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Brilland B, Boud'hors C, Copin MC, Jourdain P, Henry N, Wacrenier S, Djema A, Samoreau C, Coindre JP, Cousin M, Riou J, Croue A, Saint-André JP, Subra JF, Piccoli GB, Augusto JF. Assessment of Renal Risk Score and Histopathological Classification for Prediction of End-Stage Kidney Disease and Factors Associated With Change in eGFR After ANCA-Glomerulonephritis Diagnosis. Front Immunol 2022; 13:834878. [PMID: 35392077 PMCID: PMC8981524 DOI: 10.3389/fimmu.2022.834878] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 12/13/2021] [Accepted: 02/21/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The “Renal Risk Score” (RRS) and the histopathological classification have been proposed to predict the risk of end-stage kidney disease (ESKD) in ANCA-associated glomerulonephritis (ANCA-GN). Besides, factors associated with kidney function recovery after ANCA-GN onset remain to be more extensively studied. In the present study, we analyzed the value of the RRS and of the histopathological classification for ESKD prediction. Next, we analyzed factors associated with eGFR change within the first 2 years following ANCA-GN diagnosis. Materials and Methods We included patients from the Maine–Anjou ANCA-associated vasculitis registry with at least 6 months of follow-up. The values of ANCA-GN, histopathological classification, and RRS, and the factors associated with eGFR variations between ANCA-GN diagnosis and 2 years of follow-up were assessed. Results The predictive values of the histopathological classification and RRS were analyzed in 123 patients. After a median follow-up of 42 months, 33.3% patients developed ESKD. The predictive value of RRS for ESKD was greater than that of the histopathological classification. Determinants of eGFR variation were assessed in 80/123 patients with complete eGFR measurement. The median eGFR increased from ANCA-GN diagnosis to month 6 and stabilized thereafter. The only factor associated with eGFR variation in our study was eGFR at ANCA-GN diagnosis, with higher eGFR at diagnosis being associated with eGFR loss (p<0.001). Conclusion The RRS has a better predictive value for ESKD than the histopathological classification. The main determinant of eGFR variation at 2 years was eGFR at ANCA-GN diagnosis. Thus, this study suggests that eGFR recovery is poorly predicted by histological damage at ANCA-GN diagnosis.
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Affiliation(s)
- Benoit Brilland
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France.,Université d'Angers, Université de Nantes, Centre Hospitalier Universitaire (CHU) d'Angers, Institut National de la Santé Et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCI2NA), Structure Fédérative de Recherche Interactions Cellulaires et Applications Thérapeutiques (SFR ICAT), Angers, France
| | - Charlotte Boud'hors
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France.,Université d'Angers, Université de Nantes, Centre Hospitalier Universitaire (CHU) d'Angers, Institut National de la Santé Et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCI2NA), Structure Fédérative de Recherche Interactions Cellulaires et Applications Thérapeutiques (SFR ICAT), Angers, France
| | - Marie-Christine Copin
- Université d'Angers, Université de Nantes, Centre Hospitalier Universitaire (CHU) d'Angers, Institut National de la Santé Et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCI2NA), Structure Fédérative de Recherche Interactions Cellulaires et Applications Thérapeutiques (SFR ICAT), Angers, France.,Service de Pathologie, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Pierre Jourdain
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Nicolas Henry
- Service de Néphrologie-Dialyse, CH de Laval, Laval, France
| | - Samuel Wacrenier
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France.,Service de Néphrologie-Dialyse, CH du Mans, Le Mans, France
| | - Assia Djema
- Service de Néphrologie-Dialyse, CH de Cholet, Cholet, France
| | - Clément Samoreau
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | | | - Maud Cousin
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Jeremie Riou
- Micro et Nanomedecines Translationnelles, MINT, Université d'Angers, Unité Mixte de Recherche (UMR) Institut National de la Santé Et de la Recherche Médicale (INSERM) 6021, Unité Mixte de Recherche (UMR) Centre National de la Recherche Scientifique (CNRS) 6021, Angers, France.,Methodology and Biostatistics Department, Delegation to Clinical Research and Innovation, Angers University Hospital, Angers, France
| | - Anne Croue
- Service de Pathologie, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Jean-Paul Saint-André
- Service de Pathologie, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Jean-François Subra
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France.,Université d'Angers, Université de Nantes, Centre Hospitalier Universitaire (CHU) d'Angers, Institut National de la Santé Et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCI2NA), Structure Fédérative de Recherche Interactions Cellulaires et Applications Thérapeutiques (SFR ICAT), Angers, France
| | | | - Jean-François Augusto
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France.,Université d'Angers, Université de Nantes, Centre Hospitalier Universitaire (CHU) d'Angers, Institut National de la Santé Et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCI2NA), Structure Fédérative de Recherche Interactions Cellulaires et Applications Thérapeutiques (SFR ICAT), Angers, France
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Wacrenier S, Riou J, Jourdain P, Guibert F, HENRY NICOLAS, Assia DJEMA, Coindre JP, Crochette R, Cousin M, Croue A, Jean François SUBRA, Piccoli G, Jean François AUGUSTO, Brilland B. MO259LYMPHOPENIA AT ANCA-GLOMERULONEPHRITIS DIAGNOSIS IS CORRELATED WITH SEVERITY AND RENAL PROGNOSIS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab104.0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Lymphopenia is commonly observed in various autoimmune diseases, such as systemic lupus erythematosus, where it has been associated with disease activity or prognosis. However, in ANCA-associated vasculitis (AAV) only few, small-scale studies have been targeted to this issue. Research has not yet focused on ANCA-glomerulonephritis (ANCA-GN) patients. Thus, the aim of this study was to analyze the association between lymphocyte counts and outcomes in a large cohort of ANCA-GN patients.
