Search PubMed⌕ Search

Biomedical subjects

R Valenzuela

Publications and source records attributed to R Valenzuela.

At least 91 records · Page 5Linked to original sources

Relationship of renal histopathology in SLE nephritis to immunoglobulin class of anti-DNA.

Using a newly-developed solid-phase radioimmunoassay for DNA-binding immunoglobulins, immunoglobulin M (IgM), immunoglobulin G (IgG) and immunoglobulin A (IgA) anti-DNA were measured in serums from 11 patients with active untreated systemic lupus erythematosus (SLE) with nephritis. All patients underwent renal biopsy and were classified according to standard criteria as having diffuse or focal proliferative glomerulonephritis. Although both groups had almost identical total anti-DNA (13.1 versus 13.9 micrograms/ml, respectively), the IgM to IgG ratio was significantly higher (p less than 0.01) in the group with DPGN (7.51) than in the group with FPGN (1.10). We suggest that the switchover mechanism from IgM to IgG antibody production is more profoundly impaired in SLE with severe renal disease than in SLE with mild renal disease.

Adolescent↗

Relapsing polychondritis. Immunomicroscopic findings in cartilage of ear biopsy specimens.

Two cases of relapsing polychondritis are reported. Direct immunofluorescence examination of ear biopsy specimens in both patients showed the presence of granular deposits of immunoglobulins and the C3 component of complement at the chondrofibrous junction. These findings suggest that immunomicroscopic examination of ear cartilage could be diagnostically useful in this disease.

Biopsy↗

Histologic, ultrastructural, and immunomicroscopic findings in 96 one hour human renal allograft biopsy specimens. Immunologic and clinical significance.

Predicting the outcome of human renal allografts based on studies of one hour biopsy specimens is still controversial. We have tried to correlate histologic, ultrastructural, and immunofluorescence findings in 96 one hour biopsy specimens with histocompatibility matching, the presence of preformed antibodies, allograft ischemia and preservation times, the donor's age, the original renal disease, and allograft source, function, and survival. Ultrastructurally, 22 allografts had fibrin deposits in glomerular loops. There was a significant correlation between this finding and poor allograft function (p < 0.01), cold ischemia time (p < 0.02), and cadaveric allograft source (p < 0.01). Sixteen allografts showed epithelial cell detachment from tubular basement membranes. This finding correlated with cadaveric allograft source (p < 0.01). Many other morphologic changes were evaluated by both light and electron microscopy, but they did not bear any significant relationship to any of the aforementioned clinical parameters. Of 30 biopsy specimens studied by direct immunofluorescence, 11 showed positive findings (immunoglobulins or C3) in either glomeruli, vessels, or both. There was no significant correlation between these findings and the clinical parameters.

Adult↗

An approach to immunomicroscopy of renal disease with immunoperoxidase and periodic acid-Schiff counterstain (IMPAS stain).

A series of 127 renal specimens reflecting a wide spectrum of renal pathology was evaluated with a direct immunoperoxidase technic in which frozen tissue was first reacted with anti-Ig(G,A,M) and anti-C3-peroxidase conjugates and subsequently counterstained with periodic acid-Schiff-hematoxylin (IMPAS). This technic permitted simultaneous evaluation of light-microscopic changes and yielded a permanent immunomicroscopic record. Frequently, a distinction could be made between epimembranous, intramembranous and subendothelial deposits, which was not possible using immunofluorescence. The findings were correlated with histologic, immunofluorescent and electron-microscopic results. General patterns of immune complex and autoantibody deposition were similar in 124 cases. In one case, there was poor correlation between results obtained by immunoperoxidase and immunofluorescence. In two other cases, deposits detected by electron microscopy were not identified by either immunoperoxidase or immunofluorescence. The IMPAS stain, combining immunomicroscopy with conventional light microscopy, may be a useful approach to the laboratory diagnosis of renal disease.

Antigen-Antibody Complex↗

Globular deposits of immunoglobulins and complement in the papillary dermis. Clinical significance.

