1
|
Chauveau B, Gibier JB, Rabant M. In Reply to "'Atypical' Anti-GBM Disease: Just Atypical, or Not Anti-GBM Disease at All?". Am J Kidney Dis 2024:S0272-6386(24)00695-4. [PMID: 38604266 DOI: 10.1053/j.ajkd.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 03/22/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Bertrand Chauveau
- Department of Pathology, Pellegrin Hospital, Bordeaux University Hospital, Bordeaux, France; University of Bordeaux, CNRS UMR 5164, ImmunoConcEpT, Bordeaux, France
| | - Jean-Baptiste Gibier
- University Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France; CHU Lille, Institute of Pathology, Lille, France
| | - Marion Rabant
- Department of Pathology, Centre Hospitalier Universitaire Necker-Enfants Malades, Assistance Publique - Hopitaux de Paris (AP-HP), Paris, France; University of Paris Cité, INSERM U1151, CNRS UMR 8253, Institut Necker-Enfants Malades, Département Croissance et Signalisation, Paris, France
| |
Collapse
|
2
|
Pfirmann P, Garrigue I, Chauveau B, Rondeau V, Tumiotto C, Weinmann L, Dubois V, Couzi L, Merville P, Kaminski H, Taton B. Trends in epidemiology and risk factors of opportunistic infections in kidney transplant recipients between 2004 and 2017. Nephrol Dial Transplant 2024; 39:627-636. [PMID: 37667539 DOI: 10.1093/ndt/gfad193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND While opportunistic infections are a frequent and challenging problem in kidney transplant recipients, their long-term epidemiology remains hardly known. METHODS Opportunistic infections were recorded in 1144 recipients transplanted in our center between 2004 and 2015. Incidence rates and baseline risk factors were determined using joint frailty models. RESULTS After a median follow-up of 5.6 years, 544 opportunistic infections occurred in 373/1144 (33%) patients, dominated by viral infections (396/544, 72%), especially cytomegalovirus (CMV) syndromes and diseases (213/544, 39%). One-third of the infected patients experienced at least two opportunistic infections. The incidence of opportunistic infections was 10 times higher during the first year post-transplantation than after that (34.7 infections for 100 patient-years vs 3.64). Opportunistic infections associated with the age of the donor (P = .032), the age of the recipient (P = .049), the CMV serostatus (P < 10-6), a higher class II HLA mismatch (P = .032) and an induction treatment including rabbit anti-thymocyte globulins (P = .026). Repeated opportunistic infections associated with each other (P < 10-6) and with renal death (P < 10-6). CONCLUSION Opportunistic infections occur with a two-period incidence pattern and many susceptible patients suffer from repeated episodes. This knowledge may help tailor new prevention and follow-up strategies to reduce the burden of opportunistic infections and their impact on transplantation outcome.
Collapse
Affiliation(s)
- Pierre Pfirmann
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
| | - Isabelle Garrigue
- Laboratoire de Virologie, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5234 Microbiologie Fondamentale et Pathogénicité, Université de Bordeaux, Bordeaux France
| | - Bertrand Chauveau
- Service de Pathologie, Groupe hospitalier Pellegrin, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Virginie Rondeau
- Centre INSERM U1219, Institut de Santé Publique, d'Épidémiologie et de Développement, Bordeaux France
| | - Camille Tumiotto
- Laboratoire de Virologie, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5234 Microbiologie Fondamentale et Pathogénicité, Université de Bordeaux, Bordeaux France
| | | | | | - Lionel Couzi
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Pierre Merville
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Hannah Kaminski
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Benjamin Taton
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
| |
Collapse
|
3
|
Chauveau B, Burguet L, Merville P. An unusual macroscopic aspect of a kidney biopsy: a nephrology quiz. J Nephrol 2024:10.1007/s40620-023-01826-2. [PMID: 38530602 DOI: 10.1007/s40620-023-01826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/26/2023] [Indexed: 03/28/2024]
Affiliation(s)
- Bertrand Chauveau
- Service de Pathologie, CHU de Bordeaux, Hôpital Pellegrin, Place Amélie Raba Léon, 33000, Bordeaux, France.
- ImmunoConcEpT, UMR 5164, Université de Bordeaux, CNRS, 146 rue Léo Saignat, 33000, Bordeaux, France.
| | - Laure Burguet
- Service de Néphrologie, CH de Pau, 64445, Pau, France
| | - Pierre Merville
- ImmunoConcEpT, UMR 5164, Université de Bordeaux, CNRS, 146 rue Léo Saignat, 33000, Bordeaux, France
- Service de Néphrologie, Transplantation Dialyse, Aphérèses, CHU de Bordeaux, Hôpital Pellegrin, Place Amélie Raba Léon, 33000, Bordeaux, France
| |
Collapse
|
4
|
Chauveau B, Gibier JB, Olagne J, Morel A, Aydin S, McAdoo SP, Viallet N, Perrochia H, Pambrun E, Royal V, Demoulin N, Kemeny JL, Philipponnet C, Hertig A, Boffa JJ, Plaisier E, Domenger C, Brochériou I, Deltombe C, Duong Van Huyen JP, Buob D, Roufosse C, Hellmark T, Audard V, Mihout F, Nasr SH, Renaudin K, Moktefi A, Rabant M. Atypical Anti-Glomerular Basement Membrane Nephritis: A Case Series From the French Nephropathology Group. Am J Kidney Dis 2024:S0272-6386(23)01003-X. [PMID: 38171412 DOI: 10.1053/j.ajkd.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/06/2023] [Accepted: 11/02/2023] [Indexed: 01/05/2024]
Abstract
RATIONALE & OBJECTIVE Atypical anti-glomerular basement membrane (GBM) nephritis is characterized by a bright linear immunoglobulin staining along the GBM by immunofluorescence without a diffuse crescentic glomerulonephritis nor serum anti-GBM antibodies by conventional enzyme-linked immunosorbent assay (ELISA). We characterized a series of patients with atypical anti-GBM disease. STUDY DESIGN Case series. SETTING & PARTICIPANTS Patients identified by the French Nephropathology Group as having atypical anti-GBM nephritis between 2003 and 2022. FINDINGS Among 38 potential cases, 25 were included, of whom 14 (56%) were female and 23 (92%) had hematuria. The median serum creatinine at diagnosis was 150 (IQR, 102-203) μmol/L and median urine protein-creatinine ratio (UPCR) was 2.4 (IQR, 1.3-5.2) g/g. Nine patients (36%) had endocapillary proliferative glomerulonephritis (GN), 4 (16%) had mesangial proliferative GN, 4 (16%) had membranoproliferative GN, 2 (8%) had pure and focal crescentic GN, 1 (4%) had focal segmental glomerulosclerosis, and 5 had glomeruli that were unremarkable on histopathology. Nine patients (36%) had crescents, involving a median of 9% of glomeruli. Bright linear staining for IgG was seen in 22 cases (88%) and for IgA in 3 cases (12%). The 9 patients (38%) who had a monotypic staining pattern tended to be older with less proteinuria and rarely had crescents. Kidney survival rate at 1 year was 83% and did not appear to be associated with the light chain restriction. LIMITATIONS Retrospective case series with a limited number of biopsies including electron microscopy. CONCLUSIONS Compared with typical anti-GBM disease, atypical anti-GBM nephritis frequently presents with an endocapillary or mesangial proliferative glomerulonephritis pattern and appears to have a slower disease progression. Further studies are needed to fully characterize its pathophysiology and associated clinical outcomes. PLAIN-LANGUAGE SUMMARY Atypical anti-glomerular basement membrane (GBM) nephritis is characterized histologically by bright linear immunoglobulin staining along the GBM without diffuse crescentic glomerulonephritis or circulating anti-GBM antibodies. We report a case series of 25 atypical cases of anti-GBM nephritis in collaboration with the French Nephropathology Group. Compared with typical anti-GBM disease, we observed a slower disease progression. Patients frequently presented with heavy proteinuria and commonly had evidence of endocapillary or mesangial proliferative glomerulonephritis. About half of the patients displayed a monotypic immune staining pattern; they tended to be older, with less proteinuria, and commonly without glomerular crescents in biopsy specimens. No concomitant circulating monoclonal gammopathy was detected. Further studies are needed to fully characterize its pathophysiology and associated clinical outcomes.
