RESUMO
BACKGROUND: Polyomaviruses are expressed in both human tumors and immunodepressed patients. Malignant and nonmalignant pleural effusions create an environment that could favor the expression of opportunistic viral infections. We studied if SV40, JC, and BK viral DNA can be amplified from biopsies obtained from different pleural diseases. MATERIALS AND METHODS: DNA was extracted from mesotheliomas (MM), nonspecific inflammatory and tubercular pleural biopsies, blood and urinary sediments from patients with MM, and pleural effusion cytological specimens. SV40, JC and BK viral early regions were amplified by PCR and analyzed by Southern Blot hybridization with specific probes. RESULTS: SV40 was positive in 9/23 MM, 5/18 tubercular and 1/7 nonspecific inflammatory biopsies, and 5/12 pleural effusion cytological specimens. JC was positive in 2/23 MM and in 7/15 urinary sediments. All blood samples were negative and BK was also negative in all samples. CONCLUSIONS: Tissue specific factors, characteristic of MM and TB, may contribute to expression of SV40 in these diseases.
Assuntos
Vírus BK/isolamento & purificação , Vírus JC/isolamento & purificação , Mesotelioma/virologia , Doenças Pleurais/virologia , Neoplasias Pleurais/virologia , Vírus 40 dos Símios/isolamento & purificação , Southern Blotting , DNA Viral/análise , Humanos , Mesotelioma/sangue , Mesotelioma/patologia , Mesotelioma/urina , Doenças Pleurais/sangue , Doenças Pleurais/patologia , Doenças Pleurais/urina , Derrame Pleural/virologia , Derrame Pleural Maligno/virologia , Neoplasias Pleurais/sangue , Neoplasias Pleurais/patologia , Neoplasias Pleurais/urina , Reação em Cadeia da PolimeraseAssuntos
Hipuratos/biossíntese , Adulto , Idoso , Alcoolismo/urina , Artrite Reumatoide/urina , Benzoatos/metabolismo , Cromatografia em Camada Fina , Diabetes Mellitus/urina , Eczema/urina , Feminino , Cardiopatias/urina , Hemocromatose/urina , Hepatite A/urina , Hipuratos/urina , Humanos , Hiperbilirrubinemia Hereditária/urina , Hipertireoidismo/urina , Nefropatias/urina , Cirrose Hepática/urina , Hepatopatias/urina , Masculino , Pessoa de Meia-Idade , Neoplasias/urina , Doenças Pleurais/urina , Úlcera por Pressão/urina , Pielonefrite/urina , Fatores de TempoRESUMO
Urinothorax refers to the presence of urine in the pleural space secondary to obstructive uropathy, and is an unusual cause of pleural effusion. The importance of recognising this entity lies in the fact that the condition is completely reversible following relief of urinary tract obstruction. We describe a 35-year-old man who developed urinothorax following a percutaneous nephrolithotomy for renal calculi. We also reviewed the literature for reported cases between 1968 and 2006.
Assuntos
Creatinina/urina , Cálculos Renais/cirurgia , Nefrostomia Percutânea , Derrame Pleural/urina , Complicações Pós-Operatórias/urina , Urinoma/urina , Adulto , Diagnóstico Diferencial , Extravasamento de Materiais Terapêuticos e Diagnósticos/diagnóstico , Extravasamento de Materiais Terapêuticos e Diagnósticos/urina , Fístula/diagnóstico , Fístula/urina , Humanos , Nefropatias/diagnóstico , Nefropatias/urina , Masculino , Doenças Pleurais/diagnóstico , Doenças Pleurais/urina , Derrame Pleural/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Cintilografia , Tecnécio , Fístula Urinária/diagnóstico , Fístula Urinária/urina , Urinoma/diagnósticoRESUMO
PURPOSE OF REVIEW: The presence of urine in the pleural space (urinothorax) is a rarely recognized cause of pleural effusion. To date, only 58 cases have been reported. In this article the features of urinothorax are analyzed, and clinical and biochemical characteristics are reviewed in order to propose a classification, founded on pathogenic criteria, that will be useful in achieving the diagnosis. RECENT FINDINGS: Recently reported cases of urinothorax provide a more detailed description of the biochemical characteristics that allow a better understanding of this entity. SUMMARY: Urinothorax can be divided into two categories: (1) obstructive urinothorax, due to bilateral obstructive uropathy; and (2) traumatic urinothorax, due to unilateral traumatic injury of the urinary system, mostly iatrogenic. In patients with urinothorax, the pleural effusion usually has the biochemical characteristics of a transudate, with a pH lower than 7.30 and a pleural fluid/serum creatinine ratio higher than 1. These characteristics are not always present, however, and individually are shared by a significant number of pleural effusions of different etiology.