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Bilateral cortical necrosis of the kidneys, a review of the literature with a report of four cases occurring during pregnancy

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Keller_1934redux.pdf (4.595Mb)
Date
1934
Author
Keller, Robert J.
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Abstract
 
 
The investigation and treatment of cases of bilateral cortical necrosis of the kidneys has chiefly fallen to the lot of the obstetrician. There are now, however, an appreciable number of recorded cases which have occurred without the common . association of pregnancy and indeed several cases have occurred in men.
 
The total number of authentic cases which has been recorded in the literature is about forty -two. Last year Kellar and Arnott (1) reported three cases, Johnstone(1) one, Baird and Dunn (2) one which now brings the total number to forty - seven. The condition can no longer be regarded as a rarity although very uncommon, and indeed most pathologists and obstetricians of experience will have met with one or more examples. Professor F.J. Browne of University College told me that he had met with a case very recently. The total number of recorded cases of a disease rarity is not by any means an accurate index of its actual occurrence.
 
Clinically the condition is characterised by a profound.' or total anuria and with the striking pathological picture of almost complete necrosis of the renal cortex it forms an entity which is readily recognisable.
 
It is interesting to note that during the past twenty - seven years no less than fourteen cases of this type have been reported to the Edinburgh Obstetrical Society. Jardine and Kenn edy (3), Davidson and Turner (4), Kellar and Arnott (1). It is probable that this has a direct relationship to the high incidencE of toxaemia in Scotland.
 
In this short essay I shall first detail the four cases of this condition which I have studied and then proceed to a short discussion with reference to the literature on the subject.
 
All the kidney sections were stained haematoxylin and eosin and also with azan. In one case the alizarin stain for calcium was also employed. In case one a whole block section of the kidney was made but it was found after staining that there was no great contrast in the colour between the necrotic and the non -necrotic portions of the kidney and the striking naked eye appearance was to a great extent lost.
 
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http://hdl.handle.net/1842/34840
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