Method
We used the Maine-Anjou AAV registry that retrospectively gathers data on consecutive patients affected by AAV in four French Nephrology Centers, recorded since January 2000. We analyzed clinical, biological, and histological data at diagnosis of ANCA-GN. Biological data, including lymphocyte counts, were collected before the administration of any immunosuppressive treatment. Risk factors for end-stage kidney disease (ESKD) were analyzed. Event-free survival was also assessed.
Results
Among the 145 patients included in the study, 53 (37%) patients presented with lymphopenia at ANCA-GN diagnosis. Lymphopenic patients were older (72 [63–79] vs 66 [56–73] years old, p = 0.010), had a lower renal function at baseline (eGFR 13 mL/min vs 26 mL/min, p = 0.002), and a higher proteinuria (1.86 [1.21–3.52] g/g vs 1.30 [0.75–2.65] g/g, p = 0.042). There was a trend for a higher BVAS (18 [14–22] vs 15 [12–20], p = 0.076) in lymphopenic patients. Therapeutic management between the two groups was similar. There was no difference in relapse rate between the two groups but lymphopenic patients were more likely to require kidney replacement therapy (51% vs 25%, p = 0.003) and were more likely to die (34% vs 17%, p = 0.039). Lymphopenia was correlated with histological lesions and especially with the percentage of sclerotic glomeruli (p = 0.0027). ESKD-free survival and overall survival were lower in lymphopenic patients (p < 0.0001 and 0.0051 respectively). In multivariate Cox analysis, lymphopenia, but not death, was an independent risk factor for ESKD (HR 4.47 (95% confidence interval: [2.06–9.72], p < 0.001).
Conclusion
Lymphopenia correlates with severity of ANCA-GN at diagnosis and predicts poor renal outcome. In this view, lymphopenia could be used as a simple and cost-effective biomarker to assess renal prognosis at ANCA-GN diagnosis.
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Affiliation(s)
- Samuel Wacrenier
- Centre hospitalier du Mans, Service de Néphrologie, Le Mans, France
- Centre hospitalier universitaire d'Angers, Service de Néphrologie, Angers, France
| | - Jeremie Riou
- Université d'Angers, Micro et Nanomédecines Translationnelles, MINT, UMR INSERM 6021, UMR CNRS 6021, Angers, France., Angers, France
- Université d'Angers, Methodology and Biostatistics Department, Delegation to Clinical Research and Innovation, Angers, France
| | - Pierre Jourdain
- Centre hospitalier universitaire d'Angers, Service de Néphrologie, Angers, France
| | - Fanny Guibert
- Centre hospitalier universitaire d'Angers, Service de Néphrologie, Angers, France
- Centre hospitalier de Cholet, Service de Néphrologie, Cholet, France
| | - NICOLAS HENRY
- Centre hospitalier universitaire d'Angers, Service de Néphrologie, Angers, France
- Centre hospitalier de Laval, Service de Néphrologie, Laval, France
| | - DJEMA Assia
- Centre hospitalier de Cholet, Service de Néphrologie, Cholet, France
| | | | - Romain Crochette
- Centre hospitalier du Mans, Service de Néphrologie, Le Mans, France
| | - Maud Cousin
- Centre hospitalier universitaire d'Angers, Service de Néphrologie, Angers, France
| | - Anne Croue
- Centre hospitalier universitaire d'Angers, Département de pathologie cellulaire et tissulaire, Angers, France
| | - SUBRA Jean François
- Centre hospitalier universitaire d'Angers, Service de Néphrologie, Angers, France
| | - Giorgina Piccoli
- Centre hospitalier du Mans, Service de Néphrologie, Le Mans, France
| | | | - Benoit Brilland
- Centre hospitalier universitaire d'Angers, Service de Néphrologie, Angers, France
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3
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Wacrenier S, Riou J, Jourdain P, Guibert F, Henry N, Djema A, Coindre JP, Crochette R, Cousin M, Croue A, Subra JF, Piccoli G, Augusto JF, Brilland B. Lymphopenia at diagnosis of ANCA-vasculitis with renal involvement is correlated with severity and renal prognosis. Nephrol Dial Transplant 2021; 37:1078-1087. [PMID: 33856482 DOI: 10.1093/ndt/gfab158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Lymphopenia is commonly observed in autoimmune diseases, where it has been associated with disease activity or prognosis. However, in ANCA-associated vasculitis (AAV) only few, small-scale studies have been targeted to this issue. Research has not yet focused on AAV with renal involvement (AAV-RI) patients. Thus, the aim of this study was to analyze the association between lymphocyte counts and outcomes in a large cohort of AAV-RI patients. METHODS We used the Maine-Anjou AAV registry that retrospectively gathers data on consecutive patients affected by AAV in four French Nephrology Centers, recorded since January 2000. We analyzed clinical, biological, and histological data at diagnosis of AAV-RI. Risk factors for end-stage kidney disease (ESKD) were analyzed. Event-free survival was also assessed. RESULTS Among the 145 patients included in the study, those with lymphopenia at diagnosis had a lower renal function at baseline (eGFR 13 mL/min vs 26 mL/min, p = 0.002) and were more likely to require kidney replacement therapy (51% vs 25%, p = 0.003). Lymphopenia was correlated with histological lesions and especially with the percentage of sclerotic glomeruli (p = 0.0027). ESKD-free survival was lower in lymphopenic patients (p < 0.0001). In multivariate Cox analysis, lymphopenia was an independent risk factor for ESKD (HR 4.47 (95% confidence interval: [2.06-9.72], p < 0.001). CONCLUSION Lymphopenia correlates with the severity of AAV glomerulonephritis at diagnosis and predicts poor renal outcome. In this view, lymphopenia could be used as a simple and cost-effective biomarker to assess renal prognosis at AAV-RI diagnosis.
