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SUMMARY Glomerulonephritis with organized microtubular monoclonal immunoglobulin deposits (GOMMID) and glomerulonephritis related to type I cryoglobulin are well-known but rare complications of B cell derived chronic lymphocytic leukaemia. In these disorders, monoclonal Ig have never been studied at the molecular level. We conducted a pathological and molecular analysis in a patient with chronic lymphocytic leukaemia, glomerulonephritis and a single circulating monoclonal Ig. Unusual IgG1κ kidney deposits were observed. The heavy and light chain variable region sequences of that cryoprecipitating monoclonal Ig were characterized. Light microscopy revealed glomerulonephritis typical of cryoglobulinaemia, with neutrophil and macrophage infiltration, endocapillary hyperplasia and few protein thrombi. Electron microscopic study clearly evidenced numerous subepithelial mixed granular and organized deposits with a unique microtubular organization, reminiscent of the GOMMID. The Ig molecule sequence revealed alterations of charge and hydrophobicity potentially promoting a crystal-like aggregation and the aggregation of microtubules.This description suggests that common mechanisms are involved in various forms of precipitation and/or deposition of complete Ig molecules, with a variable extent of organization and with a possible overlap between pathological patterns of either glomerulonephritis with microtubular deposits or type I cryoglobulinic glomerulonephritis. [ABSTRACT FROM AUTHOR]

AIMS--To establish the prevalence of c-erbB-2 protein expression in a surgical series of Barrett's adenocarcinomas; and to correlate this expression with clinicopathological data and prognosis. METHODS--Sixty six surgical specimens of Barrett's adenocarcinomas were included in this retrospective study. Blocks of the tumour and of non-dysplastic Barrett's mucosa were stained with a polyclonal antibody specific for the intracytoplasmic domain of the c-erbB-2 protein. RESULTS--Seven of 66 tumours showed membrane staining for the c-erbB-2 protein. The non-dysplastic Barrett's mucosa was negative in all cases. There was no difference between c-erbB-2 positive and negative tumours with regard to mean age, sex ratio, percentage of alcohol misusers, percentage of smokers, tumour differentiation, depth of invasion, lymph node response, and proliferative activity, assessed by the percentage of tumour cells positive with the MIB-1 antibody directed against the Ki-67 antigen. All c-erb B2 positive tumours were of Lauren's intestinal type compared with negative c-erbB-2 tumours. Patients with c-erbB-2 positive tumours had a significantly poorer prognosis than patients with negative tumours. CONCLUSIONS--The prevalence of Barrett's adenocarcinomas expressing c-erbB-2 found in this study (11%) was similar to that observed in published series of gastric adenocarcinomas. c-erbB-2 protein expression could be an important prognostic indicator in Barrett's adenocarcinoma. [ABSTRACT FROM PUBLISHER]

Focuses on acute renal failure and hematuria in marathon runners, examining the role of glomerular bleeding in tublar injury in the risk of renal failure in runners and referencing the case report of a 46-year-old male marathon runner. Details on the symptoms the runner presented; Factors which contributed to the onset of renal failure; Information on the tests conducted on the patient; Treatment administered to the patient.

Objectifs L’hémochromatose néonatale (HN) est caractérisée par une insuffisance hépatocellulaire aiguë avec cirrhose et surcharge ferrique diffuse liée à une allo-immunisation maternofoetale avec activation du complément. La destruction hépatocytaire massive, à l’origine d’une carence en hepcidine foetale entraînant un afflux transplacentaire de fer. Le SHU est une microangiopathie thrombotique (MAT). Sa survenue en période néonatale doit faire évoquer une forme atypique (SHUa) généralement liée à une activation incontrôlée de la voie alterne du complément. Sujet Nous rapportons les observations de deux nouveau-nés décédés précocement ayant présenté un tableau évocateur de SHUa avec insuffisance rénale aigue (IRA), anémie hémolytique mécanique et thrombopénie. Les autopsies ont permis de poser le diagnostic d’HN. L’histologie rénale n’a pas retrouvé de lésions de MAT ni de dysgénésie tubulaire rénale mais de rares dépôts ferriques. Discussion L’HN est une cause classique d’insuffisance hépatocellulaire à transaminases normales. La particularité de nos observations est la présence de stigmates de MAT non décrits dans l’ HN. Conclusion Le diagnostic d’HN devra être évoqué chez un nouveau-né présentant des signes de SHU, a fortiori si des troubles de l’hémostase sont présents. [ABSTRACT FROM AUTHOR]