ABSTRACT
Transbronchial lung biopsies were performed on 6 consecutive patients with presumptive diagnoses of Goodpasture's syndrome. Diagnoses were subsequently confirmed by the typical clinical presentation, circulating antibody to glomerular basement membrane and linear deposition of IgG on renal biopsy. We demonstrated linear deposition of IgG along the alveolar capillary basement membrane in each of the transbronchial lung biopsies. Rapid, meticulous processing allowed us to obtain reproducible results. The routine use of transbronchial lung biopsy with immunofluorescent staining is recommended for all presumptive cases of Goodpasture's syndrome.
Subject(s)
Anti-Glomerular Basement Membrane Disease/immunology , Bronchi/immunology , Adolescent , Adult , Anti-Glomerular Basement Membrane Disease/pathology , Bronchi/pathology , Fluorescent Antibody Technique , Humans , Immunoglobulin G/analysis , MaleABSTRACT
A child with diphenylhydantoin hypersensitivity developed an associated interstitial nephritis. Circulating autoantibody of the IgG class which reacted with normal human tubular basement membrane was linearly deposited along host renal TBM. Cell-mediated immunity to the DPH antigen was also present. In addition, deposits of DPH were demonstrated along the renal TBM. It is suggested that initial alteration of host renal TBM by DPH deposition with secondary immune injury directed at the DPH-TBM antigen may have altered the TBM or uncovered new antigenic sites, rendering it susceptible to further injury on an autoimmune basis.
Subject(s)
Autoantibodies , Immunity, Cellular , Nephritis, Interstitial/immunology , Phenytoin/adverse effects , Basement Membrane/immunology , Child , Drug Hypersensitivity/complications , Female , Humans , Immunoglobulin G , Kidney Tubules/immunology , Kidney Tubules/pathology , Lymph Nodes/pathology , Lymphocyte Activation , Nephritis, Interstitial/chemically induced , Phenytoin/immunologyABSTRACT
Eleven biopsies in 6 consecutive patients having reduction mammaplasties by a technique which uses a dermal pedicle have established that dermis does remain in the pedicle. The term "de-epithelization" is not correct and should be abandoned in this context.
Subject(s)
Breast/surgery , Dermatologic Surgical Procedures , Surgery, Plastic/methods , Biopsy , Epithelium/surgery , Female , HumansABSTRACT
In 2 patients with hemoptysis and hematuria, Goodpasture's syndrome was documented by clinical presentation, demonstration of circulating anti-glomerular basement membrane antibodies, and demonstration of linear immunofluorescence along glomerular and alveolar basement membranes. One patient was considered to have progressive disease and was treated with prednisone and cyclophosphamide. During the subsequent 18-month follow-up period, clinical remission occurred with eventual disappearance of hematuria and detectable circulating anti-glomerular basement membrane antibodies. The other patient did not have active hemoptysis at the time of referral and no therapy was instituted. After 12 months of follow-up, hemoptysis remains quiescent but hematuria and positive circulating anti-glomerular basement membrane antibodies persist. Although therapy appears to have been particularly effective in one patient, the benign course of the other patient precludes premature enthusiasm for early intervention.
Subject(s)
Anti-Glomerular Basement Membrane Disease/diagnosis , Adult , Anti-Glomerular Basement Membrane Disease/diagnostic imaging , Anti-Glomerular Basement Membrane Disease/drug therapy , Biopsy , Cyclophosphamide/therapeutic use , Hematuria/diagnosis , Hemoptysis/diagnosis , Humans , Male , Prednisone/therapeutic use , RadiographyABSTRACT
Non-immune rosette formation, where a non-sensitized lymphocyte is surrounded by three or more sheep red blood cells, is an in vitro technique which is thought to be specific in the identification of thymus-dependent (T) lymphocytes. Using the electron microscope and tissue culture techniques, we have studied the ultrastructure of the rosette-forming lymphocyte which has been stimulated by various cellular mitogens. Non-sensitized but stimulated lymphocytes, which form rosettes, have a morphology similar to that of previously identified T cells, adding further credence to the concept that non-sensitized rosette-forming cells represent a population of T cells. Changes in the binding pattern of the sheep red cell membrane to the lymphocyte have been identified which may represent an early phase of cell 'activation'. This marker of activation offers a potential method of studying membrane responses in attempts to localize cellular defects involving the T lymphocyte. In addition, preliminary studies using fluorescein-labelled sheep red blood cell fragments suggest specific attachment of labelled membrane to the T lymphocyte, allowing rapid identification of T cells in smears or tissue preparations.
