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Biomedical subjects

J Crosnier

Publications and source records attributed to J Crosnier.

At least 37 records · Page 2Linked to original sources
PubMed1981

Hereditary nephritis associated with May-Hegglin anomaly.

Hereditary nephritis associated with hematologic abnormalities seems to be an exceptional occurrence. We have observed a family which nephritis was combined with May-Hegglin anomaly. A girl and her father suffered from proteinuria; a paternal uncle received kidney graft; a paternal grand aunt died on periodic hemodialysis. The girl, the father and the uncle presented macrothrombocytopenia (40-100 X 10(9)/l, size 4-8 mum) with prolonged bleeding time (which precluded renal biopsy) and cytoplasmic inclusions in neutrophils (Döhle bodies). These hematologic abnormalities characterize the May-Hegglin anomaly. This kind of association has not been reported so far.

Bleeding Time↗
PubMed1981

An unusual wart-like skin lesion found in a renal allograft recipient.

Immunosuppressed renal allograft recipients have an increased tendency to acquire warts. While studying such patients, we found a virus-induced, wart-like lesion that had an unusual histologic picture. Light microscopic studies showed bizarre keratinocytes with cytoplasmic, juxtanuclear, giant, crescentic bodies and round, nuclear inclusions, By electron microscopy, the giant cytoplasmic bodies were found to be composed of tonofilaments, and the nuclear inclusions were found to be composed of papillomavirus-like particles in a filamentous matrix. Typical papillomavirus particles were observed in a wart extract by the negative-staining method. Although virus was abundant in infected cells, no structural viral antigens of the human papillomavirus (HPV) types 1, 2, 3, or 5 could be detected by immunofluorescence microscopy, indicating infection by HPV 4 or some other, as yet undescribed, HPV type.

Adult↗
PubMed1981

Hepatitis B in haemodialysis: vaccination against HBS antigen.

Institut Pasteur Production vaccine, prepared from plasma of chronic carriers of HBsAg (ad + ay sub-types) negative for HBeAg, inactivated by formaldehyde, containing 5 microgram HBsAg per 1ml dose, with Al (OH)3 as adjuvant, was tested in a multicentric efficacy trial. After informed consent and exclusion of subjects positive for HBsAg, anti-HBc or anti-HBs, 367 permanent staff members and 138 chronic haemodialysis patients from 64 centres were enrolled in the trial. They received randomly, double-blind, 3 subcutaneous doses of either vaccine (V) or placebo (P) at one-month intervals and were followed monthly for one year. The incidence of HBV infections was significantly lower in V than in P recipients, in staff and in patients. In staff members, no HBV infections occurred in V recipients after the second injection, whereas they were distributed throughout the whole 12 month follow-up period in P recipients. Anti-HBs titres greater than or equal to 10mIU/ml were obtained in 94% of vaccinated subjects. Antibody peak (mean +/- 2 SE) reached 2433 +/- 1077mIU/ml two months after the third injection, with a further rise to about 30 times this value following a booster injection, 16 +/- 2 months after the first injection. These results demonstrate the immunogenicity and efficacy of Institut Pasteur Production hepatitis B vaccine.

Adult↗
PubMed1980

[Secondary hyperparathyroidism: subtotal parathyroidectomy versus total parathyroidectomy with parathyroid autotransplantation (author's transl)].

Between 1967 and 1978, among more than 1 000 patients under haemodialysis, 66 who had severe secondary hyperparathyroidism, underwent parathyroidectomy (PTx). Subtotal PTx's were performed in 57 patients and total PTx's immediately followed by autotransplantation of parathyroid gland fragments in 9 patients. The patients operated upon by these two methods since 1976 were compared. Among the 10 patients who had undergone subtotal PTx recurrence of severe biological hyperparathyroidism was observed in four cases and permanent hypoparathyroidism in two cases. Among the 9 patients with total PTx and immediate autotransplantation only one was considered as suffering from recurrent hyperparathyroidism on account of increased plasma parathyroid hormone concentrations; none of the other patients in this group had hypoparathyroidism. On follow-up, the clinical and radiological findings were comparable in both groups. At the present moment, our choice of surgical method remains arbitrary. Total PTx with immediate autotransplantation is carried out in all cases of reexploration of the neck, in patients who do not comply with the proposed medical treatment and when surgery reveals grossly enlarged parathyroid glands. In all other cases we continue to perform subtotal PTx.

