Elísio Carvalho

University of Porto, Porto, Distrito do Porto, Portugal

Are you Elísio Carvalho?

Claim your profile

Publications (5)10.74 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Fabry disease is an X-linked glycosphingolipidosis caused by deficiency of alpha-galactosidase. Progressive chronic kidney disease (CKD) is a major cause of morbidity and mortality in males. Although 40% of heterozygous females may develop renal involvement, pathologic data on Fabry nephropathy in heterozygotes are scarce. We reviewed the kidney biopsies of four affected females who had normal to slightly sub-normal renal function, two of them with overt proteinuria. Chronic non-specific degenerative lesions and glycosphingolipid accumulation per cell type were semi-quantitatively assessed by light and electron microscopy. Cellular distribution of glycosphingolipid deposits was best assessed on semithin sections. Podocyte effacement was seen only in proteinuric patients. Combined analysis of our data with those of two earlier series showed that glomerular sclerosis and tubulointerstitial fibrosis are predictors of proteinuria and CKD stage. There was no histopathological evidence supporting a major role of vascular damage in the early pathogenesis of Fabry nephropathy in females.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 07/2009; 454(6):721-2. · 2.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fabry disease is an X-linked glycosphingolipidosis caused by deficiency of alpha-galactosidase. Progressive chronic kidney disease (CKD) is a major cause of morbidity and mortality in males. Although 40% of heterozygous females may develop renal involvement, pathologic data on Fabry nephropathy in heterozygotes are scarce. We reviewed the kidney biopsies of four affected females who had normal to slightly sub-normal renal function, two of them with overt proteinuria. Chronic non-specific degenerative lesions and glycosphingolipid accumulation per cell type were semi-quantitatively assessed by light and electron microscopy. Cellular distribution of glycosphingolipid deposits was best assessed on semithin sections. Podocyte effacement was seen only in proteinuric patients. Combined analysis of our data with those of two earlier series showed that glomerular sclerosis and tubulointerstitial fibrosis are predictors of proteinuria and CKD stage. There was no histopathological evidence supporting a major role of vascular damage in the early pathogenesis of Fabry nephropathy in females.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 10/2008; 453(4):329-38. · 2.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Data from registries of renal biopsy (RB), currently an important source for diagnosing renal disease, are available for a number of countries, but different patterns seem to exist in different countries. We reviewed the records of all patients who underwent an RB at our institution over a 27-year period (January 1, 1977, to December 31, 2003), in northern Portugal, a European region with a predominantly Caucasian population. We aimed at identifying patterns of glomerular disease frequency, as well as the corresponding changes over time. The patients were grouped for analysis in 9-year intervals: period A (1977 through 1985), period B (1986 through 1994) and period C (1995 through 2003). Nephrotic syndrome was the most common clinical presentation for RB (42.0%), followed by urinary abnormalities (28.5%), acute renal failure (9.7%), chronic renal failure (9.3%) and nephritic syndrome (9.3%). Primary glomerulonephritis (GN) was the most common type of kidney disease in the present study, representing 50.4% of all renal pathology, followed by secondary GN (29.4%) and vascular and tubulointerstitial diseases (14.0%). The relative frequency of secondary GN and vascular and tubulointerstitial diseases increased significantly over time, and so did IgA nephropathy, the most common type of primary glomerular disease in the present study (31.2%). Focal and segmental glomerulosclerosis represented 6.9% of primary glomerular disease, and its frequency did not increase in the time period under study. Regarding secondary glomerular diseases, apparent changes were noted in the incidence of a number of diseases, including vasculitis, thin glomerular basement membrane disease and Henoch-Schönlein pur-pura. A somewhat similar situation was noted with vascular and tubulointerstitial diseases. We conclude that, as occurs in other European and Asiatic populations, and unlike the findings in the American continent, IgA nephropathy is the most frequent glomerular disease in our population.
    Journal of nephrology 01/2006; 19(4):500-7. · 2.02 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Renal disease is a complication of heroin addiction. Using renal biopsies in Caucasian patients, we studied the types of nephropathy associated with heroin abuse. Nineteen renal biopsies were performed on heroin addicts between January 1993 and December 2001. The indications for renal biopsy included proteinuria with or without renal insufficiency. All 19 patients had serological evidence of hepatitis C virus (HCV) infection, one had hepatitis B virus surface antigen and three were HIV positive. Thirteen patients (68.4%) were found to have membranoproliferative glomerulonephritis (MPGN), 12 with type I and one with type III. Of the remaining patients, two had chronic interstitial nephritis, two had acute proliferative glomerulonephritis, one had amyloidosis and one had granulomatous glomerulonephritis with interstitial nephritis. No apparent decline in the incidence of renal disease was observed. In this cohort of male Caucasian heroin addicts, HCV-associated MPGN was the most frequent pattern of nephropathy, showing that the nephropathy associated with heroin abuse in Caucasians is not of the focal and segmental glomerulosclerosis type, in contrast to previous reports on African-Americans. This aspect may have important implications for patient management and prognosis.
    Nephrology Dialysis Transplantation 12/2003; 18(11):2308-13. · 3.37 Impact Factor
  • Source