RESUMO
A 84-year-old women underwent renal biopsy because of rapidly progressive renal failure. Rabeprazole induced interstitial nephritis was diagnosed. Interstitial nephritis may complicate the course of any proton pump inhibitor treatment. It is a rare and serious complication. Clinician's awareness of this adverse event is essential for early diagnosis and prompt recovery.
Assuntos
2-Piridinilmetilsulfinilbenzimidazóis/efeitos adversos , Antiulcerosos/efeitos adversos , Nefrite Intersticial/induzido quimicamente , 2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , Doença Aguda , Idoso de 80 Anos ou mais , Antiulcerosos/administração & dosagem , Feminino , Humanos , RabeprazolRESUMO
An acquired circulating anticoagulant with anti-factor V activity appeared in a 29 year old AIDS patient with widespread Kaposi's sarcoma following 21 days of fresh frozen plasma therapy for haemolytic and uraemic syndrome. Residual factor V activity was very low (< 5% of normal). However, the inhibitor was of low titre (0.5 Bethesda Units/ml), while antigenic factor V levels remained at 100%. Dot blotting with human factor V and polyvalent and specific immunoglobulin antisera showed the antibody to belong to the IgG class. Haemostatic tests in vitro were only partly corrected by addition of washed human platelets and despite transfusion of large amounts of platelets the patient died from massive pulmonary haemorrhage. This would appear to be the first documented case of an anti-factor V inhibitor occurring in an AIDS patient.
Assuntos
Síndrome da Imunodeficiência Adquirida/sangue , Anticoagulantes/sangue , Fator V/antagonistas & inibidores , Imunoglobulinas/análise , Síndrome da Imunodeficiência Adquirida/mortalidade , Adulto , Anticoagulantes/farmacologia , Coagulação Sanguínea/efeitos dos fármacos , Hemostasia , Humanos , MasculinoRESUMO
MHC class II-encoded molecules HLA-DR, -DP and -DQ play a pivotal role in the human immune response. Their constitutive expression is restricted to a number of immunocompetent cells referred to as antigen-presenting cells. However, gamma-interferon (gamma-IFN) has been shown to induce MHC class II molecule expression in several epithelia. Using flow cytometric analysis, we show here that normal and SV40-transformed human podocytes in culture constitutively expressed gamma-IFN receptors. We also show that MHC class I molecules are constitutively expressed in these cells and that HLA-DR, -DP and -DQ expression, which is not found in unstimulated cells, can be induced by gamma-IFN stimulation. This induction was a time-dependent event, a lag phase of 24-48 h being necessary for MHC class II molecules to become detectable at the cell surface by flow cytometric analysis. Induction of MHC class II molecules in human podocytes also showed a concentration dependence, a plateau being reached at a concentration of 500 IU of gamma-IFN/ml of culture medium. This effect was blunted by coincubation of the cells with an antihuman gamma-IFN receptor monoclonal antibody. HLA-DR expression was associated with specific mRNA accumulation, as detected by Northern blot analysis. By indirect immunofluorescence, the intercellular adhesion molecule 1 was also induced by gamma-IFN stimulation. Induction of DR, DP and DQ in human podocytes may be involved in the pathogenesis of immune glomerulonephritis in man.
Assuntos
Antígenos HLA-DP/análise , Antígenos HLA-DQ/análise , Antígenos HLA-DR/análise , Molécula 1 de Adesão Intercelular/análise , Interferon gama/farmacologia , Glomérulos Renais/química , Glomérulos Renais/citologia , Northern Blotting , Células Cultivadas , Células Epiteliais , Epitélio/química , Citometria de Fluxo , Imunofluorescência , Regulação da Expressão Gênica , Antígenos HLA-DP/genética , Antígenos HLA-DQ/genética , Antígenos HLA-DR/genética , Humanos , Molécula 1 de Adesão Intercelular/genética , Interferon gama/metabolismo , RNA Mensageiro/análise , RNA Mensageiro/genética , Receptores de Interferon/análise , Receptores de Interferon/metabolismoRESUMO
Von Meyenburg complexes (VMC) are rare malformations of the bile ducts. They are usually associated with adult dominant polycystic disease (ADPCD). Although generally benign, they may give rise to cholangiocarcinomas. Herein, we report the third MR documented case of VMC. The comparative diagnostic value of ultrasound (US), computed tomography (CT), and magnetic resonance (MR) examinations is discussed.
Assuntos
Ductos Biliares Intra-Hepáticos/patologia , Imageamento por Ressonância Magnética , Idoso , Cistos/diagnóstico , Feminino , Humanos , Nefropatias/patologia , Fígado/patologia , Hepatopatias/diagnóstico , Hepatopatias/patologiaRESUMO
HLA-DP allodeterminant elicit weak cellular and humoral immune responses. This study was undertaken to find out if the low immunogenicity of HLA-DP could be accounted for by a low level of expression on peripheral blood mononuclear cells. Double staining experiments and flow cytometry were performed in 28 healthy individuals, HLA-DP was found to be as expressed as DR and DQ on B lymphocytes. Furthermore, a DP+/DR- lymphocyte sub-population was identified and characterized as freshly activated T lymphocytes.