RESUMO
OBJECTIVES: Zinc metabolism is frequently abnormal in renal allograft recipients. These abnormalities may be immune mediated because zinc metabolism is affected by inflammation. METHODS: We determined urinary zinc and neopterin concentrations in 24 allograft recipients (18 kidney, 3 combined kidney-pancreas and 3 liver allografts) daily for 1-41 days. In addition, serum zinc concentrations were measured in 11 patients. RESULTS: Serum zinc was decreased and urinary zinc concentrations were increased in kidney as well as liver transplant recipients when compared with healthy controls. Urinary zinc concentrations were only slightly elevated in patients with uncomplicated post-transplant course, but the increase was more pronounced in renal allograft recipients with acute tubular necrosis. Urinary zinc concentrations were drastically increased during rejection of various organs. In addition, significant associations between urinary zinc and neopterin concentrations were observed. CONCLUSION: Our results suggest that enhanced urinary zinc excretion in allograft recipients is due to immune activation. The data indicate that cytokines play a role in zinc metabolism.
Assuntos
Biopterinas/análogos & derivados , Transplante de Rim/métodos , Transplante de Fígado/métodos , Transplante de Pâncreas/métodos , Zinco/urina , Adolescente , Adulto , Idoso , Biopterinas/urina , Criança , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/urina , Feminino , Rejeição de Enxerto/urina , Herpes Simples/complicações , Herpes Simples/urina , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Neopterina , Valores de Referência , Transplante Homólogo , Zinco/sangueRESUMO
This study was designed to reassess the cytomorphology of viral infections in urinary cells obtained from renal transplant patients and to examine the association, if any, between these cytologic changes and the transplant rejection. A total of 2,354 cytologic specimens obtained from 91 renal transplant recipients was evaluated. A combination of techniques, including cellulosic filters, immunofluorescence, hemagglutination inhibition and electron microscopy, was utilized. Cytologic observations were correlated with the patient's clinical history. Thirty-eight patients revealed cytologic evidence of viral infections (herpes simplex, cytomegalovirus and papovavirus). These viral infections had distinct cytomorphology. Cytomegalovirus infection may manifest as intracytoplasmic, orangeophilic inclusions, in addition to the classical intranuclear inclusion. In the majority of renal transplant patients there appeared to be no relationship between the viral infection and the renal transplant rejection episodes.
