and the duration of pneumoperitoneum. CONCLUSIONS: The duration and level of intraabdominal pressure are responsible for changes of hepatic function during laparoscopic procedures. Although no symptom appears in patients with normal hepatic function, patients with severe hepatic failure should probably not be subjected to prolonged laparoscopic procedures.

Adolescent↗
PubMed1997

[The complement system in kidney diseases].

The multifaceted relations between complement system and immune-mediated nephropathies are reviewed. Several conditions in which either the complement activation induces renal damage without hypocomplementemia or hypocomplementemia occurs in the absence of circulating IC are reported as well as disorders in which immune complexes promote hypocomplementemia. The complement system is involved in the clearance of immune complexes, both modifying the immune complex size and favouring the physiologic neutralization by the erythrocyte transport system. In certain pathological conditions the immune complex intrinsic characteristic or genetic abnormalities prevent efficient removal from the blood stream. The purpose of the present review is to summarize these conditions, briefly describing their pathological consequences, and indicate a simple scheme to correctly interpret the biochemical abnormalities of the complement system in nephropathology.

Complement System Proteins↗