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Biomedical subjects

S Casanova

Publications and source records attributed to S Casanova.

At least 55 records · Page 3Linked to original sources
PubMed1987

Ultrastructural glomerular findings in cryoglobulinemic glomerulonephritis.

Thirty-three renal biopsies of patients affected by cryoglobulinemic glomerulonephritis (CRYGN) were investigated by electron microscopy, paying particular attention to the nature of cells responsible of glomerular hypercellularity, the presence and site of electron-dense deposits and their ultrastructural characteristics. Personal as well as literature data suggest (a) diffuse glomerular hypercellularity found in most cases of CRYGN is mainly due to polymorphonuclear leukocytes and even more to monocyte exudation; (b) the interposition of the latter cell type in the glomerular capillary wall is the main responsible cause of the frequent occurrence of the membranoproliferative pattern in CRYGN, and (c) peculiar structures found in the electron dense deposits are characteristic of CRYGN and related to cryoglobulin composition. Electron microscopy therefore seems to be a valuable diagnostic procedure for this type of glomerulonephritis.

Cryoglobulinemia↗
PubMed1987

Prognostic factors and effectiveness of treatment in acute renal failure due to multiple myeloma: a review of 50 cases. Report of the Italien Renal Immunopathology Group.

We studied 50 patients with myeloma acute renal failure to investigate possible prognostic factors and to evaluate the effectiveness of the various treatment schedules used. Renal failure was reversible 1 month after the onset in 50% of the patients considered. The patients treated with chemotherapy and plasma exchange recovered renal function more frequently (61% of the cases) than those treated only with chemotherapy (27%). The most important clinical prognostic factors were total proteins, serum creatinine values and myeloma type. Considering the histological findings, the prognosis correlated with the severity of the lesions and number of tubular casts. Survival at 1 year was higher in the patients who regained renal function than in those in whom renal function did not improve.

Acute Kidney Injury↗
PubMed1986

Steroid-sensitive nephrotic syndrome with mesangial IgA deposits: a separate entity? Observation of two cases.

In minimal-change steroid-sensitive nephrotic syndrome with selective proteinuria, mesangial IgA deposition at immunofluorescence is a very rare finding which has been previously considered a pure coincidence. Two patients, aged 6 and 14 years, respectively, with a steroid-sensitive but frequently relapsing nephrotic syndrome and highly selective proteinuria, exhibited minor glomerular alterations at light microscopy and an immunofluorescence deposition of predominant and diffuse mesangial IgA, confirmed by electron microscopy as dense deposits. The observed syndrome, that is surprisingly identical to sporadic literature reports, can be considered a separate entity or subgroup belonging either to IgA nephropathy or to lipoid nephrosis. In the latter case mesangial IgA could be the marker of an easy relapsing course.

Adolescent↗
PubMed1986

Unexpected presentation of deep candidiasis in a recipient of a mismatched bone marrow transplant.

A Caucasian male of 37 years with acute non-lymphoid leukemia underwent a mismatched allogeneic bone marrow transplantation; he was in relapse but otherwise well. After conditioning with cyclophosphamide, total body irradiation and cytosine arabinoside, he received from his sister a graft depleted of T lymphocytes and cyclosporin A. Soon after transplantation he developed fever and a skin rash, followed, after response to high-dose steroids, by fever, acute renal failure, jaundice, progressive loss of consciousness and death after 2 weeks of transplant. Unexpectedly, autopsy revealed deep candidiasis of the liver and kidneys; here the histologic pattern was peculiar, because tubules were filled and occluded by Candida albicans organisms and hyphae. The uniqueness of this case and the fulminating clinical course did not allow to start an appropriate antifungal therapy.

Adult↗
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↗
PubMed1984

An unusual manifestation of renal osteodystrophy.

Besides the more frequent aspects, an unusual manifestation of renal osteodystrophy occurred in a 19-year-old man on regular hemodialysis treatment. About 6 years after the start of hemodialysis, the patient, who had severe osteodystrophy, presented a brown tumor, localized to the jaw, which caused a serious deformity of the face. Pharmacological treatment for hyperparathyroidism did not reduce the volume of the mass. Only total surgical removal gave long-lasting success. Brown tumor is an unusual but serious complication of renal bone disease which can be treated successfully by surgical removal of the tumoral mass and by pharmacological treatment for hyperparathyroidism.

Adult↗
PubMed1984

Immunohistochemical typing of amyloid on hydroxyethyl-methacrylate-embedded renal biopsies.

Hydroxyethyl-methacrylate (GMA)-embedded renal biopsies containing amyloid were tested by the indirect immunoperoxidase method with antibodies against the following purified amyloid fibril proteins: AA, three different A lambda preparations, Ak and AF. The anti-AA reagent was monoclonal (mc13), all the others were polyclonal. In four biopsies from cases with generalized amyloidosis, two were found to be of the AA and two of the A lambda type. Two control cases of membranous glomerulonephritis showed only a marginal reaction with anti-A lambda. These results demonstrate that GMA-embedded tissue sections are suitable for immunohistochemical classification of amyloid diseases, because proteinaceous antigenic determinants of amyloid fibril are preserved.

Aged↗
PubMed1984

Renal osteodystrophy in CAPD patients.

