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1.
Urol Ann ; 13(2): 130-133, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34194138

RESUMO

Introduction: Renal cell carcinoma (RCC) has various histopathological tumor subtypes which have a significant implication on the oncological outcome of these patients. We aimed to evaluate the distribution of RCC subtypes presenting at a tertiary care center in the Middle East, in comparison to the distribution reported in different geographic areas worldwide. Methods: A retrospective chart review was conducted on all patients who underwent partial or radical nephrectomy for RCC at the American University of Beirut Medical Center between January 2012 and January 2018. Data on histologic subtypes were compiled and compared to representative series from different continents. Results: One hundred and seventy-nine patients with RCC were identified, of whom 122 (68.2%) were classified as clear cell, 30 (16.8%) as papillary, 17 (9.5%) as chromophobe, and 10 (5.6%) as unclassified. When compared to other regions of the world, this Middle Eastern series demonstrated a higher prevalence of the chromophobe subtype compared to Western populations (9.5% in the Middle East vs. 5.3% in the US and 3.1% in Europe) and a lower prevalence of clear cell subtype (68.2% in the Middle East vs. 78.7% in the US and 85.8% in Europe). Conversely, there was a higher prevalence of papillary RCC in the Middle East (16.8%) compared to North America (13.1%, 95% confidence interval [CI]: 12.7-13.6), Europe (11.1%, 95% CI: 10.0-12.1), and Australia (10.2%). The prevalence of chromophobe and clear cell RCC in the Middle East was similar to that reported in South America. Conclusions: The distribution of RCC subtypes in this Middle Eastern cohort was significantly different from that reported in the Western hemisphere (Europe and the US) but similar to that reported in South America and Australia. These findings may point to a possible genetic predisposition underlying the global variation in distribution.

2.
Am J Transplant ; 21(5): 1948-1952, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33206467

RESUMO

Collagenofibrotic glomerulopathy (CG) is a rare disease characterized by the deposition of collagen type 3 fibrils in the glomeruli. Patients may have proteinuria, hematuria, and/or renal dysfunction. CG is considered a progressive disease with variable rates of progression. The definitive diagnosis is made by electron microscopy with the presence of characteristic subendothelial and mesangial curved, comma-like, banded collagen type 3 fibers of 40-65 nm periodicity. We are reporting the first case of CG in a kidney transplant recipient with kidney disease of unknown cause.


Assuntos
Nefropatias , Transplante de Rim , Colágeno Tipo III , Humanos , Nefropatias/etiologia , Glomérulos Renais , Transplante de Rim/efeitos adversos , Proteinúria
3.
Ann Saudi Med ; 39(3): 155-161, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31215222

RESUMO

BACKGROUND: Recent international reports have shown significant changes in the incidence of different glomerular diseases. OBJECTIVE: Examine temporal and demographic trends of biopsy-diagnosed glomerular diseases in the adult population of Saudi Arabia over the last two decades. DESIGN: Medical record review. SETTINGS: Four tertiary medical centers in Saudi Arabia. PATIENTS AND METHODS: We identified all patients that underwent native kidney biopsy between 1998 and 2017. MAIN OUTCOME MEASURES: The frequency and the disease trends in four biopsy eras (1998-2002, 2003-2007, 2008-2011, and 2012-2017) for different glomerular diseases. SAMPLE SIZE AND CHARACTERISTICS: 1070 patients, 18-65 years of age; 54.1% female. RESULTS: Of 1760 patients who underwent native kidney biopsies, 1070 met inclusion criteria. Focal segmental glomerulosclerosis was the most common biopsy-diagnosed disease, with comparable frequencies over the four eras (23.6%, 19.8%, 24.1%, and 17.1, respectively [ P value for trend=.07]). The frequency of immunoglobulin A nephropathy increased progressively. The incidence of membranoproliferative glomerulonephritis declined significantly. Among the secondary types of glomerular diseases, systemic lupus erythematosus-associated lupus nephritis was the most common, followed by diabetic nephropathy. The prevalence of diabetic nephropathy increased from 1.4% in the first era to 10.2% in the last one. CONCLUSIONS: Trends in biopsy-diagnosed glomerular disease have changed. While focal segmental glomerulosclerosis remains the most common glomerular disease, there has been a significant rise in the prevalence of immunoglobulin A nephropathy and diabetic nephropathy. In contrast, membranoproliferative glomerulonephritis has declined. LIMITATIONS: Retrospective methodologies are vulnerable to lost data. CONFLICT OF INTEREST: None.


