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Biomedical subjects

R Montagnac

Publications and source records attributed to R Montagnac.

78 records · Page 5Linked to original sources
PubMed1986

[Hemolytic-uremic syndrome during oral contraception].

A hemolytic and uremic syndrome is described in a 41 year old woman on oral contraceptives for 18 years, only discontinued during the course of 4 normal pregnancies. A renal biopsy performed on the 20th day, after correction of the thrombopenia, confirms the typical aspect of advanced thrombotic microangiopathy. The usual etiological work-up is negative, but the search for steroidal anti-hormones antibodies by radioimmuno assay is positive. The evolution is favorable with hemodialysis, perfusion of fresh plasma during the sessions, calciparin, dipyridamol and anti-hypertensive drugs with, eight months later, a creatinin clearance of 45 ml/min and important persisting ischemic lesions in a new renal biopsy. The hemolytic and uremic syndrome following oral contraceptives remains rare (about thirty cases reported in the literature) and its prognosis remains severe despite a well adjusted treatment. Prevention includes the detection of risk patients and the search for steroidal anti-hormones antibodies could certainly play a role which remains to be evaluated.

Adult↗
PubMed1985

[The kidney failure of Bourneville's tuberous sclerosis: a new form of glomerular damage as a result of hyperfiltration?].

Chronic renal failure, rarely seen in tuberous sclerosis (TS), is usually related to renal hamartomas and/or cysts, but has only been very rarely linked to glomerular changes. In a patient with TS, we have performed repeated renal biopsies at early and advanced stages of renal failure. We have correlated the renal function deterioration with the evolution of focal and segmental glomerulosclerosis. Renal insufficiency would be in relation not only with renal involvement by multiple tumors, but also with the progression of focal and segmental glomerulosclerosis. This would be caused by hemodynamic changes in remnant glomeruli, after reduction in renal mass induced by renal tumors, and would be a new example of renal injury due to hyperfiltration.

Adult↗
PubMed1983

[Extramembranous glomerulonephritis of acquired syphilis in a patient recently infected by the hepatitis B virus. Demonstration of the treponemal antigen in the kidney by indirect immunofluorescence].

A 38 years old male homosexual with active secondary syphilis presented with pure nephrotic syndrome while HBs and HBe tests were positive without clinical hepatitis. He had circulating immune complexes, IgG--IgM cryoglobulinemia and high IgA, IgM and IgE levels; the C3 and C4 complement constituents were normal. Examination of renal biopsy sections under light, fluorescent and electronic microscopy showed stage I membranous glomerulonephritis the syphilitic origin of which was confirmed by indirect immunofluorescence and by rapid cure under penicillin treatment. This case calls for the following comments: (1) glomerular deposits are extramembranous rather than subendothelial in syphilitic nephrosis, a disease now classified among circulating immune complexes diseases; (2) in the kidney, the treponema antigen can be demonstrated by indirect immunofluorescence and the anti-treponema antibody, by elution; (3) the outcome of the nephrotic syndrome is always favourable, either spontaneously or after penicillin treatment; (4) syphilis and HBs antigens are frequently associated, particularly in homosexual patients; one should be looked for when the other is discovered.

Adult↗