PubMed Health⌕ Search

Biomedical subjects

D Belghiti

Publications and source records attributed to D Belghiti.

At least 19 recordsLinked to original sources
PubMed1993

Mucosal immunity in primary glomerulonephritis. III. Study of intestinal permeability.

To study the specificity of gut hyperpermeability in primary glomerulonephritis, we investigated intestinal permeability by means of 51Cr-EDTA testing in 20 healthy individuals and in 30 patients with Immunoglobulin A nephropathy (IgA GN), 25 with idiopathic nephrotic syndrome (INS) and 20 with immune complex glomerulonephritis (IC-GN; membranous+membranoproliferative glomerulonephritis). Gut permeability was statistically increased in each patient group versus the controls [controls: 2% (0.4-3.9); IgA GN: 3.25% (0.7-17.70); INS: 3.71% (0.82-10); IC-GN: 3.40% (0.30-16); results are median (range); p < 0.005, nonparametric Mann-Whitney test]. An increase in intestinal permeability exceeding the upper limit of control values (95th percentile) was observed in 36% of IgA GN, 60% of INS and 50% of IC-GN patients. We conclude that intestinal permeability is frequently increased in primary glomerulonephritis and may also be increased in types of glomerulonephritis other than IgA GN.

Adult↗
PubMed1993

Long-term cyclosporin A therapy for severe idiopathic membranous nephropathy.

Fifteen patients with nephrotic idiopathic membranous nephropathy (MN) with predictors of poor outcome were treated with a long cyclosporin A (CyA) regimen at the dose of 4-5 mg/kg/day for a median period of 15 months (range 12-30). Four of the 15 patients did not respond to CyA, and the therapy was discontinued after 4 months. A partial remission (proteinuria < 2 g/day) was observed in 7 of 15 patients and a complete remission (proteinuria < 0.2 g/day) in 4 of 15 patients; good results (partial+complete remission) were, thus, obtained in 11 of 15 patients (73%). Two patients are still receiving therapy. A relapse of the nephrotic syndrome occurred in 3 of 9 patients on withdrawal of CyA, but the relapse remained sensitive to CyA. Side effects were mild. We conclude that CyA may be efficient in the treatment of MN and should be evaluated in controlled trials.

Adult↗
PubMed1992

Monoclonal immunoglobulins in patients with renal transplants: characterization, evolution and risk factors.

Gammopathies were found to be present in 25 (13%) of 192 HIV-negative renal transplant recipients with more than 30 months follow-up prospectively investigated for monoclonal or oligoclonal immunoglobulins (mIg) by agarose gel electrophoresis and immunofixation. Eleven patients had only one monoclonal band, whereas 14 had two or more bands. Of these bands, 60% were IgG kappa, 29% IgG lambda and 11% IgM lambda or kappa, and 90% did not exceed 2 g/l. Most gammopathies occurred early post-transplant (median 5 months) and they were always transient. Some predisposing factors for mIg emergence could be identified: 1. age, but only in women, 2. duration of dialysis, 3. occurrence of prior cytomegalovirus infection, and 4. immunosuppressive regimen including cyclosporine. Serological evidence for active EBV infection was obtained in ten patients, but in six cases infection occurred subsequent to the finding of mIg. In eight patients, the clinical course was characterised by severe infection or tumours (one Kaposi's sarcoma, one B-cell brain lymphoma). The present findings and experimental studies support the view that the development of mIg in renal transplant patients is associated with a failure of regulatory T-cell function. This T-B-cell imbalance requires a careful follow-up in these patients.

Antibodies, Monoclonal↗
PubMed1990

[Cytomegalovirus (CMV) and human immunodeficiency virus (HIV) co-infection, of multinucleated giant cells in acquired immunodeficiency syndrome (AIDS) encephalopathy].

A 31-year-old HIV-1-seropositive Haitian male presented with HIV-nephropathy and typical features of subcortical dementia. He died 4 months after the onset of neurological signs. Neuropathological examination revealed HIV encephalitis with diffuse progressive leukoencephalopathy, diffuse poliodystrophy and massive calcifications of white matter, basal ganglia and dentate nuclei probably partly related to renal failure. It was associated with focal, subependymal CMV encephalitis. In the periventricular regions, morphologically characteristic multinucleated giant cells, positive for CD68, and negative for GFAP, contained early CMV antigens (E13) in their nuclei and HIV antigens (gp41 and p24) in their cytoplasm. The co-infection of a single cell by both viruses was confirmed by electron microscopy. The finding that HIV and CMV can co-infect in vivo the same cell raises the question of a direct cooperation of both viruses at the single cell level, and suggests the possibility of a role for CMV as co-factor in the pathogenesis of HIV encephalopathy.

AIDS Dementia Complex↗
PubMed1990

Microscopic Wegener's disease: a particular form of Wegener's granulomatosis.

