Renal lesions in AIDS: a biopsy and autopsy study.

We studied renal lesions at biopsy (20 cases) and at autopsy (21 cases) among patients with the acquired immune deficiency syndrome (AIDS). Nephrotic syndrome with concomitant renal insufficiency was most common indication for biopsy. 85 percent of biopsies showed features of HIV associated nephropathy (HIVAN) which include: Focal segmental glomerulosclerosis (FSGS), glomerular collapse and mesangial hyperplasia.

Morphometric study of the placental vessels and its correlation with umbilical artery Doppler flow.

Objective: To determine the changes in the vessel-wall thickness and the radius of the lumen in tertiary-stem villi of the placenta with advancing gestational duration and their relationship to umbilical artery Doppler flow studies.

Methods: Placentas from 63 miscarriages and preterm and term deliveries (between 19 and 40 weeks) were used for morphometric study of the tertiary-stem villi vessels. Each woman had undergone Doppler flow study of the umbilical artery.

Heat shock protein 72/73 in normal and diseased kidneys.

The induction of heat shock (stress) proteins (HSP) is a response by cells due to a variety of physical, chemical, and infectious agents. They have a significant role as cytoprotectants, in the regulation of cellular functions, and in the recovery after sublethal injury. Using antibody to mammalian HSP 72/73, we have performed as immunohistological study of human renal tissue in normal and diseased states, including idiopathic nephrotic syndrome, proliferative and crescentic glomerulonephritis, and interstitial nephritis.

Renal disease in Marfan syndrome.

We encountered 4 individuals with Marfan syndrome who presented with microhematuria and proteinuria. In 2 of them, a renal biopsy was performed. The predominant glomerular change by light microscopy was a focal segmental increase in mesangial matrix with early sclerotic lesions.

Adrenal pseudocyst: report of two cases.

Adrenal cysts are uncommon lesions. The authors discuss two cases of adrenal pseudocyst, and its classification and possible pathogenesis and complications. The role of radiologic findings in preoperative evaluation of renal/suprarenal masses also is detailed.

[A clinicopathological study of eighteen autopsy cases with acquired toxoplasmosis].

Eighteen autopsy cases of acquired toxoplasmosis in New York City were studied. Seventeen cases were with acquired immunodeficiency syndrome (AIDS) and one patient with Hodgkin's disease. All 18 cases involved the brain and nine of them disseminated to the heart (8 cases), lung (4 cases), pancreas (3 cases), alimentary tract (2 cases) and urogenital organs (3 cases).

Intraepidermal squamous carcinoma (Bowen's disease) of the nipple.

A case of Bowen's disease of the nipple clinically resembling Paget's disease is reported. This lesion was differentiated from other pagetoid lesions by negative histochemical stains for mucin and melanin, positive immunohistochemical preparation for high-molecular weight cytokeratin 66 kd (904) using adequate controls, and electron microscopic findings of squamous cell features. The therapeutic implications of such a pagetoid nipple lesion in the absence of an underlying breast carcinoma are discussed.

Fibrillary glomerulonephritis without immunoglobulin deposits in the kidney.

Three patients are presented, who by electron microscopy, showed prominent fibrillary deposits in the glomeruli, and in two, also around the tubules. By immunohistology these two cases had no immunoglobulins in either glomeruli or around the tubules. In the third case, which probably represents a slightly different form of the disease, minor deposits of IgM were found in the glomeruli, while fibrillary deposits were extensive and widespread.

Renal failure due to tubular obstruction by large protein casts in patients with massive proteinuria.

We describe two patients with nephrotic syndrome whose histologic findings on renal biopsy and at autopsy are characterized by numerous large protein casts in dilated cortical tubules, as well as podocyte swelling with effacement of foot processes in the glomeruli. Both patients progressed rapidly to renal failure. The casts and the protein precipitate in the Bowman's capsule were found to be composed of varying proportions of albumin and globulin but contained no Tamm-Horsfall protein.

Alkaptonuria and renal failure: a case report and review of the literature.

In alkaptonuric ochronosis, the absence of homogentisic acid oxidase results in the accumulation of homogentisic acid in the body. Associated renal failure is rare and usually occurs in the later stages of the disease. We report a 19-yr-old girl who presented initially with severe renal failure, without family or past history of illness.

Pathologic manifestations of the eosinophilia myalgia syndrome: analysis of 11 cases.

We describe the histopathologic changes of skin, muscle, vessels, and fascia in 11 patients with eosinophilia myalgia syndrome, a newly described entity that has been linked to the ingestion of L-tryptophan. This syndrome is defined clinically by severe incapacitating myalgias and a peripheral eosinophilia. Arthralgias, edema of the extremities, morbilliform rashes, skin induration, weakness, fatigue, and respiratory weakness may be present as well.

Gastric hemorrhage and Kaposi's sarcoma treated with radiotherapy.

