Immunoglobulin G4–related disease (IgG4-RD) is a chronic fibrosing inflammatory systemic disorder that has been recognized relatively recently in the medical literature. Little is known about the exact disease pathogenesis and epidemiology. IgG4-RD may be asymptomatic or may have minimal symptoms or involve multiple organs with overt symptoms. The different phenotypes of IgG4-RD can lead to delayed or incorrect diagnosis. We report the case of a 66-year-old male with coal worker’s pneumoconiosis who presented with progressive kidney disease and was diagnosed with tubulointerstitial nephritis due to IgG4-RD. The patient was noted to have progressive kidney disease, skin involvement, worsening interstitial lung disease, complete vision loss in the left eye, and retroperitoneal fibrosis. Serologic workup revealed elevated inflammatory markers, IgG4 and IgG1 levels, and hypocomplementemia. A tissue biopsy helped us establish a definitive diagnosis of IgG4-RD and initiate treatment with glucocorticoids to prevent further progression of kidney disease and other end-organ damage.

Feline morbillivirus (FeMV) is a recently discovered virus belonging to the genus Morbillivirus of the virus family Paramyxoviridae. Often, the virus has been detected in urine of cats with a history of urinary disease and has a worldwide distribution. Currently, it is unclear which receptor the virus uses to enter the target cells. Furthermore, many aspects of FeMV biology in vivo, including tissue tropism, pathogenesis, and virus excretion in the natural host remain unclear. In this study we analyzed the replication of FeMV in various cell lines. Secondly, we tested if the presence of feline SLAMF1 (Signaling Lymphocytic Activation Molecule family 1/CD150, principal entry receptor for other members of the Morbillivirus genus) improved FeMV replication efficiency in vitro. Finally, to elucidate in vivo biology in cats, as a natural host for FeMV, we experimentally infected a group of cats and monitored clinical symptoms, viremia, and excretion of the virus during the course of 56 days. Our study showed that FeMV shares some features with other morbilliviruses like the use of the SLAMF1 receptor. For the first time, experimental infection of SPF cats showed that FeMV does not induce an acute clinical disease like other morbilliviruses but can induce lesions in the kidneys, including tubulointerstitial nephritis. Further investigations are needed to confirm the site and dynamics of replication of FeMV in the urinary tract and the longer-term impact of FeMV-induced lesions on the renal function. Whether FeMV infection can result in chronic kidney disease will require the monitoring of cats over a longer period.

Submitted by Ubirajara Cruz (ubirajara.cruz@gmail.com) on 2017-06-26T15:49:03Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Carolina_Sapin.pdf: 1243520 bytes, checksum: e9ae4587ba4ba0e8a1905c812da97edf (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2017-06-27T19:05:07Z (GMT) No. of bitstreams: 2 Carolina_Sapin.pdf: 1243520 bytes, checksum: e9ae4587ba4ba0e8a1905c812da97edf (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-06-27T19:05:07Z (GMT). No. of bitstreams: 2 Carolina_Sapin.pdf: 1243520 bytes, checksum: e9ae4587ba4ba0e8a1905c812da97edf (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-02-19 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Nesta dissertação, abordam-se as patologias do sistema urinário. Os dados referentes a estas enfermidades são relacionados aos casos diagnosticados na região sul do Rio Grande do Sul em um período de 36 anos. Com base nesses achados foram elaborados dois artigos científicos. No primeiro trabalho avaliaram-se todas as lesões do sistema urinário de cães, constantes nos protocolos de necropsia e exames histopatológicos do Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas, no período de 1978 a 2014. Foram encontrados diagnósticos de afecções do sistema estudado em 363 cães, correspondente a 4,04% do total de 8980 diagnósticos realizados no período para a espécie. As lesões renais representaram 93,1%, sendo 309 primárias do rim; dentre as principais lesões estavam a nefrite túbulo-intersticial (142 casos), geralmente associada à 47 casos de Leptospirose. O trato urinário inferior (TUI) representou 6,9% dos casos destacando-se a cistite aguda com 19 casos de um total de 60 lesões do TUI. Neste estudo a insuficiência renal, aguda ou crônica, representou importante causa mortis em cães. No segundo artigo descreve-se um diagnóstico anatomo-patológico de metaplasia disontogênica uretral em um felino fêmea, de um mês de idade e sem raça definida. Havia histórico de aumento de volume abdominal desde o nascimento. Ainda apresentava disúria, eliminando a urina apenas por cistocentese, sondagem vesical ou gotejamento. Foi eutanasiado e na necropsia observou-se bexiga aumentada e dilatada, rins diminuídos e ureteres dilatados e tortuosos. Histologicamente havia metaplasia disontogênica da uretra e displasia renal bilateral. Conclui-se nesta dissertação que as principais lesões renais foram a necrose tubular aguda, nefrite túbulo-intersticial, fibroplasia e glomeruloesclerose; e quanto ao TUI sobressaíram-se a cistite aguda, urolitíase, ruptura de bexiga e neoplasias primárias. / This thesis addresses the pathologies of the urinary system. The data concerning disorders of the urinary tract are related to cases diagnosed in southern Rio Grande do Sul in a period of 36 years. Based on these findings two papers were written. The first article assessed all the urinary tract lesions of canine, described in the necropsy reports and histopahtological tests from the Regional Laboratory of Diagnosis of the College of Veterinary in the Federal University of Pelotas in the period from 1978 to 2014. From a total of 8980 diagnosis, 363 dogs were found to have affections of the urinary system, which represents 4,04% of diagnosis performed for that period and species. Renal injury accounted for 93.1% of the cases, with 309 being primary kidney lesions; from which the main lesions were the tubulointerstitial nephritis (142 cases) often associated with Leptospirosis (47). Injuries of the lower urinary tract (LUT) accounted for 6.9% of the cases where acute cystitis stands out with 19 cases of a total of 60 LUT injuries. In this study, renal failure, acute or chronic, represented an important cause of death in dogs. The second article describes an anatomopathological diagnosis of dysontogenic urethral metaplasia in a female, one monthold, mongrel cat. The animal had history of abdominal enlargement since birth and dysuria, eliminating urine only cystocentesis, urinary catheterization or drip. It was euthanized and in the necropsy was observed enlarged and distended bladder, reduced kidneys and dilated and tortuous ureters. Histologically, it had dysontogenic metaplasia of the urethra and bilateral renal dysplasia. It is concluded in this thesis that the main renal lesions were acute tubular necrosis, tubulointerstitial nephritis, fibroplasia and glomerulosclerosis; and when the LUT is concerned, acute cystitis, urolithiasis, bladder rupture and primary neoplasms stood out.