Humans↗
PubMed1980

Effect of parathyroidectomy on left-ventricular function in haemodialysis patients.

The effect of parathyroidectomy on left-ventricular function was evaluated in chronic-haemodialysis patients with advanced hyperparathyroidism. Radionuclide angiocardiography (22 patients) and ultrasound echography (8 patients) revealed a significant increase in left-ventricular ejection fraction 1--2 weeks after parathyroidectomy. This improvement was associated with an augmented cardiac index (radionuclide method) and with an increase in mean velocity of circumferential myocardial fibre shortening (echocardiography). Circulating blood volume and erythrocyte space, as well as arterial blood-pressure, had changed little after parathyroidectomy, whereas plasma calcium, phosphate, and immunoreactive parathyroid hormone were significantly lower after surgery. Thus, correction of severe hyperparathyroidism led to a significant improvement in cardiac performance.

Adult↗
PubMed1980

[Mesangial IgA glomerulonephritis: a frequent case of terminal renal failure (author's transl)].

Two hundred and forty end-stage kidneys removed during transplantation, were studied by immunofluorescence. Mesangial IgA glomerulonephritis was demonstrated in 24 cases. Since mesangial IgA glomerulonephritis accounts for 10% of the cases of terminal renal failure requiring transplantation, its prognosis is not as mild as it was initially believed. About one third of the patients must eventually develop renal insufficiency. Such an unfavourable course is even possible when the disease began during childhood.

Acute Kidney Injury↗
PubMed1980

Hepatitis B antigen-associated periarteritis nodosa in patients undergoing long-term hemodialysis.

Periarteritis nodosa was observed in three of 266 persistent hepatitis B antigen (HBsAg) carriers undergoing long-term hemodialysis; no cases of necrotizing vasculitis occurred among 384 other patients undergoing dialysis having either no or transient antigenemia. Circulating e antigen, but no e antibody, was found in two of these three patients. The serum level of the third component of complement (C3) was normal in two patients and low in the third. Circulating immune complexes were demonstrated in all three patients, using polyethylene-glycol (PEG) precipitation, PEG-C4, and solid phase C1q tests. HBsAg and anti-hepatitis B antibody (HBsAb) were identified in the PEG precipitates using radioimmunoassay and electron microscopy technics. Direct immunofluorescence performed on a muscle biopsy specimen from one patient was positive for HBsAg, but not for immunoglobulin G (IgG), immunoglobulin M (IgM), C3 or C1q. These data support the hypothesis that circulating immune complexes involving HBsAg may be involved in the pathogenesis of periarteritis nodosa.

Antigen-Antibody Complex↗
PubMed1980

A potentially oncogenic human papillomavirus (HPV-5) found in two renal allograft recipients.

We have observed 2 immunosuppressed renal allograft recipients with skin lesions induced by human papillomavirus type 5 (HPV-5). One recipient had multiple pityriasis versicolor-like (PV-like) skin lesions on his arms and trunk, and multiple Bowenoid in-situ skin cancers. The other had 2 warty lesions on the back of her fingers. Structural antigens of human papillomavirus type 5 (HPV-5) were identified in benign lesions from both patients by immunofluorescence. The histologic and ultrastructural features observed in lesions from both patients were similar to those previously seen in HPV-5-induced lesions occurring in patients with the rare disease epidermodysplasia verruciformis (EV). The severe form of EV is characterized by HPV-5-induced PV-like lesions, multiple skin cancers, and usually depressed cell-mediated immunity. The picture seen in one of our renal allograft recipients recalls this severe form of EV. HPV-5, until now, has been found only in EV patients. The role of this potentially oncogenic virus in skin cancers which are known to occur with increased frequency in immunosuppressed renal allograft recipients must be determined.

Adult↗
PubMed1980

Are there non-steroid-dependent rejection episodes?

