Renal actinomycosis complicated by renoduodenal fistula and diabetes mellitus.
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Biomedical subjects
Publications and source records attributed to G Stefanova.
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A juxtaposition between the clinical-laboratory, immunologic and radionucleotide articular parameters was performed in 50 patients with psoriatic arthropathy, distributed according to the incidence of X-ray manifestations. The late and moderate changes in ESK, leukocytes, fibrinogen, DPA and phosphatasemia do not characterize the severity of the disease. A tendency to hyperuricemia and hypercalcemia is established in the period of arthralgia before the X-ray image for bone-tissue damage. The genetic HLA-B27 predetermination plays a certain role for the more frequent involvement of the spine and sacroiliac joints in the pathological process. The disturbances in the immune system are manifested with increased number of early T-lymphocytes, FcG-receptor lymphocytes, complement (C3b)--receptor lymphocytes and spontaneously blast-transformed cells. The increasing IgG content correlates with the accumulation of macromorphological X-ray images and with the index of mineral metabolism from the articular study with 99MTc-pyrophosphate. The changes in the pertechnetium index for articular vascularization are quantitatively insignificant and do not allow the joining of the psoriatic arthropathy to the group of primary synoviarthritis. The accumulation of technetium pyrophosphate in the articular structures is asymmetric, focal and precedes the changes in the X-ray image.
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The following indices were studied in 21 patients with chronic pyelonephritis: T-lymphocytes - early and late, their TG and TM subpopulations; B-lymphocytes: complement-receptor, antibody (hemolysin) synthesizing, carring surface immunoglobulins (sIg+) and cytoplasmatic immunoglobulins (cIg+); immunoblasts in peripheral blood; serum level of immunoglobulins and of C3 - fraction of complement. The authors established a tendency to increase of early T-lymphocytes and their TG - subpopulations in the patients. TM - subpopulations were considerably lower, as compared with those of the healthy subjects. The complement - receptor and immunoglobulin-containing B cella in the patients with chronic pyelonephritis were increased as compared with the same in healthy subjects. Only IgM level in serum of the patients studied was higher than in the healthy subjects from the humoral factors of immune reactivity. Chronic pyelonephritis, was concluded, by the authors, to participate in the cellular-humoral immune mechanisms with a predominating activation of B-populations and IgM synthesis.
The changes in cellular-humoral immune reactivity were followed up in 13 patients with lupus nephritis and 10 patients with chronic glomerulonephritis, treated with corticosteroids or with corticosteroids and imuran. A tendency to correction of lymphocyte and T-lymphocyte deficiency, inhibition of FsG- and FsM-receptor lymphocytes and of T-gamma and T-mu lymphocyte subpopulations was established in the patients with lupus nephritis, treated only with corticosteroids. The treatment with corticosteroids and imuran inhibited more sharply T gamma- and T-mu lymphocytes than with corticosteroids alone. It was established, in the patients with chronic glomerulonephritis, treated with corticosteroids, that GsG- and FsM-receptor lymphocytes were with significantly lower values than the non-treated ones. No significant changes were established in B-cellular reactivity and serum level of immunoglobulins (IgG, IgM, IgA) with the treatment with corticosteroids and corticosteroids and imuran in both nosological entities. C3- fraction of the complement in the lupus patients treated was with lower values than in the non-treated. The authors conclude that the corticosteroids and corticosteroids and imuran, inhibiting the reactivity of T-lymphocytes, regulating the immune-biological balance, should be cautiously used and under the control of the cellular populations, exposed to their effect.
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The diagnostic significance of haptoglobin is studied as well as of sialic acid and spontaneous rosette test (SRT) and ESR as indices of the morbid process activity in 74 patients with chronic hephritis with manifested and oligospymptomatic course and in a stage of therapeutic remission and in 14 patients with acute protracted nephritis. The parallelism of the changes in all parameters studied is proved in acute protracted nephritis and in chronic nephritis with manifested course. In patients with oligosymtomatically advancing chronic nephritis, in spite of the normal values of ESR and the rest of the routine indices for determination of the morbid process activity, haptoglobin, sialic acid and SRT were established to be increased. They were hardly normalized after the advancement of a lasting therpeutic remission. That all gives grounds to the authors to think, that the significance of the studied indices for the assessment of the morbid process activity in oligosymptomatically advancing chronic glomerulonephritis, is superior, to a certain extent, to the diagnostic signficance of ESR. Their follow up in dynamics permits their application in the determination of the immunosuppressive treatment efficiency.
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