Robert C. Muehrcke

Renal vein thrombosis and the nephrotic syndrome

Abstract 1.1. Two cases of renal vein thrombosis with the nephrotic syndrome have been observed. One patient died. The second patient had multiple pulmonary infarctions and thrombosis of both common iliac veins. The nephrotic syndrome developed after gradual or incomplete occlusion of the left renal vein. Two months later more rapid occlusion of the right renal vein occurred. The right kidney became functionless, secondarily infected and was later removed. Treatment with anticoagulant and antibiotic drugs reversed the previously relentless downhill course and the patient thereafter made an uninterrupted recovery. 2.2. The clinical features of the reported cases have been reviewed, and the clinical syndrome of renal vein thrombosis with the nephrotic syndrome has been delineated. In adults, renal vein thrombosis may present with acute symptoms referable to the affected kidney, as the nephrotic syndrome of obscure etiology or as a combination of the two. The presenting picture is related to the rapidity and completeness of occlusion of the vein. 3.3. In two cases histologic studies have been made on sections from serial percutaneous renal biopsy and autopsy material and in five other cases from autopsy material. The glomerular basement membrane was thickened and the tubules were atrophied. The interstitial tissue was edematous at first and later became the seat of an extensive fibrosis. The changes in the tubules and interstices were out of proportion to the affection of the glomeruli.

THE NEPHROTIC SYNDROME IN ADULTS: A COMMON DISORDER WITH MANY CAUSES

Excerpt The metabolic, nutritional and clinical consequences of continued massive albuminuria constitute the nephrotic syndrome. Florid cases are readily recognized from infancy1, 2to extreme old a...

Natural History of Lipoid Nephrosis and of Membranous Glomerulonephritis

Abstract Twenty-one patient each with lipoid nephrosis (LN) and membranous glomerulonephritis (MGN) were observed for a long period of time. Six patients with LN and one with MGN were under 14 year...

The Nephrotic Syndrome: A Prodrome to Lymphoma

Abstract Two patients with the nephrotic syndrome were studied: one with Hodgkins disease and the other with lymphosarcoma. Kidney biopsy studies were made using light and electron microscopy and ...

Analgesic nephropathy: A clinicopathologic study using electron microscopy☆

Abstract A Clinicopathologic study was made in twenty-six patients who had consumed at least 2 kg of both acetylsalicylic acid and phenacetin. Renal function varied from normal to end-stage. Conventional histologic and electron microscopic studies confirmed a medullary site for the earliest lesion, which appeared to be an increase in interstitial collagen. Other early abnormalities included focal thickening of tubular basement membranes, degeneration, atrophy or loss of tubular epithelium, and casts. These abnormalities were apparent when renal function was not demonstrably reduced. They progressed to become a diffuse sclerosis or necrosis of the medulla, and only then were cortical histologic abnormalities present. These included peritubular, interstitial and periglomerular fibrosis; tubular atrophy, dilatation and basement membrane thickening; and in some focal round cell infiltration. Results of immunofluorescent microscopy were negative for immunoglobulin G (IgG) and beta 1 -C globulin ( β 1 C ) in kidney tissue from six patients. The earliest functional lesion was impaired ability to concentrate urine. When creatinine clearance was even slightly reduced, there was medullary sclerosis and in some patients pyelographic evidence of extensive papillary necrosis. Bacteriuria was found mainly in patients whose renal function was considerably reduced, and pyelonephritis, when present, appeared to be secondary. Renal function stabilized or improved in most patients who stopped taking mixed analgesics, but deteriorated further in those who did not.

The clinical value of renal biopsy.

Excerpt The Kea parrot kills sheep by pecking at their kidneys with its large, hawklike beak.‡The human counterpart of this bird makes ill-advised stabs with large-bore biopsy needles at the kidney...

Serum Beta1C Globulin in Glomerulonephritis and Systemic Lupus Erythematosus

Abstract Beta1Cglobulin was measured in serum from 240 patients with renal diseases and systemic lupus erythematosus (SLE) by a simple radial gel-diffusion method. Values below 97 mg/100 ml were co...

The relationship of "chronic pyelonephritis" to chronic potassium deficiency.

Excerpt Preliminary observations made in 1957, on patients chronically deficient of potassium suggested that chronic pyelonephritis was one sequel of chronic potassium deficiency (1, 2). At that ti...

Negative Effects of Vitamin B12 on Blood of Healthy Individuals, with Special Reference to Eosinophils.

Summary 1. Oral or intramuscular administration of large amounts of vit. B12 was without effect on the blood of healthy adults and children. In particular, an eosinophilia was not observed. 2. Neither allergic nor toxic symptoms were noted during or after therapy. 3. It is concluded that vit. B12 is not the eosinophilic factor present in raw calves liver.

An Autoantibody Mechanism for Membranous Glomerulonephritis Due to Renal Vein Obstruction.

Excerpt Unilateral renal vein thrombosis produces massive proteinuria and in time the nephrotic syndrome. Bilateral membranous glomerulonephritis and subsequent progressive renal failure may develo...