Globular deposits of immunoglobulins in the papillary dermis have been reported to occur in certain dermatoses, particularly in lichen planus. The clinical correlation of these deposits in 52 skin biopsy specimens reviewed by light and fluorescent microscopy was studied. These cases included five of lichen planus, 24 of lupus erythematosus or related diseases, four of dermatitis herpetiformis, three of drug eruption; two each of bullous pemphigoid, erythema nodosum, porphyria cutanea tarda; one each of vitiligo, pyoderma gangrenosum, neurodermatitis, erythema multiforme, granuloma annulare, vasculitis, epidermolysis bullosa simplex, Rothmund-Thompson syndrome, and four of unspecified dermatoses. Using an arbitrary scale of 1-4 based on the frequency of deposits, 3+ and 4+ deposits were identified in all five cases of lichen planus, as well as in six cases of lupus erythematosus, one of drug eruption, one of bullous pemphigoid, one of erythema nodosum, the vitiligo, vasculitis, and Rothmund-Thompson syndrome cases, and two cases of unspecified dermatoses; other cases showed only 1+ and 2+ deposits. In all five cases of lichen planus, the deposits contained IgM and C3, and in addition, IgA was present in four, IgG and fibrinogen in three. Among non-lichen planus cases, C3 was detected in 11 of 49, and fibrinogen in only four of 49. These findings indicate that globular deposits of Ig in the dermis, though suggestive, are not pathognomonic of lichen planus.

Biopsy↗

Immunofluorescence findings in human renal amyloidosis.

Positive direct immunofluorescence findings have been occasionally reported for human renal amyloidosis. However, no substantial information describing the frequency of immunomicroscopic pattern has been reported. Twenty-seven renal biopsy specimens with proven amyloidosis were studied by direct immunofluorescence using monospecific antisera against IgG, IgA, IgM, IgD, IgE, kappa and lambda light chains, C3, C4 properdin, alpha-2 macroglobulin, albumin, transferrin, and fibrinogen. Ten biopsy specimens were negative. The remaining specimens showed principally a diffuse immunofluorescent staining of the mesangial areas with various of the above fluorescein-labeled antisera except IgE, albumin, and transferrin antisera, which gave a consistently negative reaction. IgD, properdin, or fibrinogen were weakly identified in only one case. Immunoglobulins and C3 were observed in 14 cases. Kappa and/or lambda light chains were found in nine of ten biopsy specimens so tested. Positive immunofluorescent staining of other elements of the nephron was rarely observed. These results suggest that various immunoreactants, in addition to light chains, can be frequently detected in renal amyloidosis and that passive nonselective absorption of plasma proteins does not explain these immunomicroscopic findings.

Adult↗

Immunohistochemistry of Warthin's tumor.

This study describes results of fresh-frozen immunohistochemistry applied to two typical Warthin's tumors. Polyclonal follicular center cell staining and an apparent reduction in the number of T-lymphocytes were found. These observations tend to support the concept that the lymphoid infiltrate in Warthin's tumor represents a reactive cellular proliferation.

Adenolymphoma↗

Cutaneous macroglobulinosis.

A patient with Waldenström's macroglobulinemia had firm, translucent papules and nodules on the extremities. Clinically, the skin lesions were suggestive of amyloidosis cutis. Histologically, a homogeneous eosinophilic material was observed in the upper dermis and encasing the hair follicles. Special histochemical stains, electron microscopy, and immunofluorescence microscopy identified the material as IgM.

Amyloidosis↗

Hyaline arteriolar nephrosclerosis. Immunofluorescence findings in the vascular lesions.

