[The usefulness of renal biopsy in the differentiation of various chronic kidney diseases in the child].
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Biomedical subjects
Publications and source records attributed to L Georgescu.
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Epidemiological, clinical pathological investigations concerning Balkan nephritis (BN) have revealed some particular aspects which define this condition as a distinct nosologic entity. Its endemic familial character and its occurrence restricted to some limited geographic areas in Bulgaria, Yugoslavia and Romania, are highly unusual. BN leads to chronic impairment of the renal function which is, however, not constantly associated with edema and hypertension. The duration of the disease is prolonged; death takes place from uremia within five to ten years. Gross pathologic changes are consisting of severe bilateral atrophy of the kidneys, with structural changes suggesting a 'renal cirrhosis'. The etiology of the disease is obscure. Investigations carried out by means of electron microscopy and immunofluorescence tests are suggesting that the pathogenesis is rather complex. The role of a persistent tolerated or slow, latent virus infection in certain families, that of some toxic factors, and the implication of autoimmune mechanisms are to be considered.
An observation is presented, of a case, of particular demonstrative value, of "porcelain gall-bladder", in which the authors were able to evidence the intervention of three local pathogenic factors: chronic inclavation of a stone in the bladder neck and obliteration of the cystic duct (which eliminated from the physiological viewpoint the gall-bladder); a chronic inflammation of the wall and ischaemia of the entire organ following the previous obliteration of the cystic artery. These factors are only in exceptional circumstances met in the same patient and this explains the rarity of this complication of biliary lithiasis.
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Lesions of glomerular nephropathy were found in 5 cases of acute trichinosis, characterized by a low proteinuria and hematuria as well as by moderate deficit of the renal function. Renal biopsy revealed lesions of proliferative glomerulitis, while immunofluorescence examination showed granular deposits of IgG and beta1-C-globulin on basement membranes. Serum complement was reduced. These observations suggest an immunological mechanism in the development of the glomerular nephropathy during acute trichinosis.
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The blue-polychrome-tannin rapid staining (BPT-Drăgan, 1968) applied on fresh and dried vaginal smears makes possible the identification of different forms of Trichomonas vaginalis (TV) parasite. The nucleus is coloured in blue-violet and the cytoplasm in various degrees of blue-green, violet or bichromatical, with blue and violet zones at the cell periphery. In the cytoplasm, the staining allows the identification of many granules and vacuoles. All the stainable substrates have an acid character and represent morphohistochemical aspects which reflect the parasite metabolism in different functional and evolutive stages. Our results allow the recommendation of the method in the screening actions of the TV identifications.
The authors discuss the anatomoclinical case of an infant 3 months and 2 weeks old, presenting a clinical picture of interstitial pneumonia, in shock. Microscopic histologic examination of the lung revealed a lung disease with hyaline membranes, an unusual entity after the neonatal period. The authors assume the formation of hyaline membranes to be due to prolonged shock and the inadequate alveolar surfactant.
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