Tubulointerstitial nephritis in methylmalonic acidemia.

We report two patients with methylmalonic acidemia (MMA) in whom renal biopsy demonstrated interstitial nephritis, bringing the total of such reported cases to four. In addition, hypertension, observed in one of our patients, has not been previously reported as the presentation of renal disease in MMA. The etiology of interstitial nephritis in MMA did not appear to be due to urate nephropathy.

Immunoproliferative small intestinal disease with duodenojejunal lymphoma: radiologic changes.

The radiologic changes in 1090 cases of lymphoma of the small bowel were analyzed and correlated with the pathologic findings. The material was collected in Iran, a high incidence area for immunoproliferative small bowel disease (IPSID). Of 100 cases of primary intestinal lymphoma associated with IPSID, 48 involved the duodenum and upper jejunum.

[Roentgenologic observations in small bowel lymphoma (author's transl)].

A comparison of the reontgenologic pattern of 100 cases of lymphoma of the small bowel with the clinical and pathological findings revealed three basic types: 1. The primary lymphoma with malabsorption, in which the classical tumor signs of the lymphoma are accompanied by signs of sprue in the nonlymphomatous mucosa. The disease is most severe in the duodenum and jejunum and less so in the ileal mucosa.

Epidemiologic studies of gastric carcinoma: comparison between Iranians and two racial groups in the USA.

Gastric carcinoma in 226 cases from the two major racial groups--black and white--in Richmond, VA, USA, and in 75 cases from Shiraz, Iran, were studied. The age at onset and the ratio of intestinal to diffuse gastric carcinoma were compared with those for the high- and low-risk groups from Colombia. Poor socioeconomic conditions are directly related to intestinalization of the gastric mucosa and onset of carcinoma at a relatively young age.

Gastrointestinal mucosa and primary gastrointestinal lymphoma.

The primary gastrointestinal lymphomas in Shiraz, Iran, and Richmond, Virginia, USA were compared. Upper duodenojejunal lymphoma is always associated with atrophy of the surrounding nonlymphomatous mucosa, plasma cell infiltration and formation of lymph follicles. This is frequently linked to repeated gastroenteritis leading to mucosal atrophy, mutation of plasma cell precursors and secretion of alpha-heavy-chain.

Endemic infantile pneumocystis carinii infection: the Shiraz study.

Orphanage epidemics of interstitial plasma cell pneumonia (IPCP) occur among premature infants whose passive immunity due to maternally transferred antibodies has lost its effectiveness before the infants' humoral immune systems have reached sufficient maturity to respond effectively to Pneumocystis carinii. IPCP occurs also among mature newborns receiving substandard care in understaffed and crowded orphanages. Infantile diarrhea in these institutions leads to marasmus and deficient immune response in infants 3-4 months after birth.

Therapy and prophylaxis of Pneumocystis carinii pneumonia.

Pentamidine isethionate and sulfadoxine plus pyrimethamine are excellent therapeutic agents in experimental and hypoergic, hypoimmune pneumocystosis as well as in focal interstitial plasma cell pneumonia (IPCP) in infants. Their effectiveness is seriously limited in cases in which either a diffuse massive plasma cell exudate has been established or in adults in whom the phagocytic and resorptive facility is depressed. Infantile pneumocystosis leading to IPCP can be completely prevented by proper feeding and care of the patient or prophylactic drug therapy with sulfadoxine-pyrimethamine.

[Considerations regarding the influence of intrauterine and early postnatal diseases and nutritional deficiencies on immunity and disease epidemiology (author's transl)].

Malnutrition, infectious and toxic stress, hormonal and enzymatic deficiencies as well as graft versus host reactions during the last trimester of pregnancy and during the first six months of life lead to persistent depressions of cell mediated immunity. The subsequent imbalance between the cell mediated and humoral system of immunity leads to differences in disease prevalence in poor and rich populations. Particularly leprosy, tuberculosis, viral disease as for instance frequently fatal measles and diseases due to complexes between humoral antibody and bacterial components as for example acute rheumatic fever occur with increased frequency in B (+) T (-) populations.

Persistent cell mediated immune-deficiency following infantile stress during the first 6 months of life.

The cell mediated immunity as expressed by 2,4 DNCB skin sensitivity was measured in 50 healthy Iranian orphans of the age from 15 years. Complete records of the development of these children from birth were available. Children with severe gastroenteritis leading to marasmus and temporary thymic atrophy during the first 6 months of life showed a persistent atopy 1-5 years later.

[Radiological evaluation of the course of pneumocystosis (author's transl)].

Serial chest X rays were performed on 124 infants in an orphanage with endemic Pneumocystic carinii infection. The infection was serologically and autoptically proven in 98 cases. The interstitial infiltrate in the lungs is not specific for Pneumocystis carinii infection, but is the result of the host reaction, which persists after the antigen has been destroyed.

Radiological changes in inhalation anthrax. A report of radiological and pathological correlation in two cases.

The radiological changes in two cases of inhalation anthrax are correlated with pathological findings. The earliest radiological sign was widening of the mediastinum, followed by prominent lung markings with peribronchial infiltration due to pulmonary oedema and haemorrhage. Associated pleural effusions are common, and non-specific super-imposed pulmonary infiltration may also be present.

Mycetoma in Iran.

The subject of mycetoma is reviewed and 7 cases are reported for the first time from southern Iran. Four were causes by Actinomyces israelii and one each by Nocardia asteroides, Actinomadura madurae and Allescheria boydii.