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Biomedical subjects

G Lagrue

Publications and source records attributed to G Lagrue.

At least 109 records · Page 6Linked to original sources
PubMed1989

Dietary manipulation for idiopathic nephrotic syndrome. A new approach to therapy.

To evaluate the role of food antigens in idiopathic nephrotic syndromes, we used dietary manipulations in 26 cases in whom steroid therapy had failed. In the six reported, restricted diets according to clinical and biological data were followed by complete remissions, suggesting that food can be responsible for idiopathic nephrotic syndrome in selected cases, and leading to a new therapeutic approach. The mechanism by which such antigens can be implicated in the pathogenesis of this glomerular disease is discussed.

Adolescent↗
PubMed1989

Food allergy and idiopathic nephrotic syndrome.

Patients with the idiopathic nephrotic syndrome (INS) with steroid treatment failure, who did or did not have a history suggesting food intolerance, were systematically evaluated for food allergy. We evaluated 42 cases for sensitization to usual foods. The following results were obtained: skin tests (intradermal, Stallergenes Lab) were positive in 16 out of 42 cases; total serum IgE was elevated in 12 of 42 patients; specific IgE (RAST) was positive in eight of 42 patients; the basophil histamine release test (HRT) was positive in 20 of 42 patients. For each of these tests, the results in the INS patients with steroid treatment failure were significantly different from controls. The following exclusion or challenge tests were carried out. In seven cases, an elemental diet was used; proteinuria decreased in one case, but acceptance of the diet was poor in the other cases. In 27 cases, a limited diet with exclusion of one or several foods was used. A complete remission was induced by this diet in seven steroid-dependent INS cases, allowing steroids to be discontinued during a follow-up of one to five years. However, relapses were frequent. More recently, an oligoantigenic diet was prescribed for 10 days without modifying steroid therapy. In 13 INS patients (5 steroid-dependent, 3 steroid-resistant, and 5 multiple relapses), 24-hour urine protein was significantly reduced (P less than 0.05). Proteinuria decreased by more than half in nine patients, with complete disappearance in five cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens↗
PubMed1989

[Arterial sequelae of pregnancy hypertension. Detection by carotid piezogram].

High blood pressure (HTA) is characterized by elevation of pression, but also by modifications of arterial pulse wave. Carotid piezograms were used to evaluate arterial pulse wave. Diastolic blood pressure is significantly correlated with dicrotic notch pressure. The duration of dicrotic notch is negatively correlated with arterial wall elasticity. Thus by carotid piezogram analysis one can determine the respective participation of arterial wall elasticity, peripheral resistance and cardiac factors in blood pressure elevation. Carotid piezograms were measured in 97 women (mean age 27, 8 y), with previous hypertensive pregnancy and apparently cured (mean blood pressure 122-74 mmHg at time of examination). 25 women only had normal piezogram drawing. Abnormalities similar to that of permanent hypertensive disease were observed in most cases. Dicrotic notch duration was significantly reduced and dicrotic notch pressure enhanced; in 34 women both of these abnormalities were present. In conclusion, among women previously hypertensive during pregnancy, even when blood pressure is returned to normal, abnormalities of arterial pulse wave may be present, suggesting that these women are prone to subsequent permanent hypertension.

Adult↗
PubMed1989

[Significance of IGA antigliadin antibodies during primary glomerulonephritis with mesangial IGA deposits].

The association of IgA anti-gliadin antibodies and IgA glomerulonephritis (IgA GN) was first reported in 1987 (Am J Nephrol, 1987, 7, 178-183) and has since been confirmed by other groups. We have developed a second generation ELISA (alkaline phosphatase, biotin-avidin) and used it to test 45 adult IgA GN, 34 idiopathic membranous nephropathy (MN), 31 idiopathic nephrotic syndrome (INS), and 11 idiopathic membranoproliferative glomerulonephritis (MPG) patients. IgA anti-gliadin antibodies were found in 24 IgA GN (53%), 1 MN (3%), 1 INS (3%), and 1 MGP (9%) patients. The presence of these antibodies in a patient with proteinuria strongly suggests IgA GN, with a sensitivity of 53%, a specificity of 96%, a positive predictive value of 88% and a negative predictive value of 77%. The presence of IgA anti-gliadin antibodies in IgA GN did not necessarily indicate coeliac disease because: a) neither IgG nor IgA anti-reticulin nor IgA anti-endomysium antibodies were found; b) intestinal absorption tests (folates, EDTA) were normal; c) biopsies of the small intestine were normal; and d) a gluten-free diet did not alter the evolution of the disease. Immunochemical analysis (footprinting after separation of the gliadins by rocket electrophoresis) showed the variability of the fractions recognized by the IgA antibodies from patients and controls, in addition to the absence of a typical profile. Gliadin does not have a lectin effect, since mannan and mannose did not inhibit the ELISA. Immunofluorescent labeling of human kidney with purified rabbit IgG anti-gliadin antibodies did not reveal a common epitope shared by gliadin and renal structures.(ABSTRACT TRUNCATED AT 250 WORDS)

Enzyme-Linked Immunosorbent Assay↗
PubMed1989

[Nicotine gum and lipid profile].

