ABSTRACT
We present two patients with Hantaan virus infection, admitted to the Department of Nephrology, Skopje, at the same time, with the same clinical presentation (chills, fever, abdominal pain, hemorrhages, nausea, headache, proteinuria, hematuria, oliguria, acute renal failure) but with different pathohistological findings and different disease courses. In the first case diffuse proliferative glomerulonephritis was found, with a complete recovery of renal function after a month, with a mild proteinuria and erythruria during the second and the third month. In the second case, glomeruli were normal in general, with slight mesangial proliferation found in two out of twenty, but interstitial edema, lymphocyte infiltrations and tubular changes were noted. Complete recovery was not noted after 3 months of follow-up. The patient is now without hemodialysis treatment, with polyuria, in the stable phase of chronic renal failure which is not improving.
Subject(s)
Acute Kidney Injury/microbiology , Glomerulonephritis/microbiology , Hemorrhagic Fever with Renal Syndrome/pathology , Kidney/pathology , Orthohantavirus , Adult , Hemorrhagic Fever with Renal Syndrome/epidemiology , Hemorrhagic Fever with Renal Syndrome/microbiology , Humans , Male , Yugoslavia/epidemiologyABSTRACT
Out of 99 histologically verified carcinomas (HCC), 73 (73.7%) belonged to HCC with associated cirrhosis and 26 (26.2%) belonged to HCC without cirrhosis. The relatively high incidence of HBsAg in the serum of patients with non-cirrhotic HCC (57.6%) shows that HBV infection persistence could be, one of the very important bases for HCC development, more than cirrhosis itself. The negative finding of HBsAg in the serum couldn't exclude the possibility of an integrated HBV genome in the cirrhotic tissue. There is an alternative possibility of an induced infection with hepatitis NANB (transfusions). A non-significant inclination towards younger age groups exists in non-cirrhotic HCC. Males are predominant in both groups, but females are more present in non-cirrhotic HCC than in cirrhotic HCC. The clinical course of non-cirrhotic HCC is usually slower; often there are no signs of portal hypertension or surrounding organ involvement, which offers better prognostic prospects than cirrhotic HCC. In relation to cirrhotic HCC, patients with non-cirrhotic HCC had a less frequent history of hepatitis (19.2%), a higher albumin-globulin ratio (1.5) and lower values in serum alpha-1 fetoprotein elevation (53.8%). Ultrasonographically, HCC without cirrhosis is presented with a mono-nodular shape in the majority of cases, or as a primary and dominant form, with surrounding satellite lesions even within the other lobe. Pathoanatomic findings usually show massive, compact, solid tissue formation alone, or accompanied by satellite lesions. Histologically, there is low-degree evolution with minimal necrosis and mild mitotic activity with a presence of minimal fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)