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Affiliation(s)
- Samuel Wacrenier
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France.,Service de Néphrologie, Centre Hospitalier du Mans, Le Mans, France
| | - Jérémie Riou
- Micro et Nanomédecines Translationnelles, MINT, Université d'Angers, UMR INSERM 6021, UMR CNRS 6021, Angers, France.,Methodology and Biostatistics Department, Delegation to Clinical Research and Innovation, Angers University Hospital, Angers, France
| | - Pierre Jourdain
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Fanny Guibert
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France.,Service de Néphrologie, Centre Hospitalier de Cholet, Cholet, France
| | - Nicolas Henry
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France.,Service de Néphrologie, Centre Hospitalier de Laval, Laval, France
| | - Assia Djema
- Service de Néphrologie, Centre Hospitalier de Cholet, Cholet, France
| | | | - Romain Crochette
- Service de Néphrologie, Centre Hospitalier du Mans, Le Mans, France
| | - Maud Cousin
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Anne Croue
- Département de pathologie cellulaire et tissulaire, Université d'Angers, CHU Angers, Angers, France
| | - Jean-François Subra
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Giorgina Piccoli
- Service de Néphrologie, Centre Hospitalier du Mans, Le Mans, France
| | - Jean-François Augusto
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Benoit Brilland
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
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4
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Henry N, Mellaza C, Fage N, Beloncle F, Genevieve F, Legendre G, Orvain C, Garnier AS, Cousin M, Besson V, Subra JF, Duveau A, Augusto JF, Brilland B. Retrospective and Systematic Analysis of Causes and Outcomes of Thrombotic Microangiopathies in Routine Clinical Practice: An 11-Year Study. Front Med (Lausanne) 2021; 8:566678. [PMID: 33718396 PMCID: PMC7952313 DOI: 10.3389/fmed.2021.566678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/29/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Thrombotic microangiopathies (TMAs) are highly suspected in patients showing mechanical hemolytic anemia, thrombocytopenia, and haptoglobin consumption. Primary [thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome] and secondary TMA are considered. Even if ADAMTS13 measurements and alternative complement pathway explorations have greatly improved the ability to identify primary TMA, their diagnosis remains difficult, and their frequency relative to that of secondary TMA is undetermined. The objectives of the present study were, therefore, to describe the etiologies, management, and the outcomes of patients presenting with TMA in real-life clinical practice. Methods: We conducted a retrospective study between 01/01/2008 and 31/12/2018 that included all consecutive patients presenting with biological TMA syndrome at admission or developing during hospitalization. Patients were identified from the laboratory databases, and their medical files were reviewed to confirm TMA diagnosis, to determine etiology, and to analyze their therapeutic management and outcomes. Results: During this period, 239 patients with a full TMA biological syndrome were identified, and the TMA diagnosis was finally confirmed in 216 (90.4%) after the cases were reviewed. Primary TMAs (thrombotic thrombocytopenic purpura or atypical hemolytic uremic syndrome) were diagnosed in 20 of 216 patients (9.3%). Typical HUS was diagnosed in eight patients (3.7%), and the most frequent secondary TMAs were HELLP syndrome (79/216, 36.6%) and active malignancies (30/219, 13.9%). ADAMTS13 measurements and alternative complement pathway analyses were performed in a minority of patients. Multiple factors identified as TMA triggers were present in most patients, in 55% of patients with primary TMA, vs. 44.7% of patients with secondary TMA (p = 0.377). Death occurred in 57 patients (23.4%) during follow-up, and dialysis was required in 51 patients (23.6%). Active malignancies [odds ratio (OR) 13.7], transplantation (OR 4.43), male sex (OR 2.89), and older age (OR 1.07) were significantly associated with death. Conclusion: Secondary TMAs represent many TMA causes in patients presenting a full TMA biological syndrome during routine clinical practice. Multiple factors favoring TMA are present in about half of primary or secondary TMA. ADAMTS13 and complement pathway were poorly explored in our cohort. The risk of death is particularly high in patients with malignancies as compared with patients with other TMA.
