RENAL HISTOLOGY DURING TREATMENT WITH OXAZOLIDINE-DIONES (TRIMETHADIONE, ETHADIONE, AND PARAMETHADIONE)

PEDIATRICS ◽  
1962 ◽  
Vol 30 (4) ◽  
pp. 601-607
Author(s):  
A. Bergstrand ◽  
C. G. Bergstrand ◽  
N. Engström ◽  
K. M. Herrlin
Keyword(s):  
Electron Microscopy ◽  
Nephrotic Syndrome ◽  
Renal Disease ◽  
Renal Biopsy ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Present Knowledge ◽  
Short Report ◽  
Renal Histology ◽  
Renal Changes

Seven patients with petit mal seizures treated with trimethadione, ethadione, or paramethadione for long periods were subjected to renal biopsy at the age of 14½ 16½ years. None of the patients had clinical signs of renal disease at the time of the biopsy, but three of them had previously shown transient hematuria or proteinuria. The renal histology was studied by conventional methods and by electron microscopy, the latter method only including the glomeruli. The changes found must with the present knowledge be regarded as physiological. A short report is given of a patient with phenylketonuria and epilepsy who developed a nephrotic syndrome during treatment with tridione. No definite pathologic renal changes were demonstrated at the when the clinical symptoms had disappeared.

scholarly journals Histologic Variants of FSGS: An Epidemiological and Pathological Perspective.

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Shaheera Shakeel ◽  
Rahma Rashid ◽  
Muhammed Mubarak
Keyword(s):  
Chronic Kidney Disease ◽  
Nephrotic Syndrome ◽  
Kidney Disease ◽  
Renal Disease ◽  
Renal Biopsy ◽  
End Stage Renal Disease ◽  
The World ◽  
Stage Renal Disease ◽  
End Stage

Focal segmental glomerulosclerosis (FSGS) is a conglomerate of glomerular pathological lesions unified by the segmental distribution of proliferative, sclerosing or collapsing lesions in less than 50% of glomeruli (i.e., focal distribution) in the early stages of the process and can only be diagnosed on renal biopsy. Epidemiologically, FSGS has acquired the top position among the causes of nephrotic syndrome (NS) in adults in many parts of the world and has emerged as the main cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. Numerous approaches have been used to classify this lesion, but all have merits and demerits and no one system is entirely satisfactory. One of the popular schemes for the classification is based on morphological features and distribution of the lesions in the glomeruli, the so-called Columbia classification of FSGS. In this review, we briefly summarize the relevant epidemiology and pathology of FSGS variants in the light of our own experience with the use of this classification.

scholarly journals Susceptibility of Exopalaemon carinicauda to the Infection with Shrimp Hemocyte Iridescent Virus

2019 ◽  
Author(s):  
Xing Chen ◽  
Liang Qiu ◽  
Hailiang Wang ◽  
Peizhuo Zou ◽  
Xuan Dong ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Clinical Symptoms ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Taqman Probe ◽  
Exopalaemon Carinicauda ◽  
Hematopoietic Tissue ◽  
Iridescent Virus ◽  
Transmission Electron

In this study, ridgetail white prawns Exopalaemon carinicauda were infected per os with debris of Shrimp hemocyte iridescent virus (SHIV)-infected Penaeus vannamei and via intramuscular injection (im) with raw extracts of SHIV. The infected E. carinicauda showed obvious clinical symptoms, including weakness, empty gut and stomach, pale hepatopancreas, and partial death with cumulative mortality of (50.0±26.5)% and (76.7±18.3)%, respectively. Results of TaqMan probe based real-time quantitative PCR showed that the moribund and survival individuals with clinical signs of infected E. carinicauda were SHIV-positive. Histological examination showed that there were dark eosinophilic inclusions, of which some were surrounded with or contained tiny basophilic staining, and pyknosis in cytoplasm of hemocytes in the hepatopancreatic sinus, hematopoietic cells, and cuticular epithelium, etc. Positive hybridization signals were observed in stomach, hematopoietic tissue, cuticular epithelium, and hepatopancreatic sinus of infected prawns from both per os and im groups, according to the results of in situ DIG-labeling-loop-mediated DNA Amplification (ISDL). Transmission electron microscopy of ultrathin sections showed that icosahedral SHIV particles existed in hepatopancreatic sinus and gills of the infected E. carinicauda of the per os group. The viral particles were also observed in the hepatopancreatic sinus, gills, pereiopods, muscles, and uropods of the infected E. carinicauda from the im group. The assembled virions mostly distributed outside of the assembling area near cellular membrane of infected cells, which were with envelope and about 150 nm in diagonal diameter. The results of molecular biological tests, histopathological examination, ISDL, and transmission electron microscopy confirmed that E. carinicauda is one of the susceptible hosts of SHIV. This study also reminded that E. carinicauda showed some degree of tolerance to the infection with SHIV per os challenge mimicking natural pathway.