Collapse
Affiliation(s)
- Bertrand Chauveau
- Department of Pathology, Pellegrin Hospital, Bordeaux University Hospital, Bordeaux, France; CNRS UMR 5164, ImmunoConcEpT, University of Bordeaux, Bordeaux, France.
| | - Jean-Baptiste Gibier
- UMR9020-U1277, CANTHER, Cancer Heterogeneity Plasticity and Resistance to Therapies, University of Lille, Lille, France; Institute of Pathology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Jérôme Olagne
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France; Department of Pathology, Strasbourg University Hospital, Strasbourg, France
| | - Antoine Morel
- Nephrology and Renal Transplantation Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Henri Mondor Hospital University, Rare Disease Center "Idiopathic Nephrotic Syndrome," Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Selda Aydin
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Pathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Stephen P McAdoo
- Centre for Inflammatory Disease, Department of Immunology & Inflammation, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Nicolas Viallet
- Department of Nephrology-Transplantation, Centre Hospitalier Universitaire de la Réunion Felix Guyon, Saint Denis, Réunion, France
| | - Hélène Perrochia
- Pathology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Emilie Pambrun
- Department of Nephrology Dialysis Apheresis, Nîmes University Hospital, Nîmes, France
| | - Virginie Royal
- Department of Pathology, Hôpital Maisonneuve-Rosemont, University of Montreal, Quebec, Canada
| | - Nathalie Demoulin
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Division of Nephrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Jean-Louis Kemeny
- Pathology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Carole Philipponnet
- Nephrology, Dialysis, and Transplantation Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | | | - Jean-Jacques Boffa
- Department of Nephrology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Emmanuelle Plaisier
- Department of Nephrology, Association pour l'Utilisation du Rein Artificiel Paris Plaisance, Paris, France; Unité Mixte de Recherche S1155, Sorbonne Université and Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Camille Domenger
- Department of Nephrology, Dialysis and Transplantation, Polynésie Française Hospital, Pirae, Tahiti
| | - Isabelle Brochériou
- INSERM UMR S1155, Sorbonne Université, Pitié-Salpêtrière Hospital, Paris, France; Department of Pathology, Pitié-Salpêtrière Hospital, Paris, France
| | - Clément Deltombe
- Nephrology and Transplantation Department, Department of Nephrology and Immunology, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Jean-Paul Duong Van Huyen
- Department of Pathology, Centre Hospitalier Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - David Buob
- INSERM UMR S1155, Sorbonne Université, Pitié-Salpêtrière Hospital, Paris, France; Department of Pathology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Candice Roufosse
- Centre for Inflammatory Disease, Department of Immunology & Inflammation, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Thomas Hellmark
- Nephrology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Vincent Audard
- Nephrology and Renal Transplantation Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Henri Mondor Hospital University, Rare Disease Center "Idiopathic Nephrotic Syndrome," Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France; Institut Mondor de Recherche Biomédicale, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris-Est Créteil, Créteil, France
| | - Fabrice Mihout
- Department of Nephrology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Samih H Nasr
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Karine Renaudin
- Department of Pathology, Centre Hospitalier Universitaire de Nantes, Nantes, France; Centre de Recherche en Transplantation et en Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France
| | - Anissa Moktefi
- Institut Mondor de Recherche Biomédicale, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris-Est Créteil, Créteil, France; Department of Pathology, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Marion Rabant
- Department of Pathology, Centre Hospitalier Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM U1151, CNRS UMR 8253, Institut Necker-Enfants Malades, Département Croissance et Signalisation, University of Paris Cité, Paris, France
| |
Collapse
|
5
|
Julien A, Gremeau AS, Campagne-Loiseau S, Chauveau B, Chauvet P, Combet L, Canis M. Case Report of an exceptional spontaneous abdominal heterotopic pregnancy with superfetation: Diagnosis and treatment: Heterotopic pregnancy with superfetation (8+1 WG & 5+4 WG). J Gynecol Obstet Hum Reprod 2024; 53:102701. [PMID: 38013015 DOI: 10.1016/j.jogoh.2023.102701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 11/29/2023]
Abstract
Heterotopic pregnancy is an extremely rare condition in which an intrauterine and an extrauterine pregnancy co-exist. In spontaneous conceptions, heterotopic pregnancy occurs in only 1/30 000 pregnancies. The treatment of heterotopic pregnancy must be as minimally invasive as possible to preserve the development of the intrauterine pregnancy. Superfetation, defined as the coexistence of 2 or more foetuses of different gestational ages, remains particularly exceptional and poorly explained (second ovulation? embryonic diapause?). Here, we present an extremely rare case of a spontaneous heterotopic evolutive pregnancy with superfetation, consisting of an embryo in the pouch of Douglas estimated at 8 + 1 weeks of gestation (WG) and a progressive intrauterine pregnancy estimated at 5 + 4 WG. We treated the extrauterine pregnancy with an intra-cardiac injection of potassium chloride echo-guided via the vaginal route, and the patient then underwent exploratory laparoscopy 9 days later and lavage and aspiration of the abdominal heterotopic pregnancy due to pain and biological inflammatory syndrome probably caused by pelvic mass syndrome and peritoneal irritation from the foetal necrosis. She has not yet given birth and is currently at 36 WG.
