ABSTRACT
A 84-year-old women underwent renal biopsy because of rapidly progressive renal failure. Rabeprazole induced interstitial nephritis was diagnosed. Interstitial nephritis may complicate the course of any proton pump inhibitor treatment. It is a rare and serious complication. Clinician's awareness of this adverse event is essential for early diagnosis and prompt recovery.
Subject(s)
2-Pyridinylmethylsulfinylbenzimidazoles/adverse effects , Anti-Ulcer Agents/adverse effects , Nephritis, Interstitial/chemically induced , 2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage , Acute Disease , Aged, 80 and over , Anti-Ulcer Agents/administration & dosage , Female , Humans , RabeprazoleABSTRACT
An acquired circulating anticoagulant with anti-factor V activity appeared in a 29 year old AIDS patient with widespread Kaposi's sarcoma following 21 days of fresh frozen plasma therapy for haemolytic and uraemic syndrome. Residual factor V activity was very low (< 5% of normal). However, the inhibitor was of low titre (0.5 Bethesda Units/ml), while antigenic factor V levels remained at 100%. Dot blotting with human factor V and polyvalent and specific immunoglobulin antisera showed the antibody to belong to the IgG class. Haemostatic tests in vitro were only partly corrected by addition of washed human platelets and despite transfusion of large amounts of platelets the patient died from massive pulmonary haemorrhage. This would appear to be the first documented case of an anti-factor V inhibitor occurring in an AIDS patient.
Subject(s)
Acquired Immunodeficiency Syndrome/blood , Anticoagulants/blood , Factor V/antagonists & inhibitors , Immunoglobulins/analysis , Acquired Immunodeficiency Syndrome/mortality , Adult , Anticoagulants/pharmacology , Blood Coagulation/drug effects , Hemostasis , Humans , MaleABSTRACT
MHC class II-encoded molecules HLA-DR, -DP and -DQ play a pivotal role in the human immune response. Their constitutive expression is restricted to a number of immunocompetent cells referred to as antigen-presenting cells. However, gamma-interferon (gamma-IFN) has been shown to induce MHC class II molecule expression in several epithelia. Using flow cytometric analysis, we show here that normal and SV40-transformed human podocytes in culture constitutively expressed gamma-IFN receptors. We also show that MHC class I molecules are constitutively expressed in these cells and that HLA-DR, -DP and -DQ expression, which is not found in unstimulated cells, can be induced by gamma-IFN stimulation. This induction was a time-dependent event, a lag phase of 24-48 h being necessary for MHC class II molecules to become detectable at the cell surface by flow cytometric analysis. Induction of MHC class II molecules in human podocytes also showed a concentration dependence, a plateau being reached at a concentration of 500 IU of gamma-IFN/ml of culture medium. This effect was blunted by coincubation of the cells with an antihuman gamma-IFN receptor monoclonal antibody. HLA-DR expression was associated with specific mRNA accumulation, as detected by Northern blot analysis. By indirect immunofluorescence, the intercellular adhesion molecule 1 was also induced by gamma-IFN stimulation. Induction of DR, DP and DQ in human podocytes may be involved in the pathogenesis of immune glomerulonephritis in man.
Subject(s)
HLA-DP Antigens/analysis , HLA-DQ Antigens/analysis , HLA-DR Antigens/analysis , Intercellular Adhesion Molecule-1/analysis , Interferon-gamma/pharmacology , Kidney Glomerulus/chemistry , Kidney Glomerulus/cytology , Blotting, Northern , Cells, Cultured , Epithelial Cells , Epithelium/chemistry , Flow Cytometry , Fluorescent Antibody Technique , Gene Expression Regulation , HLA-DP Antigens/genetics , HLA-DQ Antigens/genetics , HLA-DR Antigens/genetics , Humans , Intercellular Adhesion Molecule-1/genetics , Interferon-gamma/metabolism , RNA, Messenger/analysis , RNA, Messenger/genetics , Receptors, Interferon/analysis , Receptors, Interferon/metabolismABSTRACT
Von Meyenburg complexes (VMC) are rare malformations of the bile ducts. They are usually associated with adult dominant polycystic disease (ADPCD). Although generally benign, they may give rise to cholangiocarcinomas. Herein, we report the third MR documented case of VMC. The comparative diagnostic value of ultrasound (US), computed tomography (CT), and magnetic resonance (MR) examinations is discussed.
Subject(s)
Bile Ducts, Intrahepatic/pathology , Magnetic Resonance Imaging , Aged , Cysts/diagnosis , Female , Humans , Kidney Diseases/pathology , Liver/pathology , Liver Diseases/diagnosis , Liver Diseases/pathologyABSTRACT
HLA-DP expression has been widely investigated on T lymphocytes activated under different conditions. In the present study, a double staining procedure was used in flow cytometric experiments to define DP expression on normal peripheral blood T lymphocytes. In about two-thirds of the case analyzed, DP was expressed on a higher percentage of normal peripheral T lymphocytes than DR was. This was particularly true for 1 of the 16 cases investigated in which the percentage of T lymphocytes expressing DP was 46% and in which DP expression was mainly the prerogative of CD8+ and CD56+ lymphocytes.
Subject(s)
HLA-DP Antigens/blood , T-Lymphocyte Subsets/metabolism , Antigens, CD/analysis , Biomarkers , Female , Flow Cytometry , Fluorescent Antibody Technique , HLA-DP Antigens/biosynthesis , HLA-DR Antigens/blood , Humans , Immunophenotyping , Lymphocyte Activation , MaleABSTRACT
HLA-DP allodeterminant elicit weak cellular and humoral immune responses. This study was undertaken to find out if the low immunogenicity of HLA-DP could be accounted for by a low level of expression on peripheral blood mononuclear cells. Double staining experiments and flow cytometry were performed in 28 healthy individuals, HLA-DP was found to be as expressed as DR and DQ on B lymphocytes. Furthermore, a DP+/DR- lymphocyte sub-population was identified and characterized as freshly activated T lymphocytes.
