Hemophagocytic syndrome associated with coxsackie virus A 9 infection in a non-immunosuppressed adult.
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Biomedical subjects
Publications and source records attributed to F Berthoux.
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We report a case of renal macroangiopathy occurring after transplantation in a 50-year-old woman who received a cadaveric kidney and who was immunosuppressed with cyclosporin A. Accelerated hypertension at 3 months led to renal angiography which revealed diffuse narrowing of the two main renal arteries and their intrarenal branches. The patient returned to regular haemodialysis four months post-transplantation. These angiographic cyclosporin A-ascribed findings are similar to those recently reported by Sawaya.
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The authors report two cases of early transplant renal vein thrombosis after kidney transplantation. In the two cases, the graft had to be removed. Many difficulties prevented the diagnosis of this fortunately unusual (0.8% of all transplantations performed) vascular injury.
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The authors report a case of a ureteral stenosis of a transplanted kidney. The cause was a compression by the spermatic cord. The treatment was surgical, with a ureteroureterostomy with pyelostomy tube intubating the anastomosis. A bit of the drain remained in the renal pelvis; it was removed by percutaneous nephroscopy.
The authors report two patients with renal failure due to total procidentia. Surgical repair led to an improvement in renal function. Mild chronic renal failure persisted. Thus the renal status must be assessed in cases of uterine prolapse.
We report our experience with a converting-enzyme inhibitor, enalapril, as antihypertensive agent in eighteen patients with hypertension after renal transplantation. Renal function was prospectively followed up. Six patients demonstrated an acute renal failure episode (defined by a 25% increase of serum creatinine during enalapril therapy). Renal failure was always reversible with interruption or dosage reduction of the drug. We recommend to start therapy with low dose and to closely monitor renal function.
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Allopurinol is widely used in the treatment of hyperuricemia. Unusual (78 cases published up to 1984) but severe toxicity includes renal, skin and hepatic involvement. We report a new case of serious toxic manifestations with acute interstitial nephritis. We stress the need to adapt the daily dosage of the drug to the glomerular filtration rate and to interrupt drug administration rapidly if allergic manifestations develop.
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Hippuran labelled with iodine 123 is now used for short- and long-term monitoring of renal transplants. Sixty-one explorations were performed in 24 patients, using this new radiopharmaceutical agent. Repeated explorations, facilitated by the lower doses of radiations as compared with 131I-hippuran, are particularly useful to diagnose thrombosis of the renal artery, early acute tubular lesions, acute and chronic rejection and impaired evacuation of the kidney. 123I-hippuran is the first-choice method of exploration of transplanted kidneys and can be followed, if required, by explorations more aggressive for the patient and the kidney.
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In one family of twenty-four members hereditary angio-oedema was present in the family for six generations. The protein C1 esterase inactivator found in nine patients proved to be non-active in a functional test. Another anomaly found in the complementary system was labelled C3 nephritic factor without any renal, or other clinical symptoms. Study of HL-A haplotypes did not show any linkage with the loci A, B and C. Hereditary angio-oedema is a disease arising from a specific defect in the inactivator of the C1 esterase (C1 INA) which is a regulating component of the complement system (Donaldson & Evans, 1963). This system is of current interest because of its interaction with other mechanisms of inflammation. Moreover, some links have been discovered recently between HL-A and hereditary defects of complement. This paper reports new findings in a family with hereditary angio-oedema.
Cystinosis was discovered by chance in two adolescent boys who had proteinuria with minor tubular abnormalities. Renal biopsies were examined by light microscopy, electron microscopy and immunofluorescence. There were few histological changes but crystals were present in the epithelial cells of the glomerulus and occasionally in the tubules. A further unusual feature was the detection of IgA deposits in the mesangium.
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