Collapse
Affiliation(s)
- A Julien
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France; Department of Biology and Reproductive Medicine, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France.
| | - A-S Gremeau
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France; Department of Biology and Reproductive Medicine, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France
| | - S Campagne-Loiseau
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France
| | - B Chauveau
- Radiology Department, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France; EnCoV, IP, UMR 6602 CNRS, Clermont Auvergne University, Clermont-Ferrand, France
| | - P Chauvet
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France; EnCoV, IP, UMR 6602 CNRS, Clermont Auvergne University, Clermont-Ferrand, France
| | - L Combet
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France
| | - M Canis
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France; EnCoV, IP, UMR 6602 CNRS, Clermont Auvergne University, Clermont-Ferrand, France
| |
Collapse
|
6
|
Chauveau B, Merville P. Segment Anything by Meta as a foundation model for image segmentation: a new era for histopathological images. Pathology 2023; 55:1017-1020. [PMID: 37813761 DOI: 10.1016/j.pathol.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/16/2023] [Accepted: 09/17/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Bertrand Chauveau
- CHU de Bordeaux, Service de Pathologie, Hôpital Pellegrin, Bordeaux, France; ImmunoConcEpT, CNRS, Université Bordeaux, UMR 5164, Bordeaux, France.
| | - Pierre Merville
- ImmunoConcEpT, CNRS, Université Bordeaux, UMR 5164, Bordeaux, France; CHU de Bordeaux, Service de Néphrologie-Transplantation-Dialyse-Aphéréses, Hôpital Pellegrin, Bordeaux, France
| |
Collapse
|
7
|
Chambord J, Chauveau B, Djabarouti S, Vignaud J, Taton B, Moreau K, Visentin J, Merville P, Xuereb F, Couzi L. Measurement of the Immunosuppressant Possession Ratio by Transplant Clinical Pharmacists Captures a Non-Adherence Associated With Antibody-Mediated Rejection. Transpl Int 2023; 36:11962. [PMID: 38089004 PMCID: PMC10713790 DOI: 10.3389/ti.2023.11962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023]
Abstract
Our objective was to calculate an immunosuppressant possession ratio (IPR) to diagnose non-adherence at the time of antibody-mediated rejection (ABMR). IPR was defined as the ratio of number of pills collected at the pharmacy to the number of pills prescribed over a defined period. In a first cohort of 91 kidney transplant recipients (KTRs), those with an IPR < 90% had more frequently a tacrolimus through level coefficient of variation >30% than patients with an IPR = 100% (66.7% vs. 29.4%, p = 0.05). In a case-control study, 26 KTRs with ABMR had lower 6 months IPRs than 26 controls (76% vs. 99%, p < 0.001). In KTRs with ABMR, non-adherence was more often diagnosed by a 6 months IPR < 90% than by clinical suspicion (73.1% vs 30.8%, p = 0.02). In the multivariable analysis, only de novo DSA and 6 months IPR < 90% were independently associated with ABMR, whereas clinical suspicion was not (odds ratio, 4.73; 95% CI, 1.17-21.88; p = 0.03; and odds ratio, 6.34; 95% CI, 1.73-25.59; p = 0.007, respectively). In summary, IPR < 90% is a quantifiable tool to measure immunosuppressant non-adherence. It is better associated with ABMR than clinical suspicion of non-adherence.
Collapse
Affiliation(s)
- Jérémy Chambord
- Service de Pharmacie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Bertrand Chauveau
- Service d’Anatomopathologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Sarah Djabarouti
- Service de Pharmacie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- INSERM U1312 BRIEC, Université de Bordeaux, Bordeaux, France
| | - Jean Vignaud
- Service de Pharmacie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Benjamin Taton
- Service de Néphrologie, Transplantation, Dialyse, Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Karine Moreau
- Service de Néphrologie, Transplantation, Dialyse, Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Jonathan Visentin
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
- Service d’Immunologie et Immunogénétique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Pierre Merville
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
- Service de Néphrologie, Transplantation, Dialyse, Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Fabien Xuereb
- Service de Pharmacie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- INSERM U1034, Université de Bordeaux, Bordeaux, France
| | - Lionel Couzi
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
- Service de Néphrologie, Transplantation, Dialyse, Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| |
Collapse
|
8
|
Noelle J, Mayet V, Lambert C, Couzi L, Chauveau B, Thierry A, Ecotière L, Bertrand D, Laurent C, Lemal R, Grèze C, Freist M, Heng AE, Rouzaire PO, Garrouste C. Impact of Calcineurin Inhibitor-Based Immunosuppression Maintenance During the Dialysis Period After Kidney Transplant Failure on the Next Kidney Graft Outcome: A Retrospective Multicenter Study With Propensity Score Analysis. Transpl Int 2023; 36:11775. [PMID: 37799669 PMCID: PMC10548547 DOI: 10.3389/ti.2023.11775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/25/2023] [Indexed: 10/07/2023]
Abstract
The impact of immunosuppressive therapy (IS) strategies after kidney transplant failure (KTF) on potential future new grafts is poorly established. We assessed the potential benefit of calcineurin inhibitor (CNI)-based IS maintenance throughout the dialysis period on the outcome of the second kidney transplant (KT). We identified 407 patients who underwent a second KT between January 2008 and December 2018 at four French KT centers. Inverse probability of treatment weighting was used to control for potential confounding. We included 205 patients with similar baseline characteristics at KTF: a total of 53 received at least CNIs on the retransplant day (G-CNI), and 152 did not receive any IS (G-STOP). On the retransplant date, G-STOP patients experienced a longer pretransplant dialysis time, were more often hyperimmunized, and underwent more expanded-criteria donor KTs than G-CNI patients. During the second KT follow-up period, rejection episodes were similar in both groups. The 10-year survival rates without death and dialysis were 98.7% and 59.5% in G-CNI and G-STOP patients, respectively. In the multivariable analysis, CNI-based IS maintenance was associated with better survival (hazard ratio: 0.08; 95% confidence interval: 0.01-0.58, p = 0.01). CNI-based IS maintenance throughout the dialysis period after KTF may improve retransplantation outcomes.
