Subject(s)
Deferoxamine/therapeutic use , Iron/metabolism , Kidney Failure, Chronic/complications , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Peritoneal Dialysis/adverse effects , Adult , Anemia, Sickle Cell/complications , Deferoxamine/administration & dosage , Female , Humans , Injections, IntravenousABSTRACT
The effect of protein and calorie supplementation on the immune function of two maintenance hemodialysis patients was assessed. Before nutritional supplementation, both patients were anergic to four skin test antigens and had low relative percentages and absolute number of T lymphocytes. After 3 months of nutritional supplements both patients responded to in vivo skin testing to at least two antigens and in both patients, the relative percentage and absolute number of T lymphocytes increased. These two cases illustrate that the defect in cell-mediated immunity and impaired delayed cutaneous hypersensitivity which is known to occur in hemodialysis patients may be a reversible manifestation of protein-calorie malnutrition.
Subject(s)
Food, Fortified , Immune System Diseases/diet therapy , Protein-Energy Malnutrition/diet therapy , Renal Dialysis/adverse effects , Humans , Hypersensitivity, Delayed/immunology , Immune System Diseases/etiology , Immunity, Cellular , Leukocyte Count , Male , Middle Aged , Protein-Energy Malnutrition/complications , Skin Tests , T-Lymphocytes/pathologyABSTRACT
A teenage male, with Goodpasture's syndrome and serum antiglomerular basement membrane (anti-GBM) antibodies, had a focal proliferative glomerulonephritis with crescents. Immunofluorescence microscopy of his glomeruli using anti-IgG antibodies demonstrated both intense linear GBM staining, and granular subepithelial staining. Electron microscopy revealed numerous subepithelial electron-dense deposits. Identical IgG subclass restriction (dominance of IgG1 and IgG4) of both types of glomerular deposits in this patient supports, but does not prove, a postulate that the linear staining was due to anti-GBM antibodies bound to intact GBM, and that the granular staining was due to anti-GBM antibodies complexed with freed GBM antigens.