Assuntos
Nefropatias Diabéticas/epidemiologia , Glomerulosclerose Segmentar e Focal/epidemiologia , Nefropatias/epidemiologia , Nefrite Lúpica/epidemiologia , Adolescente , Adulto , Idoso , Biópsia , Feminino , Glomerulonefrite por IGA/epidemiologia , Humanos , Incidência , Nefropatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Adulto Jovem
4.
Ultrastruct Pathol ; 42(5): 430-439, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30285525

RESUMO

AIM: Focal segmental glomerulosclerosis (FSGS) is a common progressive chronic renal disease. Podocyte injury and loss are the postulated pivotal events that trigger FSGS. In this study, the authors aim to examine the evolution of FSGS in murine models histologically, ultrastructurally and immunohistochemically with special emphasis on podocytes and parietal epithelial cells (PECs). MATERIAL AND METHODS: FSGS resembling primary FSGS in humans was initiated in Wistar rats using intravenous Adriamycin injections. Blood and urine analysis were performed at 0, 8, and 12 weeks. Both the control kidneys and the test kidneys were harvested at 8 and 12 weeks, examined histologically and ultrastructurally and the findings correlated with the glomerular expression of immunostains specific for podocytes (WT-1) and for activated PECs (CD44). RESULTS: FSGS developed in both 8 and 12 weeks test groups showing progressive proteinuria, podocytopathy and segmental glomerular scarring. There was a decrease in the glomerular expression of WT-1 with a concurrent increase in the glomerular expression of CD44, indicating podocyte loss with synchronous increase in activated PECs. The evolving FSGS correlated negatively with podocytes and positively with activated PECs. CONCLUSION: Our study shows that with podocyte injury there is podocyte effacement and loss, proteinuria, glomerular segmental adhesion and scarring, all culminating in FSGS. In addition, there is activation, hyperplasia and hypertrophy of PECs. This demonstrates that both podocyte loss and PEC activation promote FSGS. Our findings are consistent with recent investigations. More studies are required to further understand the role of these cells in the evolution of FSGS and subsequently introduce new targeted treatment modalities.


Assuntos
Glomerulosclerose Segmentar e Focal/patologia , Glomérulos Renais/patologia , Glomérulos Renais/ultraestrutura , Animais , Biomarcadores/análise , Modelos Animais de Doenças , Glomerulosclerose Segmentar e Focal/metabolismo , Receptores de Hialuronatos/biossíntese , Imuno-Histoquímica , Glomérulos Renais/metabolismo , Podócitos/metabolismo , Podócitos/patologia , Podócitos/ultraestrutura , Ratos , Ratos Wistar , Proteínas WT1/biossíntese
5.
Saudi Med J ; 39(10): 990-993, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30284580

RESUMO

OBJECTIVES: To examined the short and long-term outcome of class II lupus nephritis (LN).   Methods: This retrospective study included patients with class II LN at their first renal biopsy between January 1996 and December 2016 in King Khaled University Hospital, Riyadh, Saudi Arabia. The rate of complete remission, worsening renal function, and histological transformation in the second biopsy were examined.   Results: The study included 32 female patients with class II LN. The most frequent presentation (62.5% of patients) was hematuria with subnephrotic range proteinuria. The clinical presentation included acute kidney injury in 22% of patients, and 9.4% had nephrotic range proteinuria. Management with steroid monotherapy in 25 patients resulted in complete remission for 92% of these patients at 6 months. After a median follow up of 8 years, 2 patients had a doubling of their serum creatinine. During the follow up 17 patients (53%) needed a second biopsy, which revealed  transformation to other classes (65%).  Conclusions: Daily steroid monotherapy may be an appropriate first-line treatment for class II LN that presents with subnephrotic range proteinuria and normal kidney function. Patients with acute kidney injury and/or nephrotic range proteinuria may warrant more aggressive immunosuppressive regimens.