Collapse
Affiliation(s)
- Juliette Noelle
- Service de Néphrologie Centre hospitalo-universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Valentin Mayet
- Service de Néphrologie Centre hospitalo-universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Céline Lambert
- Unité de Biostatistiques, Direction de la recherche clinique et d’ innovation, Centre hospitalo-universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Lionel Couzi
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Centre hospitalo-universitaire Bordeaux, Bordeaux, France
| | - Bertrand Chauveau
- Service de Pathologie, Centre hospitalo-universitaire de Bordeaux, Bordeaux, France
| | - Antoine Thierry
- Service de Néphrologie-Hémodialyse-Transplantation Rénale, Centre hospitalo-universitaire Poitiers, Poitiers, France
| | - Laure Ecotière
- Service de Néphrologie-Hémodialyse-Transplantation Rénale, Centre hospitalo-universitaire Poitiers, Poitiers, France
| | - Dominique Bertrand
- Service de Néphrologie, Centre hospitalier régional universitaire rouen, Rouen, France
| | - Charlotte Laurent
- Service de Néphrologie, Centre hospitalier régional universitaire rouen, Rouen, France
| | - Richard Lemal
- Service d’Histocompatibilité et Immunogénétique, Centre hospitalo-universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Clarisse Grèze
- Service de Néphrologie Centre hospitalo-universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Marine Freist
- Service de Néphrologie Centre hospitalo-universitaire Clermont-Ferrand, Clermont-Ferrand, France
- Service de Néphrologie et Dialyse, Centre hospitalier Emile Roux, Le Puy-en-Velay, France
| | - Anne-Elisabeth Heng
- Service de Néphrologie Centre hospitalo-universitaire Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Paul-Olivier Rouzaire
- Service d’Histocompatibilité et Immunogénétique, Centre hospitalo-universitaire Clermont-Ferrand, Clermont-Ferrand, France
- EA 7453 CHELTER, Clermont-Ferrand, France
| | - Cyril Garrouste
- Service de Néphrologie Centre hospitalo-universitaire Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
- EA 7453 CHELTER, Clermont-Ferrand, France
| |
Collapse
|
9
|
Marichez A, Chauveau B, Bail BL, Chiche L. Isolated IgG4-related cholecystitis mimicking an advanced gallbladder cancer: Don't fall into the trap. Dig Liver Dis 2023; 55:1297-1298. [PMID: 37316364 DOI: 10.1016/j.dld.2023.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/30/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Arthur Marichez
- Department of Hepato-Bilio-Pancreatic Surgery and Liver Transplantation, Haut Leveque Hospital, Bordeaux University Hospital, France; INSERM UMR 1312 Team 3 "Liver Cancers and tumoral invasion", Bordeaux Institute of Oncology, University of Bordeaux, France.
| | - Bertrand Chauveau
- Department of Pathology, Pellegrin Hospital, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux 33000, France; CNRS UMR 5164, University of Bordeaux, ImmunoConcEpT, 146 Rue Léo Saignat, Bordeaux 33000, France
| | - Brigitte Le Bail
- INSERM UMR 1312 Team 3 "Liver Cancers and tumoral invasion", Bordeaux Institute of Oncology, University of Bordeaux, France; Department of Pathology, Pellegrin Hospital, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux 33000, France
| | - Laurence Chiche
- Department of Hepato-Bilio-Pancreatic Surgery and Liver Transplantation, Haut Leveque Hospital, Bordeaux University Hospital, France; INSERM UMR 1312 Team 3 "Liver Cancers and tumoral invasion", Bordeaux Institute of Oncology, University of Bordeaux, France
| |
Collapse
|
10
|
Chauveau B, Taton B, Pfirmann P. A Patient with Lymphadenopathy, Hypercalcemia, and Kidney Injury. Kidney360 2023; 4:e1341-e1342. [PMID: 37332104 PMCID: PMC10547216 DOI: 10.34067/kid.0000000000000176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 06/20/2023]
Affiliation(s)
- Bertrand Chauveau
- CHU de Bordeaux, Service de Pathologie, Hôpital Pellegrin, Bordeaux, France
- ImmunoConcEpT, CNRS, Université de Bordeaux, UMR 5164, Bordeaux, France
| | - Benjamin Taton
- CHU de Bordeaux, Service de Néphrologie-Transplantation-Dialyse-Aphérèses, Hôpital Pellegrin, Bordeaux, France
| | - Pierre Pfirmann
- CHU de Bordeaux, Service de Néphrologie-Transplantation-Dialyse-Aphérèses, Hôpital Pellegrin, Bordeaux, France
- Maison du rein – AURAD aquitaine, Gradignan, France
| |
Collapse
|
11
|
Chauveau B, Merville P, Soulabaille B, Taton B, Kaminski H, Visentin J, Vermorel A, Bouzgarrou M, Couzi L, Grenier N. Magnetic Resonance Elastography as Surrogate Marker of Interstitial Fibrosis in Kidney Transplantation: A Prospective Study. Kidney360 2022; 3:1924-1933. [PMID: 36514413 PMCID: PMC9717636 DOI: 10.34067/kid.0004282022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/29/2022] [Indexed: 01/12/2023]
Abstract
Background Fibrosis progression is a major prognosis factor in kidney transplantation. Its assessment requires an allograft biopsy, which remains an invasive procedure at risk of complications. Methods We assessed renal stiffness by magnetic resonance elastography (MRE) as a surrogate marker of fibrosis in a prospective cohort of kidney transplant recipients compared with the histologic gold standard. Interstitial fibrosis was evaluated by three methods: the semi-quantitative Banff ci score, a visual quantitative evaluation by a pathologist, and a computer-assisted quantitative evaluation. MRE-derived stiffness was assessed at the superior, median, and inferior poles of the allograft. Results We initially enrolled 73 patients, but only 55 had measurements of their allograft stiffness by MRE before an allograft biopsy. There was no significant correlation between MRE-derived stiffness at the biopsy site and the ci score (ρ=-0.25, P=0.06) or with the two quantitative assessments (pathologist: ρ=-0.25, P=0.07; computer assisted: ρ=-0.21, P=0.12). We observed negative correlations between the stiffness of both the biopsy site and the whole allograft, with either the glomerulosclerosis percentage (ρ=-0.32, P=0.02 and ρ=-0.31, P=0.02, respectively) and the overall nephron fibrosis percentage, defined as the mean of the percentages of glomerulosclerosis and interstitial fibrosis (ρ=-0.30, P=0.02 and ρ=-0.28, P=0.04, respectively). At patient level, mean MRE-derived stiffness was similar across the three poles of the allograft (±0.25 kPa). However, a high variability of mean stiffness was found between patients, suggesting a strong influence of confounding factors. Finally, no significant correlation was found between mean MRE-derived stiffness and the slope of eGFR (P=0.08). Conclusions MRE-derived stiffness does not directly reflect the extent of fibrosis in kidney transplantation.
