Biomedical subjects

A R Vilches

Publications and source records attributed to A R Vilches.

13 recordsLinked to original sources

PubMed1988

Mesangial deposits: is it a distinct pathological entity?

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Glomerular Mesangium↗

PubMed1984

Persistent anti-DNA antibodies and DNA-anti-DNA complexes in post-streptococcal glomerulonephritis.

Two patients with the typical clinical, serological and pathological features of acute post-streptococcal glomerulonephritis were found to have elevated serum concentrations of DNA-anti-DNA complexes, and, in one case, of anti-DNA antibody, both single and double stranded. The DNA-anti-DNA complexes were found to persist for 15 and 21 months respectively following the initial illness, despite rapid resolution of the clinical features and severe renal dysfunction. It is suggested that the DNA-anti-DNA complexes may have a pathogenetic role in post-streptococcal nephritis, or alternatively act as a marker of those patients who will develop nephritis after a streptococcal infection.

Acute Disease↗

PubMed1983

Late onset systemic lupus erythematosus and lupus-like disease in patients with apparent idiopathic glomerulonephritis.

We report 17 patients who presented with either apparent idiopathic glomerulonephritis (16 patients) or post-streptococcal glomerulonephritis (one patient). Doubts arose about the nature of these patients' disease, either because their initial renal histology was suggestive of systemic lupus erythematosus (SLE) in the absence of its clinical or serological features, or because they developed with time the clinical or serological features of SLE. Three patients had a positive antinuclear antibody (ANA) test at the onset of their illness, but normal levels of serum binding of double-stranded DNA (dsDNAB). In another four patients the dsDNAB was slightly raised but with a negative ANA. On renal biopsy the predominant appearance was membranous glomerulonephritis (GN) in 10, subendothelial mesangiocapillary GN (MCGN) in three, and focal segmental glomerulosclerosis in two; one patient each had a focal proliferative GN and a diffuse endocapillary GN. On 1 micron renal sections stained with toluidine blue, 10 patients had immune deposits at multiple sites within the glomeruli. Over a period of one to 14 years, six patients developed extrarenal features suggestive of SLE, nine a positive ANA, and 12 increased serum levels of dsDNAB. Five patients became hypocomplementaemic. Cryoglobulins were isolated from the sera of 10 out of 12 patients; seven contained DNA. Separated cryoglobulin IgG from eight patients showed antibody activity directed against both ss and dsDNA in four, and against dsDNA only in three. On the basis of the clinical, histological and serological observation during follow-up five patients were reclassified as definite SLE, four as probable SLE and two as possible SLE. Rarely, SLE may present with nephritis as the sole disease manifestation, antedating other clinical features and even immunological markers of the disease by years. In addition, some patients with a glomerulonephritis may show clinical and immunological, or histological features of SLE, but do not fit accepted definitions of the disease.

Adolescent↗

PubMed1982

Significance of mesangial IgM deposition in "minimal change" nephrotic syndrome.

During a 6-year period, 64 patients with a nephrotic syndrome, shown histologically to result from minimal change nephropathy, were studied for a mean of 4.5 years. Fifty of the patients showed no glomerular immunoglobulin on immunofluorescent or immunoperoxidase study, but 14 had mesangial deposits of IgM. The onset characteristics, response to treatment, and long-term course were similar in the two groups. We conclude that IgM deposition in the mesangium in patients with minimal change nephrotic syndrome is of no prognostic value, and our data do not suggest that this group of patients, although a histopathologic entity, represent a clinically distinct group.

Adolescent↗

PubMed1982