[Acute pericarditis in chronic renal failure treated with repeated hemodialysis].
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Biomedical subjects
Publications and source records attributed to G Richet.
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Histologic studies of renal tissue were performed in 21 cases of IgG or IgA benign monoclonal gammopathy, in 19 cases of IgM monoclonal gammopathy, and in 11 cases of mixed idiopathic IgG-IgM cryoglobulinemias. Except for myeloma, glomerular lesions were very frequent. Amyloidosis was found in one patient with myeloma, in two with benign IgG gammopathy, and in three with Waldenström macroglobulinemia. Intraglomerular deposits were found in 13 patients. In 7 of these patients (6 with Waldenström macroglobulinemia, 1 with benign IgA monoclonal gammopathy), the deposits were isolated without cellular proliferation. In the other 6 patients (one with benign IgG monoclonal gammopathy, five with IgG-IgM cryoglobulinemias) the deposits were associated with severe endocapillary proliferation. Immunohistologic study showed the presence of immunoglobulins in these deposits. The immunoglobulin(s) present in the glomerular deposits was (were) similar to the serum monoclonal immunoglobulin or immunoglobulins of the cryoglobulin. Crystals were found in the glomerular endothelial cells in one case of benign IgG gammopathy. The significance of these lesions is briefly discussed.
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Of 178 episodes of neurological derangement in 103 patients with renal failure, only about 40% were due to known causes such as hypertension or electrolyte failure. One-third were due to drug intoxication and no definite aetiology was found for the remainder. Drug intoxication is due partly to the accumulation of a drug normally excreted by the kidney and partly to a greater susceptibility of the central nervous system in uraemic patients. The prognosis is favourable.
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