[Microalbuminuria in essential arterial hypertension]. / Microalbuminuria en la hipertensión arterial esencial.

BACKGROUND: The occurrence of microalbuminuria (mAlb) in essential hypertension (HT) was evaluated. METHODS: 100 patients were studied (56 males), with mean age 39 +/- 6 years, body mass index (BMI) 28 +/- 4. 32 had borderline HT, 47 had mild HT and 21 had moderate HT. 74 were in stage I of the WHO and 26 were in stage II. All had normal renal function (creatinine 91 +/- 12 mumol, Clcr 92 +/- 13 ml/m/1.73 m2) and no proteinuria as measured by sulphosalicylic acid. mAlb was immuno-nephelometrically measured in two 24-hour urine samples, and was given as urinary albumin excretion (UAE). In 62 patients, noninvasive ambulatory recording of blood pressure (NIAR) was carried out. In 39, ventricular mass was estimated by echocardiography. RESULTS: UAE was correlated with SPB24h (r = 0.39) and DBP24h, but not with SBP or DBP. UAE was greater in patients with moderate HT than in those with mild or borderline HT (p less than 0.01). UAE was less than 20 mg/24 h in 70 patients (group A) and greater than 20 mg/24 h in 30 (group B). The comparative analysis of the two groups showed different clinical BP values (SBP p less than 0.01; DBP p less than 0.001) and NIAR (SBP 24 h p less than 0.001; DBP 24 h p less than 0.05). In the 47 patients with mild HT the only differential parameter between groups A and B was SBP24h (p less than 0.05). Regarding echocardiographic data, in higher UAE levels a greater left ventricular mass index was found in males (chi-square p less than 0.05). CONCLUSIONS: Increased mAlb is associated with more severe HT. This finding may be helpful for the initial evaluation of hypertensive patients.

[Langerhans cell histiocytosis of lymph node]. / Histiocitosis de células de Langerhans de presentación ganglionar.

Langerhans cell Histiocytosis or Histiocytosis X encompasses the syndromes of Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma. The localized disease usually consisted of isolated bone involvement as osteolytic areas. The isolated lymph node disease is uncommon. A case study of eosinophilic granuloma of lymph node in a 27 years-old woman who underwent several recurrences as lymphadenitis is presented. This case is presented in light of the cytologic, histologic and immunohistochemical findings of node-based eosinophilic granuloma and the favorable prognosis of this localized form treated with steroids.

[Acute rhabdomyolysis. A study of 44 cases]. / Rabdomiolisis aguda. Estudio de 44 casos.

Fourty four patients suffering non traumatic rhabdomyolysis (RM) are studied. The most frequently encountered etiologies were neurologic abnormalities in 26 patients, followed by infections in 7 patients and metabolic abnormalities in four cases. Eleven patients (25%) presented several associated factors. The clinical manifestations of RM were not very significant, with only 18% of patients presenting muscle pain, 38.6% proteinuria and 36.4% hematuria. A significant increase in K, CPK, LDH, and ASAT values was observed after the RM episode (p less than 0.05). Those patients with an infectious RM were older (p less than 0.05) and presented higher urea (p less than 0.01) and creatinine (p less than 0.05) values. Only two patients presented renal failure. One patient with septic shock died. RM is a relatively common condition, often secondary to multiple systemic processes, which can go unnoticed due to the underlying disease.