A 66-year-old man, with advanced alcoholic liver disease with Kaposi's sarcoma involving the stomach and the skin of the lower extremities, developed upper gastrointestinal hemorrhage. He was treated with radiation therapy to the stomach and the skin with rapid resolution of the gastric lesions, as demonstrated by serial endoscopy.

Significance of cytoplasmic inclusions in lupus nephritis.

The report describes 22 cases of lupus nephritis (20 diffuse and 2 mesangial) showing frequent tubuloreticular inclusions (TRI) in the glomerular and peritubular capillary endothelial cells as well as cylindric confronting cisternae (CCC) mainly in interstitial infiltrating cells. Ten other cases of lupus nephritis that were actively treated or were in the sclerosing stage and did not show CCC were also studied. The presence of cytoplasmic inclusions correlated with various clinical and histologic parameters.

Mesangiocapillary glomerulonephritis in Down's syndrome.

The clinical and pathologic features of progressive renal disease in 4 patients with Down's syndrome are described. All patients were male, between 20 and 30 years of age at the time of clinical presentation. Three out of 4 had proteinuria, and 2 had hematuria.

Correlation of glomerular basement membrane alterations with clinical data in progressive hereditary nephritis (Alport's syndrome).

Electron microscopic examination of glomerular basement membrane (GBM) was performed in 19 patients whose morphological changes as well as clinical features indicated the diagnosis of progressive hereditary nephritis (Alport's syndrome). The percentage of characteristically thickened and split and of thin GBM portions was determined in all the cases. The clinical course was more severe in males, which corresponded to higher rate of GBM alterations.

Hepatitis-B-associated glomerulonephritis: pathology, pathogenesis, and clinical course.

Hepatitis-B-associated glomerulonephritis (HBGN) is a distinct entity occurring frequently in hepatitis-B-prevalent areas of the world. The disease affects both adults and children who are chronic hepatitis-B-virus (HBV) carriers with or without a history of overt liver disease. The diagnosis is established by serologic evidence of HBV antigens/antibodies, presence of an immune complex glomerulonephritis, immunohistochemical localization of 1 or more HBV antigens, and pertinent clinical history, when available.

Morphometric analysis of glomerular basement membranes (GBM) in thin basement membrane disease (TBMD).

We measured the thickness of glomerular basement membrane in 46 patients with thin basement membrane disease (TBMD), (age range 15-50 years, almost equal M:F ratio), and compared with that in a control group of 5 patients (age range 5-38 years) with normal glomerular morphology. The measurements of glomerular basement membrane taken from electron micrographs (magnification x 12,500) were analyzed using an interactive image analysis system assembled around an INTEL 10 microcomputer, with a high resolution touch sensitive screen as the interactive peripheral. Calculation was done by printing on an electron micrograph a grating replica (21,600 lines/cm), with the same magnification as the electron micrographs of the glomeruli and calibrating the arithmetic (AM) and harmonic (HM) mean for each case.

Acute hyperuricemic nephropathy and renal failure after transplantation.

This report describes a patient who was treated for rejection of a cadaveric renal allograft with a variety of drugs, including the continuous administration of ciclosporin over a period of 16 months. The patient developed hyperuricemia, attacks of gout and finally a rapidly progressing renal failure 17 months after transplantation. The removed transplanted kidney showed extensive tubular dilatation, intratubular deposits of uric acid crystals and characteristic granulomas.

Immunohistochemical localization of renin in end-stage kidneys.

Hypertension in chronic renal failure is usually due to excessive accumulation of salt and water. In some cases, sodium and volume depletion by dialysis fail to reduce the high BP, and plasma renin activity tends to be higher. We performed a semiquantitative analysis of the immunohistochemical distribution of renin in the kidneys of ten patients with end-stage renal disease and hypertension using a specific antihuman renin antibody and a peroxidase-antiperoxidase technique on paraffin sections of nephrectomy and/or autopsy specimens.

Colchicine therapy of the renal amyloidosis of ulcerative colitis.

Two patients with severe proteinuria, due to renal amyloidosis complicating chronic ulcerative colitis, improved remarkably with colchicine therapy. One patient with an initial daily urine protein excretion of 13.70 g had a reduction within 2 mo to 6.

Vascular lesions in lupus nephritis.

Three groups of kidney specimens from patients with systemic lupus erythematosus (SLE) were examined for histologic evidence of vascular lesions in small arteries and arterioles. Group 1 consisted of 24 autopsy kidneys from patients who died before the advent of steroid therapy, and Group 2, of 26 more recent autopsy specimens from patients treated with steroids and/or immunosuppressive drugs. Group 3 comprised 276 renal biopsies.

Nephropathy after combination chemotherapy of lymphoma.

Two patients with malignant (Hodgkin's and non-Hodgkin's lymphoblastic type) lymphoma developed chronic renal failure following prolonged combination chemotherapy and a course of radiotherapy to the para-aortic lymph nodes. The individual drugs used in both patients are believed to have very low or no nephrotoxic potential. The kidneys were shielded in a standard manner and no more than 200 rads reached the organs.