Clinical Electron Microscopy of the Glomerulus in Human Renal Disease

1969 ◽  
Vol 27 ◽  
pp. 208-209
Author(s):  
R. V. Weimer ◽  
C. E. Rupe ◽  
J. H. L. Watson
Keyword(s):  
Electron Microscopy ◽  
Systemic Lupus Erythematosus ◽  
Nephrotic Syndrome ◽  
Basement Membrane ◽  
Renal Disease ◽  
Clinical Significance ◽  
Lupus Erythematosus ◽  
Significant Contribution ◽  
Systemic Lupus ◽  
Glomerular Lesions

Electron microscopy of the glomerulus in human renal disease has yielded much data of clinical significance. Two predominant classifications of glomerular pathology are met: proliferative and membranous transformations. The latter is further divisible into those with or without deposits, usually associated with the capillary basement membrane BM. A precise ultrastructural classification would be a significant contribution to diagnosis. Seven of the classical glomerular lesions will be presented. The figures represent four of them. Three others will also be given in the demonstration viz. "Systemic" Lupus Erythematosus, Amyloidosis and The Nephrotic Syndrome.

Acute Human Parvovirus B19 Infection and Nephrotic Syndrome in Patients with Sickle Cell Disease

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4816-4816
Author(s):  
Lynn Quek ◽  
Claire Sharpe ◽  
Neelanjana Dutt ◽  
David Rees ◽  
Sue Height ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Sickle Cell Disease ◽  
Renal Biopsy ◽  
Sickle Cell ◽  
Interstitial Fibrosis ◽  
Parvovirus B19 ◽  
Human Parvovirus B19 ◽  
Cell Disease ◽  
Renal Histology ◽  
Collapsing Fsgs

Abstract Human Parvovirus B19 (HPV B19) infection has previously been thought to be a trigger of nephrotic syndrome. The virus is associated with significant morbidity in patients with sickle cell disease (SCD) and a major cause of transient red cell aplasia (TRCA). We report three patients with SCD who presented with TRCA secondary to acute HPV B19 infection who subsequently developed significant proteinuria and nephrotic syndrome (NS) on outpatient follow up. There were 37 cases of acute HPV B19 infection in SCD patients admitted to King’s College Hospital between November 2002 and July 2008. 29 cases were in children below the age of 16 years, eight in patients over the age of 16 years. The average age of the cohort was just over 11 years at diagnosis. Three patients developed NS within 4 months of acute HPV B19 infection and TRCA. Two of these patients were aged 17 and 26 years at diagnosis (patient 1 and 2 respectively), whereas the third was a child aged 11 (patient 3). Renal histology demonstrated the collapsing variant of focal segmental glomerulosclerosis (FSGS) in the acute phase of NS in patient 1, a characteristic finding associated with HPV B19-associated nephrotic syndrome. A subsequent biopsy in the same patient two years later demonstrated non-collapsing FSGS and marked interstitial fibrosis. Patient 2 had a renal biopsy performed 4 months after the onset of NS. This demonstrated non-collapsing FSGS, acute sickle nephropathy and significant chronic tubular atrophy. Patient 3 also had a renal biopsy 1 year after her acute HPV B19 infection which demonstrated the cellular variant of FSGS. Patient 1 was treated with immunosuppression and although the NS has improved slowly he continues to have significant proteinuria and progressive renal impairment. Patient 2 has not received immunosuppressive therapy and has also slowly improved from her NS but continues to have significant proteinuria; her estimated GFR has fallen from 169 ml/min to 104 ml/min six months after the acute HPV B19 infection. Patient 3 was treated with corticosteroids with subsequent improvement in serum albumin and symptoms but proteinuria persists with normal renal function. Consistent with previous reports, we observe that NS is a relatively rare complication of HPV B19 infection in young children with SCD (one case in 29 in our cohort). However, two out of eight patients older than 16 years developed this complication. Proteinuria in patients with SCD is common and gradual in onset, and eventually may progress to NS. Nephrotic syndrome of acute onset in adults with SCD is rare, only two cases were observed during a 6-year period among our cohort of over 400 adult patients with SCD. In both cases, they were associated with recent HPV B19 infection. It has previously been noted that acute HPV B19 infection in older patients with HbSC SCD have a more severe clinical course than younger children (Smith-Whitley et al., 2004). Our data, though limited by small numbers in the cohort, suggest that older SCD patients with acute HPV B19 infection may be more susceptible to chronic complications including the development of NS and progressive renal fibrosis. A correct diagnosis of the aetiology of NS is vitally important as the HPV B19-associated condition may not be responsive to corticosteroids, unlike other aetiologies of NS in this age group. It is possible that antiviral therapy may be of benefit in the acute setting but this needs further investigation. Furthermore, immunisation of older children and young adults who are HPV B19-naïve may be effective in preventing an important contributor of chronic renal disease in SCD patients.

