[Monoclonal free light-chain immunoglobulins: their clinical interpretation]. / Monoklonal'nye svobodnye legkie tsepi immunoglobulinov: klinicheskaia interpretatsiia.

23 cases of free light chains (FLC) occurrence in the blood and/or urine in the absence of monoclonal gammopathy are reported. Of them 15 cases were attributed to renal diseases associated with deranged catabolism of low-molecular proteins including FLC. In the rest cases FLC hyperproduction in autoimmune diseases was suspected to cause FLC appearance. No correlation was found between the amounts of FLC, creatinine, beta 2-microglobulin, light chains, kappa/lambda proportions.

[The epidemiological indices of multiple myeloma and concomitant nephropathies]. / Epidemiologicheskie pokazateli mielomnoi bolezni i sochetaiushchikhsia s nei nefropatii.

The authors have conducted an epidemiological study for multiple myeloma morbidity and mortality among 80,000 patients of the Medical Center examined in 1988-1995. Myeloma was diagnosed in 65 cases. Standard incidence rate was 4.09, 3.18 and 3.5 per 100,000 for myeloma in males, females and both sexes, respectively. Standard mortality was 2.76 and 1.73 per 100,000 for males and females, respectively. The above rates do not differ much from those of other countries. In terminal myeloma renal insufficiency occurred in 39 of 41 cases. In 8 cases chronic pyelonephritis was an independent course of renal failure thus indicating the importance of its persistent treatment.

[Renal lesions in elderly patients with diabetes mellitus]. / Porazhenie pochek u bol'nykh sakharnym diabetom pozhilogo vozrasta.

AIM: To elucidate the role of some renal diseases, pyelonephritis in particular, in elderly patients with type 2 diabetes mellitus (DM). MATERIALS AND METHODS: The trial included 150 patients with diabetes mellitus type 2 aged over 60 years with DM duration 16.6 +/- 7.8 years. All the patients underwent general clinical examination, Reberg-Tareev test, urine seeding, renal ultrasonography. RESULTS: The diagnoses associated with renal pathology were made in 75% of patients, the specific renal parenchymal damage (diabetic nephropathy-DN) proper was much less common (73 patients with type 2 DM). 16 of them were found to have chronic renal failure. The concurrent abnormalities included pyelonephritis (21%), urolithiasis (14%), renal cysts (19%), their combination (43%). Concomitant pyelonephritis had the most significant impact on renal function. Essential hypertension occurred in 65% of patients. CONCLUSION: In old age, renal damage specific for DM develops in the presence of pyelonephritis, cystic degeneration of the parenchyma, involutional processes, atherosclerotic and hypertensive arteriolosclerosis.

[Antigliadin antibodies in the absence of celiac disease]. / Antigliadinovye antitela v otsutstvie tseliakii.

Antigliadin antibodies (AGA) mark celiac disease, but AGA are also encountered in IgA-nephritis, psoriasis, sickle-cell anemia, hepatic disorders, juvenile rheumatoid arthritis, autoimmune thyroidism and in persons who occupationally contact great amounts of wheat. AGA IgA and/or IgG were registered in 19 of 60 subjects (51 adults and 9 children) with various immunomediated diseases without symptoms of celiac disease: in 4 cases of chronic active hepatitis, in 2 of 4 cases of chronic persistent hepatitis, in 4 of 16 cases of rheumatoid arthritis, in 3 of 19 cases of IgA-deficiency, in 1 of 8 cases of SLE, in 2 cases of postvaccine reaction, in all the single cases of juvenile rheumatoid arthritis, focal scleroderma, macroglobulinemia. IgA only occurred in in 6 patients, IgG- in 6 patients, both IgA and IgG in 7 patients. The most pronounced positive reaction to AGA was recorded in 8-year-old girl with juvenile rheumatoid arthritis. The emergence of AGA in immunomediated diseases may be attributed to the response to food protein in pathological conditions and is often unrelated closely with celiac disease.