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G Gordillo

Publications and source records attributed to G Gordillo.

34 records · Page 2Linked to original sources
PubMedDate not supplied

Serologic evidences suggesting the presence of Borrelia burgdorferi infection in Mexico.

BACKGROUND: Lyme disease is the most common vector-borne human disease in Europe and the United States. In Mexico, clinical cases suggestive of Lyme borreliosis have been reported; however, infection was not confirmed by serologic or microbiologic tests. METHODS: To study the prevalence of IgG antibodies against Borrelia burgdorferi among Mexican persons, a community-based sero-survey including all states of Mexico was done. A sample of 2,890 sera representing individuals of all ages and all socioeconomic levels was studied. Antibodies anti-B. burgdorferi were determined by enzyme-linked immunosorbent assay (ELISA) using a whole-cell sonicated extract of B. burgdorferi strain B31. Serum specimens positive for ELISA were further studied by Western blot (WB). A serum sample was considered positive by WB if at least three of the following protein bands were recognized: 18, 24, 28, 29, 31, 34, 39, 41, 45, 58, 62, 66, and 93 kDa. Some WB positive specimens were further confirmed with an immunodot-blot (IDB) test using recombinant and purified B. burgdorferi proteins. RESULTS: Of the 2,890 specimens, 34 were positive for ELISA; nine of these 34 were confirmed as positive by WB. Four of the nine WB positive sera were tested by IDB and all four were positive. The prevalence of WB confirmed cases in the sample studied was 0.3%. Positive specimens were from residents of the northeastern and central areas of Mexico. CONCLUSIONS: The serological evidences of this study suggest that Borrelia burgdorferi infection is present in the Mexican population. This finding should be confirmed by documenting the infection in clinical cases and in tick vectors.

Adolescent↗
PubMedDate not supplied

Gonadal changes in nephrological patients treated with cyclophosphamide.

Therapeutic use of immunosupressive drugs in progressive renal diseases has increased during the last decade. Information concerned severe gonadal damage after such therapy, stresses the need for careful evaluation in each particular case before deciding to use these drugs. Gonadal lesions were investigated in 18 patients who were treated with cyclophosphamide and in one who received chlorambucil at variable doses and length of time; there were frequent relapses in patients with idiopathic nephrotic syndrome and with progressive forms of glomerulonephritis. Nine patients were females and received cyclophosphamide therapy at the ages of 11 a 16 years, being evaluated from 11 to 22 years of age with vaginal smears, gonadotropins and 17-ketosteroids. No alterations were found in these parameters and two of the girls became pregnant and had successful deliveries of healthy babies. Ten patients were males; one of them received chlorambucil and all the others received cyclophosphamide at the ages of 8 to 15 years; they were evaluated from 9 to 19 years of age. Because of their ages, gonadal function was not studied in 3 children, but the other 7 showed azoospermia, testicular atrophy was present in four out of these patients in whom testicular biopsy was performed. The patient who received chlorambucil was among this group. From these results and from the literature, we conclude: 1) immunosuppressive therapy is less risky in girls than in boys; 2) it is imperative to evaluate the risk/benefit ratio before deciding this therapy in any case and 3) doses not above 2 mg/kg/day and for periods no longer than 6 weeks may be considered safe.

Adolescent↗
PubMedDate not supplied

[Development and prognosis of diffuse endocapillary and focal extracapillary proliferative glomerulonephritis].

Early renal biopsies performed in children with primary nephritic syndrome of acute onset have identified various glomerular pathological patterns with distinct evolution. Complete recovery has been observed in those cases with diffuse endocapillary proliferation. However, progressive disease has resulted from most of the other forms. A histological type characterized by diffuse glomerular endocapillary proliferation with a variable number of glomeruli affected by extracapillary proliferation with crescents, has been observed. A diffuse form of this entity, that is, crescents in 80 to 100 per cent of the glomeruli, has been described in the so-called "rapidly progressive glomerulonephritis". This lesion usually progresses to renal insufficiency in less than six months. Information concerning the focal form, that is, the presence of crescents in less than 80 per cent of the glomeruli, is limited and the long-term prognosis of this morphological finding has not been conclusively established. This communication deals with: 1) history and initial clinical features in 48 patients with focal endo and extracapillary glomerulonephritis, and 2) the correlations between streptococcal etiology, initial features, percentage of glomeruli with crescents and the final outcome, in 27 cases followed for more than two years. Age of patients at the onset of the disease was between 11 months and 14 years; 63 percent of the patients were male. Streptococcal infection was documented in 20 out of the 48 cases. Nephritic syndrome at onset was found in all the 48 cases. Twenty-nine patients had significant proteinuria and in 16 of these, the characteristics of the nephrotic syndrome were also present; 10 patients presented severe arterial hypertension and in other 6, acute renal failure was an initial feature.