Collapse
Affiliation(s)
- Bertrand Chauveau
- CHU de Bordeaux, Service de Pathologie, Hôpital Pellegrin, Place Amélie Raba Léon, Bordeaux, France,Université de Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, Bordeaux, France
| | - Pierre Merville
- Université de Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, Bordeaux, France,CHU de Bordeaux, Service de Néphrologie, Transplantation Dialyse, Aphérèses, Hôpital Pellegrin, Bordeaux, France
| | - Bruno Soulabaille
- CHU de Bordeaux, Service d’Imagerie Diagnostique et Interventionnelle de l’Adulte, Hôpital Pellegrin, France
| | - Benjamin Taton
- CHU de Bordeaux, Service de Néphrologie, Transplantation Dialyse, Aphérèses, Hôpital Pellegrin, Bordeaux, France
| | - Hannah Kaminski
- Université de Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, Bordeaux, France,CHU de Bordeaux, Service de Néphrologie, Transplantation Dialyse, Aphérèses, Hôpital Pellegrin, Bordeaux, France
| | - Jonathan Visentin
- Université de Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, Bordeaux, France,CHU de Bordeaux, Laboratoire d’Immunologie et Immunogénétique, Hôpital Pellegrin, Bordeaux, France
| | - Agathe Vermorel
- CHU de Bordeaux, Service de Néphrologie, Transplantation Dialyse, Aphérèses, Hôpital Pellegrin, Bordeaux, France
| | - Mounir Bouzgarrou
- CHU de Bordeaux, Service d’Imagerie Diagnostique et Interventionnelle de l’Adulte, Hôpital Pellegrin, France
| | - Lionel Couzi
- Université de Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, Bordeaux, France,CHU de Bordeaux, Service de Néphrologie, Transplantation Dialyse, Aphérèses, Hôpital Pellegrin, Bordeaux, France
| | - Nicolas Grenier
- CHU de Bordeaux, Service d’Imagerie Diagnostique et Interventionnelle de l’Adulte, Hôpital Pellegrin, France
| |
Collapse
|
12
|
Chauveau B, Merville P, Soulabaille B, Taton B, Kaminski H, Visentin J, Vermorel A, Bouzgarrou M, Couzi L, Grenier N. L’élastographie par résonance magnétique dans l’évaluation de la fibrose interstitielle en transplantation rénale : résultats d’une étude prospective. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
13
|
Bos F, Chauveau B, Ruel J, Fontant G, Campistron E, Meunier C, Jambon F, Moreau K, Delmas Y, Couzi L, Korbi S, Charrier M, Viallard JF, Luciani L, Merville P, Lazaro E, Kaminski H. Serious and atypical presentations of Bartonella henselae infection in kidney transplant recipients. Open Forum Infect Dis 2022; 9:ofac059. [PMID: 35211636 PMCID: PMC8863078 DOI: 10.1093/ofid/ofac059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/03/2022] [Indexed: 11/14/2022] Open
Abstract
This article describes 5 cases of bartonellosis with fever and atypical clinical presentations in kidney transplant recipients: thrombotic microangiopathies, recurrent hemophagocytosis, and immune reconstitution syndrome after treatment. The diagnosis, the pathological lesions, and treatments are described. Bartonellosis must be researched in solid organ transplant recipients with fever of undetermined origin.
Collapse
Affiliation(s)
- Feline Bos
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Bertrand Chauveau
- Department of Pathology, Bordeaux University Hospital, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
| | - Jules Ruel
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Gabriel Fontant
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Elise Campistron
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Camille Meunier
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Frédéric Jambon
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Karine Moreau
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Yahsou Delmas
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Lionel Couzi
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
| | - Skander Korbi
- Department of Pathology, Bordeaux University Hospital, Bordeaux, France
| | - Manon Charrier
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Jean-François Viallard
- CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
- Department of Internal Medicine, Bordeaux University Hospital, Bordeaux, France
| | - Léa Luciani
- Centre National de Référence des Rickettsies, Coxiella et Bartonella IHU-Méditerranée Infection, APHM, Marseille, France
| | - Pierre Merville
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
| | - Estibaliz Lazaro
- CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
- Department of Internal Medicine, Bordeaux University Hospital, Bordeaux, France
| | - Hannah Kaminski
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
| |
Collapse
|
14
|
Rigothier C, Chauveau B, Rubin S, Combe C. Chronic kidney disease of unknown origin in agricultural communities: beyond tropical mist? Nephrol Dial Transplant 2021; 36:961-962. [PMID: 33106851 DOI: 10.1093/ndt/gfaa265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/27/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Claire Rigothier
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France.,Tissue Bioengineering Unit BioTis, INSERM U1026, Bordeaux, France
| | | | - Sébastien Rubin
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France.,Biologie des Maladies Cardio-Vasculaires, University of Bordeaux, INSERM U1034, Pessac, France
| | - Christian Combe
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France.,Tissue Bioengineering Unit BioTis, INSERM U1026, Bordeaux, France
| |
Collapse
|
15
|
Mebroukine S, Chauveau B, Boulenger de Hauteclocque A, Percot M, Dupitout L, Blanc P, Alezra E, Estrade V, Bensadoun H, Ravaud A, Bladou F, Robert G, Ferrière J, Yacoub M, Gross-Goupil M, Bernhard J. Néphrectomie partielle robot-assistée après immunothérapie : faisabilité et partage d’expérience. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
16
|
Puissegur A, Salesse N, Delabaere A, Chauveau B, Ouchchane L, Debost-Legrand A, Lemery D. Impact of ultrasound speed choice on the quality of the second-trimester fetal ultrasound examination in obese women. Diagn Interv Imaging 2020; 102:109-113. [PMID: 32819887 DOI: 10.1016/j.diii.2020.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/12/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to assess the impact of the free choice of ultrasound propagation velocity on ultrasound image construction to improve the completion rate and anatomical quality of fetal second-trimester ultrasound examination in obese women. MATERIALS AND METHODS This repeated cross-sectional single-center study retrospectively collected second-trimester ultrasound images of 88 obese women. During the first period, ultrasound examinations were performed in 44 women (mean age, 31.4±5.9 [SD] years; range: 21.1 - 45.3 years) applying only the standard 1540m/s tissue ultrasound velocity (group 1). During the second period, ultrasound examinations were performed in other 44 women (mean age, 31.4±5.1 [SD] years; range: 20.6 - 41.6 years) with the operator free to choose among three available velocity settings (1420m/s, 1480m/s or 1540m/s) for the scanning planes for the morphological images (group 2). All women underwent mid-trimester ultrasound examination at 20 to 24 gestational weeks. Two observers assessed the examinations in both groups for completeness, quality, and duration of fetal ultrasound examinations. RESULTS No differences in age (P>0.99), body mass index (P=0.67), prevalence of previous cesarean delivery (P=0.30) or gestational age at the second-trimester scan (P=0.20) were found between the two groups. The mean cumulative duration of these ultrasound examinations was longer in group 1 than in group 2 (for both the complete (P=0.04) and incomplete (P=0.03) examinations). The quality of the anatomic images according to Salomon's criteria was less often acceptable in group 1 (5/44, 11.4%) than in group 2 (15/44, 34.1%) (P=0.02). CONCLUSION Free choice of ultrasound velocity improves the overall performance of fetal second-trimester ultrasound examinations in obese women.