Of 536 renal specimens examined by direct immunofluorescence in the past 2 years, 153 contained vascular deposits of C3 without associated immunoglobulin or fibrin deposition. Excluding vasculitides, renal transplants, and outside cases with inadequate clinical data, 110 were selected for further study. Light microscopy showed periodic acid-Schiff-positive hyaline vascular deposits in 83 cases, and large electron-dense deposits were identified by electron microscopy in 47 cases. Fifty-one patients had immunologic glomerular disease in addition to hyaline arteriolar nephrosclerosis. Albumin, transferrin, and alpha-2 macroglobulin were not detected in the vessel walls of several selected cases so tested, indicating that passive diffusion probably does not explain C3 deposition. However, properdin was present in 11 of 14, and C4 in two of 11. The mechanism for this association between C3 and properdin deposition and hyaline arteriolar nephrosclerosis is not clear at present, but our findings suggest possible involvement of the alternative pathway of the complement system.

Adolescent↗

Chronic glomerular microangiopathy and metastatic carcinoma.

Two patients with metastatic colonic adenocarcinoma developed deterioration of renal function six and nine months after the diagnosis of malignant disease. A renal biopsy specimen in one case and both postmortem specimens revealed thickening of glomerular capillary loops with focal reduplication of basement membrane-like material. Ultrastructural examination of all three specimens demonstrated a lucent subendothelial zone and no evidence of electron dense deposits. Antifibrinogen staining outlined most capillary loops in one case. It appears that chronic intravascular coagulation induced by the neoplasm was the major pathogenetic process involved in the production of the glomerular lesion in each case.

Adenocarcinoma↗

Chronic hereditary nephritis. A clinicopathologic study of 23 new kindreds and review of the literature.

Thirty-three patients with chronic hereditary nephritis, obtained from 23 unrelated families, were evaluated with respect to clinicopathologic features. Renal tissue was examined by light microscopy in 25 cases, immunofluorescence in 19 cases, and electron microscopy in 16 cases. The light microscopic findings varied, and foam cells were present in only four cases. Immunofluorescence was negative in all but four cases, and in these the immunomicroscopic pattern was compatible with the findings of end stage glomeruli and hyaline arteriolar sclerosis. Although electron microscopy uniformly showed marked thinning or splitting of the glomerular basement membrane, parallel splitting of the glomerular basement membrane with interposition of electron dense granular particles was seen in only eight cases. Association of glomerular basement membrane splitting with granular particles was observed in four of six patients with IgA nephropathy, in two patients with benign familial hematuria, and in a normal kidney donor. Eleven patients, seven men and four women, had chronic renal failure requiring dialysis. Of five patients who received renal allografts, three are alive, with post-transplant survival ranging from 24 to 70 months. The other two died of septicemia.

Adolescent↗

Reliability of immunofluorescence of renal tissue obtained at autopsy.

A retrospective study of kidney tissues accessioned in the Department of Immunopathology was undertaken to determine the reliability of the direct immunofluorescence technic applied to necropsy tissues. Of 72 accessioned specimens, 27 were positive and showed a spectrum of immunomicroscopic patterns corresponding to different renal diseases. Only two patients whose specimens were negative by immunofluorescence had shown any clinical or light microscopic evidence of active glomerular disease. Periods from death to autopsy ranged from one to 20 hours. Positive fluorescence was found in tissues obtained as long as 20 hours after death. These findings suggest that immunofluorescent studies of autopsy-derived renal tissue yield acceptable results.

Acute Kidney Injury↗

IgD myeloma. Report of a case with unusual clinical and immunologic features.

A case of IgD myeloma in a 48-year-old Caucasian man is reported. The unusual features of this case included the absence of osteolytic lesions by x-ray, absence of anemia, absence of monoclonal spike on serum electrophoresis, association of kappa light chains, absence of Bence Jones proteinemia and Bence Jones proteinuria, and a remarkable, temporary clinical response to therapy. Immunoelectrophoresis of whole serum yielded a pattern consistent with IgD kappa monoclonal gammopathy. Immunoelectrophoresis of a pure serum IgD preparation, previously separated by gel chromatography (Sephadex G-200), revealed definitive information about an IgD kappa monoclonal gammopathy. Immunomicroscopic examination of bonemarrow smears showed the presence of delta and kappa chains only in the cytoplasm of plasma cells.

Humans↗