Assuntos
Nefrite Lúpica/tratamento farmacológico , Nefrite Lúpica/patologia , Corticosteroides/uso terapêutico , Adulto , Biópsia , Progressão da Doença , Feminino , Humanos , Imunossupressores/uso terapêutico , Nefrite Lúpica/complicações , Masculino , Indução de Remissão , Estudos Retrospectivos , Arábia Saudita , Resultado do Tratamento
6.
Ultrastruct Pathol ; 42(4): 365-368, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30019987

RESUMO

AIM: To identify the underlying diseases with TRI-positive kidney biopsies, and describe the histological pattern and spectrum of TRI-positive kidney biopsies. METHODS: A retrospective analysis of all patients' chart that underwent renal biopsy at King Saud University Medical City between 2012 and 2017 was done. Kidney biopsies that indicated a positive result for tubuloreticular inclusions (TRI's) on electron microscopy were reviewed and the underlying disease and histological pattern was extracted. RESULTS: Of 1,473 native kidney biopsies reviewed, 96 (6.5%) were TRI-positive. Of the 96 TRI-positive kidney biopsies, 87 (90.6%) were TRI-positive lupus nephritis (LN); of which 10 (11.5%) were Class V, 49 (56.3%) were active LN, and 28 (32.2%) were inactive LN. The underlying diseases of the nine non-LN TRI-positive cases included diabetic nephropathy, connective tissue disorders, immune complex mediated Glomerulonephritis (GN), acute thrombotic microangiopathy, rhabdomyolysis, and Wegener's disease. CONCLUSION: LN is a very common finding in TRI-positive kidney biopsies. Active LN and chronic LN are the more common classes of TRI-positive LN kidney biopsies, than pure membranous (Class V) LN. TRI positive kidney biopsies without LN are commonly found in diabetic nephropathy, connective tissue disorders and immune mediated GN's. This study highlights this finding in our patients cohort in opposition to what has been reported in the literature.


Assuntos
Glomerulonefrite/patologia , Corpos de Inclusão/patologia , Rim/patologia , Nefrite Lúpica/patologia , Biópsia , Humanos , Nefrite Lúpica/imunologia , Nefrectomia/métodos , Estudos Retrospectivos , Centros de Atenção Terciária
7.
Saudi J Ophthalmol ; 32(1): 75-78, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29755277

RESUMO

Childhood orbital teratomas are congenital lesions that presents most often at birth with progressive, severe unilateral proptosis. Due to the rarity of such tumors, the diagnosis is often missed with delay in the patient's management. We are presenting a unique case of an immature right orbital teratoma with extensive growth in a full-term newly born baby boy. In this case report, we provide description of the clinical findings, initial misdiagnosis and the eventual management with review of similar reported cases.