Collapse
Affiliation(s)
- A Puissegur
- Obstetric Department, University Hospital of Clermont-Ferrand, 1, place Lucie Aubrac, 63000 Clermont-Ferrand, France
| | - N Salesse
- Obstetric Department, University Hospital of Clermont-Ferrand, 1, place Lucie Aubrac, 63000 Clermont-Ferrand, France
| | - A Delabaere
- Obstetric Department, University Hospital of Clermont-Ferrand, 1, place Lucie Aubrac, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS-UMR 6602, Pascal Institut, 63000 Clermont-Ferrand, France.
| | - B Chauveau
- Department of Radiology, University Hospital Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - L Ouchchane
- Clermont Auvergne University, CNRS-UMR 6602, Pascal Institut, 63000 Clermont-Ferrand, France; Public Health Department, University Hospital Gabriel Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - A Debost-Legrand
- Obstetric Department, University Hospital of Clermont-Ferrand, 1, place Lucie Aubrac, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS-UMR 6602, Pascal Institut, 63000 Clermont-Ferrand, France
| | - D Lemery
- Obstetric Department, University Hospital of Clermont-Ferrand, 1, place Lucie Aubrac, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS-UMR 6602, Pascal Institut, 63000 Clermont-Ferrand, France
| |
Collapse
|
17
|
Le Flecher A, Viallet N, Hebmann D, Chauveau B, Vacher Coponat H. Atypical anti-glomerular basement membrane disease presenting as macroscopic haematuria, loin pain and acute kidney injury after intensive exercise. Clin Kidney J 2019; 12:801-802. [PMID: 31807293 PMCID: PMC6885666 DOI: 10.1093/ckj/sfz044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Indexed: 12/04/2022] Open
Abstract
We report a 35-year-old man who suffered from recurrent macroscopic haematuria after intensive exercise. One episode was associated with bilateral loin (flank) pain and severe acute kidney injury. His kidney biopsy revealed an atypical anti-glomerular basement membrane (GBM) disease typified by bright linear GBM staining for monotypic immunoglobulin G but without a diffuse crescentic phenotype and no circulating anti-GBM antibody. Outcome was spontaneously favourable. The patient had no recurrence or urine abnormality without running. The original presentation emphasized that exercise could reveal an underlying glomerulopathy.
Collapse
Affiliation(s)
- Arnaud Le Flecher
- Department of Nephrology - Transplantation, CHU de la Réunion Felix Guyon, Saint Denis, Réunion, France
| | - Nicolas Viallet
- Department of Nephrology - Transplantation, CHU de la Réunion Felix Guyon, Saint Denis, Réunion, France
| | - Delphine Hebmann
- Department of Nephrology - Transplantation, CHU de la Réunion Felix Guyon, Saint Denis, Réunion, France
| | | | - Henri Vacher Coponat
- Department of Nephrology - Transplantation, CHU de la Réunion Felix Guyon, Saint Denis, Réunion, France.,Université de la Réunion, UFR Santé, Réunion, France
| |
Collapse
|
18
|
Affiliation(s)
- B Chauveau
- Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand, France
- Pôle Radiologie, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - C Auclair
- Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand, France
- Service de Santé Publique, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - A Legrand
- Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand, France
- Pôle Femme Et Enfant, Hôpital Estaing, Centre Hospitalier Universitaire de Clermont-Ferrand, 1 Place L&R Aubrac, 63003, Clermont-Ferrand Cedex 1, France
| | - R Mangione
- Collège Français d'Echographie Foetale (CFEF), France
| | - L Gerbaud
- Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand, France
- Service de Santé Publique, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - F Vendittelli
- Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand, France
- Pôle Femme Et Enfant, Hôpital Estaing, Centre Hospitalier Universitaire de Clermont-Ferrand, 1 Place L&R Aubrac, 63003, Clermont-Ferrand Cedex 1, France
| | - L Boyer
- Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand, France
- Pôle Radiologie, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - D Lémery
- Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand, France
- Pôle Femme Et Enfant, Hôpital Estaing, Centre Hospitalier Universitaire de Clermont-Ferrand, 1 Place L&R Aubrac, 63003, Clermont-Ferrand Cedex 1, France
| |
Collapse
|
19
|
Chauveau B, Le Loarer F, Bacci J, Baylac F, Dubus P, Ling C, Parrens M. [Indolent T-lymphoblastic proliferation in association with localized Castleman disease: A case report]. Ann Pathol 2018; 39:29-35. [PMID: 30554835 DOI: 10.1016/j.annpat.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/18/2018] [Accepted: 09/03/2018] [Indexed: 01/09/2023]
Abstract
Herein we report the case of a 41-year-old woman who presented with pelvic pain. Magnetic Resonance Imaging exhibited a single pelvic mass, measuring 50mm long axis, alongside the right iliac vessels. Histological examination of the excision specimen showed a lymphoid tumor with features of localized Castleman disease, hyaline vascular type. Moreover we identified multiple interfollicular dark clusters, composed of cells morphologically resembling cortical thymocytes. Their immunophenotype was consistent with an intermediate stage of T-cell differentiation, with the expression of CD3, CD4, CD8, TdT, CD1a, CD99, CD2, CD5, CD7 and CD10, with 40% Ki67. After integration of clinical and molecular data, the retained diagnosis was an indolent T-cell lymphoblastic proliferation associated with hyaline vascular localized Castleman disease. The clinical course confirmed the indolent nature of the proliferation, despite a late local recurrence at 7 years of the initial diagnosis, without histological modification, due to an incomplete initial resection surgery.