Acute Kidney Injury↗
PubMedDate not supplied

[Recurrent hematuria of glomerular origin].

Nine hundred and forty children with hematuria were admitted to the nephrology service from 1958 to 1973. Percutaneous renal biopsies were performed in all of them. Thirty cases out of this group had recurrent hematuria and constitute the clinical material of this study. The clinical picture was: acute nephrotic syndrome in 19; monosymptomatic hematuria in 8, anaphylactoid purpura nephritis in 2, and hematuria associated with nephrotic syndrome in one patient. All patients with nephritic syndrome showed in their biopsies various types of glomerular lesions; most of the patients with monosymptomatic hematuria had normal glomeruli; at the light microscopy, the immunofluorescence was positive in some of them. Both patients with anaphylactoid nephritis showed diffuse endocapillary and focal extracapillary proliferation and in the only one with nephrotic syndrome, the hematuria was familial and the biopsy showed features of Alport's syndrome. Twenty-four patients who were followed for over two years showed no relationship between the age of onset, sex, initial significant proteinuria, hypertension, frequency of bouts of hematuria and the clinical evolution. At the end of the study, 7 patients had prolonged remission: the light microscopy showed normal glomeruli, endocapillary proliferation and endo and extracapillary proliferation with less than 30% of the glomeruli affected by "crescents". The remaining cases were still active and one of them with endo and extracapillary glomerulonephritis with more than 30% of the glomeruli affected by "crescents", developed chronic renal insufficiency. In conclusion, the prognosis of recurrent hematuria of glomerular origen is related with the type of glomerular lesions and constitutes an indication for renal biopsy. Renal specimens must be studied under light microscopy and immunofluorescence techniques; electromicroscopy is required when hematuria is present in more than one member of the family.

Adolescent↗
PubMedDate not supplied

[Acute non-bacterial interstitial tubular nephritis].

With the idea in mind to review the etiologic characteristics and evolution of nonbacterial acute tubulointerstitial nephritis, 29 cases seen at the Hospital Infantil de México between 1972 and 1978 were studied. The ages of patients fluctuated from 3 months to 14 years; 18 of them were males. The disease was associated with the administration of nephrotoxic agents, fundamentally antibiotics, being in order of frequency; gentamicin, kanamycin, ampicillin and streptomycin. The main initial manifestations were hematuria and oliguria. At the onset of the disease, acute renal failure was found in 5 of the patients. Two patients developed chronic renal failure, which in one of them was caused by diphenylhydantoin and was reversible on discontinuance of the drug. There were 3 deaths which in 2 cases followed infectious complication and in 1, renal failure. Considerations are made on the pathogenesis of the disease which is predominantly immunologic of following direct toxic action.

Acute Disease↗
PubMedDate not supplied

[Glomerulonephritis with mesangial IgA deposit (IgA mesangiopathy?)].

Clinical correlations and evolution were studied in 34 biopsies from patients with the following diagnosis: Henoch-Schönlein purpura in 17, monosymptomatic hematuria in 11, idiopathic nephrotic syndrome in 3, and Fanconi Syndrome, Systemic lupus erythematosus and tubulointerstitial nephritis, one for each diagnosis respectively. All these biopsies showed anti-IgA mesangial deposits, by immunofluorescence techniques with variable morphology by light microscopy. Endo and extracapillary proliferation was the most frequent lesions. Twenty cases had follow-up observation for over 2 years: 7 cases were in remission, hematuria and/or proteinuria persisted in 10 and 3 cases progressed to chronic renal failure. In conclusion, mesangial IgA deposits are not an infrequent finding in renal biopsies performed in the Hospital Infantil de México. Although the predominant clinical diagnosis was either Henoch-Schönlein purpura or monosymptomatic hematuria, other diagnosis were also found. Some cases with this mesangiopathy presented as idiopathic nephrotic syndrome or post-streptococcal glomerulonephritis, but with serum complement within normal levels. Long-term prognosis was related to glomerular morphology as in other glomerulopathies.

Adolescent↗
PubMedDate not supplied

[Idiopathic nephrotic syndrome with diffuse mesangial proliferation].