8.
Saudi Pharm J ; 25(6): 944-953, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28951683

RESUMO

Methoxy poly(ethylene oxide)-block-poly(ɛ-caprolactone) (PEO-b-PCL) copolymers are amphiphilic and biodegradable copolymers designed to deliver a variety of drugs and diagnostic agents. The aim of this study was to synthesize PEO-b-PCL block copolymers and assess the toxic effects of drug-free PEO-b-PCL micelles after multiple-dose administrations via oral or intraperitoneal (ip) administration in rats. Assembly of block copolymers was achieved by co-solvent evaporation method. To investigate the toxicity profile of PEO-b-PCL micelles, sixty animals were divided into two major groups: The first group received PEO-b-PCL micelles (100 mg/kg) by oral gavage daily for seven days, while the other group received the same dose of micelles by ip injections daily for seven days. Twenty-four hours following the last dose, half of the animals from each group were sacrificed and blood and organs (lung, liver, kidneys, heart and spleen) were collected. Remaining animals were observed for further 14 days and was sacrificed at the end of the third week, and blood and organs were collected. None of the polymeric micelles administered caused any significant effects on relative organ weight, animal body weight, leucocytes count, % lymphocytes, liver and kidney toxicity markers and organs histology. Although the dose of copolymers used in this study is much higher than those used for drug delivery, it did not cause any significant toxic effects in rats. Histological examination of all the organs confirmed the nontoxic nature of the micelles.

9.
Indian J Pathol Microbiol ; 60(3): 365-370, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28937373

RESUMO

INTRODUCTION: Early detection of breast cancer plays a pivotal role in the outcome of the disease. Diagnostic modalities encompass radiological and pathological findings. The aim of this study is to evaluate the correlation between the results of these two modalities in a tertiary hospital. MATERIALS AND METHODS: From a total of 180 patients, 203 ultrasound-guided breast core needle biopsies (US-CNBs) were included in this study over a period of a year (May 2015 - May 2016). All clinical parameters, the site of the biopsy, the size of the needle, the radiological findings, the pathological diagnoses as well as all available follow-up data were reviewed. The concordance between the radiological and pathological results was studied and a statistical analysis conforms to the Pearson Chi-square test was applied. RESULTS: The majority of our patients were above 40 years of age. A strong and statistically significant association was noted between radiological findings and histopathological results (Pearson's Chi-square test = 186.28, P ≤ 0.0001) with only four discordant cases (1.97%). This discrepancy was not statistically associated with age, site of biopsy, needle size, or number of cores obtained (P = 0.621, P = 0.584, P = 0.786, and P = 0.478, respectively). CONCLUSIONS: US-CNB is an accurate method in the diagnosis of breast lesions. Radiological and pathological correlation is of utmost importance in relation to patient's care and to reduce false rates. Follow-up of concordant benign lesions is essential. In addition, the importance of a multidisciplinary breast conference during which input from all teams caring for the patient is strongly emphasized.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Testes Diagnósticos de Rotina/métodos , Patologia/métodos , Radiografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Feminino , Humanos , Pessoa de Meia-Idade , Centros de Atenção Terciária , Adulto Jovem
10.
Exp Clin Transplant ; 15(3): 289-294, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28137206

RESUMO

OBJECTIVES: Our objective was to study the clinico-pathologic correlations in BK virus nephropathy. MATERIALS AND METHODS: We conducted a retrospective study of all patients with biopsy-proven polyoma (BK) virus infection. We compared their survival and renal outcomes versus BK virus-negative patients with biopsy-proven graft rejection. Histopathologic characterization by a blinded nephropathologist was performed. RESULTS: BK nephropathy was found in 10 patients biopsied for graft dysfunction. All virus-positive patients received antithymocyte globulin induction therapy compared with only 59.3% of the BK-negative group (P = .06). The percentage of patients in the BK-negative group who received acyclovir was significantly higher than that in the BK-positive group (P = .01). After a mean observation period of 6.8 ± 3.2 years, 70% of the BK group had functioning grafts compared with 68% in the BK-negative group (P = .9) with similar 3-year graft survival in the 2 groups (80% and 90%; P = .8). Within the BK group, graft survival was better in the older group (P = .005) and in those with deceased donor kidney grafts (P = .016). Patients in the BK-negative group were heavier (mean weight of 64.3 ± 12.1 vs 46.7 ± 20.6 kg; P = .003). None of the histopathologic features studied had any effect on renal prognosis. CONCLUSIONS: The risk factors for developing BK nephropathy were use of antithymocyte globulin, lower weight, and not using acyclovir as early prophylaxis. Within the BK nephropathy group, better graft survival was observed in deceased donor kidney recipients and in older patients. The viral load and polyoma virus nephropathy stage did not affect graft survival in this small sample study.


