Anuria with necrosis of the renal convoluted tubules / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
[1909]
Catalogue details

Licence: In copyright

Credit: Anuria with necrosis of the renal convoluted tubules / by F. Parkes Weber. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    a very narrow zone at the junction of the cortex and medulla. The epithelial cells lining these tubules would hardly stain at all with logwood and their nuclei could not he differentiated from the cytoplasm. The glomerular epi- thelium was to some extent affected in the same way. A zone of the cortical tissue just beneath the capsule and a zone adjacent to the medulla showed congestion and small cell infiltration, but there was no increase of interstitial fibrous tissue in any part of either kidney. The renal artery and its primary branches showed some thickening, but the change on which the authors chiefly insisted was an arterial thrombosis, which apparently involved (and was practically confined to) all the interlobular arteries of both kidneys and their branches, including all the glomerular arterioles given off distally to the point of thrombosis (distally to the junction line of medulla and cortex). As far as I can make out from their paper Dr. Bradford and Mr. Lawrence regarded the thrombosis of the interlobular arteries as a sudden lesion perhaps in some way associated with the pregnancy and as the cause of the cortical necrosis and fatal anuria. In 1905 Dr. W. S. A. Griffith and Dr. W. P. Herringham described a similar case under the heading ‘ ‘ A Case of Necrosis of the Entii’e Renal Cortex of Both Kidneys, to- gether with Thrombosis of all the Cortical Arteries, occurring in the Puerperal State.”2 The patient, a woman, aged 35 years, a multipara, who had had symptoms of chronic nephritis for several years, was delivered of a dead child and 12 ounces of old clot immediately after admission to the Queen Charlotte’s Hospital. From that time until her death, nine and a half days later, she passed only ten ounces of urine, and none at all was passed during the last six days of her life. The small quantity of urine obtained for examina- tion was clear and contained a trace of albumin and renal casts. Ordinary uraemic symptoms were almost absent till the end. At the post-mortem examination the left ventricle of the heart was found to be somewhat hypertrophied. The kidneys to the naked eye closely resembled those in Bradford and Lawrence’s case, but microscopic sections showed a difference between the cases in two respects. In Griffith and Herringham’s case, unlike that of Bradford and Lawreqce, LPubUsherl somewhat later in the Journal of Pathology and Bac- teriology, 1906, vol. xf., p. 23?.