Biomedical subjects
Publications and source records attributed to J Montoliu.
Immunoglobulin A nephropathy developed in two siblings who shared the DRw4 antigen but who were otherwise HLA-A, -B, and -C unrelated. It is suggested that a genetically induced alteration in the immune response can cause some of the cases of mesangial IgA glomerulopathy and that close blood reltaives of patients with this disease should be checked for the possible existence of renal abnormalities.
Explore the source record for details and available documents.
In the absence of lupus, mesangial electron-dense deposits in membranous nephropathy are thought to be uncommon. In this study 18 renal biopsies of 16 cases seen over a 2-year period were evaluated by light and electron microscopy and immunofluorescence, directing particular attention to the mesangium. Lupus had been excluded in every instance by the usual serologic tests. In seven of the 18 biopsies, mesangial electron-dense deposits were found. Clinically, almost all of these patients were characterized by atypical features: five patients had underlying diseases which have been associated with membranous nephropathy (renal vein thrombosis, epidermoid carcinoma of the lung, SH-antigenemia, rheumatic heart disease and penicillamine therapy); there was one instance of spontaneous remission and another patient who progressed to terminal renal failure in less than 2 years. The results suggest that the presence of mesangial deposits in membranous nephropathy may be more common than has previously been suspected. This finding is not necessarily associated with systemic lupus erythematosus and may indicate an unusual or atypical form of membranous nephropathy.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Delayed hyperacute rejection, with its characteristic clinical course and histopathologic findings, occurred within one month after transplantation in five recipients of kidney transplants from HLA-A, B and D identical sibling donors. In all cases, unidirectional mixed lymphocyte cultures and immunologic studies to detect cytotoxic antibodies in the recipients against their respective donors, before kidney transplantation and after transplant nephrectomy, were unresponsive or negative. Onset of delayed hyperacute rejection was preceded by bacteremia in two of these patients. Two of these received second kidney transplants, three to six months later, from HLA-A, B and D identical sibling donors again. Although both have had an episode of acute rejection in the early postoperative period, the grafts have maintained excellent function for 21 and 25 months, respectively. Irreversible forms of transplant rejection, such as delayed hyperacute rejection, do occur even in recipients of kidney transplants from HLA-A, B and D identical sibling pairs, indicating that genetic determinants other than HLA-A, B and D loci, and perhaps other nongenetic immune mechanisms, play an important role in the ultimate results of kidney transplantation.
Explore the source record for details and available documents.
A 30 year old man developed renovascular hypertension and extreme elevation of plasma renin activity. Daily proteinuria ranged from 13 to 31 g. There were no criteria for the diagnosis of malignant hypertension. A primary glomerulopathy was excluded by a basically normal renal biopsy from the unprotected kidney. On electron microscopy the epithelial cell foot processes were not fused, thus ruling out simultaneous lipoid nephrosis. The source of renin was removed by means of a left nephrectomy. Following the procedure the patient became normotensive, the renin values normalized and the proteinuria disappeared. The results suggest that renin can cause significant proteinuria in man.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.