Assuntos
Vírus BK/isolamento & purificação , Transplante de Rim/efeitos adversos , Rim/patologia , Infecções por Polyomavirus/patologia , Infecções Tumorais por Vírus/patologia , Aciclovir/uso terapêutico , Adolescente , Adulto , Soro Antilinfocitário/efeitos adversos , Antivirais/uso terapêutico , Vírus BK/efeitos dos fármacos , Biópsia , Peso Corporal , Criança , Feminino , Sobrevivência de Enxerto , Humanos , Imunossupressores/efeitos adversos , Estimativa de Kaplan-Meier , Rim/efeitos dos fármacos , Rim/virologia , Masculino , Pessoa de Meia-Idade , Infecções por Polyomavirus/epidemiologia , Infecções por Polyomavirus/prevenção & controle , Infecções por Polyomavirus/virologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Infecções Tumorais por Vírus/epidemiologia , Infecções Tumorais por Vírus/prevenção & controle , Infecções Tumorais por Vírus/virologia , Adulto Jovem
11.
Ultrastruct Pathol ; 41(1): 51-54, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28029267

RESUMO

BACKGROUND: Thin glomerular basement membrane (GBM) has been noted in several glomerular diseases including IgA nephropathy, focal segmental glomerulosclerosis (FSGS), Fabry's disease, and Alport's syndrome. We conducted this study to investigate the pathological ultrastructural spectrum of thin GBMs, to identify associated diseases, and to measure the GBM thickness in thin GBMs in our adult population. MATERIALS AND METHODS: All renal biopsies with thin GBM, diagnosed between 2010 and 2016, were retrieved and reviewed. RESULTS: Of 24 cases, 50.0% were diagnosed with FSGS, 12.5% with IgA nephropathy, 8.3% with tubulointerstitial nephritis, 4.2% with acute thrombotic microangiopathy, 4.2% with focal global sclerosis, 4.2% with lupus nephritis, and 16.7% with only thin GBM disease. Mean GBM thickness was 213.4 ± 24.7 nm. Mean interstitial fibrosis/tubular atrophy percentage (IF/TA) was 27.9 ± 22.2%. There was no significant correlation between GBM thickness and patients' age or IF/TA percentage. CONCLUSION: The association of thin GBM with FSGS and IgA nephropathy is high. Morphometric analysis of the GBM thickness should be made routine, noting that ethnic variations in the GBM thickness are reported. Cases of thin GBM should be reported to facilitate proper diagnosis and institute the most appropriate treatment.


Assuntos
Membrana Basal Glomerular/ultraestrutura , Nefropatias/diagnóstico , Adolescente , Adulto , Biópsia , Feminino , Glomerulonefrite por IGA/diagnóstico , Glomerulonefrite por IGA/patologia , Glomerulosclerose Segmentar e Focal/diagnóstico , Glomerulosclerose Segmentar e Focal/patologia , Humanos , Nefropatias/etnologia , Nefropatias/patologia , Masculino , Microscopia Eletrônica de Transmissão , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Arábia Saudita , Centros de Atenção Terciária , Adulto Jovem
12.
Int J Surg Case Rep ; 26: 118-20, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27490676

RESUMO

INTRODUCTION: A delayed foreign body reaction to polypropylene sutures has not been previously reported following tendon repair. PRESENTATION OF CASE: A 12-year old boy underwent tendon transfer. Tendon repair was done using polypropylene sutures. Five months later, a slowly growing granuloma was seen at the tendon repair site. Skin testing did not show an allergic reaction to the suture. Excision of the granuloma and removal of sutures were curative. Histology confirmed a foreign body granuloma. DISCUSSION: A mass developing several months at the site of tendon repair indicates either an allergic or foreign body reaction to the suture. Skin testing (for allergy) and histological examination of the mass differentiate allergic from foreign body reactions. CONCLUSION: We report on a rare case of a giant granuloma caused by a delayed foreign body reaction to polypropylene sutures used in tendon repair.

