Histological diagnosis and risk of renal vein thrombosis, and other thrombotic complications in primitive nephrotic syndrome

Vol. 54 No. 3 Suppl., 2013
This supplement was not sponsored by Outside Organizations.

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

M. Harza, G. Ismail, G. Mitroi, Mihaela Gherghiceanu, A. Preda, G. Mircescu, I. Sinescu

Background: The risk of thromboembolic events is increased in patients with nephrotic syndrome (NS) as compared with other medical conditions and is a severe complication associated with significant morbidity and mortality. We aimed to assess the risk of renal vein thrombosis, and other venous thromboembolic events (VTE) in a large cohort of patients with NS and to identify the disease-specific risk for VTE. Patients and Methods: We performed a prospective observational study including consecutive adult patients with primitive NS admitted to our department. Clinical and biological data were obtained every six months during follow-up. Occurrence of VTE confirmed by imaging techniques was the primary study outcome. Results: We enrolled 191 patients (47+/-15 years, 53% men) with a median follow-up of 24 [IQR:12,36] months. During follow-up, 23 VTE occurred, of which 65.2% in the first six months. The disease-specific risk of VTE during the follow-up period was different across the histological groups, with the lowest risk in minimal change disease and IgA nephropathy and the highest in membranous nephropathy and membranoproliferative glomerulonephritis patients. In the subgroup of membranous, the severity of the subepithelial electron dense deposits did not correlate with the risk for VTE (p=0.5). Conclusions: In this prospective study, the risk of VTE was higher in the first six months of follow-up in NS patients. The histological pattern seems to influence the risk of VTE in this setting.

Corresponding author: Gener Ismail, MD, PhD; e-mail: gener732000@yahoo.com

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ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Gh. Muhlfay, O. S. Cotoi, Cl. Marginean, G. Lostun, H. Mozes, Karin Ursula Horvath

Background: The nose is a complex and defining organ not only for its respiratory, olfactory and phonatory function but also for facial esthetics. It is plastic and reconstructive techniques are at the same time an otorhinolaryngological issue and an interdisciplinary one. Materials and Methods: Among the materials used for reconstructive-reparatory surgery of the nose, we can distinguish the elastic ear cartilage transplant from patients own auricle. By analogy, we used in our experiment the rabbit ear as donor site and three radically different types of tissue as integrating structures. The modifications of the cartilages transplanted into abdominal subcutaneous tissue, muscles of the hip and under the skull periosteum were monitored through monthly sacrificing of the experimental animals. Results: No matter of the presence or lack of own perichondrium coverage the cartilage pieces showed radical transformation to total changes in structure from perichondral fibrosis to endochondral ossification and even complete resorption. Conclusions: We consider that at least a part of the reconstructive and esthetic plastic surgery failure comes from not knowing these significant changes that take place on the insertion site of own transplanted cartilage. The future surgical guidelines should remember the phenomena described for the first time in our research.

Corresponding author: Ovidiu Simion Cotoi, Lecturer, MD, PhD; e-mail: ovidiu.cotoi@umftgm.ro

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