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Affiliation(s)
- Nicolas Henry
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Chloé Mellaza
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Nicolas Fage
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - François Beloncle
- Service de Médecine Intensive et Réanimation, Médecine Hyperbare, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Franck Genevieve
- Laboratoire d'Hématologie, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Guillaume Legendre
- Département de Gynécologie et Obstétrique, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Corentin Orvain
- Service d'Hématologie, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Anne-Sophie Garnier
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Maud Cousin
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Virginie Besson
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Jean-François Subra
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Agnès Duveau
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Jean-François Augusto
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
| | - Benoit Brilland
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, Centre Hospitalier Universitaire (CHU) Angers, Angers, France
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Jourdain P, Brilland B, Medhioub O, Caron J, Samoreau C, Djema A, Gansey R, Coindre JP, Cousin M, Garnier AS, Henry N, Wacrenier S, Riou J, Piccoli GB, Augusto JF. Incidence and Temporal Trend in Risk Factors of Severe Infections in ANCA-Glomerulonephritis Patients. Kidney Int Rep 2021; 6:1161-1165. [PMID: 33912765 PMCID: PMC8071615 DOI: 10.1016/j.ekir.2020.12.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/17/2020] [Accepted: 12/29/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Pierre Jourdain
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Benoit Brilland
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Ouassim Medhioub
- Micro et Nanomedecines Translationnelles, MINT, Université d'Angers, UMR INSERM 6021, UMR CNRS 6021, Angers, France
| | - Jeanne Caron
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Clément Samoreau
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Assia Djema
- Service de Néphrologie-Dialyse, CH de Cholet, Cholet, France
| | - Renaud Gansey
- Service de Néphrologie-Dialyse, CH de Laval, Laval, France
| | | | - Maud Cousin
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Anne Sophie Garnier
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France
| | - Nicolas Henry
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France.,Service de Néphrologie-Dialyse, CH de Laval, Laval, France
| | - Samuel Wacrenier
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France.,Service de Néphrologie-Dialyse, CH du Mans, Le Mans, France
| | - Jeremy Riou
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Methodology and Biostatistics Department, Delegation to Clinical Research and Innovation, Angers University Hospital, 49100 Angers, France
| | - Giorgina Barbara Piccoli
- Service de Néphrologie-Dialyse, CH de Laval, Laval, France.,Department of Clinical and Biological Sciences University of Torino, Italy
| | - Jean-François Augusto
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
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6
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Henry N, Brilland B, Wacrenier S, Djema A, Garnier AS, Gansey R, Coindre JP, Besson V, Duveau A, Subra JF, Cousin M, Piccoli GB, Augusto JF. Incidence and Risk Factors of Venous Thromboembolic Events in Patients with ANCA-Glomerulonephritis: A Cohort Study from the Maine-Anjou Registry. J Clin Med 2020; 9:E3177. [PMID: 33007967 PMCID: PMC7599765 DOI: 10.3390/jcm9103177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 09/03/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 11/17/2022] Open
Abstract
(1) Introduction: The incidence of venous thromboembolisms (VTE) has not been extensively analyzed in patients with antineutrophil cytoplasmic antibody (ANCA)-glomerulonephritis (ANCA-GN). Thus, the aim of the present study was to assess the frequency and the risk factors of VTE in patients with ANCA-GN. (2) Methods: Patients from the Maine-Anjou ANCA-associated vasculitis (AAV) registry with a biopsy showing pauci-immune glomerulonephritis were included. VTE events, site, and interval from AAV diagnosis were analyzed. (3) Results: 133 patients fulfilled the inclusion criteria of the study and were analyzed. VTE episodes were diagnosed in 23/133 (17.3%) patients at a median delay of 3 months from ANCA-GN diagnosis. Patients with VTE had lower serum albumin (p = 0.040), were less frequently on statin therapy (p = 0.009) and had less frequently proteinase-3 (PR3)-ANCAs (p = 0.078). Univariate analysis identified higher age (p = 0.022), lower serum albumin (p = 0.030), lack of statin therapy (p = 0.009), and rituximab treatment (p = 0.018) as significant risk factors of VTE. In multivariate analysis, only lack of statin therapy (HR 4.873; p = 0.042) was significantly associated with VTE. (4) Conclusion: Patients with ANCA-GN are at high risk of VTE, especially within the first months following AAV diagnosis. Our results suggest that statin therapy is associated with a lower risk of VTE in ANCA-GN patients.
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Affiliation(s)
- Nicolas Henry
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
| | - Benoit Brilland
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
- CHU d’Angers, Université d’Angers, INSERM U1232, CRCINA, 49000 Angers, France
| | - Samuel Wacrenier
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
- Service de Néphrologie-Dialyse, CH du Mans, 72000 Le Mans, France; (J.-P.C.); (G.B.P.)
| | - Assia Djema
- Service de Néphrologie-Dialyse, CH de Cholet, 49300 Cholet, France;
| | - Anne Sophie Garnier
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
| | - Renaud Gansey
- Service de Néphrologie-Dialyse, CH de Laval, 53000 Laval, France;
| | - Jean-Philippe Coindre
- Service de Néphrologie-Dialyse, CH du Mans, 72000 Le Mans, France; (J.-P.C.); (G.B.P.)
| | - Virginie Besson
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
| | - Agnès Duveau
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
| | - Jean-François Subra
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
- CHU d’Angers, Université d’Angers, INSERM U1232, CRCINA, 49000 Angers, France
| | - Maud Cousin
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
| | | | - Jean-François Augusto
- Service de Néphrologie-Dialyse-Transplantation, Université d’Angers, CHU Angers, 4 rue Larrey, 49033 Angers CEDEX 09, France; (N.H.); (B.B.); (S.W.); (A.S.G.); (V.B.); (A.D.); (J.-F.S.); (M.C.)