13.
Ultrastruct Pathol ; 40(5): 261-4, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27409363

RESUMO

The aim of this work was to determine the mean glomerular basement membrane (GBM) thickness in the Saudi population. We calculated the average GBM thickness in patients diagnosed with minimal change disease, and the ultrastructural analysis of at least three glomeruli was reviewed using a digital camera installed in an electron microscope. There were a total of 53 cases from 53 Saudi patients aged 2-70 years old. The mean GBM thickness for all cases was 323.6 ± 49.5 nm. There was no significant statistical difference in the mean GBM thickness between males and females. There were significant differences in the mean GBM thickness between all age groups, except for between the age groups 18-60 and >60 years old, where GBM thickness did not differ significantly. Age was significantly correlated with definite progression or diminution in the thickness of the GBM. The mean GBM thickness in our Saudi sample population was comparable to the very few reported measurements in the literature. There was no significant association between GBM thickness and gender; however, GBM thickness is directly proportional to age, up to 60 years old.


Assuntos
Membrana Basal Glomerular/ultraestrutura , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Microscopia Eletrônica de Transmissão , Pessoa de Meia-Idade , Arábia Saudita , Adulto Jovem
14.
Saudi J Kidney Dis Transpl ; 27(2): 305-11, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26997383

RESUMO

Lupus nephritis (LN) is characterized by a highly variable clinical course. It has been reported that histopathologic lesions are risk factors for the progression of LN. The aim of this study is to investigate the relationship among the co-deposition of C1q, clinicopathological features, and renal outcomes in patients with LN. The clinical and histological parameters were studied in patients with International Society of Nephrology/Renal Pathology Society Class III or IV LN, who underwent two kidney biopsies. The patients were divided into two groups based on the glomerular C1q deposits: C1q-positive and C1q-negative. The impact of C1q status and longterm renal outcome on the doubling of serum creatinine and the rate of remission in the two groups were further investigated. Fifty-three patients had pure proliferative nephritis and 37.7% of these had a co-deposition of C1q. Doubling of serum creatinine was observed in 25% of patients with C1q-positive and 24.2% of patients with C1q-negative deposits. There was no difference between the two groups in terms of achieving complete or partial remission. The renal survival in the two groups was similar (P = 0.75). Upon repeat biopsy, the persistence of C1q positivity was associated with a poor outcome (P = 0.007). C1q deposition in the glomerulus in the baseline biopsy was not associated with a poor renal outcome or severe pathologic features in patients with proliferative LN. However, the persistence of C1q positivity in repeat kidney biopsy is associated with a poor renal outcome.


Assuntos
Proliferação de Células , Complemento C1q/metabolismo , Rim/imunologia , Nefrite Lúpica/diagnóstico , Adolescente , Adulto , Biomarcadores/metabolismo , Biópsia , Creatinina/sangue , Feminino , Humanos , Rim/metabolismo , Nefrite Lúpica/imunologia , Nefrite Lúpica/patologia , Nefrite Lúpica/terapia , Masculino , Valor Preditivo dos Testes , Indução de Remissão , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
15.
Int J Clin Exp Pathol ; 8(5): 5787-92, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26191298

RESUMO

OBJECTIVES: Although necrotic lesions are common in proliferative lupus nephritis (LN), little is known about the impact of these lesions on outcomes. This study was undertaken to investigate the impact of glomerular necrotic lesions on renal outcomes of doubling serum creatinine in patients with class III and IV LN and necrotic lesions. METHODS: 52 patients with ISN/RPS class III or IV LN were enrolled in this retrospective study, with mean follow-up of 7.4 years. All patients underwent a repeat biopsy at 12-18 months after a baseline biopsy. RESULTS: The prevalence of necrotizing lesions was observed in 24% of those with class III versus 70.4% with class IV (P=0.001). The rate of no remission was 44% and 22.2% in those with and without necrosis (P=0.007), respectively. The doubling of serum creatinine was observed in 32% of those with necrosis and in 14.8% with no necrosis (P=0.01). The chronicity index in the repeat biopsy was significantly worse among those with necrosis. CONCLUSIONS: Glomerular necrosis identifies lupus nephritis patients at the greatest risk for progression to renal failure. Proactive intervention and possibly more aggressive induction therapies in patients with necrotizing lesions may protect the kidneys from developing chronic renal impairment.


