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Biomedical subjects

G Lagrue

Publications and source records attributed to G Lagrue.

At least 127 records · Page 7Linked to original sources
PubMed1988

Renal survival in membranoproliferative glomerulonephritis (MPGN): role of long-term treatment with non-steroid anti-inflammatory drugs (NSAID).

The renal survival of 53 MPGN patients treated on a long-term basis by non-steroid anti-inflammatory drugs (NSAID) was compared to that of untreated MPGN patients previously reported in the literature. The difference between NSAID-treated and untreated patients (Habib's and Legrain's series) was significant by chi-square and logrank test performed during 10 and 14 years of follow-up. Our results were not significantly different from those observed by West in 45 MPGN children treated by steroids alone or in association with cytotoxic agents. After a follow-up of 14 years, 21 among our NSAID patients were in renal survival and 8 in end-stage renal disease (ESRD). They were respectively 11 and 3 in West' series, and for the untreated groups, 4 and 19 in Legrain's series and 1 and 33 in Habib's series.

Adolescent↗
PubMed1988

Enhanced beta 2-microglobulin levels in lymphocyte culture supernatants from patients with idiopathic nephrotic syndrome: inhibition of lymphocyte activation by cyclosporine.

Idiopathic nephrotic syndrome (INS) is associated with a disorder of T-lymphocyte function, and an enhanced production of a vasoactive lymphokine, the vascular permeability factor (VPF). In an attempt to evaluate lymphocyte activation in various phases of INS, we measured beta 2-microglobulin (beta 2m) levels in lymphocyte culture supernatants (LCS). In 23 cases of untreated active INS, beta 2m levels in unstimulated LCS were significantly increased in comparison with those of 13 cases of untreated INS in complete remission (p less than 0.001), of 17 cases of active membranous nephropathy (p less than 0.01) and of 14 controls (p less than 0.001). In 13 patients treated with cyclosporine (Cs) (3-4.5 mg/kg/d) during 3 months, beta 2m levels were within the normal range. Although the beta 2m of 7 Cs patients without proteinuria was lower than 5 Cs patients with residual proteinuria, the difference was not statistically significant. In 15 prednisone(Pr)-treated INS patients, beta 2m levels were normalized. However their beta 2m levels were lower in 8 cases of complete remission than in 7 cases of persistent proteinuria (p less than 0.05). Concanavalin-A stimulation increased beta 2m amounts in all groups with a similar magnitude. In vitro addition of Cs (100 ng/ml) inhibited both beta 2m and VPF elevations observed in active INS. beta 2m level and VPF activity were significantly correlated (r = 0.54, p less than 0.01). High levels of beta 2m in LCS from INS are the consequence of an enhanced cellular synthesis and they are inhibited by Pr and Cs. Thus beta 2m increase in INS indeed reflects lymphocyte activation.

Adolescent↗
PubMed1988

[Idiopathic nephrotic syndrome and food hypersensitivity. Value of an exclusion diet].

A case of idiopathic nephrotic syndrome (INS) evolving since more than 7 years with 4 successive corticosensitive relapses is reported. At the time of a 5th relapse corticosteroid treatment was refused by the parents and evolution went on without any spontaneous tendency to remission. Three months later, allergy tests detected various sensitizations, especially for food allergens. An antiallergic treatment including dietary exclusions induced a complete and durable remission. Five similar cases are reported. These facts, compared to data from the literature, indicate the possible role of food hypersensitivity in INS. Its mechanism has been discussed; the possible part of a lymphocyte activation has been emphasized.

Adrenal Cortex Hormones↗
PubMed1988

[Proteins C and S of coagulation: new markers of thrombotic risk in nephrotic syndromes?].

Thromboembolic events remain one of the most serious complications in patients with nephrotic syndrome (NS). The natural anticoagulant system protein C-protein S was evaluated in patients with proteinuria and NS. Protein C levels were found to be normal or increased in NS. Protein C levels correlated positively with proteinuria, cholesterol and triglycerides and negatively with serum albumin. All of the 17 patients with NS exhibited urinary loss of protein C. Total protein S and C4BP were increased in mild and moderate forms of NS. Free protein S was identical in controls and NS patients. Nine of ten patients had urinary loss of protein S. No correlation was found between protein S and the various usual biologic parameters of NS. However, two patients with NS and thrombosis of the renal veins had an acquired deficit in either free protein S or protein C. Thus, in some patients, an acquired deficit in free protein S and/or protein C may contribute to the development of thrombotic complications in NS.

Antigens, Differentiation↗
PubMed1988

Distribution of cyclosporin A between blood cells and plasma of cardiac and renal transplant recipients.

The relationship between blood cells and plasma concentrations of cyclosporin A (Cy A) determined by radioimmunoassay, was investigated in 12 heart and 12 kidney transplant recipients. The decision between a linear and nonlinear model was made according to a standardized residuals plot. We observed high blood cells-plasma concentration ratios in the two groups, indicating a high affinity of Cy A for blood cells. The distribution of Cy A between blood cells and plasma was ascribed to a nonlinear saturable model in the two groups. According to our results we have simulated the blood-plasma concentration ratio of Cy A as a function of plasma Cy A concentration and hematocrit.