- CHU d’Angers, Université d’Angers, INSERM U1232, CRCINA, 49000 Angers, France
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Miquelestorena-Standley E, Jaulerry C, Machet MC, Rabot N, Barbet C, Hummel A, Karras A, Garrouste C, Crepin T, Ducloux D, Cousin M, Albert C, Rivalan J, Cornec-Le Gall E, Pourreau F, Deltombe C, Nochy D, Szlavik N, Felix S, Croué A, Buob D, Rioux-Leclerc N, Doucet L, Goujon JM, Renaudin K, Blanchard E, Eymieux S, Rabant M, Halimi JM. Clinicopathologic features of infection-related glomerulonephritis with IgA deposits: a French Nationwide study. Diagn Pathol 2020; 15:62. [PMID: 32460869 PMCID: PMC7254713 DOI: 10.1186/s13000-020-00980-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/28/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022] Open
Abstract
Background Infection-related glomerulonephritis with IgA deposits (IRGN-IgA) is a rare disease but it is increasingly reported in the literature. Data regarding epidemiology and outcome are lacking, especially in Europe. We aimed to assess the clinical, pathologic and outcome data of IRGN-IgA. Methods Clinical and outcome data from patients from 11 French centers over the 2007–2017 period were collected retrospectively. We reviewed pathologic patterns and immunofluorescence of renal biopsies and evaluated C4d expression in IRGN-IgA. We analyzed the correlation between histological presentation and outcome. Results Twenty-seven patients (23 men, mean age: 62 ± 15 years) were included. Twenty-one (78%) had Staphylococcus aureus infection and twelve (44%) were diabetic. At the time of biopsy, 95.2% had haematuria, 48.1% had a serum creatinine level of > 4 mg/dL, and 16% had hypocomplementemia. The most common pathologic presentation included mesangial (88.9%) and endocapillary proliferative glomerulonephritis (88.9%) with interstitial fibrosis and tubular atrophy (IF/TA) (85.1%). Diffuse and global glomerular C4d expression was found in 17.8%, mostly in biopsies with acute or subacute patterns, and was associated with a short delay between infection and renal biopsy compared to segmental and focal staining. After median follow-up of 13.2 months, 23.1% died, 46.2% had persistent renal dysfunction and 15.4% reached end-stage renal disease. Renal outcome was correlated to IF/TA severity. Conclusions Infection-related glomerulonephritis with IgA deposits is usually associated with Staphylococcus infections and mainly affects adult men. This entity has a poor prognosis which is correlated to interstitial fibrosis and tubular atrophy severity.
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Affiliation(s)
- Elodie Miquelestorena-Standley
- Service d'anatomie et cytologie pathologiques, Hôpital Trousseau, CHRU Tours, Tours, France. .,Université de Tours, PRES Centre-Val de Loire, Tours, France.
| | - Charlotte Jaulerry
- Université de Tours, PRES Centre-Val de Loire, Tours, France.,Service de néphrologie, CHRU de Tours, Tours, France
| | - Marie-Christine Machet
- Service d'anatomie et cytologie pathologiques, Hôpital Trousseau, CHRU Tours, Tours, France.,Université de Tours, PRES Centre-Val de Loire, Tours, France
| | - Nolwenn Rabot
- Service de néphrologie, CHRU de Tours, Tours, France
| | | | - Aurélie Hummel
- Service de néphrologie, Hôpital Necker-enfants malades, Paris, France
| | - Alexandre Karras
- Service de néphrologie, Hôpital européen Georges Pompidou, Paris, France
| | - Cyril Garrouste
- Service de néphrologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Thomas Crepin
- Service de néphrologie, CHU de Besançon, Besançon, France
| | - Didier Ducloux
- Service de néphrologie, CHU de Besançon, Besançon, France
| | - Maud Cousin
- Service de néphrologie, CHU d'Angers, Angers, France
| | | | | | | | | | - Clément Deltombe
- Service de néphrologie et immunologie clinique, Institut de transplantation urologie et néphrologie ITUN, CHU de Nantes, Nantes, France
| | - Dominique Nochy
- Service d'anatomie pathologique, Hôpital européen Georges Pompidou, Paris, France
| | - Nora Szlavik
- Service d'anatomie pathologique, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Sophie Felix
- Service d'anatomie pathologique, CHU de Besançon, Besançon, France
| | - Anne Croué
- Service d'anatomie pathologique, CHU d'Angers, Angers, France
| | - David Buob
- Service d'anatomie pathologique, Hôpital Tenon, Paris, France
| | | | - Laurent Doucet
- Service d'anatomie pathologique, CHU de Brest, Brest, France
| | | | - Karine Renaudin
- Service d'anatomie pathologique, CHU de Nantes, Nantes, France
| | - Emmanuelle Blanchard
- Université de Tours, PRES Centre-Val de Loire, Tours, France.,Plateforme IBiSA de Microscopie Electronique, CHRU de Tours, Tours, France
| | - Sébastien Eymieux
- Université de Tours, PRES Centre-Val de Loire, Tours, France.,Plateforme IBiSA de Microscopie Electronique, CHRU de Tours, Tours, France
| | - Marion Rabant
- Service d'anatomie pathologique, Hôpital Necker-enfants malades, Paris, France
| | - Jean-Michel Halimi
- Université de Tours, PRES Centre-Val de Loire, Tours, France.,Service de néphrologie, CHRU de Tours, Tours, France
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8
