RESUMEN
A patient had recurrent episodes of acute glomerulonephritis following exacerbations of chronic relapsing pancreatitis. Light microscopy of the renal biopsy performed during the episode of acute glomerulonephritis showed fibroepithelial crescents involving 70% of the glomeruli. The patient recovered without specific therapy. The time interval involved and the presence of subendothelial deposits with mesangial deposition of C3 complement and IgM suggest immune complex injury.
Asunto(s)
Glomerulonefritis/complicaciones , Pancreatitis/complicaciones , Enfermedad Aguda , Adulto , Alcoholismo/complicaciones , Complejo Antígeno-Anticuerpo , Enfermedad Crónica , Complemento C3 , Glomerulonefritis/inmunología , Glomerulonefritis/patología , Humanos , Inmunoglobulina M , Riñón/patología , Masculino , Pancreatitis/etiología , Pancreatitis/patologíaRESUMEN
Seventeen patients with femoral arteriovenous bovine shunts (FAVBS) were evaluated to delineate the cardiovascular consequences of the procedure. The resting cardiac index (CI), as estimated by echocardiography, was increased in 8 patients (47%). Twelve of the 17 patients (71%) had more than a 20% reduction in CI after 5 minutes of shunt occlusion. In 6 of these, the CI returned to normal from an abnormally high value. As a group, the decrease in CI was significant (P = 0.001). This was accomplished mainly by a significant decrease in stroke volume (P less than or equal to 0.004). Signs and symptoms of congestive heart failure developed in 10 of the 17 patients during the year following FAVBS. Because of the marginal cardiac reverse in patients with renal failure and the significant increase in cardiac index resulting from FAVBS, alternative forms of vascular access should be used whenever possible.