To assess the influence of continuous ambulatory peritoneal dialysis (CAPD) on the evolution of renal osteodystrophy, we studied 36 adult patients with end-stage renal failure before starting dialysis and after 7-30 months. 17 patients (12 males and 5 females) were treated by CAPD as first treatment and 19 (14 males and 5 females) received maintenance hemodialysis. The two groups were age- and sex-matched and no patient received vitamin D. All patients had adequate clinical and metabolic follow-up with a radiological survey and quantitative bone histology at the start of dialysis and at the end of the study. Serum phosphate concentrations were much easier to control in CAPD than in hemodialysis patients. There was no difference in the evolutive pattern of vascular and periarticular calcifications in the two groups. The 25-hydroxyvitamin D3 levels were frequently lower in CAPD than in hemodialysis patients. In some CAPD patients, there was a significant loss of trabecular bone volume at the end of the study. The radiological and histological appearances of secondary hyperparathyroidism improved or seemed to worsen to a lesser degree in CAPD compared to hemodialysis patients.

Adult↗
PubMed1983

Myeloid metaplasia of the breast. A lesion which clinically mimics carcinoma.

The authors report a case of myeloid metaplasia of the breast presenting as a tumor mass with homolateral axillary lymphadenopathy. The lesion was clinically misinterpreted as a breast cancer and developed in an elderly woman 8 years after the diagnosis of primary myelofibrosis was made. Immunohistochemical and ultrastructural studies confirmed the haematopoietic nature of the proliferating cells. The differential diagnosis from other breast lesions is discussed.

Aged↗
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

Immunohistochemical staining on hydroxyethyl-methacrylate-embedded tissues.

Hydroxyethyl-methacrylate (GMA) embedding has recently been proposed for light microscopy studies. In the present investigation extracellular protein antigens were localized on GMA-embedded renal biopsy tissue. Conventionally frozen sections were compared with GMA sections from 55 renal specimens for the detection of extracellular protein antigens. Sections were directly stained with fluorescein- or peroxidase-conjugated antisera against immunoglobulin (Ig) G, IgA, IgM, C3, C1q, and fibrinogen. Results obtained using these two methods showed a 74-89% agreement, depending on the antigen under study. Some discrepancy between GMA and frozen sections was observed in three cases of renal amyloidosis and those cases presenting focal or trace reactions; the differences did not, however, influence the diagnosis. Prerequisites for antigen recovery on GMA sections were a) choice of fixative; b) abrupt dehydration of specimens; and c) treatment of sections with nonspecific protease. The improved localization and the lower background staining obtained led to easy and immediate detection of antigens on GMA sections despite the reduced antigenicity due to the embedding process.

Acrylates↗
PubMed1983

The presence of J chain in mesangial immune deposits of IgA nephropathy.

In order to identify polymeric IgA in the mesangial IgA deposits of 33 patients, the presence of J chains by a PAP method was investigated. In 9/27 cases of primary IgA nephropathy (PIgANP) and in 4/4 cases of Henoch-Schönlein glomerulonephritis (HSGN) J chains were absent. The remaining cases, two of them with IgA glomerulonephritis associated with alcoholic cirrhosis (ACIgAGN), were J-positive. The two groups, PIgANP J-positive and PIgANP J-negative, were compared according to clinical features. The only difference detected was the time length between the disease onset and the renal biopsy, being shorter in the negative group.

Adult↗
PubMed1982

Therapeutic effects of 25-hydroxycholecalciferol and sodium etidronate on renal osteodystrophy.

The effects of long-term treatment with 25-hydroxycholecalciferol (25OHD3) and disodium ethane-1-hydroxydiphosphonate, or 25OHD3 alone on biochemical parameters, and radiographic and quantitative histomorphometry of bone tissue were evaluated in 17 dialysis patients. They all displayed evidence of bone disease consisting of osteitis fibrosa and defective mineralization of varying degree and predominance. 100 micrograms/day of 25OHD3 significantly improved the state of bone mineralization in many patients with a pronounced fall in the osteoid volume and surface and produced a small reduction in the active resorption surface. Serum parathyroid hormone (iPTH) and alkaline phosphatase levels decreased in some patients. The combination of 25OHD3 with EHDP caused the healing of bone mineralization as did 25OHD3 alone and produced a significant fall in serum alkaline phosphatase and iPTH. The mean magnitude of the reduction in iPTH was higher in patients treated with 25OHD3 and EHDP than with 25OHD3 alone. Treatment with 25OHD3 and EHDP seems more effective for the improvement of osteitis fibrosa than is 25OHD3 alone.

Adult↗
PubMed1981

Effect of chenodiol on the small intestine. Unimpaired structure and function during therapy for gallstone dissolution.

To test whether long-term oral dosage with chenodiol (chenodeoxycholic acid) used for dissolution of cholesterol gallstones would cause impairment of small-intestinal structuree or function, ten patients were studied before and after three months of oral chenodiol administration, 15 mg/kg of body weight per day. Small-intestinal structure was assessed by roentgenogram and intestinal biopsy, using both light and electron microscopy. Small-intestinal function was assessed by xylose, fat and vitamin B12, lactose, and bile-acid absorption. Bile acid metabolism was also characterized by the breath test for deconjugation using carbon dioxide labeled with radioactive carbon 14. No significant abnormalities were found. The results suggest that oral chenodiol administration does not impair intestinal structur or function in doses used for gallstone dissolution.

Administration, Oral↗