Kidney failure is a contraindication to interferon therapy, and active chronic hepatitis is incompatible with kidney transplantation. Our study was aimed at investigating the activity and tolerability of leukocyte interferon-alpha in patients undergoing pre-transplant dialysis and suffering from chronic active hepatitis due to Hepatitis C virus infection. Ten patients, with persistently high ALT levels, were treated with leukocyte interferon-alpha, at a dose of 1 MU three times weekly for one year. Viraemia, ALT levels and other blood and urine tests, hepatitis stage and drug tolerance were all monitored throughout the study and the six-month follow-up period. After six months of treatment, two patients had continuing normalisation of ALT, negative HCV-RNA tests and normalisation of histological features ('long-term responders'). Four patients relapsed; three did not respond to treatment; and one patient discontinued it because of intolerance. The four relapsing patients received a second cycle with the same interferon, at a dose of 3 MU three times weekly, with attainment, in one patient, of complete remittance after six months of follow-up. Leukocyte interferon-alpha yielded an overall 30% therapeutic response in dialysed patients with chronic hepatitis C. Its use is helpful in enabling dialysed patients to undergo transplantation.
34 adult patients with membranoproliferative glomerulonephritis are reviewed; the diagnosis was based on histological studies, by light and electron microscopy. Hypocomplementemia was detected in 67.6% of the cases; the C3 depression was associated with normal early complement components (82.5%) and low levels of C3 PA (65.2%). In the serum of ten hypocomplementemic patients the presence of circulating factor, which is able to break down the normal C3in vitro, was found. Immunofluorescence deposits of C3 were present in 100% of the cases, IgM in 92, IgG in 86, IgA in 30, C1q in 53 and C4 in 46% of the cases. Only in a few cases there was a correlation between serum complement profile and the immunofluorescence pattern. Hypocomplementemic patients with ‘classical’ pathway activation seemed to have a worse clinical course than the others. The results of humoral and cellular immunity studies do not permit to draw any clear conclusion.
A multicenter comparative study was carried out to evaluate the efficacy of aztreonam and gentamicin in 186 patients with symptomatic renal or urinary tract infections. Patients were divided randomly into two groups: 94 patients received aztreonam 1 g/day intramuscularly and 92 patients received gentamicin 80 mg i.m. twice daily. The clinical and microbiologic results found a single daily dose of aztreonam to be more effective than gentamicin b.i.d. Furthermore, no evidence of side effects was seen with aztreonam. Such results are generally thought to ensure better compliance in outpatients.
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