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L Revert

Publications and source records attributed to L Revert.

At least 55 records · Page 3Linked to original sources
PubMed1992

Antimyeloperoxidase autoantibody-associated necrotizing alveolar capillaritis.

In this report, we describe 3 patients who had pauci-immune necrotizing alveolar capillaritis-related pulmonary hemorrhage and who never developed other organic involvement, as revealed by clinical and laboratory data and also by autopsy examination in 1 case. Serum samples from these patients disclosed antimyeloperoxidase autoantibodies with initial immunofluorescence titers ranging from 1:1,600 to 1:3,200. Rapid institution of immunosuppressive therapy, as well as plasma exchange, led to prompt clinical improvement in 2 patients who were receiving mechanical ventilation support. We conclude that antimyeloperoxidase autoantibodies become new clues to support an underlying alveolar capillary vasculitis in patients with idiopathic isolated pulmonary hemorrhage, thus facilitating therapeutic decisions in this life-threatening condition.

Adult↗
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

[Neutrophil anticytoplasmic antibodies in a patient with Wegener's granulomatosis: therapeutic implications of its detection and relation to clinical activity].

The case of a patient with a multisystemic process characterized by polyarthritis, hemoptysis, leucocytoclastic vasculitis, renal failure and ulcerated lesions in the palate and nasal bone is reported. The existence of antineutrophil anticytoplasmic antibodies (cytoplasmatic pattern) was proven by indirect immunofluorescence with an initial serum titration of 1:1.600. Detection of these antibodies permitted the establishment of immunosuppressive treatment when the clinical situation of the patient was considered serious (pulmonary hemorrhage with progressive diminution of the hematocrit). Four days after the initiation of treatment the histopathological results of the palate and nasal mucous biopsies were received and were compatible with Wegener's granulomatosis. Serial determination of the titers of these antibodies demonstrated a close correlation with the clinical biological activity of the process. Indeed, 3 days after initiation of the immunosuppressive treatment the concentration of the same had reduced to half, something which has not been previously reported. It is concluded that high specificity and sensitivity of antineutrophil anticytoplasmic antibodies with a cytoplasmatic pattern for Wegener's granulomatosis may contribute to the improvement, not only of the diagnosis but also to the prognosis, in permitting the immediate initiation of therapeutic measures when the clinical situation of the patient thus requires.

Adult↗
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

[Diagnosis of renal carcinoma in acquired cystic renal disease. Usefulness of echography in detection during subclinical phase].

BACKGROUND: The patients with end-stage renal disease on periodic hemodialysis often develop acquired cystic renal disease, and they have renal tumours more commonly than the normal population. METHODS: To evaluate the usefulness of echography for the evaluation of these lesions and the prevalence of acquired cystic renal disease and occult renal tumours in patients treated with hemodialysis during years, a prospective ultrasonographic study was carried out. To this end, renal echographic studies were performed in 43 asymptomatic patients treated with periodic hemodialysis during 5 years or more. Patients with renal polycystic disease were excluded from the study. RESULTS: The overall prevalence of acquired cystic renal disease was 86%. It was higher in males (96%) than in females (70%). Two patients (4.6%) had malignant renal tumours. CONCLUSIONS: In view of the high prevalence of tumours in acquired cystic renal disease, it is suggested that periodic echographic studies should be carried out in patients with end-stage renal disease treated with hemodialysis during years to detect renal carcinoma in subclinical stage.

Adolescent↗
PubMed1991

[Kidney failure, acute hepatitis and rhabdomyolysis secondary to an acute cytomegalovirus infection in a previously healthy patient].

A 40-year-old male with unremarkable past history was admitted because of fainting during an athletic run in the city. At the time of admission there were increased plasma creatinine level and phosphokinase activity, with myoglobinuria and increased transaminase activity. Serologic tests for viruses on admission and after 15 days showed a selective increase in the anti-CMV titer from 1/16 to 1/256, being negative for the remaining viruses. The renal function rapidly recovered without sequelae. According to the literature, this would be the first reported case of acute renal failure, rhabdomyolysis and acute hepatitis due to cytomegalovirus infection in a previously healthy individual.

Acute Disease↗
PubMed1991

Tumor markers in chronic renal failure and hemodialysis patients.

Serum levels and the incidence of elevated levels of several tumor markers were measured in 30 patients with chronic renal failure (CRF) of different degrees, as well as in 36 hemodialyzed (HD) patients without clinical evidence of neoplasia. The tumor markers evaluated were carcinoembryonic antigen (CEA), CA 125, CA 15.3, CA 19.9, CA 50, alpha-fetoprotein, neuron-specific enolase (NSE), squamous cell carcinoma antigen (SCC), prostatic acid phosphatase and prostatic-specific antigen. Serum levels of CEA were above the cutoff limit in 33% of patients with CRF and 47% of HD patients, CA 50 was higher than normal values in 37 and 44% of patients, respectively. SCC was elevated in 43 and 72% of patients, respectively. Serum levels of CA 125 were elevated in 18% of patients with CRF and NSE in 36% of HD patients. In CRF several tumor markers (CEA, SCC, CA 50 and NSE) show a high false positive rate and may be unreliable for monitoring malignancies in uremic patients, while the other markers evaluated appear to maintain their specificity in this situation.

Adult↗
PubMed1991

Prognostic implication of anti-neutrophil cytoplasmic autoantibodies with myeloperoxidase specificity in anti-glomerular basement membrane disease.

Anti-neutrophil cytoplasmic autoantibodies (ANCA) were detected in 12 out of 37 (32%) serum samples from patients with anti-glomerular basement membrane (GMB) disease by an indirect immunofluorescence assay. In 11 cases, ANCA were directed against myeloperoxidase, as revealed employing neutrophils devoid of this enzyme as the test substrate. Patients having both ANCA and anti-GBM antibodies (AGBMA) were considerably older (mean age 59 years) than patients with AGBMA alone (mean age 33 years). In addition, patients with both antibodies had some clinical and pathologic data that suggested an associated systemic vasculitis. This was supported by the fact that among these patients, those with highest ANCA titres recovered renal function despite being initially on hemodialysis, as opposed to those with lowest ANCA titres or AGBMA alone. In patients with both antibodies, there was an inverse relationship between AGBMA and ANCA values (p = 0.02). Moreover, the mean AGBMA level tended to be higher for patients with AGBMA alone than for those with both ANCA and AGBMA. These results suggest that, at least in some cases, there may be a contribution of an ANCA-related mechanism in the pathogenesis of anti-GBM disease. Although the exact role of ANCA in this and other diseases remains to be clarified, there is important clinical evidence that in anti-GBM disease ANCA may represent a serologic marker of good prognosis identifying a subset of patients who may recover renal function.

Adolescent↗