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1.
Mod Rheumatol ; 25(3): 468-71, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-24252042

RESUMO

We present a case of idiopathic retroperitoneal fibrosis (IRF) complicated by severe renal failure and multiple intracranial lesions, which are probable results of cerebral vasculitis. IRF is an idiopathic hyperplasia of the retroperitoneal tissue that often entraps the ureters and causes post-renal failure. While the etiology of IRF is unclear, researchers consider IRF a systemic autoimmune disease complicated by immune-mediated vasculitides. The chief complaints of the patient were cognitive disorders, and brain MRI findings revealed multiple intracranial lesions with accompanying central degeneration. Given that vasogenic cerebral edemas derive from uremia, we speculated that the lesions in our case were related to more destructive changes such as aortic and periaortic inflammation. Details on this case manifesting rare cerebrovascular complications may help elucidate the pathogenesis of IRF.


Assuntos
Córtex Cerebral/patologia , Fibrose Retroperitoneal/complicações , Vasculite do Sistema Nervoso Central/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fibrose Retroperitoneal/patologia , Vasculite do Sistema Nervoso Central/patologia
2.
Pathol Int ; 61(11): 686-90, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22029682

RESUMO

Renal involvement is a significant complication of multicentric Castleman's disease (MCD) and various glomerular involvements have been reported. A 45-year-old Japanese man presented with persistent proteinuria, with lymphadenopathy and hypergammaglobulinemia. He had been diagnosed 4 years previously with MCD. As his renal impairment had progressed to renal failure, he underwent a renal biopsy. Histology revealed diffuse and global membranous lesions with large and heterogeneous epimembranous deposits. In addition, mesangial cell proliferation and focal extracapillary lesions were found. Under immunofluorescence, granular staining for anti-IgG, IgG1, IgG2 and IgA was strongly positive in the capillary loop, and weakly positive in the mesangium. As such, there was a diversity of histological features. Our perspective with regard to pathogenesis is that the formation of the immune-complex contributed to the membranoproliferative glomerulonephritis type 3-like lesion. This histological multiform with MCD is valuable for increasing our understanding of the mechanism for onset of immune-complex glomerular deposition and cellular proliferation of glomerulonephritis.


Assuntos
Hiperplasia do Linfonodo Gigante/patologia , Glomerulonefrite Membranoproliferativa/patologia , Rim/patologia , Insuficiência Renal/etiologia , Complexo Antígeno-Anticorpo/imunologia , Biópsia , Hiperplasia do Linfonodo Gigante/complicações , Hiperplasia do Linfonodo Gigante/imunologia , Diagnóstico Diferencial , Mesângio Glomerular/patologia , Glomerulonefrite Membranoproliferativa/complicações , Glomerulonefrite Membranoproliferativa/imunologia , Humanos , Hipergamaglobulinemia , Glomérulos Renais/patologia , Doenças Linfáticas , Masculino , Pessoa de Meia-Idade , Proteinúria
3.
J Neurol Sci ; 372: 417-420, 2017 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-27836107

RESUMO

BACKGROUND: Reduced glomerular filtration rate (GFR) and albuminuria have been independently associated with an increased risk of stroke and unfavorable long-term outcomes. However, the association between GFR, albuminuria, and early neurological deterioration (END) in patients with ischemic stroke has not been well studied to date. We therefore investigated the ability of estimated GFR (eGFR) and albuminuria to predict END in patients with acute ischemic stroke. METHODS: We retrospectively enrolled 294 patients that were admitted to our stroke center with acute ischemic stroke between January 2011 and September 2012. General blood and urine examinations, including eGFR and urinary albumin/creatinine ratio (UACR) measurements, were performed on admission. Kidney dysfunction was defined by a low eGFR value (<60mL/min/1.73m2) and/or increased albuminuria (≥30mg/g creatinine). END was defined as a ≥2-point increase in the National Institutes of Health Stroke Scale (NIHSS) score within 7days after admission. RESULTS: Kidney dysfunction was diagnosed in 200 of the 294 patients (68.0%). END was observed in 60 patients (20.4%). Age, blood glucose level on admission, UACR on admission, and NIHSS score on admission were significantly associated with END, while no relationship between eGFR on admission and END was identified. A multivariable logistic regression analysis showed that END was positively associated with high UACR (≥39.6mg/g creatinine) and a high NIHSS score (≥6 points). CONCLUSIONS: Our data suggest that high UACR on admission may predict END in patients with acute ischemic stroke. Larger prospective studies are required to validate the correlation between albuminuria and END.


Assuntos
Albuminúria/etiologia , Doenças do Sistema Nervoso/diagnóstico por imagem , Doenças do Sistema Nervoso/etiologia , Acidente Vascular Cerebral/complicações , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , Isquemia Encefálica/complicações , Creatinina/sangue , Feminino , Taxa de Filtração Glomerular/fisiologia , Hospitalização , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Valor Preditivo dos Testes , Curva ROC , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/etiologia
4.
Clin Exp Nephrol ; 13(2): 174-178, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19110655

RESUMO

A 29-year-old man with malignant lymphoma developed membranous nephropathy (MN) after allogeneic bone-marrow transplantation (BMT). There had been no obvious findings of graft versus host diseases (GVHD) after BMT, and the dosage of immunosuppressant drugs had not been reduced during this period. At the onset of MN, a few lymphoma cells still remained in the bone marrow; the patient achieved complete remission of MN after the disappearance of the lymphoma cells. In this case it is suggested that immune complexes including antigens expressed by lymphoma cells might induce MN. Therefore, this is a significant case that may reveal an alternative mechanism of the onset of MN related to BMT.


Assuntos
Transplante de Medula Óssea/efeitos adversos , Glomerulonefrite Membranosa/etiologia , Linfoma/complicações , Linfoma/terapia , Neoplasia Residual/complicações , Adulto , Transplante de Medula Óssea/imunologia , Glomerulonefrite Membranosa/imunologia , Humanos , Imunoglobulina G/imunologia , Rim/imunologia , Rim/patologia , Linfoma/imunologia , Masculino , Neoplasia Residual/imunologia , Indução de Remissão , Transplante Homólogo
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