Insuficiência renal aguda secundária à sarcoidose / Acute renal failure secondary to sarcoidosis

A sarcoidose é uma doença sistêmica de etiologia desconhecida, caracterizada pela inflamação crônica granulomatosa, que acomete com maior frequencia os pulmões, a pele e os olhos e, muito raramente, detectamos envolvimento renal na patologia. relatamos aqui o caso de uma paciente de 47 anos, branca, internada em uma unidade de emergência de Hospital Universitário, devido a sintomas e achados radiológicos sugestivos de pneumonia. Desde o início da internação ela se apresentava com quadro laboratorial de insuficiência renal aguda, inicialmente atribuída ao histórico recente de uso abusivo de anti-inflamatórios. No entanto, devido à evolução arrastada e aparentemente desfavorável, inclusive com necessidade de terapia renal substitutiva (TRS), a paciente foi submetida a uma biópsia renal para esclarecimento diagnóstico e avaliação prognóstica. A descrição histológica mostrava um quadro de nefrite intersticial aguda granulomatosa, característico de sarcoidose renal, diagnóstico confirmado após revisão do prontuário médico, que revelava internação anterior devido a evento pulmonar da doença. Iniciado tratamento com prednisoma 1mg/kg/dia, a paciente evoluiu com melhora do quadro de insuficiência renal aguda, não mais necessitando de TRS. Atualmente, a paciente é mantida em acompanhamento ambulatorial com função renal estável.

The Sarcoidosis is a systemic disease of unknown etiology characterized by chronic granulomatous inflammation, which affects most frequently the lungs, skin and eyes and very rarely detected renal involvement in pathology. report here the case of a 47 year old white, admitted in an emergency unit of University Hospital because of symptoms and radiological findings suggestive of pneumonia. Since the beginning of hospitalization she performed with a laboratory diagnosis of acute renal failure, initially attributed to the recent history of abuse of anti-inflammatory drugs. However, due to unfavorable prolonged evolution and apparently, also in need of renal replacement therapy (RRT), the patient underwent renal biopsy for diagnosis and prognostic assessment. Histology showed a picture of acute interstitial nephritis, granulomatous characteristic of renal sarcoidosis, confirmed after review of medical records, which revealed previous hospitalization due to lung of the disease. Treatment with Prednisone 1mg/kg/day, the patient presented improvement of acute renal failure, no longer requiring RRT. Currently, the patient is maintained as an outpatient with stable renal function.

Effect of feed restriction on learning, memory and stress of rodents

Feed restriction (FR) has been recognized as the major experimental assay able to retard aging and degeneration diseases, although the effects of dietary manipulation at Central Nervous System (CNS) superior functions as learning and memory remain controversial. The aim of the present study was to evaluate the FR effects in CNS superior functions focusing in learning and memory in rodent models. Male Wistar rats were divided into three groups (n = 9/group) according to dietary conditions: ad libitum (AL) with unlimited access to standard rat diet (22 percent of protein, 8 percent fiber, 4 percent fat, 10 percent minerals, 1.4 percent Calcium, 0.8 percent Phosphorus); FR30 and FR60 groups were fed with 70 percent and 40 percent, respectively, of total rat diet offered to the AL group for 15 weeks. The animals FR30 and FR60 showed significant increase of learning performance in Y maze compared to animals fed ad libitum. The FR30 group, in memory task, also showed strong preference to the correct arm in Y maze at the first trials and greater rightness probability, in relation to the AL and FR60 groups. The AL group had significantly higher exploratory activity at the open field test than both FR groups. These findings implicate the FR on modulation of CNS functions as learning, suggesting, also, a possible anxiogenic-like effect of stress caused by FR.