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Biomedical subjects

D Droz

Publications and source records attributed to D Droz.

At least 109 records · Page 6Linked to original sources
PubMed1985

Renal prognosis in women with hereditary nephritis.

Renal prognosis cannot be easily predicted in females with hereditary nephritis (HN). Thirty-six women with persistent urinary abnormalities, belonging to 24 families with progressive HN, were studied. Renal biopsy specimens were available in 23 patients and were studied by light and electron microscopy (EM). Nine women (group I) progressed to early renal failure, at 35 yrs of age or less. Five women (group II) progressed to late renal failure at 45 yrs of age or more. In contrast, 22 patients have so far normal renal function, and 14 of these (group IV) range from 31 to 62 yrs of age. Diffuse glomerular basement membrane (GBM) thickening was found by EM in 6 of 7 cases of group I, whereas it was found in no patient of group IV. The following features are suggestive of progressive nephritis in females: gross hematuria in childhood, nephrotic syndrome, and diffuse GBM thickening by EM. In contrast, family history of HN without nerve deafness, normal or nearly normal kidney on repeat biopsy, and thin or normal GBM by EM are suggestive of less or nonprogressive renal disease. Further follow-up is needed to assess the prognostic significance of these features.

Adolescent↗
PubMed1984

Recurrent hematuria in 4 white patients with sickle cell trait.

Extensive investigations failed to disclose the etiology of recurrent gross hematuria in 4 white patients of Algerian descent. Hemoglobin electrophoresis revealed sickle cell trait in all cases. The hematuria ceased after bed rest and hydration in 3 patients, and following partial nephrectomy after visualization of the bleeding site at operative nephroscopy in 1. We recommend that hemoglobin electrophoresis be considered when evaluating every patient, black or white, presenting with unexplained hematuria.

Adult↗
PubMed1984

Nonsteroid antiinflammatory agents as a substitute treatment for steroids in ATGAM-treated cadaver kidney recipients.

A nonsteroid antiinflammatory agent (Ibuprofen) was used in a controlled randomized study to determine its ability to replace steroids in the prophylaxis of cadaveric kidney rejection. Thirty-three cadaver kidney recipients were randomly assigned either to a control group (16 patients) receiving azathioprine, high doses of prednisolone, and antithymocyte globulin (ATGAM) for three months, or to an experimental group (17 patients) receiving azathioprine and ATGAM according to the same protocol, ibuprofen instead of steroids. The frequency of rejection was higher in the experimental group (2.18 episodes per patient) than in the control group (1.44 episodes per patient). Nevertheless, in the experimental group 5 patients had no early rejection episode, 60% of early rejections were totally reversible without steroids, and 3 patients never received steroids at all during the first year and had normal renal function and biopsies. Steroids had to be introduced in the treatment of 14 patients, but after an average period of 32.5 days after surgery OKT3+ cell level was higher in the experimental group than in the control group, but similar to the OKT3+ cell level of patients receiving conventional therapy without ATGAM. Whatever the type of treatment, an increase in the OKT4+/OKT8+ ratio was associated in most cases with increased serum creatinine values. Conversely, a decreased OKT4+/OKT8+ ratio associated with renal failure was found in cases showing biological evidence of cytomegalovirus infection.

Adult↗
PubMed1984

Cholangiocellular carcinoma in polycystic kidney and liver disease.

Cholangiocellular carcinoma developed in two uremic patients with polycystic kidney and liver disease, who had been treated with intermittent hemodialysis for one and nine years. In one case, in situ transformation of the liver cyst epithelium into cholangiocellular carcinoma could be demonstrated. The incidence of cholangiocellular carcinoma in patients undergoing long-term dialysis for polycystic kidney and liver disease, however, has yet to be determined.

Adenoma, Bile Duct↗
PubMed1984

Liver involvement in nonamyloid light chain deposits disease.

Liver examination performed in seven patients who had renal failure related to light chain deposits demonstrated in all cases the presence of liver light chain deposits. In all of our patients clinical renal involvement antedated the liver disease. The portal areas and the Disse spaces contained a granular material which strongly reacted with antilight chain antiserum (kappa or gamma). In one patient in whom lesions were severe, the sinusoid edge was ruptured and a pelliosis -like lesion was observed. In the five patients who were hemodialyzed for more than several months at the time of discovery of liver deposits, increased amounts of collagen were present in the Disse spaces, and one patient had extensive liver fibrosis by light microscopy. Clinical liver involvement was defined by moderate hepatomegaly in five patients, with ascites in two. A slight increase in phosphatase alkaline activity was frequently observed and bromsulphalein retention was present in two. In one patient liver tests remained entirely normal despite the presence of diffuse kappa light chain deposits.

Aged↗
PubMed1984

Renal granular monoclonal light chain deposits: morphological aspects in 11 cases.

Eleven cases of renal light chain deposition without amyloïdosis are reported (7 multiple myeloma, one Waldenström's disease, 3 without multiple myeloma without spike in serum or urine). Ten had kappa light chain deposits and 1 lambda light chain deposits along tubular basement membranes and in glomeruli. Ultrastructural study showed granular electron dense material on the external side of tubules with a very dark appearance in 4 cases and lighter appearance in the others. Five cases had nodular glomerulosclerosis with a finely granular, light appearance, corresponding to membrane-like material with kappa fixation in 4. Granular light chain deposition is analogous to type AL amyloïdosis in that their distribution is identical and both originate from light chains. The major difference between AL type amyloïdosis and light chain deposits lies in their ultrastructural appearance. Amyloïd substance is characterized by a fibrillar appearance and light chain substance by a granular appearance.

