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Biomedical subjects

L Cagnoli

Publications and source records attributed to L Cagnoli.

At least 37 records · Page 2Linked to original sources
PubMed1986

Cell interposition in glomerular capillary walls in cryoglobulinemic glomerulonephritis (CRYGN). Ultrastructural investigation of 23 cases.

The present report describes ultrastructural findings on twenty-three cases of CRYGN showing membranoproliferative pattern under light microscopy. Attention was paid to the presence of double contoured peripheral basement membranes and to the characteristics of the interposed cells. The latter, according to the well known characteristics of membranoproliferative GN, are thought to be mesangial in nature. In fact, mesangial cells were found in 8 cases only, always associated with monocytes. Only monocytes were recorded in 12 cases, whereas in other 3 cases double contours were not connected to cell interposition. Despite similarities under light microscopy, CRYGN is therefore rather different from idiopathic membranoproliferative GN because of the prevalence of exudative changes, mainly due to monocyte infiltration, over proliferative lesions.

Cryoglobulinemia↗
PubMed1986

Clinical and morphologic evolution of idiopathic membranous nephropathy.

Twenty-five adult patients with idiopathic membranous nephropathy (IMN) and nephrotic syndrome (NS) who had participated at a long-term randomized trial with steroid and chlorambucil for six months, underwent repeated renal biopsies. The mean interval between pretreatment and the second biopsy was 41 months. Five evolutionary morphologic changes were adopted. Extensive normalization of the basement membrane (stage V) was observed in 6 of the 9 patients with complete and sustained remission. Only patients in stages I or II at admission seemed to get to reparation stage V. Persistence of NS or a partial remission was usually associated to the progression of the capillary wall lesion to stage III or IV. Our treatment schedule significantly increased the likelihood of getting to the reparation stage V.

Adolescent↗
PubMed1985

B and T cell abnormalities in patients with primary IgA nephropathy.

The in vitro function of B and T cells was studied in 16 patients with primary IgA nephropathy (PIgA-N). The distribution of OKT3+ cells (total peripheral T cells) and of regulatory T cell subsets (helper OKT4+ and cytotoxic/suppressor OKT8+ cells) was evaluated and a testing for 47 HLA-A, B, C, DR, and DQ antigens was carried out in the 16. B lymphocyte IgA production, after stimulation by pokeweed mitogen in the presence of T cells from normal donors treated with mitomycin C, was significantly greater in patients than in controls. T lymphocytes from patients with PIgA-N were more efficient than T cells from controls in providing IgA specific helper activity for normal B cells. The analysis of the individual data showed that the overactivity of B cells and the T cell operational dysfunction was present in about 50% of the patients and did not correlate. No numerical imbalance between T lymphocyte subsets nor any association between lymphocyte behavior, HLA antigen distribution, and a number of clinical, laboratory, and immunohistological findings was observed. Our data, therefore, suggest that PIgA-N is an immunologically heterogeneous disease and that an IgA-specific B cell overactivity and/or overall IgA-specific T cell helper activity may be present in some patients.

Adolescent↗
PubMed1985

Plasma exchange therapy in rapidly progressive renal failure due to multiple myeloma.

Nineteen patients with severe renal failure due to multiple myeloma and with Bence Jones proteinuria greater than 1 gm/day were randomly assigned to group I or group II. Corticosteroids and cytotoxic drugs were given to all cases. The 9 patients of group I were also treated by peritoneal dialysis and the 10 patients of group II by plasma exchange and hemodialysis. Only 1 patient of group I, who was not oliguric at the onset, showed partial recovery from renal failure after 3 months of therapy, while 9 patients of group II (3 of whom were oliguric) had significant decrease in Bence Jones proteinuria and rapid improvement from the renal failure. In our experience, plasma exchange is more effective than peritoneal dialysis for reducing Bence Jones proteinuria and recovering from renal failure, even when there is oliguria.

Aged↗
PubMed1984

Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy.

Sixty-seven adults with idiopathic membranous nephropathy and the nephrotic syndrome were randomly assigned to symptomatic treatment only or to a six-month course of methylprednisolone alternated with chlorambucil every other month. Patients were followed for one to seven years. At the end of follow-up (mean of 31.4 +/- 18.2 months for the treated group and 37.0 +/- 22.0 for the control group) 23 of 32 treated patients were in complete or partial remission, as compared with 9 of 30 control patients (P = 0.001). Twelve of the treated patients were in complete remission, as compared with only two of the controls. In the treated group there were no changes in renal function during follow-up, whereas in the control group the reciprocal of the plasma creatinin level, which is proportional to the creatinine clearance, decreased significantly (P = 0.00017) after two years of follow-up. Side effects were minimal in all treated patients except two, who were dropped from the study because of peptic ulcer and gastric intolerance to chlorambucil. We conclude that steroid and chlorambucil treatment for six months favors remission of the nephrotic syndrome in adults with idiopathic membranous nephropathy and can preserve renal function for at least some years.