Assuntos
Glomérulos Renais/patologia , Nefrite Lúpica/patologia , Adulto , Progressão da Doença , Feminino , Humanos , Masculino , Necrose , Estudos Retrospectivos
16.
J Coll Physicians Surg Pak ; 25(5): 332-6, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26008657

RESUMO

OBJECTIVE: To determine the histological features of renal biopsies of Systemic Lupus Erythematosus (SLE) patients with and without antiphospholipid antibodies in Saudi population. STUDY DESIGN: Cross-sectional, comparative study. PLACE AND DURATION OF STUDY: King Khalid University Hospital, Riyadh, Saudi Arabia, from January to December 2013. METHODOLOGY: Consecutive SLE patients admitted to King Khalid University Hospital, Riyadh for renal biopsy for evaluation of proteinuria or deterioration of renal function were recruited. SLE patients with renal involvement were divided in two groups. Group one included patients with positive APS antibodies and group two included patients with negative APS antibodies. The histological features of renal biopsies of the two patients groups were compared. Data was analyzed using simple statistical analysis. RESULTS: The mean age of APS antibodies-positive patients was 30.37 ± 10.714 years while mean age of APS negative patients was 33.62 ± 11.717 years (p=0.224). Twenty five (83.33%) patients were females and 5 (16.67%) patients were males in APS positive patients while 42 (89.36%) were females and 5 (10.63%) were males in group two. Acute lesions like thrombotic microangiopathy were in 2 (6.7%) of APS positive patients while chronic lesions like focal cortical atrophy was found in 6 (20%) and fibrous intimal hyperplasia was found in 9 (30%). Other significant histological findings in APS antibodies positive group were glomerular basement membrane wrinkling in 12 (40%), glomerular double wall contour in 17 (56.7%), fibrous adhesions in 11 (36.7%) patients with APS antibodies. CONCLUSION: Systemic Lupus Erythematosus (SLE) patients with positive APS antibodies has specific histological findings suggesting an important role of APS antibodies in the pathogenesis of APS nephropathy.


Assuntos
Anticorpos Antifosfolipídeos/imunologia , Síndrome Antifosfolipídica/patologia , Nefropatias/imunologia , Rim/patologia , Lúpus Eritematoso Sistêmico/patologia , Microvasos/patologia , Adulto , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/epidemiologia , Biópsia por Agulha Fina , Estudos Transversais , Feminino , Humanos , Nefropatias/etiologia , Nefropatias/patologia , Lúpus Eritematoso Sistêmico/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Arábia Saudita/epidemiologia , Adulto Jovem
17.
J Hand Surg Am ; 40(7): 1377-81, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25899181

RESUMO

We report a patient who developed a delayed hypersensitivity reaction to a polypropylene suture used in flexor pollicis longus repair. We also review the literature and aim to increase the awareness of hand surgeons to the presentation, diagnosis, and management of these rare cases.


Assuntos
Traumatismos dos Dedos/cirurgia , Hipersensibilidade Tardia/etiologia , Polipropilenos/efeitos adversos , Suturas/efeitos adversos , Traumatismos dos Tendões/cirurgia , Adulto , Humanos , Masculino
18.
Middle East Afr J Ophthalmol ; 21(3): 287-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25100920

RESUMO

Angiokeratoma is a rare, usually acquired muco-cutaneous wart-like vascular lesion that is frequently reported in the scrotum. Bleeding may occur if angiokeratoma is excoriated or traumatized. We report an exceedingly rare solitary eyelid angiokeratoma in an otherwise normal middle aged male. Our case represents the second case in the English peer reviewed literature since 1966, when the first case of eyelid angiokeratoma was reported.