We describe a case of Wegener's granulomatosis in which the disease was manifested with crescentic glomerulonephritis, upper airway ulcerations, and microangiopathic hemolytic anemia with consumptive coagulopathy. No granuloma was identified but antibodies to cytoplasmic components of neutrophils were strongly positive with a diffuse pattern. Because microscopic vessels were predominantly involved (capillaritis), and granuloma were absent, were refer to this particular form of the disease as "microscopic Wegener's disease."

Aged↗
PubMed1989

Conservative treatment of renal allograft rupture with polyglactin 910 mesh and gelatin resorcin formaldehyde glue.

Renal-sparing treatment of spontaneous renal allograft rupture remains a surgical challenge, since profuse hemorrhage may result from these friable kidneys during surgical repair. A technique is proposed to achieve control of local bleeding with a synthetic glue (gelatin, resorcin and formaldehyde) and external compression with a polyglactin 910 absorbable mesh. We report 4 cases of spontaneous allograft rupture associated with rejection and bleeding was controlled in all 4. Three grafts were preserved with more than 1 year of followup. The other graft had to be removed for uncontrolled vascular rejection despite satisfactory control of renal fractures. Renal wrapping with external compression is proposed to improve results of conservative management of renal allograft rupture.

Adult↗
PubMed1989

[A new syndrome: acute interstitial nephropathy with uveitis. Apropos of a case].

A 17 year old female presented with an acute interstitial nephritis and anterior uveitis. She had constitutional symptoms, a biological inflammatory syndrome, circulating immune complexes and a negative tuberculin reaction. None of the usual causes of acute interstitial nephritis and/or uveitis was found; the infectious diseases work-up was negative and the diagnosis of Behcet's syndrome and sarcoidosis were excluded. The nephritis regressed spontaneously within a few weeks; the uveitis responded to local steroids. A review of the literature revealed 26 similar cases, which suggests that this syndrome is more than a coincidental association. The kidney and the eye could be target organs of humoral and cellular immune reactions to an acute antigenic aggression; the nature of this remains unclear.

Adolescent↗
PubMed1988

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

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

Adolescent↗
PubMed1987

Relapses of idiopathic diffuse crescentic glomerulonephritis without immune deposits: report of 6 cases.

Idiopathic diffuse crescentic glomerulonephritis without immune deposits is a variant of rapidly progressive glomerulonephritis which can account for up to 40% of crescentic nephritis. The prognosis may depend on both the severity of histological injury at presentation and the efficacy of treatment. Recent advances in therapy have improved the outlook further, and prolonged stable remissions with mild renal failure can occur which contrast with the previously common evolution towards end-stage renal failure within a few weeks. However, relapses in otherwise stable remission may be seen, and we describe a series of 6 acute relapses interrupting such prolonged remissions. The relapses were defined by clinical and histological means. This modification of the natural history of some crescentic glomerulonephritis may reflect new therapeutic strategies, and the relapses may reflect a cyclical nature to the disease evolution which was previously hidden by hemodialysis. The possibility of successive flares suggests that kidney biopsies should be repeated when a rapid deterioration of renal function occurs, since treatment such as high-dose steroids and/or plasma exchange can be again effective if started early.

Adult↗
PubMed1987

Diclofenac, a nonsteroidal anti-inflammatory drug, decreases proteinuria in some glomerular diseases: a controlled study.

Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) was first used in glomerulonephritis (GN) in 1966 but its efficiency is still debated. We studied the antiproteinuric effect of such a treatment in a double-blind study. 29 GN patients with normal renal function (17 membranoproliferative GN, 12 IgA GN) were randomly assigned to receive 100 mg/day of diclofenac or placebo for at least 2 months. There was a significant antiproteinuric effect of diclofenac versus placebo with a fall of 70% in the diclofenac group versus 6% in the placebo group (p less than 0.001 with the Mann-Whitney test). The median was 3 mg/min at onset and 2.45 mg/min after 2 months treatment with the placebo. In the diclofenac group, it was 2.2 and 0.95 mg/min, respectively (p less than 0.01). Diclofenac did not significantly increase creatinine levels. Gastric irritation was noted only once. This study establishes the short-term antiproteinuric action of diclofenac. Whether this action affects the final outcome is not yet determined.

Adolescent↗
PubMed1987

[Natural killer cells of the lung].

Natural killer cells are lymphocytes which spontaneously destroy tumoral or virus-infected cells in vitro. They are identified on morphological criteria (LGL) and/or on the presence of "surface markers". However, none of these criteria is specific, and they can only be defined by their spontaneous cytolytic activity. These cells, present in numerous organs, have been particularly studied in blood and lymphoid tissue. They intervene in defence mechanisms against virus-infected cells, in the graft-versus-host reaction and in immunosurveillance or tumours. Few studies have been devoted to natural killer cells of the lung. They are present in that organ in the same proportion of lymphocyte population as in blood, but their activity is inhibited by the local microenvironment.

Antigens, Surface↗