RESUMO
Se presenta una paciente de 34 años, que después del segundo embarazo comenzó la ingesta de anovulatorios (Etinilestradiol-levonorgestrel durante 5 años, en el transcurso del tercer año notó la aparición del cuadro de telangiectasia nevoide unilateral, que actualmente se lo relaciona con cambios estrogénicos fisiológicos o patalogicos, sin embargo su fisiopatología no esta totalmente aclarada.
Assuntos
Humanos , Feminino , Adulto , Ombro/patologia , Telangiectasia/diagnóstico , Telangiectasia/fisiopatologia , Etinilestradiol/efeitos adversos , Levanogestrel/efeitos adversosRESUMO
Se presenta una paciente de 34 años, que después del segundo embarazo comenzó la ingesta de anovulatorios (Etinilestradiol-levonorgestrel durante 5 años, en el transcurso del tercer año notó la aparición del cuadro de telangiectasia nevoide unilateral, que actualmente se lo relaciona con cambios estrogénicos fisiológicos o patalogicos, sin embargo su fisiopatología no esta totalmente aclarada. (AU)
Assuntos
Humanos , Feminino , Adulto , Telangiectasia/diagnóstico , Telangiectasia/fisiopatologia , Ombro/patologia , Etinilestradiol/efeitos adversos , Levanogestrel/efeitos adversosRESUMO
Radiation of the kidney often leads to renal failure. The contribution of arterial hypertension to the development of this complication is unclear. The aim of this study was to determine the renal effects of antihypertensive therapy in 1- and 2-kidney rat models of radiation nephritis. Five groups of Long Evans rats had X-irradiation of the left kidney. In groups 1 and 2, the right kidney was left undisturbed (2-kidney model). The rats in group 3, 4 and 5 underwent right nephrectomy 21 days before radiation (1-kidney model). Groups 1 and 3 received no drug treatment and served as controls for each model. Groups 2 and 4 had enalapril 50 mg/l in drinking water and group 5 hydrochlorothiazide (HCT) 200 mg/l, also in drinking water. Blood pressure increased significantly in both control groups and remained normal throughout the study in all treated groups. At the end of the study, mean urinary protein excretion was lower in the two enalapril-treated groups but not in HCT-treated animals. Groups 1 and 2 (2-kidney models) showed similar increments in plasma creatinine (PCreat), and, in both groups, the creatinine clearance (CCreat) dropped to the same extent. Among nephrectomized animals (1-kidney model), PCreat was lower and CCreat higher in the enalapril-treated group. Consistent with these findings, glomerular sclerosis was less severe in both enalapril-treated groups. We conclude that, in radiation nephritis, lowering blood pressure with enalapril exerts a beneficial effect on renal function and structure, whereas a similar reduction in blood pressure induced by HCT does not.
Assuntos
Enalapril/farmacologia , Hidroclorotiazida/farmacologia , Nefrite/tratamento farmacológico , Lesões Experimentais por Radiação/tratamento farmacológico , Animais , Pressão Sanguínea/efeitos dos fármacos , Hipertensão Renal/prevenção & controle , Nefrectomia , Nefrite/patologia , Nefrite/fisiopatologia , Lesões Experimentais por Radiação/patologia , Lesões Experimentais por Radiação/fisiopatologia , Ratos , Fatores de TempoRESUMO
This study was undertaken to investigate the role played by renal functional and structural changes in the development of radiation-induced hypertension. Four groups of rats were studied: 1) left kidney radiated, 2) sham procedure, 3) uninephrectomy followed 3 weeks later by radiation of the contralateral kidney, and 4) uninephrectomy followed by sham procedure 3 weeks later. All radiated rats became hypertensive at 12 weeks (p less than 0.05) and had higher protein excretion (p less than 0.05). In the presence of an intact contralateral kidney, radiation causes mild-to-moderate histological abnormalities, and therefore, creatinine clearance and water and sodium handling do not change. Plasma renin activity increased in this group (p less than 0.05). Radiated uninephrectomized rats showed decreased creatinine clearance (p less than 0.05), but renin activity remained unchanged. These rats developed severe histological abnormalities in glomeruli, interstitia, tubuli, and vessels resulting in increased sodium and water output. The average of individual tubular and interstitial scores correlated significantly with both water intake and output but not with sodium excretion. These studies suggest that in the presence of an intact kidney, renin is an important determinant in the development or maintenance of radiation hypertension, whereas in the absence of the contralateral kidney, severe histological changes and renal failure are prominent despite increased water intake and output. The more severe glomerular sclerosis and proteinuria in the latter model could be related to diminished renal mass.