Assuntos
Angioceratoma/patologia , Neoplasias Palpebrais/patologia , Neoplasias Cutâneas/patologia , Angioceratoma/cirurgia , Neoplasias Palpebrais/cirurgia , Humanos , Masculino , Neoplasias Cutâneas/cirurgia
19.
Ultrastruct Pathol ; 38(5): 303-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24956069

RESUMO

BACKGROUND/AIM: Effacement of the epithelial cell foot processes of glomerular podocytes are thought to be diffuse in the primary form of focal and segmental glomerulosclerosis (FSGS). In contrast, effacements that occur in the secondary form of FSGS are thought to be focal. To evaluate this theory, the extent of epithelial cell foot process effacement was analyzed and compared in podocytes from cases of primary and secondary FSGS. METHODS: Consecutive cases of adult primary and secondary FSGS that were diagnosed between January 1997 and December 2010 were retrospectively retrieved and analyzed. The electron microscopy materials of all specimens were reviewed. Glomerular podocytes from each sample were counted, recorded and analyzed for the percentage of diffuse versus focal epithelial foot process effacement. RESULTS: Seventeen primary and 16 secondary FSGS specimens were reviewed. In the 17 primary FSGS cases, 35.1% of the podocytes were focally fused, and 64.9% were diffusely fused. In the 16 secondary FSGS cases, 72.1% of the podocytes were focally fused. There were significantly more focally fused podocytes in secondary FSGS than in primary FSGS. In contrast, significantly more diffusely fused podocytes were observed in primary FSGS than in secondary FSGS. CONCLUSION: This is the first study to perform a quantitative analysis of the extent of epithelial cell foot process effacement in podocytes in primary and secondary FSGS. This study also confirms that the electron microscopic characteristics of the podocyte effacement process can be used to facilitate the diagnosis of primary versus secondary FSGS.


Assuntos
Células Epiteliais/ultraestrutura , Glomerulosclerose Segmentar e Focal/patologia , Glomérulos Renais/patologia , Podócitos/ultraestrutura , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Microscopia Eletrônica/métodos , Pessoa de Meia-Idade , Adulto Jovem
20.
Saudi J Kidney Dis Transpl ; 25(3): 539-43, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24821149

RESUMO

Tubulo-reticular inclusions (TRIs) are organized subcellular structures that may be found in endothelial cells of patients with systemic lupus erythematosus (SLE). This study was conducted to determine the presence or absence of TRIs and their correlation with the activity index (AI) and lupus nephritis (LN) class. A retrospective analysis of 57 cases of LN over a three-year period (2008-2011) was performed from medical records of the King Khalid University Hospital (KKUH), Riyadh. After reviewing and sorting them by class as per the International Society of Nephrology (ISN/RPS) 2004 classification of LN, the cases were divided according to the presence or absence of TRIs. The relationships between the presence or absence of TRIs and the AI were determined. Of the 57 kidney biopsies reviewed, 49 were proliferative cases (Class III and IV), of which 12 (24.5%) had TRIs. The mean AI was 6.01 ± 3.8 and the mean chronic index was 3.0 ± 1.5. Four (11.4%) class IV cases had a high AI, while no Class III cases with TRIs showed increased activity. The presence of TRIs was significantly associated with the AI (r = 9.40, P = 0.002), but not with LN class (r = 0.099, P = 0.753). Examining for TRIs in LN is still favorable and helpful in cases where the diagnosis of SLE is pending or not yet established, although the presence of TRIs is not a specific finding.


Assuntos
Corpos de Inclusão/ultraestrutura , Túbulos Renais/ultraestrutura , Nefrite Lúpica/patologia , Biópsia , Proliferação de Células , Hospitais Universitários , Humanos , Nefrite Lúpica/terapia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Arábia Saudita , Índice de Gravidade de Doença
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