Adolescent↗
PubMed1988

[Conjunctival and peri-ungual angioscopy in noninsulin-dependent diabetes mellitus. Informational value of observed anomalies].

Microangiopathy is one of the most frequent and serious complications of diabetes. Its diagnosis is based on fundus of eye and fluorescein angiography findings, but several teams have emphasized the value of conjunctival angioscopy (CA) and peri-ungual capillaroscopy (PUC), describing suggestive anomalies: microectatic venous dilatation (V/A greater than 4.5), sludge on CA, "fish shoal" capillaries on PUC. Up to the present, however, the diagnostic value of these anomalies has not been evaluated based on data that are sensitive, specific and indicate predictive positive and negative values of a sign (Se, Sp, PPV, NPV). Anomalies of CA and PUC as a function of presence or absence of "diabetes" were studied in 114 patients with moderate hypertension, including 46 "diabetics" (33 with glucose regulation disorders and 13 non-insulin dependent diabetics). "Diabetes" was observed more predominantly in males of more advanced age and with a significantly higher global CA score (4.25 +/- 1.44 as against 2.65 +/- 1.35), and this in an increased manner as the "diabetes" was severe. Some anomalies had themselves a major orientation value with an Sp greater than 80% and an Se close to 40% (global score greater than 4; V/A greater than 4.5, microectasia, rheologic changes). For the fish shoal appearance the Sp was 73.5% and the Se 43.5%. The Sp was greater than 95% when at least 4 of the following 6 signs were present: global score greater than 4, V/A greater than 4.5, microectasia, rheologic disorders, fish shoal, gerontoxons. The more signs associated the more the Sp increased; the Se decreased from 40% for one sign to less than 10% for 4 associated signs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Altered C1 inhibitor genes in type I hereditary angioedema.

Hereditary angioedema is an inherited disease transmitted as an autosomal dominant trait and characterized by deficient activity of C1 inhibitor, a glycoprotein that limits intravascular activation of complement. The unavailability of markers for the C1 inhibitor locus has so far precluded access to the genetic bases of the disorder. Using a recombinant-DNA probe for the C1 inhibitor gene, we identified a cluster of four distinctive DNA restriction sites in a multigeneration family. The strict cosegregation of these markers with a low C1 inhibitor level supports the conclusion that a defective structural gene is responsible for the disease. The occurrence of distinct DNA markers in patients from unrelated kinships indicates that, like forms of the condition displaying dysfunctional C1 inhibitor variants, those characterized by protein deficiency are also genetically heterogeneous. Although multiple restriction-site changes in the C1 inhibitor gene are carried by certain patients, DNA markers for this locus are strikingly infrequent among normal persons. These findings indicate that the gene alterations responsible for hereditary angioedema arise more often from DNA rearrangements than from nucleotide substitutions. Such variations in the structure of the C1 inhibitor gene may provide the basis for early and direct identification of persons at risk.

Angioedema↗
PubMed1987

[Hereditary angioneurotic edema. Treatment of a pseudosurgical digestive attack with C1 inhibitor concentrate].

Although anabolic androgens can be used to prevent acute attacks of hereditary angioneurotic oedema, these are still observed. When they are severe, and even more so when they involve the larynx or the abdominal viscera, an emergency treatment is necessary, ideally with the purified C1-inhibitor (C1-INH) administered by intravenous infusion. In a case with pseudo-surgical abdominal symptoms, this treatment was followed by an unusually dramatic regression of all symptoms. Serial laboratory examinations showed an increase in C1-INH and C2 plasma levels and in the number of basophils within less than 30 minutes; the increase in C4 levels occurred later. Thus, C1-INH is very effective in the treatment of acute hereditary angioneurotic oedema, but the product is not widely available; it should be reserved to severe forms affecting the larynx and the viscera.

Abdomen, Acute↗
PubMed1987

[Membranoproliferative glomerulonephritis associated with Buckley's syndrome treated with cyclosporin].

A 38-year old patient had been suffering, since the age of 17, from membranoproliferative glomerulonephritis associated with chronic atopic eczema and recurrent sinusitis. Bouts of eczema with severe itching occurred simultaneously with sinusitis and proteinuria. Permanently extreme serum IgE levels (greater than 10,000 IU/ml), defective neutrophil chemotaxis and monocyte phagocytic function (Buckley's syndrome) were present. Because cyclosporin reduces excessive IgE levels in Brown Norway rats with mercuric chloride nephritis, we gave the patient this drug in daily doses of 3-4 mg/kg. A dramatic improvement resulted within a few days: itching disappeared, the eczema progressively cleared, proteinuria decreased to less than 0.5 g/day and serum IgE levels to 4000 KIU/l. Reduction of dosage was followed by recurrence of all clinical and biological signs. In spite of the improvement obtained, serum creatinine levels, which were initially high (200-250 mumol/l) rose up to 300 mumol/l after one year of treatment.

Adult↗