ABSTRACT
This is the first case of nonprimary collapsing focal segmental glomerulosclerosis (FSGS) associated with Loa loa filariasis. Loa loa micofilariae were detected on a blood smear after a patient presented with nephrotic syndrome (NS), microhematuria, and renal failure. The renal biopsy showed a collapsing glomerulopathy variant of FSGS. Microfilariae also were identified in renal microvasculature, including the afferent arterioles and the glomerular and peritubular capillaries.
Subject(s)
Glomerulosclerosis, Focal Segmental/parasitology , Loiasis/complications , Acute Kidney Injury/parasitology , Animals , Arterioles/parasitology , Capillaries/parasitology , Female , Glomerulosclerosis, Focal Segmental/pathology , Hematuria/parasitology , Humans , Kidney/blood supply , Kidney Glomerulus/blood supply , Kidney Glomerulus/parasitology , Kidney Glomerulus/pathology , Kidney Tubules/blood supply , Loa , Loiasis/blood , Microcirculation/parasitology , Middle Aged , Nephrotic Syndrome/parasitologyABSTRACT
AIMS: To study the pathogenesis of tumoral calcinosis (TC), we investigated 111 cases registered in Zaire over 30 years. METHODS AND RESULTS: The patients were 108 black Africans and three Caucasians between 3 and 74 years of age (mean, 37.7; median, 39). The gender was known in 33 males and 46 females; in 79 the gender was unknown. All but three were healthy and one had tuberculosis. The majority presented with a painless swelling in single or multiple periarticular regions. The hip was the most commonly affected (57%). Seven recurrences after surgical removal of the mass were reported. On microscopic examination, lesions were classified as follows: 24% stage I, 16% stage II and 60% stage III depending on the cellular activity at the border of the cysts. In five stage I cases only, and in no advanced stage II/III lesions, were exuberant cellular proliferative changes seen adjacent to the classical cystic form. These consisted of either ill-defined reactive-like perivascular solid cell nests admixed with mononuclear and iron-loaded macrophages, or well-organized variably sized fibrohistiocytic nodules embedded in a dense collagenous stroma. These immature changes indicated newly appearing lesions and were assumed to represent the earliest discernible stages in the evolution of TC. The unique well-defined fibrohistiocytic nodules have not been described previously. CONCLUSIONS: These findings have thus described the full spectrum of lesions occurring in TC. We believe that the adjacent findings are potentially important either in recognizing early stages of the disease or in understanding its pathogenesis.
Subject(s)
Calcinosis/etiology , Calcinosis/pathology , Joint Diseases/pathology , Adolescent , Adult , Aged , Bursitis/pathology , Calcinosis/metabolism , Cartilage, Articular/pathology , Child , Child, Preschool , Cysts/etiology , Cysts/pathology , Democratic Republic of the Congo , Female , Humans , Joint Diseases/etiology , Male , Middle Aged , Skin Diseases/etiology , Skin Diseases/pathologyABSTRACT
Les objectifs ont ete de proposer une methode standardisee de l'examen microscopique de l'urine et de determiner les valeurs de reference. Cent dix-neuf echantillons recoltes lors de la premiere et/ou de la seconde miction matinale provenant de 100 sujets sains. Les urines etaient d'aspect limpide chez tous les sujets et de coloration jaune clair (58;80 pour cent); jaune fonce (27;7 pour cent) (jaune paille (13;4 pour cent). L'urine de la premiere et de la seconde miction constitue l'echantillon ideal pour l'examen microscopique urinaire. Les valeurs de reference obtenues sont comparables a celles rapportees dans la litterature. Ces resultats suscitent l'interet de la vulgarisation de la methode standardisee
