ABSTRACT
An unselected group of 33 renal transplant recipients were examined by upper gastrointestinal endoscopy at between two and four months after transplantation. All abnormal lesions were documented and biopsied and, in addition, random biopsies were obtained from the gastric antrum and from the first part of the duodenum. The biopsies were examined and graded for gastritis and duodenitis and the presence of Helicobacter pylori was noted. Duodenitis was identified in 16 patients and gastritis in 10; four patients had a gastric ulcer. Helicobacter was identified in the gastric antrum of 16 patients (48%) and was strongly associated with symptomatic dyspepsia, with gastritis, and with peptic ulceration. There was no relationship between H pylori and prednisolone dose, serum cyclosporine levels, or renal function. H pylori was found to be common in the upper GI tract of renal transplant recipients and may explain the high prevalence of upper GI pathology in these patients. It is interesting to speculate that immunosuppression may contribute to this, although there is no direct evidence from this study to support this theory.
Subject(s)
Helicobacter Infections/epidemiology , Helicobacter pylori/isolation & purification , Kidney Transplantation , Duodenal Ulcer/epidemiology , Duodenal Ulcer/microbiology , Duodenal Ulcer/pathology , Duodenitis/epidemiology , Duodenitis/microbiology , Duodenitis/pathology , Esophagitis/epidemiology , Esophagitis/microbiology , Esophagitis/pathology , Follow-Up Studies , Gastritis/epidemiology , Gastritis/microbiology , Gastritis/pathology , Graft Rejection , Helicobacter Infections/diagnosis , Helicobacter Infections/pathology , Humans , Prevalence , Prospective Studies , Stomach Ulcer/epidemiology , Stomach Ulcer/microbiology , Stomach Ulcer/pathology , Time FactorsABSTRACT
Syphilitic arthritis has been well characterized but not previously described as the initial presentation of human immunodeficiency virus (HIV) infection. Our patient presented with chronic symmetric polyarthritis and autoimmune abnormalities, including positive rheumatoid factor, antinuclear antibody, dsDNA, and initially negative syphilis serologies. Subsequent investigations revealed HIV seropositivity, depletion of CD4 cells, and strongly positive syphilis serologies. Our patient's arthritis completely resolved with penicillin therapy.
Subject(s)
Arthritis, Infectious/diagnosis , Arthritis, Rheumatoid/diagnosis , HIV Infections/diagnosis , Lupus Erythematosus, Systemic/diagnosis , Syphilis/diagnosis , Adolescent , Antibodies, Antinuclear/analysis , Arthritis, Infectious/complications , Arthritis, Infectious/drug therapy , Arthritis, Rheumatoid/complications , Diagnosis, Differential , HIV Infections/complications , Humans , Lupus Erythematosus, Systemic/complications , Male , Penicillins/therapeutic use , Rheumatoid Factor/analysis , Syphilis/complications , Syphilis/drug therapy , Syphilis SerodiagnosisABSTRACT
A case of bilateral metachronous renal cell carcinoma with gallbladder and pancreatic metastases, presenting with hematobilia and anemia is presented. The presentation of metastatic renal cell carcinoma with hematobilia and anemia is previously unreported. This case illustrates (1) the occasionally very long interval between metachronous renal carcinoma; (2) this tumor's propensity to unusual metastases and unpredictable presentation; and (3) the significant palliation which may be achieved by appropriate surgical resection of these metastases.
Subject(s)
Anemia, Hypochromic/etiology , Carcinoma, Renal Cell/secondary , Gallbladder Neoplasms/secondary , Hemobilia/etiology , Kidney Neoplasms/pathology , Neoplasms, Multiple Primary/pathology , Pancreatic Neoplasms/secondary , Adult , Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell/pathology , Female , Gallbladder Neoplasms/complications , Humans , Kidney/pathology , Pancreatic Neoplasms/complications , Time FactorsABSTRACT
All cases of pleomorphic salivary adenoma treated at the West of Scotland Regional Plastic and Oral Surgery Unit, Canniesburn Hospital, over the 10-year period 1974-1983 have been reviewed. Nearly one-fifth of patients were treated for recurrence. These patients presented with their primary tumour at a significantly younger age (p less than 0.001) than those who remained disease-free. Sixteen of 31 who subsequently developed recurrence were under 30 years of age at initial presentation. Of all patients under 30 years of age at first presentation, 42% subsequently developed recurrent diseases.