Adult↗
PubMed1983

Focal glomerulosclerosis in patients with unilateral nephrectomy.

To investigate whether proteinuria and focal glomerulosclerosis (FSG) might develop in humans as well as in experimental models following a reduction in renal mass, we performed a retrospective study of 24 patients previously nephrectomized for unilateral renal disease. None of the patients presented signs of systemic diseases. Alport syndrome, essential hypertension, reflux nephropathy, and other abnormalities on intravenous pyelography. At the time of the first observation seven patients had pathological proteinuria (group 1) while 17 presented a normal protein excretion (group 2). All patients in group 1 and only 4 of 17 in group 2 were male. No other significant differences were found between the two groups. The median age at nephrectomy of the proteinuric patients was 22.3 years, and proteinuria developed after a mean period of 12.2 years. A renal biopsy was performed in four patients and showed a constant pattern of FSG. After a mean follow-up period of 7.3 years from the onset, proteinuria remains unchanged and renal function is well preserved in all the patients. In conclusion our series suggests that also in humans proteinuria and FSG might appear in solitary kidneys due to nephrectomy. This glomerular damage may result from the association of glomerular overload with other unidentified factors.

Adult↗
PubMed1983

Berger's nephropathy: relationship between histological pattern, blood pressure and renin.

Vascular damage (VD), glomerular sclerosis (GS), renin (PRA) and blood pressure were assessed in 50 patients with Berger's nephropathy. GS was present in 5/15 patients without VD and affected more than 15 per cent of glomeruli in seven patients with minimal VD. Nine out of 19 patients with GS were normotensive. VD was present in 35 patients: 16 were hypertensive and 19 normotensive. Therefore hypertension is not the only mechanism responsible for VD. In the seven normotensive patients with high PRA, GS was not present while VD was absent or minimal.

Adolescent↗
PubMed1983

Controlled trial of monthly alternated courses of steroid and chlorambucil for idiopathic membranous nephropathy.

Forty-nine patients with membranous nephropathy (MN) and nephrotic syndrome (NS) were randomly allocated to supportive or specific therapy. The latter consisted of steroids or chlorambucil given in alternate months for a cumulative period of six months. Three patients in the experimental group were dropped from the study because of therapy related side-effects. At the end of follow-up there were significantly more patients in complete or partial remission in the experimental group than in the controls. The mean serum creatinine did not change in treated patients, but it significantly increased in controls.

Chlorambucil↗
PubMed1981

[Serum anti-dsDNA antibodies in lupus nephritis].

Antibodies to native DNA (dsDNA), are frequently observed in sera from patients with Systemic Lupus Erythematosus (SLE), particularly when a severe glomerular involvement is present. An uncomplicated immunofluorescent technique for measuring these antibodies employs the kinetoplast of "Crithidia luciliae" as a dsDNA substrate. We studied with this assay and with ANA-test, 16 patients with active lupus glomerulonephritis before therapy. In 6 cases both ANA and nDNA tests were positive. In 9 cases a positivity was observed only for ANA-test and in 1 for nDNA test. Twelve patients were restudied after therapy when the activity of the disease was reduced. A significant decrease of the titre of ANA-test was observed in 9 out of 11 cases and a reduction of nDNA titre was seen in 4 out of 6 patients. In all cases a good correlation was present between clinical and biological features of the disease and degree and degree of positivity of the tests reported.

Antibodies↗
PubMed1981

Cell mediated immunity in idiopathic glomerulonephritis.

Various recent reports have suggested the presence of a functional defect of lymphocyte subpopulations in minimal-change nephropathy during the active phase. A probable role of inhibitory humoral factor(s) has been hypothesized. However, other authors have been unable to detect a significant difference between plasma from patients with nephrotic syndrome due to minimal-change nephropathy and plasma from other glomerulonephritis in the degree of inhibition of mitogen-induced lymphocyte transformation. In our study, T cell function, as measured by the response to PHA in autologous plasma, was depressed only in patients with minimal-change nephrotic syndrome and in patients with membranoproliferative glomerulonephritis. The lymphocyte function returned to normal when lymphocytes were cultured in homologous plasma. The lymphocyte responsiveness of patients with other glomerulonephritis with or without nephrotic syndrome was normal in both autologous and homologous plasma. Moreover, only plasma from patients with minimal-change nephropathy in the active phase and with membranoproliferative glomerulonephritis were able to induce inhibition of mitogenesis of lymphocytes from healthy donors. These data seem to confirm the presence of specific humoral inhibitory factor(s) in the plasma of these patients. Finally, preliminary findings seem to demonstrate an increase of the number of TG cells in patients with minimal-change nephropathy in remission who relapse early in the subsequent follow-up.

Adult↗