Collapse
Affiliation(s)
- Bertrand Chauveau
- Service de pathologie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France; Université de Bordeaux, Campus de Carreire, 146, rue Léo-Saignat CS 61292, 33076 Bordeaux cedex, France.
| | - François Le Loarer
- Service de biopathologie, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France; Université de Bordeaux, Campus de Carreire, 146, rue Léo-Saignat CS 61292, 33076 Bordeaux cedex, France
| | - Julia Bacci
- Service de biopathologie, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France
| | - François Baylac
- SCP Lhomme-Baylac-cabinet d'anatomie et cytologie pathologiques, 182, rue de Périgueux, 16000 Angoulême, France
| | - Pierre Dubus
- Université de Bordeaux, Campus de Carreire, 146, rue Léo-Saignat CS 61292, 33076 Bordeaux cedex, France; Service de biologie des tumeurs et tumorothèque, hôpital Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France
| | - Catherine Ling
- Service de pathologie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France; Université de Bordeaux, Campus de Carreire, 146, rue Léo-Saignat CS 61292, 33076 Bordeaux cedex, France
| | - Marie Parrens
- Service de pathologie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France; Université de Bordeaux, Campus de Carreire, 146, rue Léo-Saignat CS 61292, 33076 Bordeaux cedex, France
| |
Collapse
|
20
|
Chauveau B, Auclair C, Legrand A, Mangione R, Gerbaud L, Vendittelli F, Boyer L, Lémery D. Improving image quality of mid-trimester fetal sonography in obese women: role of ultrasound propagation velocity. Ultrasound Obstet Gynecol 2018; 52:769-775. [PMID: 29363850 DOI: 10.1002/uog.19015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 11/20/2017] [Accepted: 01/05/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The quality of ultrasound images is impaired in obese patients. All ultrasound scanners are calibrated for an ultrasound propagation velocity of 1540 m/s, but the propagation in fatty tissue is slower (in the order of 1450 m/s). The main objective of this study was to evaluate the quality of images obtained with different ultrasound propagation velocity settings during the mid-trimester fetal ultrasound examination in obese patients. METHODS This was a cross-sectional study using image sets of four recommended scanning planes collected from 32 obese pregnant women during their mid-trimester fetal scan. Each image set comprised three images obtained successively at three different propagation velocity settings (1540 m/s, 1480 m/s and 1420 m/s). A panel of 114 experts assessed the quality of 100 image sets, grading them from A (most acceptable) to C (least acceptable). Scanning-plane-specific indicators of adiposity (fatty layer thickness, probe-to-organ distance) were analyzed for each scanning plane. RESULTS The experts had a mean of 18.1 ± 10.2 years of experience. The grade distribution (A, B, C) differed significantly (P < 0.0001) between the three propagation velocity settings tested; at the lower speed of 1480 m/s, images were most often graded A, while at the conventional speed of 1540 m/s, they were most often graded C. Regardless of the scanning plane, the thicker the fatty layer of the abdominal wall in a given plane, the lower the preferred speed (P < 0.0001). CONCLUSION The construction of images taking into account ultrasound propagation velocities lower than 1540 m/s can improve significantly the quality of images obtained during mid-trimester fetal ultrasonography in obese women. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- B Chauveau
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Clermont-Ferrand, France
- Pôle Radiologie, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - C Auclair
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Clermont-Ferrand, France
- Service de Santé Publique, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - A Legrand
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Clermont-Ferrand, France
- Pôle Femme Et Enfant, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - R Mangione
- Collège Français d'Echographie Foetale (CFEF), France
| | - L Gerbaud
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Clermont-Ferrand, France
- Service de Santé Publique, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - F Vendittelli
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Clermont-Ferrand, France
- Pôle Femme Et Enfant, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - L Boyer
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Clermont-Ferrand, France
- Pôle Radiologie, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - D Lémery
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Clermont-Ferrand, France
- Pôle Femme Et Enfant, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| |
Collapse
|
21
|
Issaoui M, Debost-Legrand A, Skerl K, Chauveau B, Magnin B, Delabaere A, Boyer L, Sauvant-Rochat MP, Lémery D. Shear wave elastography safety in fetus: A quantitative health risk assessment. Diagn Interv Imaging 2018; 99:519-524. [PMID: 29934239 DOI: 10.1016/j.diii.2018.04.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/09/2018] [Accepted: 04/18/2018] [Indexed: 01/18/2023]
Abstract
PURPOSE To identify the effects of shear wave elastography in the fetus for evaluation in widespread use. MATERIALS AND METHODS The Health Risk Assessment method proposed by the National Research Council was used with literature to evaluate the safety of shear wave elastography for the fetus regarding its potential effects in human tissues. RESULTS The experimental and epidemiologic data from 25 articles showed that shear wave elastography maintained the same thermal effect as pulsed Doppler ultrasound already authorized in obstetrics, and that cavitation effect on fetal tissue is improbable. Nonetheless, the vibratory character of shear waves could induce displacement of fetal tissue while potential effects of very short duration energy peaks of the radiation force focused wave front remain unknown. CONCLUSION The actual knowledge does not provide enough information to assess the effects of shear wave elastography on fetal tissues, thus these points have to be explored by further experimental studies.
Collapse
Affiliation(s)
- M Issaoui
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France
| | - A Debost-Legrand
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France; Pôle Femme et Enfant, centre hospitalier universitaire de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - K Skerl
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France
| | - B Chauveau
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France; Pôle radiologie, centre hospitalier universitaire de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - B Magnin
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France; Pôle radiologie, centre hospitalier universitaire de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - A Delabaere
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France; Pôle Femme et Enfant, centre hospitalier universitaire de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - L Boyer
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France; Pôle radiologie, centre hospitalier universitaire de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - M-P Sauvant-Rochat
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France; Pôle Femme et Enfant, centre hospitalier universitaire de Clermont-Ferrand, 63003 Clermont-Ferrand, France; Département de santé publique et environnement, université Clermont-Auvergne, faculté de pharmacie, 63000 Clermont-Ferrand, France
| | - D Lémery
- CNRS-UMR 6602, institut Pascal, université Clermon-Auvergne, Axe TGI, 63000 Clermont-Ferrand, France; Pôle Femme et Enfant, centre hospitalier universitaire de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
| |
Collapse
|
22
|
Avan P, Giraudet F, Chauveau B, Gilain L, Mom T. Unstable distortion-product otoacoustic emission phase in Menière's disease. Hear Res 2011; 277:88-95. [PMID: 21426928 DOI: 10.1016/j.heares.2011.03.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 03/07/2011] [Accepted: 03/10/2011] [Indexed: 11/29/2022]
Abstract
The presence of endolymphatic hydrops as a marker of Menière's disease (MD) suggests abnormal pressure in the intralabyrinthine compartments of patients and excessive stiffness of sound-sensitive structures. Otoacoustic emissions (OAEs) have been reported to respond to changes in the ear's stiffness, including those produced by intracranial pressure steps, by a characteristic phase shift around 1 kHz, thereby suggesting a noninvasive means of monitoring MD. Here, body tilt was used for modulating intracranial pressure in forty-one patients with definite MD who were tentatively measured at two stages, with and without active symptoms. Their distortion-product OAEs (DPOAEs) were dynamically monitored around 1 kHz every few seconds in response to body tilt. In a control sample of thirty normal ears, the maximum phase rotation of DPOAEs produced by body tilt was between -18° and +37°. In MD ears with the complete set of symptoms, the posture-induced phase shifts in 32 out of 35 tests fell outside the normative interval, and in 10 tests, although DPOAEs were well above noise floor, their phase was always so abnormally erratic that body tilt produced hardly any additional effect. When MD ears were asymptomatic, nine out of 32 posture tests were abnormal. The excessive DPOAE phase shift is consistent with either a too stiff cochlear partition or a displacement of the operating point of outer hair cells by endolymphatic hydrops.