Minimal change disease

2019 ◽  
pp. 175-224
Author(s):  
Claudio Ponticelli ◽  
Richard J Glassock ◽  
Rosanna Coppo
Keyword(s):  
Electron Microscopy ◽  
Nephrotic Syndrome ◽  
Light Microscopy ◽  
Renal Biopsy ◽  
Minimal Change Disease ◽  
The Elderly ◽  
Minimal Change ◽  
Common Cause ◽  
Foot Process

This chapter discusses minimal change disease (MCD), which is chiefly characterized clinically by episodes of nephrotic syndrome (NS) and presents with massive proteinuria, hypo-albuminaemia, hyperlipidaemia, and generalized oedema, Morphologically, it is characterized by no or only minimal glomerular abnormalities in a renal biopsy examined by light microscopy and immunofluorescence, while there is diffuse effacement of the podocyte foot process by electron microscopy. MCD is the most common cause of NS in children but it may also develop at any age, including in the elderly. This chapter covers the pathology, presentation, and treatment of MCD, including practical tips for the practitioner.

A case of minimal change disease during pregnancy – Benefits of early diagnosis and use of corticosteroids

2021 ◽  
pp. 1753495X2199021
Author(s):  
Priyanka S Sagar ◽  
Eddy Fischer ◽  
Muralikrishna Gangadharan Komala ◽  
Bhadran Bose
Keyword(s):  
Nephrotic Syndrome ◽  
Early Diagnosis ◽  
Renal Biopsy ◽  
Early Pregnancy ◽  
Minimal Change Disease ◽  
Minimal Change ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Prompt Diagnosis ◽  
In Pregnancy

Nephrotic syndrome presenting in pregnancy is rare and poses a diagnostic and therapeutic challenge. Timing of renal biopsy is important given the increased risk of bleeding and miscarriage, and the choice of immunosuppression is limited due to the teratogenicity profiles of standard drugs. We report and discuss a case of minimal change disease diagnosed by renal biopsy during early pregnancy and treated with corticosteroids throughout the pregnancy. Prompt diagnosis and treatment of glomerular disease in pregnancy are vital to prevent poor maternal and fetal outcomes.

scholarly journals The Continuing Need for Electron Microscopy in Examination of Medical Renal Biopsies: Examples in Practice

2021 ◽  
pp. 1-15
Author(s):  
Michifumi Yamashita ◽  
Mercury Y. Lin ◽  
Jean Hou ◽  
Kevin Y.M. Ren ◽  
Mark Haas
Keyword(s):  
Electron Microscopy ◽  
Renal Biopsy ◽  
Renal Allograft ◽  
Comprehensive Evaluation ◽  
Diagnostic Value ◽  
Ultrastructural Studies ◽  
The Past ◽  
Biopsy Diagnosis ◽  
Renal Biopsies ◽  
Clinical Consequences

<b><i>Background:</i></b> For the better part of the past 6 decades, transmission electron microscopy (EM), together with routine light microscopy and immunofluorescence and/or immunohistochemistry (IHC), has been an essential component of the diagnostic workup of medical renal biopsies, particularly native renal biopsies, with increasing frequency in renal allograft biopsies as well. Studies performed prior to the year 2000 have indeed shown that a substantial fraction of renal biopsies cannot be accurately diagnosed without EM. Still, EM remains costly and labor-intensive, and with increasing pressure to reduce healthcare costs, some centers are de-emphasizing diagnostic EM. This trend has been coupled with advances in IHC and other methods in renal biopsy diagnosis over the past 2–3 decades. <b><i>Summary:</i></b> Nonetheless, it has been our experience that the diagnostic value of EM in the comprehensive evaluation of renal biopsies remains similar to what it was 20–30 years ago. In this review, we provide several key examples from our practice where EM was essential in making the correct renal biopsy diagnosis, ranging from relatively common glomerular lesions to rare diseases. <b><i>Key Messages:</i></b> EM remains an important component of the diagnostic evaluation of medical renal biopsies. Failure to perform EM in certain cases will result in an incorrect diagnosis, with possible clinical consequences. We strongly recommend that tissue for EM be taken and stored in an appropriate fixative and ultrastructural studies be performed for all native renal biopsies, as well as appropriate renal allograft biopsies as recommended by the Banff consortium.

