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G Monga

Publications and source records attributed to G Monga.

104 records · Page 6Linked to original sources
PubMedDate not supplied

Intertubular capillary changes in kidney allografts: an ultrastructural study in patients with transplant glomerulopathy.

Fifteen kidney allograft specimens from 14 patients with transplant glomerulopathy were investigated by electron microscopy. Intertubular capillaries of all patients showed splitting and multilayering of the basement membranes, a change recalling that observed in the glomerular basement membranes in transplant glomerulopathy. Although the severity of the lesions varied from case to case, it was, to a certain extent, constant in each specimen and correlated well with the severity of the glomerular basement membrane changes in the same patient. The similarity of the two lesions suggests a possible common pathogenetic mechanism. The constant finding of intertubular capillary splitting and multilayering in patients with transplant glomerulopathy leads to the suspicion of this condition when such changes are found in kidney samples in which glomeruli are lacking. Therefore electron microscopy could achieve a specific diagnostic relevance in this field of nephropathology.

Adult↗
PubMedDate not supplied

Intertubular capillary changes in the cortex and medulla of transplanted kidneys and their relationship with transplant glomerulopathy: an ultrastructural study of 12 transplantectomies.

Twelve kidney allografts removed 3 to 98 months (mean, 44.8 months) after transplantation were investigated. The presence and severity of intertubular capillary changes, which were characterized by splitting and multilayering of the basement membrane, were carefully noted. These changes were graded as mild, moderate, and severe according to the number of basement membrane layers. They were found in both cortical and medullary capillaries in all but one kidney and were always associated with transplant glomerulopathy. Ultrastructural changes observed in the glomeruli and capillaries were similar, suggesting that they share the same pathogenetic mechanisms, probably connected to immune-mediated endothelial cell damage. Although glomeruli can be absent in small biopsy specimens, intertubular capillaries are easily detectable. Because capillary changes can be considered a marker of transplant glomerulopathy, which is known to have ominous prognostic significance, the identification of such changes acquires clinical relevance. Electron microscopic investigation is therefore strongly advisable whenever a renal biopsy is performed to identify transplant glomerulopathy.

Adult↗
PubMedDate not supplied

[Renal damage in type 2 diabetes].

Renal involvement in patients with type 2 diabetes will (probably) be one of the most important clinical problems for nephrologists to face during the next few years. Unlike type 1 diabetes, in type 2 diabetes the renal damage has not yet been well defined at both clinical and pathological levels. Pathological examination of renal biopsies has displayed different patterns of renal damage including diabetic glomerulosclerosis (Class 1), mostly chronic vascular changes (Class 2) and superimposed glomerular diseases (Class 3a) or unrelated to diabetic glomerulosclerosis (Class 3b). Despite the large number of papers published in this field, the actual prevalence and outcome of the different histological classes still remain to be established. Reported discrepancies are most likely caused by ethnic and geographic factors. However, as documented by a recent study carried out on a large number of patients, the prevalence of histological patterns is also greatly influenced by the policy for performing renal biopsies adopted at the various nephrological centers. Although the natural history of type 2 glomerulosclerosis (Class 1) still remains to be defined, those patients with clinical nephropathy and impairment of renal function have very poor outcome with a high rate of mortality and progression to uremia. Moreover, when diabetic glomerulosclerosis is complicated by superimposed glomerular diseases (Class 3a) the prognosis is much worse. On the contrary, when glomerular diseases are not associated with glomerulosclerosis lesions (Class 3b) the prognosis is markedly better. During the last ten years controlled studies have shown that the outcome in type 1 diabetic nephropathy has improved as a result of the use of drugs inhibiting the renin-angiotensin system. Although it is likely that this type of drug might also favourably influence the outcome of type 2 diabetic nephropathy, any conclusive evidence is presently still lacking.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

[Comparison between biopsy data and the resistive index obtained by Doppler echography in the evaluation of the transplanted kidney].

Doppler sonography is nowadays considered as a "first step" tool for diagnosis of vascular complications in kidney transplantation. Quite recently, it has been sometimes considered useful and effective investigation in order to obtain information about parenchymal dysfunctional pathologies, particularly about acute rejection. This has been obtained by studying the variation of resistive indexes. The goal of the following investigation was compare Doppler sonography data and histological examination in 50 kidney transplanted recipients in whom the renal biopsy was performed on a clinical basis. In the Authors' experience. Doppler sonography and study of the resistive index does not offer any reliable help in differentiating acute rejection from cyclosporine A toxicity.

Biopsy↗
PubMedDate not supplied

Tubular aggregates in a case of osteomalacic myopathy due to anticonvulsant drugs.

We describe a case of severe osteomalacia and secondary myopathy due to anticonvulsant drugs--barbiturates and phenytoin. The clinical course of the patient, a 29-year-old epileptic woman subject to anorexia, demonstrates the importance of alimentary intake in the pathogenesis of the disease. Muscle biopsy performed before and after treatment showed the efficacy of therapy with 25-hydroxy cholecalciferol. However, in both biopsies tubular aggregates were found: this unusual ultrastructural finding probably indicates the direct action of the anticonvulsant drugs on the sarcoplasmic reticulum membranes. This is the second case of osteomalacic myopathy due to anticonvulsants confirmed by histologic and ultrastructural examinations; it is also the first report of tubular aggregates in this muscular disease.

Adult↗