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J Andreu

Publications and source records attributed to J Andreu.

At least 55 records · Page 3Linked to original sources
PubMed1993

Blood and graft eosinophilia as a rejection index in kidney transplant.

The relevance of eosinophilia in the physiopathology of transplant rejection has yet to be established. The appearance of eosinophilia has been occasionally associated with an adverse prognosis on graft rejection episodes. The aim of the present study was to evaluate the role and prognostic implications of blood and graft eosinophilia in kidney transplant rejection. We have examined the intrarenal infiltrate in 173 fine-needle aspiration biopsies from 36 consecutively transplant patients, and blood samples obtained simultaneously with fine-needle aspirations. Two different immunosuppressive regimens were administered: triple therapy (azathioprine + prednisone + antilymphocytic globulin) in patients with posttransplant acute tubular necrosis and cyclosporine A monotherapy in the rest of the patients. Comparing the two immunosuppressive groups, more elevated eosinophil values were observed in the monotherapy group during stable graft and also at the rejection episode. In the monotherapy group, a significant increase in the eosinophil values, in peripheral blood samples and in the intragraft infiltrates were noted at the rejection episode with respect to the stable situation. Following pulsed-steroid treatment an immediate disappearance of the eosinophils was evident. In contrast, no differences could be demonstrated between these two clinical situations in the TT group. Higher rates of eosinophils in the intrarenal infiltrate with respect to peripheral blood samples were observed during rejection episodes, suggesting some role of the eosinophils in the physiopathology of graft rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Cerebral amyloid angiopathy and recurrent cerebral hematoma. Clinicopathological study of a case].

Cerebral amyloid angiopathy (CAA) is an almost constant finding in Alzheimer's disease and in Alzheimer type senile dementia (EA/DSTA) but it has also been described in association with other processes such as in age-related hereditary or non hereditary cerebral hemorrhage (CH) relapse. The case of a non hypertensive 78 year old women is presented. Over a period of 27 months the patient had 3 cerebral hemorrhages located in the left parietotemporal, caudate nucleus and right frontobasal and right parietotemporal lobes, all of which had cortico-subcortical topography and eruption of blood to the subarachnoid space. The fundamental finding in the neuropathological study was the CAA with massive involvement in the leptomeninges and cortex, less in cerebellum and nucleus of the base, occasional in white matter and absent in the brain stem trunk. Abundant senile plaques and figures of neurofibrillar degeneration were found. Granulovacuolar degeneration or Hyrano bodies were not observed. At the level of the main intracraneal arterial trunks only a small plaque of atheroma was observed in the left vertebral artery. The association of CAA and CH in the literature and their relation with EA/DSTA are revised.

Aged↗
PubMed1992

Acquired renal cystic disease in HD: a study of 82 nephrectomies in young patients.

In order to study the development of acquired renal cystic disease (ARCD) and its potential complications, we studied, macro- and microscopically, 82 surgical specimens of nephrectomy carried out on young patients with chronic renal failure previous to renal transplantation. Statistical correlation of pathological findings with age, sex and time on hemodialysis (HD) have been done. There were 72 cases of ARCD (87.8%). It was statistically correlated with male sex (p less than 0.02) and prolonged time on HD (p less than 0.001) as has been previously reported. Hyperplasia of the cystic epithelium was found in 42 cases (52%), with 18 (22%) showing marked papillary proliferation. Also, there were 22 cases (27%) with renal adenomas. This incidence of hyperplastic and neoplastic proliferations, more than would be common in such a young population (males: 33.5 +/- 9.3 years; females: 35.4 +/- 11.7 years), suggests the potential of patients affected by ARCD to develop neoplasms. Thus, we consider that these patients must be checked periodically to detect possible malignant neoplasms.

Adenoma↗
PubMed1991

[Aspiration cytology in the diagnosis of renal transplant rejection].

BACKGROUND: The use of fine needle aspiration for the diagnosis of renal transplant rejection is advantageous for its innocuousness, thereby making it an acceptable method for monitoring. However, the clinical use reported among several groups has been variable and indeed, the influence it may have on the results of the use of different lines of immunosuppressors is little known. METHODS: Thirty-six consecutive renal transplanted patients were studied prospectively over the 2 months following the transplantation of the organ. The basal immunosuppressor treatment consisted in the administration of prednisone and antilymphocytic serum in patients presenting acute post-transplant tubular necrosis with the remaining patients receiving cyclosporin in monotherapy. One hundred seventy-three double punction were carried out. RESULTS: No complications were observed as a consequence of the punction. The material obtained was insufficient for evaluation on 18 occasions. The use of the method for diagnosis of rejection obtained a sensitivity and specificity of 73% and 81% respectively. Furthermore, in the group of patients with stable renal function, higher immunoactivation indexes were observed in those treated with cyclosporin in monotherapy (1.7 +/- 1.7) with respect to those who received triple treatment (0.5 +/- 0.4). CONCLUSIONS: The use of fine needle aspiration cytology is safe and clinically useful in the monitoring of the post renal transplantation period. The results should be interpreted in terms of different immunosuppressive lines.

Adolescent↗
PubMed1991

Reflex sympathetic dystrophy syndrome of the lower limbs in renal transplant patients treated with cyclosporin A.

In a 36-month period, 240 patients at our institution received kidney transplants from cadaver donors. Cyclosporin A (CsA) was used as the initial immunosuppressive therapy. Seven patients (5 men and 2 women) developed severe pain, periarticular soft tissue swelling with no effusion, and vasomotor changes in affected areas. Although articular mobility was conserved, most of the patients had great difficulty in walking. A patchy osteoporotic pattern was seen radiographically and increased uptake of 99mtechnetium with a periarticular distribution in the clinically affected areas were found. All of these symptoms and radiographic and scintigraphic signs are compatible with definite reflex sympathetic dystrophy syndrome (RSDS). Articular symptoms began within 3 months after kidney transplantation in all patients; all but 1 patient had plasma CsA levels greater than 200 ng/ml at that time. When the dosage of CsA was reduced, there was concomitant improvement in the RSDS, which appeared when the plasma CsA levels declined to less than 200 ng/ml. The mean duration of the clinical symptoms of RSDS was 8 months. We believe RSDS should be added to the list of complications that may appear in kidney transplant patients who receive CsA treatment.

Adult↗
PubMed1991

Hepatitis C virus infection among kidney transplant recipients.

The extent of hepatitis C virus (HCV) infection among kidney recipients was investigated in 67 patients by testing for anti-HCV paired serum samples, collected at time of transplantation and during follow-up (average 32 +/- 20 months). Prevalence of anti-HCV at transplant time was 48%, and was related to the time on dialysis and to the amount of blood transfusions. Following transplantation, nine (28%) seropositive patients lost anti-HCV and five (14%), previously seronegative, seroconverted. Anti-HCV was found to be positive in 92% of the patients with chronic liver disease who were on hemodialysis, but in 56% in kidney recipients with chronic hepatitis. Anti-HCV was positive in 50% of patients with resolving hepatitis before transplantation, but only in 21% of those with acute hepatitis following transplantation. This study confirms the high risk of HCV infection among hemodialysis and kidney recipient populations, and also that HCV is closely related with the length of time the patient is on hemodialysis as well as the number of blood units transfused. HCV is the main cause of acute and chronic liver disease in hemodialysis patients and of chronic liver disease in kidney recipients, but does not clearly influence the survival of the allograft nor that of patients.

Adolescent↗