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Planchais M, Brilland B, Demiselle J, Besson V, Duveau A, Croué A, Cousin M, Subra JF, Augusto JF, Garnier AS. Renal biopsy in very elderly patients (over 80 years): clinical presentation, histological diagnosis, and long-term outcome. Int Urol Nephrol 2020; 52:721-729. [PMID: 32114671 DOI: 10.1007/s11255-020-02403-3] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 02/03/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Data regarding the long-term outcome of very elderly (VE) patients undergoing renal biopsy (RB) are lacking. The objective of this study was to analyse the outcome of VE patients undergoing RB. METHODS All patients over 65 years that underwent native RB between 2004 and 2016 in our center were included. Among the 206 included patients, those over 80 years (VE, 46 patients) were analysed and compared to those aged 65-80 years (160 patients). The outcomes of the VE group were analysed. RESULTS Baseline characteristics, renal presentation, safety of RB and RB-related diagnosis were not different between VE patients and 65-80-year-old patients. Survival of VE patients was 73.1, 50.6 and 21.8% at 2, 4 and 6 years after RB, significantly poorer than those of 65-80-year-old group. Early death (< 1 year) occurred in 10 VE patients, was associated with a higher proteinuria-to-creatininuria ratio and tended to be associated with a more frequent dialysis need at RB. Of the 46 VE patients, 31 (67.4%) were diagnosed with a potentially reversible kidney disease, of whom 17 (40%) were started on immunosuppressive regimens. Survival of patients with a reversible kidney disease tended to be better than those with other diseases. CONCLUSION RB appears as a safe and valuable procedure to assess diagnosis of kidney disease in VE patients. Our data suggest that RB is critical for the identification and treatment decision of patients with potentially reversible diseases and may translate in clinical improvement.
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Affiliation(s)
- Martin Planchais
- CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Université Angers, 4 rue Larrey, 49933, Angers Cedex 9, France
| | - Benoit Brilland
- CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Université Angers, 4 rue Larrey, 49933, Angers Cedex 9, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Julien Demiselle
- CHU Angers, Département de Réanimation Médicale et Médecine Hyperbare, Université Angers, Angers, France
| | - Virginie Besson
- CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Université Angers, 4 rue Larrey, 49933, Angers Cedex 9, France
| | - Agnès Duveau
- CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Université Angers, 4 rue Larrey, 49933, Angers Cedex 9, France
| | - Anne Croué
- CHU Angers, Département de Pathologie cellulaire et tissulaire, Université Angers, Angers, France
| | - Maud Cousin
- CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Université Angers, 4 rue Larrey, 49933, Angers Cedex 9, France
| | - Jean-François Subra
- CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Université Angers, 4 rue Larrey, 49933, Angers Cedex 9, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Jean-François Augusto
- CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Université Angers, 4 rue Larrey, 49933, Angers Cedex 9, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Anne-Sophie Garnier
- CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Université Angers, 4 rue Larrey, 49933, Angers Cedex 9, France.
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9
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Augusto J, Duveau A, Planchais M, Cousin M, Buchler M, Subra J. Photothérapie extracorporelle (PEC) en transplantation rénale. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.321] [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: 10/26/2022]
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10
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Planchais M, Garnier A, Croue A, Besson V, Cousin M, Sayegh J, Subra J, Augusto J. Biopsie rénale chez les patients très âgés (80 ans et plus) : présentation clinique, diagnostic histologique et survie. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.311] [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: 11/26/2022]
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11
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Codron P, Cousin M, Subra JF, Pautot V, Letournel F, Verny C, Cassereau J. Traitement des neuropathies périphériques dysimmunitaires chroniques par échanges plasmatiques : étude rétrospective de 10 ans au CHU d’Angers. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.078] [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: 11/28/2022]
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12
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Chatelier É, Beucher A, Cousin M, Demiselle J, Lavigne C, Urbanski G. Entérite lupique : à propos de deux cas. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.056] [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: 11/27/2022]
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13
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Demiselle J, Sayegh J, Cousin M, Olivier A, Augusto JF. An Unusual Cause of Abdominal Pain: Lupus Enteritis. Am J Med 2016; 129:e11-2. [PMID: 26841297 DOI: 10.1016/j.amjmed.2016.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/20/2015] [Revised: 01/02/2016] [Accepted: 01/05/2016] [Indexed: 01/14/2023]
Affiliation(s)
- Julien Demiselle
- LUNAM Université, Angers, France; CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Angers, France.