Collapse
Affiliation(s)
- Paul Avan
- Laboratory of Sensory Biophysics (EA 2667), School of Medicine, University of Auvergne, 63000 Clermont-Ferrand, France.
| | | | | | | | | |
Collapse
|
23
|
Rémond D, Cabrera-Estrada JI, Champion M, Chauveau B, Coudure R, Poncet C. Effect of Corn Particle Size on Site and Extent of Starch Digestion in Lactating Dairy Cows. J Dairy Sci 2004; 87:1389-99. [PMID: 15290986 DOI: 10.3168/jds.s0022-0302(04)73288-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Two experiments were conducted to determine the effects of corn particle size (CPS) on site and extent of starch digestion in lactating dairy cows. Animals were fitted with ruminal, duodenal, and ileal cannulas. Dry corn grain accounted for 36% of dry matter intake. In experiment 1, 6 cows were used in a duplicate 3 x 3 Latin square design. Semiflint corn was used. Corn processing methods were grinding, medium rolling, and coarse rolling. The mean particle size of the processed corn was 730, 1807, and 3668 microm, respectively. Rumen digestibility of starch linearly decreased from 59% with ground corn to 36% with coarsely rolled corn. Similarly, small intestine digestibility linearly decreased with increased CPS, and consequently, the amount of starch digested in the small intestine was not affected by corn processing. In experiment 2, 4 cows were used in a 2 x 2 crossover design. Dent corn was used. Corn processing methods were grinding and coarse rolling. The mean particle size of the processed corn was 568 and 3458 microm, respectively. Rumen digestibility of starch decreased from 70% with ground corn to 54% with coarsely rolled corn. Small intestine digestibility of starch was not significantly affected by CPS, and the amount of starch digested in the small intestine tended to be greater for rolled than for ground corn. In both experiments, starch total tract digestibility decreased with increased CPS. In conclusion, CPS is an efficient tool to manipulate rumen degradability of cornstarch. In midlactation cows, the decrease in the amount of starch digested in the rumen between grinding and coarse rolling is partly compensated for by an increase in the amount of starch digested in the small intestine with dent genotype, but with semiflint genotype postruminal digestion is not increased and rumen escape starch is not utilized by the animal.
Collapse
Affiliation(s)
- D Rémond
- Unité de Recherches sur les Herbivores Institut National de la Recherche Agronomique St Genès-Champanelle, France.
| | | | | | | | | | | |
Collapse
|
24
|
Bernard L, Chauveau B, Rémond D. Effect of the methodology on peptide amino acid concentrations in blood and plasma of sheep. Arch Tierernahr 2002; 54:281-96. [PMID: 11921851 DOI: 10.1080/17450390109381985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Different methodologies for the measurement of peptide amino acid (PAA) in blood and plasma were compared in sheep. Preparation of blood and plasma samples consisted of a deproteinization, either chemical with sulfosalicylic acid (0.04 g for 1 ml of sample) or physical by ultrafiltration (10,000-MW cut-off filters), with or without a subsequent ultrafiltration through a 3,000-MW cut-off filter. Peptide concentrations were determined by quantification of amino acid concentrations before and after acid hydrolysis of samples. Free amino acid concentrations were similar by all the method used (about 2.5 and 2.7 mM, for blood and plasma respectively). Peptide concentrations were higher with chemical deproteinization (10.6 and 4.2 mM, for blood and plasma respectively) than with physical deproteinization (5.7 and 3.3 mM, for blood and plasma respectively). When the deproteinized samples were further treated to remove material of molecular weight above than 3 kDa, peptide concentrations were significantly reduced, which indicates inefficiencies in the ability of the deproteinizing procedures in removing all the proteinaceous materials. Concentration of small PAA (< 3 kDa) in blood was about 1.5-fold that in plasma, mainly due to peptide Gly and Glu derived from the hydrolysis of the erythrocyte glutathione. The choice of a methodology for quantifying circulating peptides is discussed.
Collapse
Affiliation(s)
- L Bernard
- Unité de Recherche sur les Herbivores, Institut National de la Recherche Agronomique de Clermont-Ferrand, 63122 St Genès-Champanelle, France.
| | | | | |
Collapse
|
25
|
Moinard C, Chauveau B, Walrand S, Felgines C, Chassagne J, Caldefie F, Cynober LA, Vasson MP. Phagocyte functions in stressed rats: comparison of modulation by glutamine, arginine and ornithine 2-oxoglutarate. Clin Sci (Lond) 1999; 97:59-65. [PMID: 10369794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The effects of diets supplemented with 6.8 mmol.day-1.kg-1 glutamine, arginine or ornithine 2-oxoglutarate [ornithine alpha-ketoglutarate (OKG), a precursor of both glutamine and arginine] on phagocyte functions [i.e. H2O2 production by leucocytes and secretion of tumour necrosis factor alpha (TNFalpha) by stimulated macrophages] of stressed rats were studied. The relationship between the immunological effects of these amino acids and their plasma and tissue (muscle and intestine) concentrations was also explored. The catabolic model used consisted of injections of dexamethasone (DEX; 1.5 mg.day-1.kg-1) for 5 days. As previously described, DEX suppressed TNFalpha secretion in stimulated macrophages. Supplementation with arginine or OKG, but not glutamine, was able to counteract the DEX effect on TNFalpha secretion. Glutamine, arginine and OKG supplementation increased H2O2 production by monocytes and polymorphonuclear neutrophils from DEX-treated rats. All DEX-treated rats showed plasma and muscle glutamine depletion and also a decrease in the concentration of arginine in the gastrocnemius. Supplementation with glutamine, arginine or OKG was not able to counteract these depletions. It was concluded that glutamine, arginine and OKG improve phagocyte responses during stress, and that glutamine depletion is not necessarily associated with dysimmunity, since no correlation between glutamine tissue pools and the immune state was observed.
Collapse
Affiliation(s)
- C Moinard
- Laboratoire de Biochimie, Biologie Moléculaire et Nutrition EA 2416 and Centre de Recherche en Nutrition Humaine, Faculté de Pharmacie, 28 Place Henri Dunant, BP 38, 63001 Clermont-Ferrand, France
| | | | | | | | | | | | | | | |
Collapse
|