We undertook two randomised studies in an effort to decrease the dosage of steroids in transplanted patients and to replace harmful steroid therapy by nonsteroid anti-inflammatory (NSAI) drugs. In the first study, 50 consecutive transplant recipients were randomly assigned to the treatment or the control group. In both groups, patients received azathioprine and prednisolone. ATG was added to this protocol in the experimental group. The number of renal failure episodes and consequently the amount of steroid necessary to control these episodes were significantly lower in the ATG group than in the other group. Two year post-transplantation kidney survival was 79% in the ATG group and 52% in the control group. In the second study, 15 consecutive transplant recipients were randomly assigned to two control groups and to one experimental group, where steroids were replaced by NSAI drugs. This preliminary, and very limited, pilot trial demonstrates the existence of early acute renal failure episodes, probably of immunological origin, which can improve spontaneously in the absence of steroid therapy.

Anti-Inflammatory Agents↗
PubMed1980

Plasma 1,25(OH)2D3 and iPTH in transplanted adults with persisting hypophosphataemia.

Hypophosphataemia is a common finding among kidney transplanted patients [1,2]. In a previous study in kidney transplanted children with plasma creatinine below 1.1mg/dl, we demonstrated [3] a negative correlation between plasma phosphorus and 1 alpha, 25-dihydroxyvitamin D3 (1,25(OH)2D3), the renal hormonal form of vitamin D. No such correlation was apparent in children with minimal increase in plasma creatinine. The aim of the present investigation carried out in hypophosphataemic transplanted adults was two-fold: 1) to determine whether hypophosphataemia results from persisting hyperparathyroidism or from a renal phosphorus leak, or both, and 2) to study the relation between plasma phosphorus, iPTH and 1,25(OH)2D3 in these patients.

Adult↗
PubMed1979

[Bacterial infections in renal homotransplant recipients. Results of regular bacteriological controls (author's transl)].

Bacterial infections were studied in 51 immunosuppression kidney transplant recipients. Eighty infectious episodes occured in the first six post-transplantation months. Forty percent of these episodes were nonfebrile, detected during the routine bacteriological follow-up examination. Out of these 80 bacterial infections, 59 were localized (47 in the urinary tract, nine in the surgical wound and three in the lungs) and 21 had spread. Neutopenia occured in 13 patients, in association with septicaemia in eight of them. Usually septicaemia appeared before neutropenia. In 12 cases, infectious episodes (10 septicaemias and two localized infections) and transplant failure were closely related. The bacterial strains responsible for these infections were essentially: Staphylococcus spp (39), Streptococcus spp (14), Klebsiella pneumoniae (9), Escherichia coli (9). Most of the localized infections cleared up when treated with a specific antibiotic. Seven failures of antibiotic treatment were observed in 21 cases of generalized infections. The importance of regular post-transplantation bacteriological check-up in detecting and treating infectious complications in graft recipients must be emphasized.

Adolescent↗
PubMed1979

Recurrence of dense deposits in transplanted kidneys: I. Sequential survey of the lesions.

Serial specimens from transplanted kidneys were obtained in 11 patients with dense deposit disease (DDD). The recurrence of DDD was obvious in 9 patients and appeared very early after grafting. Three different types of evolution of the lesions were observed. In 4 patients no modification of the lesions occurred with time, and in 2 of them the dense alteration alone persisted without any other glomerular changes. In 3 patients a progression of the lesions was observed, whereas a regression occurred in 1 other patient. From these observations the following sequence of the morphologic changes can be proposed: the dense alteration appears first and constitutes the specific marker of that disease; the C3 deposition in the kidney occurs later following the appearance of the dense lesion.

Basement Membrane↗
PubMed1979

Antibody dependent cell mediated cytotoxicity (ADCC) and complement dependent cytotoxicity (CDC) in 229 sera from human renal allograft recipients.

Comparison between CDC and ADCC in a human allogeneic model using the same cytotoxicity marker, i.e. 51Cr release from labelled target cells, provided a better definition of the optimal technical conditions for revealing ADCC. Testing 229 sera from human renal allograft recipients after transplantation, we found that CDC is detected only during rejection (43% of cases) whereas ADCC can be found both in those recipients tolerating their grafts and in those undergoing rejection, more frequently in the former than in the latter (39% vs. 21%, p less than 0.05). These in vivo results and other in vitro experiments support the assumption that two distinct varieties of antibody can mediate the in vitro ADCC phenomenon, some directed against the A, B and C HLA loci and having a deleterious effect on the graft, and others capable of exerting a protective effect and which could be directed against D related HLA determinants.

Antibody-Dependent Cell Cytotoxicity↗