| | - Johnny Sayegh
- LUNAM Université, Angers, France; CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Angers, France
| | - Maud Cousin
- LUNAM Université, Angers, France; CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Angers, France
| | - Anne Olivier
- LUNAM Université, Angers, France; CHU Angers, Service de Gastro-enterologie, Angers, France
| | - Jean-François Augusto
- LUNAM Université, Angers, France; CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Angers, France
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14
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Augusto JF, Demiselle J, Bouvier A, Cousin M, Duveau A, Guillevin L, Subra JF, Sayegh J. Bunches of grapes in renal polyarteritis nodosa. Kidney Int 2015; 88:1453-1454. [PMID: 26649673 DOI: 10.1038/ki.2015.57] [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] [Indexed: 11/09/2022]
Affiliation(s)
- Jean-François Augusto
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers, France
| | - Julien Demiselle
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers, France
| | - Antoine Bouvier
- LUNAM Université, Angers, France.,Service de Radiologie, CHU Angers, Angers, France
| | - Maud Cousin
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers, France
| | - Agnès Duveau
- Centre Hospitalier du Mans, Service de Néphrologie, Angers, France
| | - Loic Guillevin
- Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Jean-François Subra
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers, France
| | - Johnny Sayegh
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers, France
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15
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Orvain C, Pierrot M, Le Corre Y, Vatan R, Subra J, Cousin M. Syndrome catastrophique des antiphospholipides et sepsis à Capnocytophaga canimorsus au cours de l’évolution d’un syndrome de Gougerot-Sjögren : évolution favorable sous rituximab. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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16
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Fakhouri F, Delmas Y, Provot F, Barbet C, Karras A, Makdassi R, Courivaud C, Rifard K, Servais A, Allard C, Besson V, Cousin M, Châtelet V, Goujon JM, Coindre JP, Laurent G, Loirat C, Frémeaux-Bacchi V. Insights From the Use in Clinical Practice of Eculizumab in Adult Patients With Atypical Hemolytic Uremic Syndrome Affecting the Native Kidneys: An Analysis of 19 Cases. Am J Kidney Dis 2014; 63:40-8. [DOI: 10.1053/j.ajkd.2013.07.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 07/16/2013] [Indexed: 01/06/2023]
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17
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Cousin M, Girard N, Denis D. [MRI in congenital Brown's syndrome: report of 16 cases]. J Fr Ophtalmol 2012; 36:202-9. [PMID: 23127393 DOI: 10.1016/j.jfo.2012.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Revised: 02/19/2012] [Accepted: 02/23/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Superior oblique retraction syndrome or Brown's syndrome is one of the so-called restrictive syndromes causing anatomic strabismus. It is characterized by active and passive limitation of upward gaze in adduction in the field of action of the superior oblique muscle (SO). The etiology of this congenital syndrome remains unknown. The purpose of this prospective study is to analyze brain and orbital magnetic resonance imaging (MRI) in patients with congenital Brown's syndrome. PATIENTS AND METHODS Sixteen children (19 months - 9 years) underwent complete ophthalmologic evaluation followed by brain/orbital MRI with attention to the superior oblique muscle. Average age at time of MRI was 4.2 years old. Among patients included were eight girls and eight boys. MRI was performed on a 1.5T (Symphony TIM, Siemens, Erlangen) to visualize the orbit and specifically the SO. RESULTS Of 16 eyes, 13 demonstrated radiologic abnormalities of the SO muscle; six demonstrated tendon-trochlea complex hypertrophy, four demonstrated complete SO hypertrophy (tendon-trochlea-muscle belly), one demonstrated trochlear hypertrophy, and two demonstrated abnormalities solely of the tendons, of which one was longer and one was thinner with fibrosis. CONCLUSION MRI shows a high frequency of SO radiologic abnormalities in congenital Brown's syndrome. MRI permits the analysis of not only the tendon, but also the trochlea and muscle belly, whereas surgery only allows visualization of the tendon. MRI proved to be an interesting tool for investigation of these patients and for a better understanding of the pathogenesis.
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Affiliation(s)
- M Cousin
- Service d'ophtalmologie de l'hôpital Nord, département d'ophtalmologie pédiatrique, centre hospitalier universitaire de Marseille, chemin des Bourrely, 13015 Marseille, France.
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18
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Simon A, Coindre JP, Cousin M, Besson V, Augusto JF, Imiela JP, Subra JF. Artériolopathie urémique calcifiante : cinq observations. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.245] [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: 11/30/2022]
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19
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Augusto JF, Sayegh J, Delapierre L, Croue A, Tollis F, Cousin M, Subra JF. Addition of Plasma Exchange to Glucocorticosteroids for the Treatment of Severe Henoch-Schönlein Purpura in Adults: A Case Series. Am J Kidney Dis 2012; 59:663-9. [DOI: 10.1053/j.ajkd.2011.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Accepted: 12/07/2011] [Indexed: 01/06/2023]
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20
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Sayegh J, Delapierre L, Croue A, Tollis F, Cousin M, Subra JF, Augusto JF. Atteinte rénale du purpura rhumatoïde de l’adulte : intérêt des échanges plasmatiques. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.185] [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: 11/17/2022]
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21
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Denis D, Cousin M, Zanin E, Toesca E, Girard N. Apport de l’IRM dans le syndrome de Stilling-Duane : résultats préliminaires. J Fr Ophtalmol 2011; 34:476-81. [DOI: 10.1016/j.jfo.2011.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Accepted: 12/18/2010] [Indexed: 11/16/2022]
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22
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Baron-Menguy C, Toutain B, Cousin M, Dumont O, Guihot AL, Vessières E, Subra JF, Custaud MA, Loufrani L, Henrion D. Involvement of angiotensin II in the remodeling induced by a chronic decrease in blood flow in rat mesenteric resistance arteries. Hypertens Res 2010; 33:857-66. [DOI: 10.1038/hr.2010.83] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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de Coppet H, Lambert M, Charlanne H, Launay D, Morell-Dubois S, Maillard-Lefebvre H, Lamotte C, Cousin M, Hachulla E, Hatron PY. [Superficial cranial venous thromboses preceding the diagnosis of giant cell arteritis]. ACTA ACUST UNITED AC 2009; 35:23-5. [PMID: 19879706 DOI: 10.1016/j.jmv.2009.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Accepted: 09/09/2009] [Indexed: 10/20/2022]
Abstract
Temporal arteritis is a large-vessel vasculitis predominantly affecting the external carotid and its branches. Venous thrombosis is rarely found at the onset of temporal arteritis, particularly when venous symptoms precede arterial involvement. We report the case of a 70-year-old woman consulting for bilateral superficial frontal venous thrombosis. Superficial bilateral temporal venous thrombosis occurred under adequate anticoagulation before the onset of arterial symptoms suggestive of temporal arteritis. We then discuss the pathophysiology of venous thrombosis in patients with temporal arteritis.
