[The ultrastructural changes in the jejunal mucosa in gluten-sensitive enteropathy in children demonstrated by scanning electron microscopy].
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Biomedical subjects
Publications and source records attributed to P Florescu.
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The authors report on an infant of three weeks of age, suffering from mycotic septicaemia (Candida), in the course of which the syndrome of disseminated intravascular coagulation (DIC) occurred. The digestive expression of DIC was represented by numerous intestinal intramural haematomas, one of which was large enough to produce the clinical signs of mechanical ileus. The aetiology of the intestinal intramural haematoma is discussed and its relatively frequent occurrence in infants with DIC is stressed.
Kidney biopsies were obtained in 28 children with glomerular diseases and studied using indirect immunofluorescence and immunoperoxidase for IgG, IgA, IgM, C1q, C3c, C4, fibrinogen and the neoantigens of the terminal C5b-9 complement complex. C5b-9 deposits were detected in glomeruli of 14, in tubules of eight and in vessels of 12 cases. Patients with C5b-9 deposits fared worse than those without such deposits, even with the same histopathological type of glomerulonephritis. The C5b-9 complex suggests an in situ complement activation.
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Studying a series of 30 children with chronic gastritis (diagnosed by optic fiber gastroscopy and by mucosal biopsy), authors have founded important changes of the superficial mucosa and gastric glands. The histologic changes could explain the well-known functional alterations in chronic gastritis. They discussed also a possible immuno-pathogenic mechanism for these mucosal ultrastructural changes.
The authors studied a number of 445 children with malabsorption in which a jejunal biopsy was done. Concerning the celiac disease, they emphasized the value of jejunal biopsy in diagnosis and monitoring the treatment.
An 18-day-old child is presented with a ventricular septal defect and aspiration bronchopneumonia with abscesses. An extensives myocardial necrosis with calcium deposits is also present. The authors think that the myocardial necrosis is a consequence of the calcium deposition on the mitochondria of myocardial fibres, favoured by the general and local changes, especially the heart hypoxia due to the combined action of the heart congenital diseases and of bronchopneumonia.
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The authors examined microscopically 161 jejunal biopsies of which 142 presented a pathologic mucosa. The two sexes were equally represented and the prevalent age was between 1 and 2 years. Nearly one third of the cases were acute enteritides and the remaining ones--granulative and atrophic enteritides; none of them was hypertrophic. The causes of these enteropathies are various.
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The authors describe the clinical and histopathologic picture of immunoblastic lymphadenomegaly in a 66-year-old patient with allergic antecedents. The condition of the patient ameliorated following cortisone and antibiotic therapy, but adenomegalia relapsed after several months. PAS-positive granular inclusions were found in the macrophage cells in the germinative centres of the follicles, showing the aspect of a blockade with nuclear significance.
Neonatal cholestatic disturbances are frequent in premature neonates. An important role in the group of causes which may induce cholestasis is that of hypoplasia of the intrahepatic biliary pathways. Ten cases are described, of prematurely born infants with hypoplasia of the intrahepatic biliary pathways. The children had 980-1,900 g at birth. The diagnosis was made on the basis of the clinical picture, of conjugated hyperbilirubinemia, and of the necropsy findings in 7 of the cases. The incidence and the lethality were high in very small premature infants, in whom compensation responses of the hepatic tissue are rather a particular case. In all the cases the authors noted the presence of malabsorption syndromes, of atrophic enteritis, and a defect in the growth rate.
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