Ulno-basilic arteriovenous fistulae: indications and surgical technique.

Ulnar-basilic fistula is a vascular access option for hemodialysis first reported in 1967. There is no inherent reason why the ulnar artery cannot be used to create a fistula at the wrist; however, a few reports dealing with its complications and survival rates have been published in the literature. In the present work the results of 9 ulnar-basilic fistulae done in 9 adults patients on chronic hemodialysis, are reported. Two fistulae were created as primary access and the remaining 7 fistulae as secondary access after thrombosis of an ipsilateral and controlateral radiocephalic fistula in 6 cases and in a case of high-flux brachiocephalic fistula. No episodes of surgical complications were observed. This fistula is an additional option to create a distal vascular access for hemodialysis before constructing a proximal access.

Atypical renal onset and involvement in primary antiphospholipid syndrome in a child.

A case of primary antiphospholipid syndrome (APS) with renal involvement in a 10-year-old child is reported. The peculiarity of the case resided not only in the apparent "primary" occurrence of APS in the pediatric age, but also in the involvement of the kidney. The renal picture in the case described consisted of a focal proliferative glomerulonephritis, without any sign of glomerular thrombosis. We conclude that this should lead to a consideration of primary APS in the differential diagnosis of nephropathies, also in childhood.

[Goodpasture's disease or syndrome? Apropos of a case]. / Malattia o sindrome di Goodpasture? A proposito di un caso.

Goodpasture's disease is characterized by lung haemorrhage, associated with glomerulus basement membrane antibody glomerulonephritis, and circulating basement membrane antibody. Other diseases (Wegener, LES, arteritis) may have the same kidney and lung involvement. The Authors present a clinical case of rapidly progressive renal failure where renal biopsy showed an extensive extracapillary proliferative glomerulonephritis with linear deposits of antibody in the basement membrane, similar to Goodpasture's disease, with following lung involvement, but without hemoptysis and in absence of circulating antiglomerular basement membrane antibody. The Authors think it could be a case of Goodpasture's disease, even if it did not show the above-mentioned symptoms, whether out of the characteristic clinical course or the exclusion of all the other diseases. The Authors believe that the absence of circulating basement membrane antibody could be due to their sediment in the target organs and suggest a revision of the standards required for the Goodpasture's disease diagnosis.