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Affiliation(s)
- H de Coppet
- Service de médecine interne et d'explorations vasculaires, hôpital Claude-Huriez, centre hospitalier régional universitaire, 59037 Lille cedex, France
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24
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Augusto JF, Sayegh J, Simon A, Croue A, Chennebault JM, Cousin M, Subra JF. A case of sulphasalazine-induced DRESS syndrome with delayed acute interstitial nephritis. Nephrol Dial Transplant 2009; 24:2940-2. [DOI: 10.1093/ndt/gfp277] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Lobbedez T, Cousin M, Hurault de Ligny B, Ficheux M, El Haggan W, Ryckelynck JP. [Failed transplant patients: dialysis initiation and short-term outcome]. Nephrol Ther 2008; 5:188-92. [PMID: 19071082 DOI: 10.1016/j.nephro.2008.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 10/09/2008] [Accepted: 10/10/2008] [Indexed: 11/18/2022]
Abstract
UNLABELLED This study was carried out to evaluate dialysis initiation of failed transplant patient and the short-term outcome of these patients on dialysis. PATIENTS AND METHOD We conducted a retrospective study of transplanted patients from one centre returning in dialysis after allograft failure. Those patients were transplanted between 31st October 1986 and 3rd March 2004. Patients who experienced allograft failure after 6 months on transplantation were included in the study. RESULTS Among 600 transplanted patients, 92 patients restarted dialysis after allograft failure. Of the 92 failed transplant patients, 69 had a graft survival of more than 6 months. The mean glomerular filtration rate at dialysis initiation was 13+/-5mL per minute. At time of dialysis initiation, patients had mean haemoglobin level at 80.7+/-10.7g/L, and mean serum albumin level at 34+/-6g/L. Urgent dialysis was needed for 39 over 57 patients. Fourteen over 58 patients had no vascular access or peritoneal catheter at dialysis initiation. Fifty-six over 69 patients were treated by haemodialysis. Of the 13 patients treated by peritoneal dialysis 7 were on PD before transplantation whereas 49 over 57 haemodialysis patients were treated by haemodialysis before transplant failure (p<0.05). Immunosuppressive therapy was stopped during the first year following transplantation failure in 52 over 69 patients and 36 over 69 patients underwent transplantectomy. Thirteen over 56 patients presented a least one cardiovascular events after transplantation failure. CONCLUSION Unplanned dialysis initiation is frequent in failed transplant patients, in whom an early dialysis start is probably mandatory.
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Affiliation(s)
- Thierry Lobbedez
- Service de néphrologie, dialyse et transplantation, CHU Clémenceau, avenue Georges-Clémenceau, 14033 Caen cedex, France.
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Ryckelynck JP, Allard C, Cousin M, Hurault de Ligny B, El Haggan W, Lobbedez T. [Optimal use of peritoneal dialysis fluids in type 2 diabetes mellitus patients]. Nephrol Ther 2006; 2 Suppl 1:S82-5. [PMID: 17378147] [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: 05/14/2023]
Abstract
The glucose side-effects, the main osmotic agent in conventional peritoneal dialysis (PD) solutions, are structural and functional changes of the peritoneal membrane, especially diabetic alterations in the microvasculature. Therefore, hyperpermeability with high small solutes transport and less ultrafiltration necessitates more and more high glucose concentration solutions. Glucose degradation products (PDF) and advanced glycation end-products (AGE) are formed and may induce peritoneal membrane alterations. More biocompatible solutions have to be used with less PDF and physiological pH. Icodextrin containing PD solutions have beneficial effect on sustained ultrafiltration for long dwells in PD, limitating fluid overload common in PD patients above all during peritonitis episodes. Amino acid-based PD solutions contribute to the prevention of malnutrition often observed in the diabetic PD population.
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Cousin M, Apps D, Shipston M, Chow B. SNAREdinburgh: the molecular mechanisms of exocytosis and endocytosis. Trends Neurosci 2001; 24:439-40. [PMID: 11488297 DOI: 10.1016/s0166-2236(00)01863-4] [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] [Indexed: 10/18/2022]
Affiliation(s)
- M Cousin
- Membrane Biology Group, University of Edinburg, UK.
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Galichet PF, Riany M, Agounke D, Tavernier J, Cousin M, Magnin H, Radisson A. Bioecology ofLydella thompsoni Herting, [Dip. Tachinidae] within the Rhone Delta in Southern France. ACTA ACUST UNITED AC 1985. [DOI: 10.1007/bf02372338] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cousin M, Vairel E, Thely M, Choay J. [Intracellular localization and purification of a tissue proactivator of human plasminogen]. C R Acad Hebd Seances Acad Sci D 1965; 261:1767-70. [PMID: 4954437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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