Smoking promotes for atherosclerosis by several mechanisms and particularly its actions on lipid metabolism; nicotine liability is well established. In one patient the use of nicotine-gum was reported to increase total cholesterol and LDL cholesterol. We studied lipid modifications in 14 voluntary students, heavy smokers (greater than 20 cigarettes/day) and nicotine dependent (Fagerström test; score greater than 7). They gave up smoking and received in double blind study either 2 mg nicotine-gum, or placebo-gum (8-12 gums a day for one month). Total and HDL cholesterol (chol.), triglycerides (TG) were measured at day 0, day 30 and day 60. Giving up smoking was ascertained by CO-analyser. At day 30 total chol and TG were unmodified, and HDL chol appeared slightly increased. At day 60 HDL and LDL chol were significantly improved. So in nicotine-dependent smokers, by giving up smoking and receiving 2 mg nicotine-gum, lipid patterns are not worsened but improved.

Adult↗
PubMed1989

Serum IgG subclasses and IgM imbalances in adult IgA mesangial glomerulonephritis and idiopathic Henoch-Schoenlein purpura.

Serum IgG subclass levels were investigated in 27 IgA GN and HSP patients and 19 healthy paired controls using a panel of monoclonal antibodies. IgG1 and IgG2 were statistically lower than in the controls in both the non-nephrotic and nephrotic patients, and 80% of the non-nephrotic patients exhibited a partial deficiency for either IgG1, IgG2 or IgG3. Urinary losses of IgG only accounted for decreased levels of IgG4. Fifty-four percent of these patients exhibited decreased IgM levels. This IgG-IgM imbalance may increase the susceptibility of these patients to viral and bacterial infections of the upper respiratory tract and trigger the renal disease. These findings raise the hypothesis that this IgG-IgM imbalance might be involved in the etiopathogenesis of these diseases.

Adolescent↗
PubMed1989

[Edematous syndromes caused by capillary hyperpermeability. Diffuse angioedema].

Edema due to increased capillary permeability (ICP) may be diffuse or localized. Local edemas (Quincke edema, angioneurotic edema) are most often allergic or very rarely due to a defect in C1-inhibitor. Generalized edemas due to ICP share the following clinical features: Fluid retention (subcutaneous edema and diffused swelling) is predominant in lower limbs; it is worsened by orthostatism and warmth and alleviated by decubitus and cold, with important weight variations between morning and evening. It is associated with enhanced thirst, hypotension, oliguria, headaches and blood volume reduction; secondary hyperaldosteronism is the main mechanism. These troubles are due to ICP, associated with lymphatic drainage abnormalities; ICP is measured by the isotopic Landis Test. This abnormality is present in several diseases. Idiopathic orthostatic edema (IOE) is frequent and often unrecognized, occurring mainly in women, often associated with luteal insufficiency. Iatrogenic complications (diuretic and laxative abuses) are frequently superimposed. ICP may be corrected by vitamins P (rutin, anthocyanosides, diosmin, Ginkgo biloba extracts...) Cyclic shock due to ICP is rare. It is characterized by cyclic edema and shock with hypovolemia, hypoproteinemia; the mechanism of shock is a severe loss of fluid and protein from the vascular bed. It is often associated with monoclonal gammapathy and complement activation. In our personal case, the trouble in CP was present all along the disease with permanent edema and low blood pressure (especially in orthostatism). Vit "P" and Ginkgo biloba extracts were able to partially improve CP and the clinical troubles. However, in spite of this treatment a fatal shock occurred after ten years follow-up. Episodic angioedema associated with eosinophilia was first described by Gleich.(ABSTRACT TRUNCATED AT 250 WORDS)

Capillary Permeability↗
PubMed1989

[The hyper IgE syndrome (Buckley syndrome)].

An exceptional case is reported of hyper IgE syndrome and membranoproliferative glomerulonephritis with onset in 1964. Renal disease, symptoms of hyper IgE syndrome and level of serum IgE were improved by a long-term cyclosporine treatment (3/5 mg/kg/day) with a follow-up of 4 years. The characteristics of the hyper IgE syndrome, described by Buckley in 1972 are given and the respective roles of IgE-BF, IL4 and interferon in the mechanism of increase in serum IgE is discussed.

Cyclosporins↗