succimer and Thrombosis

Systemic lupus erythematosus (SLE) patients, specially those with antiphospholipid antibodies, have a high incidence of arterial and venous thrombotic manifestations. However, renal infarction has been rarely reported in these patients. The case of a young female with renal infarction, diagnosed by renal arteriography and scintigraphy, and arterial hypertension (AH) is described. In subsequent years she also suffered several cerebrovascular accidents with important neurological sequelae. No evidence of systemic disease was observed at this time. Fourteen years after the renal infarction a diagnosis of SLE was established. Despite therapy with prednisone, acetylsalicylic acid, azathioprine and antihypertensive drugs the progression of the neurological disease led to death. The sudden appearance of severe AH in a young woman with a renal infarction should alert the clinician about a possible underlying renal artery thrombosis in association with SLE and antiphospholipid antibodies.

Topics: Adult; Angiography; Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Brain Ischemia; Fatal Outcome; Female; Humans; Hypertension; Infarction; Kidney; Lupus Erythematosus, Systemic; Radionuclide Imaging; Renal Artery Obstruction; Succimer; Thrombosis

Neonatal renal venous thrombosis (NRVT) is a serious complication of newborns. Ultrasound is most useful in detecting NRVT. However, there is no detailed description of the evolution of ultrasound finding in NRVT. Here we report a patient with NRVT with complete ultrasound follow-up. Perivascular streaks were first seen at 3 days of age with a diffusely enlarged and echogenic right kidney. Echolucency then gradually appeared over the medulla area with shrinking renal size. Concomitant loss of renal function was evidenced by dimercaptosuccinic acid scan. The kidney became contracted at the age of 1 year. Since the pathognomonic perivascular streaks were present for only a few days, early ultrasound scanning should be performed for every newborn suspected of having NRVT.

Topics: Humans; Infant, Newborn; Kidney Diseases; Kidney Function Tests; Male; Organotechnetium Compounds; Radionuclide Imaging; Renal Veins; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Thrombosis; Ultrasonography

In 14 in situ canine renal transplants, intracellular phosphorus metabolites were evaluated by phosphorus-31 magnetic resonance spectroscopy (31P-MRS), performed using surface coils to investigate the usefulness of this technique for assessing renal viability in situ. Group I control kidneys (n = 5) were autografts, as were Group II (n = 5) kidneys: the latter group were subjected to surgically induced vascular ischemia and thrombosis. Group III kidneys (n = 4) were rejecting allografts. Renal flow and function, as measured by 99mTc-DTPA, and findings on histologic examination were correlated with 31P-MRS spectra. Group I kidneys showed excellent viability on both 99mTc-DTPA studies and biopsy evaluation, and their 31P-MRS-derived ratios of phosphomonoesters/inorganic phosphate (PME/Pi) and adenosine triphosphate/Pi (ATP/Pi) were high (1.32 +/- 0.23 and 0.90 +/- 0.36, respectively). In contrast, Group II kidneys demonstrated poor flow and function, histologic evidence of severe ischemia from venous and arterial thrombosis, and significantly (P < 0.005) less viability than controls, as monitored by 31P-MRS PME/Pi (0.58 +/- 0.30) and ATP/Pi (0.20 +/- 0.13) ratios. Group III kidneys also demonstrated poor flow and function with 99mTc-DTPA, and the associated histologically injury was noted to be caused by accelerated rejection and severe vascular damage. PME/Pi (0.24 +/- 0.22) and ATP/Pi (0.10 +/- 0.01) ratios were also significantly (P < 0.005) less than those in controls, reflecting nonviability. The 31P-MRS-derived PME/Pi and ATP/Pi ratios enable a qualitative noninvasive assessment of blood flow-dependent renal viability, but with currently used localization techniques the differentiation between severe ischemia and severe acute rejection was not possible.

Topics: Adenosine Triphosphate; Animals; Dogs; Graft Rejection; Graft Survival; Kidney; Kidney Transplantation; Magnetic Resonance Spectroscopy; Organotechnetium Compounds; Phosphates; Renal Artery Obstruction; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate; Thrombosis