Aged↗
PubMed1983

[Autoimmune thyroid diseases associated with glomerular nephropathy. 3 cases].

The first patient had Hashimoto's thyroiditis and developed membranous glomerulonephritis with subepithelial deposits of IgG, C3, and thyroglobulin; the second patient had Graves' disease and developed, after the second administration of 131 I 2, rapidly progressive glomerulonephritis with epithelial crescents; in the remaining patient, Hashimoto's thyroiditis was diagnosed at the time of renal insufficiency due to crescentic glomerulonephritis. All three patients had circulating antithyroglobulin antibodies, with high titers in patients I and III; in every patient, the search for circulating immune complexes was negative at the time of the renal biopsy. Apart from the classical membranous type, other glomerular lesions may be associated with thyroiditis. The frequent clinical latency of Hashimoto's disease warrants systematically testing for circulating antithyroglobulin antibodies in women presenting with apparently idiopathic glomerulonephritis.

Adult↗
PubMed1982

Some effects of chemotherapeutic drugs. III. Short- and long-term effects of cis-platinum on various hematopoietic compartments and on the kidney of the mouse.

cis-Platinum is a relatively new active anticancer drug. In the study described in this paper, its toxicity was tested in the hematopoietic and renal systems of mice after six injections of 3 mg per kg body weight at 10-day intervals. Acute hematopoietic toxicity was studied by determining the survival of pluripotent (CFU-S) and granulo-macrophagic unipotent (GM-CFC) stem cells. The number of nucleated cells in the bone marrow and in the spleen and the number of granulocytes in the blood were determined. Renal toxicity was studied by histological examination of kidneys from treated mice compared with control animals. The number of stem cells in the bone marrow and in the spleen decreased during the treatment. One year after treatment, the autorepopulating ability of CFU-S was still diminished in spite of normal numbers of these cells. No renal damage could be demonstrated by light microscopy when the protocol described was used.

Animals↗
PubMed1982

Alport's syndrome: experience at Hôpital Necker.

We review the characteristic morphologic features identifiable by electron microscopy that have been described in patients presenting with Alport's syndrome. They are diffuse thickening and splitting of the glomerular basement membrane (GBM), which are either isolated or associated with thinning. In occasional cases, only diffuse thinning can be seen. Our study of 100 families followed in Necker's hospital, of which 60 patients have had electron microscopic examination of their renal parenchyma, demonstrates that these GBM changes are highly suggestive of Alport's syndrome. All the patients included in the study fulfilled the following clinical criteria: familial incidence, nerve deafness in the propositus or in another member of the family, renal disease with progression to renal failure in the proband or in another member of the kindred. Although a failure in the proband or in another member of the kindred. Although a normal GBM was found in five patients, the GBM changes should be one of the criteria for the definition of the syndrome. Results dealing with a few other problems raised by this syndrome are reported. They concern the antigenicity and the biochemical composition of the GBM, the incidence of macular and perimacular changes, and the genetic transmission of the disease. It is concluded that Alport's syndrome is genetically heterogeneous and that the GBM ultrastructural changes are observed in most patients whatever the type of genetic transmission.

Adolescent↗
PubMed1982

[Long-term evolution of membranoproliferative glomerulonephritis in adults : spontaneous clinical remission in 13 cases with proven regression of glomerular lesions in 5 cases (author's transl)].

188 patients with type I MPGN were followed from 1957 to 1975. At last examination, 53% of patients with pure MPGN and 66% of those with lobular MPGN had renal insufficiency; 28 other patients showed clinical improvement and 13 of these had permanent complete remission. In all of these 13 cases, (10 pure MPGN and 3 lobular forms), the clinical remission was spontaneous and occurred 2 to 16 years after the apparent onset. At the time of the first renal biopsy, 7 of these patients had a nephrotic syndrome, 2 had hypertension and 1 had renal failure. A second biopsy was obtained in 5 patients during the clinical remission period and showed in all cases a clear regression of the glomerular lesions. The possibility of spontaneous permanent clinical remission in MPGN should be considered in the indications and methods of treatment and the interpretation of their results.

Adolescent↗
PubMed1981

[Contribution of intravenous urography to the etiological diagnosis of microscopic haematurias (author's transl)].

From a study of 216 patients with microscopic haematuria who were helped by technically complete intravenous urography (IU), the authors conclude that this investigations method is particularly valuable when haematuria is unaccompanied by proteinuria, pyuria or renal insufficiency. IU led to an etiological diagnosis in almost 50 p. cent of the patients revealing, among other causes, numerous calculi and a non-negligible number of tumours. Renal biopsy is very useful in cases with proteinuria but has few indications in isolated microscopic haematurias. The same applies to diagnostic angiography. Cystoscopy should be considered angiography. Cystoscopy should be considered when IU might be unable to detect small tumours of the bladder or, more generally, lesions of the vesical mucosa, particularly frequent in patients with pyuria.

Cystoscopy↗