scholarly journals Concentrations of canine prostate specific esterase, CPSE, at baseline are associated with the relative size of the prostate at three-year follow-up

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Bodil S. Holst ◽  
Sofia Carlin ◽  
Virginie Fouriez-Lablée ◽  
Sofia Hanås ◽  
Sofie Ödling ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Specific Antigen ◽  
Relative Size ◽  
Clinical Signs ◽  
Serum Concentrations ◽  
Prostatic Disease ◽  
Follow Up Study ◽  
Prostate Size ◽  
Prostate Growth

Abstract Background Enlargement of the prostate is associated with prostatic diseases in dogs, and an estimation of prostatic size is a central part in the diagnostic workup. Ultrasonography is often the method of choice, but biomarkers constitute an alternative. Canine prostate specific esterase (CPSE) shares many characteristics with human prostate specific antigen (PSA) and is related to prostate size. In men with clinical symptoms of prostatic disease, PSA concentrations are related to prostate growth. The aims of the present follow-up study were to evaluate if the concentration of CPSE is associated with future growth of the prostate, and if analysis of a panel of 16 steroids gives further information on prostatic growth. Owners of dogs included in a previous study were 3 years later contacted for a follow-up study that included an interview and a clinical examination. The prostate was examined by ultrasonography. Serum concentrations of CPSE were measured, as was a panel of steroids. Results Of the 79 dogs included at baseline, owners of 77 dogs (97%) were reached for an interview, and 22 were available for a follow-up examination. Six of the 79 dogs had clinical signs of prostatic disease at baseline, and eight of the remaining 73 dogs (11%) developed clinical signs between baseline and follow-up, information was lacking for two dogs. Development of clinical signs was significantly more common in dogs with a relative prostate size of ≥2.5 at baseline (n = 20) than in dogs with smaller prostates (n = 51). Serum concentrations of CPSE at baseline were not associated with the change in prostatic size between baseline and follow-up. Serum concentrations of CPSE at baseline and at follow-up were positively associated with the relative prostatic size (Srel) at follow-up. Concentrations of corticosterone (P = 0.024), and the class corticosteroids (P = 0.0035) were positively associated with the difference in Srel between baseline and follow-up. Conclusions The results support the use of CPSE for estimating present and future prostatic size in dogs ≥4 years, and the clinical usefulness of prostatic size for predicting development of clinical signs of prostatic disease in the dog. The association between corticosteroids and prostate growth warrants further investigation.

scholarly journals Clinical manifestations of focal segmental glomerulosclerosis in Japan from the Japan Renal Biopsy Registry: age stratification and comparison with minimal change disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takaya Ozeki ◽  
Shoichi Maruyama ◽  
Toshiyuki Imasawa ◽  
Takehiko Kawaguchi ◽  
Hiroshi Kitamura ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
Focal Segmental Glomerulosclerosis ◽  
Clinical Diagnosis ◽  
Clinical Characteristics ◽  
Minimal Change Disease ◽  
Multivariable Analysis ◽  
Laboratory Data ◽  
Minimal Change ◽  
Segmental Glomerulosclerosis

AbstractFocal segmental glomerulosclerosis (FSGS) is a serious condition leading to kidney failure. We aimed to investigate the clinical characteristics of FSGS and its differences compared with minimal change disease (MCD) using cross-sectional data from the Japan Renal Biopsy Registry. In Analysis 1, primary FSGS (n = 996) were stratified by age into three groups: pediatric (< 18 years), adult (18–64 years), and elderly (≥ 65 years), and clinical characteristics were compared. Clinical diagnosis of nephrotic syndrome (NS) was given to 73.5% (97/132) of the pediatric, 41.2% (256/622) of the adult, and 65.7% (159/242) of the elderly group. In Analysis 2, primary FSGS (n = 306) and MCD (n = 1303) whose clinical diagnosis was nephrotic syndrome (NS) and laboratory data were consistent with NS, were enrolled. Logistic regression analysis was conducted to elucidate the variables which can distinguish FSGS from MCD. On multivariable analysis, higher systolic blood pressure, higher serum albumin, lower eGFR, and presence of hematuria associated with FSGS. In Japanese nationwide registry, primary FSGS patients aged 18–64 years showed lower rate of NS than those in other ages. Among primary nephrotic cases, FSGS showed distinct clinical features from MCD.

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