The clinicopathologic correlation of 18 cases of idiopathic nephrotic syndrome (INS) with diffuse mesangial proliferation (MP), (over 3 cells per intercapillary space) showed clinical characteristics similar to INS with minimal glomerular lesions (MGL) in relation to age at onset, sex, period of evolution, intensity of proteinuria, hypercholesterolemia, hypoalbuminemia and edema. However, there was a greater incidence of cases with arterial hypertension, hematuria, azotemic retention and positive glomerular immunofluorescence. Out of the 18 cases, 10 were corticosensitive (group I) and 8 were corticoresistant (group II). Patients of I followed a similar course as those with MGL, while most cases of group II showed proteinuria through observation periods up to 5 years. No differences were found in the initial clinical presentation between these 2 groups. The only item with prognostic value was the intensity of the mesangial proliferation which in group I was of 3 to 5 cells per intercapillary space, while in group II, in the spaces of some glomeruli, there were up to 10 mesangial cells present. These findings suggest the convenience to practice renal biopsy before initiating treatment in children with INS and arterial hypertension, hematuria and/or azotemic retention in order to identify this group of patients that appears to be different from that with MGL.

Child↗
PubMedDate not supplied

[Diagnostic significance of hematuria in pediatrics].

Hematuria is the presence of more than 5 RBC's in repeated urinary sediments. Erythrocyturia may be present as an isolated finding or it may be associated to other clinical findings that may lead to the etiology of the hematuria. Its origin may be renal or extrarenal. In the neonate, meatal or urethral bleeding, polycystic kidney or hydronephrosis must be considered. In the infant, hematuria may be due to vascular disease, renal vein thrombosis, as well as to urinary tract infection, urinary tract obstruction or acute tubular interstitial nephritis due to drug ingestion. Primary and secondary glomerulopathies, urinary tract infection and urolithiasis are the most frequent causes of hematuria in pre-school or school-age children. The diagnostic approach emphasizes the importance of the clinical history, familial background and the circumstances of presentation. RBC casts and proteinuria may suggest the presence of a glomerulopathy. Leukocyturia is more frequent in urinary tract infections and requires urine cultures and intravenous pyelogram. In cases of isolated hematuria, blood clotting test, P. T., P.T.T., platelet count and RBC's morphology may be required to rule out hematological disorders. The intravenous pyelogram, voiding cystogram, and occasionally cystoscopy will help to rule out urological abnormalities. If the previous results were negative, the renal biopsy will help to distinguish IgA mesangiopathy, Alport's syndrome or essential hematuria; this last diagnosis resulting by exclusion.

Child↗
PubMedDate not supplied

[Immunopathology of nephropathy secondary to anaphylactoid purpura].

With the purpose of contributing to the study of the pathogenesis of the nephropathy of anaphylactoid purpura (NPA), investigation was made of the presence and extension of immunoglobuline deposits, complement factors and fibrinogen in renal biopsies of 15 patients with NPA, correlating the findings with glomerular lesions seen at the light microscope. Fibrin and IgA deposits were found in all biopsies in mesangium, while C3 was detected only in 5 cases with potentially progressive lesions: 3 with PEEF, one with PEED and one with MP, being negative in PSF and PE cases, which are potentially reversible. The extension of deposits was diffuse or segmentary, without the existence of a precise correlation with the different morphological types. It is concluded that the immunopathologic pattern found in NPA is quite characteristics, different from that of postinfectious acute glomerulonephritis and that there seems to exist relation between findings of C3 with progression of the glomerular lesion.

Adolescent↗
PubMedDate not supplied

[Immunopathological study in membranoproliferative glomerulonephritis].

In 39 renal percutaneous biopsies, practiced to 31 patients with membranoproliferative glomerulonephritis (GMP) with subendothelial deposits (DSE), a study with immunofluorescence technique and light microscopy was carried out. In all cases, heavy granular deposits of C3 were detected in the loops of the glomerular capillaries and in a variable proportion of cases, deposits of IgM, IgA, C3PA (factor B) and C1q of similar aspect and localizacion were found. These findings suggest immunologic pathogenesis. In the absence of C1q, no cases with factor B were found; thus, it is possible to assert that the activation of the complement system takes place exclusively through an alternate pathway, as was previously accepted. On the other hand, it was found that the presence of C1q was correlated with a faster evolution to chronic renal failure and with the presence of a higher percentage of glomeruli with extracapillary proliferation (crescents). Thus, it is concluded that activation of C1q in patients with MPG and SED, may play a role in formation of crescent and consequently, it is a sign of poor prognosis.

Adolescent↗