The renal and hepatic distribution of Bence Jones proteins depends on glycosylation: A scintigraphic study in rats

The aim of the present study was to evaluate renal and liver distribution of two monoclonal immunoglobulin light chains. the chains were purified individually from the urine of patients with multiple myeloma and characterized as lambda light chains with a molecular mass of 28 kDa. They were named BJg (high amount of galactose residues exposed) and BJs (sialic acid residues exposed) on the basis of carbohydrate content. A scintigraphic study was performed on male Wistar rats weighing 250 g for 60 min after iv administration of 1 mg of each protein (7.4 MBq), as the intact proteins and also after carbohydrate oxidation. Images were obtained with a Siemens gamma camera with a high-resolution collimator and processed with a MicroDelta system. Hepatic and renal distribution were established and are reported as percent of injected dose. Liver uptake of BJg was significantly higher than liver uptake of BJs (94.3 vs 81.4%) (P<0.05). This contributed to its greater removal from the intravascular compartment, and consequently lower kidney accumulation of BJg in comparison to BJs (5.7 vs 18.6%) (P<0.05). After carbohydrate oxidation, there was a decrease in hepatic accumulation of both proteins and consequently a higher renal overload. the tissue distribution of periodate-treated BJg was similar to that of native BJs: 82.7 vs 81.4% in the liver and 17.3 vs 18.6% in the kidneys. These observations indicate the important role of sugar residues of Bence Jones proteins for their recognition by specific membrane receptors, which leads to differential tissue accumulation and possible toxicity.UNIV São Paulo,FAC MED,LAB FISIOPATOL RENAL,BR-01246903 São Paulo,SP,BRAZILUNIV São Paulo,CTR MED NUCL,BR-05403010 São Paulo,SP,BRAZILUNIV São Paulo,HOSP CLIN,SERV RADISISOTOPOS,BR-05403000 São Paulo,SP,BRAZILUniversidade Federal de São Paulo,MOL BIOL LAB,BR-04024900 São Paulo,SP,BRAZILUniversidade Federal de São Paulo,MOL BIOL LAB,BR-04024900 São Paulo,SP,BRAZILWeb of Scienc

A utilização do Método de Rorschach no diagnóstico diferencial da Esquizofrenia e Transtorno Dissociativo de Identidade

The aim of this article was to investigate the prevalence of the Dissociative Identity Disorder (DID) in ten patients diagnosed with schizophrenia with paranoid characteristic, based on the Rorschach approach. Psychological symptoms that characterize the differential diagnosis of these patients were registered, specific clinical differences were analyzed and the framework of the data obtained with the application of the Rorschach approach. For purposes of differential diagnosis, it was observed that two patients had differential symptoms to schizophrenia, one of which showed dissociative symptoms, not confirmed the prevalence of DID among schizophrenics. In the case of schizophrenia and DID due to exhibit similar characteristics, multidisciplinary evaluations are set to make a differential diagnosis between them.O objetivo deste artigo foi investigar a prevalência do Transtorno Dissociativo de Identidade (TDI) em dez pacientes diagnosticados com esquizofrenia com característica paranóide, com base no Método de Rorschach. Foram registrados indicadores ou sintomas psicológicos que caracterizaram o diagnóstico diferencial desses pacientes, analisadas diferenças clínicas específicas e verificado o enquadramento dos dados obtidos, com a aplicação da Técnica de Rorschach. Para fins de diagnóstico diferencial, observou-se que dois pacientes apresentaram sintomas diferenciais aos da esquizofrenia, sendo que um deles apresentou sintomas dissociativos, não sendo confirmada a prevalência do TDI entre os esquizofrênicos. No caso da esquizofrenia e do TDI, devido às características similares que apresentam, avaliações multidisciplinares são indicadas para se fazer o diagnóstico diferencial entre eles

Using the Rorschach method in the differential diagnosis of Schizophrenia and Dissociative Identity Disorder

O objetivo deste artigo foi investigar a prevalência do Transtorno Dissociativo de Identidade (TDI) em dez pacientes diagnosticados com esquizofrenia com característica paranóide, com base no Método de Rorschach. Foram registrados indicadores ou sintomas psicológicos que caracterizaram o diagnóstico diferencial desses pacientes, analisadas diferenças clínicas específicas e verificado o enquadramento dos dados obtidos, com a aplicação da Técnica de Rorschach. Para fins de diagnóstico diferencial, observou-se que dois pacientes apresentaram sintomas diferenciais aos da esquizofrenia, sendo que um deles apresentou sintomas dissociativos, não sendo confirmada a prevalência do TDI entre os esquizofrênicos. No caso da esquizofrenia e do TDI, devido às características similares que apresentam, avaliações multidisciplinares são indicadas para se fazer o diagnóstico diferencial entre eles.The aim of this article was to investigate the prevalence of the Dissociative Identity Disorder (DID) in ten patients diagnosed with schizophrenia with paranoid characteristic, based on the Rorschach approach. Psychological symptoms that characterize the differential diagnosis of these patients were registered, specific clinical differences were analyzed and the framework of the data obtained with the application of the Rorschach approach. For purposes of differential diagnosis, it was observed that two patients had differential symptoms to schizophrenia, one of which showed dissociative symptoms, not confirmed the prevalence of DID among schizophrenics. In the case of schizophrenia and DID due to exhibit similar characteristics, multidisciplinary evaluations are set to make a differential diagnosis between them