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Biomedical subjects

D Chevet

Publications and source records attributed to D Chevet.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Interstitial nephropathies in sarcoidosis. Effect of corticosteroid therapy and long-term evolution. Retrospective study of 22 cases].

Interstitial Nephritis (IN) with or without epithelioid granulomas is the most frequent form of renal impairment in sarcoidosis. Nevertheless, few studies have provided conclusions about its treatment and long-term outcome. We report 22 cases collected over a 20-year period in 9 nephrologic departments of the west of France. We discuss the criteria which permit sarcoidosis to be distinguished from other causes, particularly of IN drugs. Twenty patients were treated with corticoids. In 18 the result could be evaluated on at least 12 months. In 11 there was a decrease of plasma creatinine (Pc) and in 8 of these cases this decrease reached 50%. Of the 12 who were followed from 1 to 17 years, 4 obtained a reduction of Pc of at least 50%. These improvements occurred even in patients whose Pc was initially higher than 300 mumol/l. Only 2 patients reached end-stage renal failure and hemodialysis within the observation period, one as early as the first month, the other after 6 years. Five relapses were observed after stopping treatment but 4 responded again favorably upon resumption. Two patients who received no treatment at all nevertheless had stabilization or improvement of their renal function with a follow-up of 5 years for one case. It may be concluded that the long-term prognosis of sarcoidosis IN can be fairly good but there is no proof that it depends mainly on corticosteroid therapy.

Adrenal Cortex Hormones↗
PubMed1984

[Quantification of separate renal function using Tc 99m DTPA and Tc 99m DMSA. Correlations between individual isotopic data and creatinine clearance].

The purpose of this prospective study (30 controls and 100 renal patients) is to compare one to each other the values of renal function measured with: 1--the DTPA 99mTc , 2--the DMSA 99mTc , and 3--the creatinine clearance. After the control values being established, correlations are done for the whole group (n = 130) between the creatinine clearance, the DTPA 99mTc clearance and the fixation rate of the DMSA 99mTc . The correlations obtained are:--Clcr Versus Cldtpa = 0,91.--Clcr Versus % Dmsa = 0,90. - Cldtpa Versus % Dmsa = 0,93. and indicate the two isotopic tests performed give similar quantitative results than creatinine clearance. Camera and computer allow to measure the separate renal function one by one, the two isotopic test giving similar values for each kidney. The results of these studies give a good concordance with the observed diseases, except for partial renal artery stenosis. The pyelic retention of DMSA 99mTc product, in condition of ureteral compression, gives a potential overestimation of this test and is a matter to debate. The extreme simplicity and facility of DMSA 99mTc procedures make this investigation accessible to any patient and give excellent morphological and functional tests. DTPA 99mTc clearances--global and separate kidney--give a more sensitive approach than DMSA 99mTc does because vascular captation , elimination rates could be focused. DTPA 99mTc procedure is to be used in patients with transplanted kidney, silent IVP kidney, contrast media contraindication or for exploring glomerular clearance without urine collection.

Adolescent↗
PubMed1983

Serum angiotensin-converting enzyme levels in patients with chronic renal failure.

Disagreement concerning serum angiotensin-converting enzyme (ACE) levels in patients with chronic renal failure has been observed in recent reports. Because ACE is considered as a useful tool for the diagnosis and management of sarcoidosis, and because chronic renal failure may be associated with sarcoidosis, the present work was designed to reinvestigate the possible changes of serum angiotensin-converting enzyme activity in a series of 36 non-hemodialysed consecutive patients with chronic non-sarcoid renal failure. Enzyme activity was significantly lower (p less than 0.004) in the patients (15.8 +/- 5.0 units/ml, mean value +/- 1 SD) than in 47 healthy controls (20.2 +/- 7.6 units/ml, mean value +/- 1 SD). Serum angiotensin-converting enzyme and creatinine clearance values were significantly correlated in these patients (p less than 0.0002). These results indicate that, in non-hemodialysed patients with chronic renal failure, serum angiotensin-converting enzyme levels may not be useful in establishing the diagnosis of sarcoidosis.

Adolescent↗
PubMed1982

[Glomerulonephritis in Henoch-Schoenlein purpura. Anatomo-clinical correlations and immunopathological study of twenty-five cases. (author's transl)].

Twenty-five observations (children and adults) of glomerulo-nephritis secondary to Schoenlein-Henoch purpura were studied retrospectively. Histological studies done early in the course of the disease-less than one year after the first attack-enabled us to made, in function of the evolution, clinical and pathological correlations using the method of Levy et al. The intensity of the clinical signs at the time of biopsy appeared proportional to the degree of cellular proliferation whether it was endo or extracapillary form; it is much more difficult to define when mesangial proliferation predominates or in the absence of proliferation. In addition to the usual immunopathological abnormalities, this study found that IgE plasma concentration was frequently elevated. Thus, IgE may play a role in the pathogenesis of this systemic disease.

Adolescent↗
PubMed1981

Pulmonary uptake of Tc-99m-Labeled methylene diphosphonate in a patient with a parathyroid adenoma.

Intense diffuse uptake of Tc-99m-labeled methylene diphosphonate was seen in both lungs of a patient submitted to surgery for a primary parathyroid adenoma. Five scans performed over the 3 yr following the operation showed persistence of lung uptake despite restoration of normal blood calcium concentration. Mild chronic renal failure caused by the hypercalcemia also persisted postoperatively. The present case confirms that pulmonary uptake of bone tracer can occur asymptomatically when both hypercalcemia and renal failure are present. Lung uptake of a bone tracer probably reflects tissue deposition of hydroxyapatite rather than of amorphous structures. Correction of the hypercalcemia failed to resolve the abnormal scan pictures.

Adenoma↗
PubMed1980

HLA-DR4 antigen and IgA nephropathy.

HLA-A, B and DR antigens were tested in 45 unrelated patients with IgA nephropathy (Berger's disease). A significant association with HLA-DR4 was noted. An unusual finding was a secondary association with the A2-B12 antigen combination.

Histocompatibility Antigens Class II↗
PubMed1978

Hereditary lecithin cholesterol acyltransferase deficiency. Report of a new family with two afflicted sisters.

One case of lecithin cholesterol acyltransferase (LCAT) deficiency is discovered by renal biopsy. Through the study of a French family, native to Brittany, one sister is found to be carrier of the trait. This finding suggests that the gene defect hitherto reported from Scandinavia is not restricted to this region. The patient shows typical signs of the disease, corneal opacities, anemia with a hemolytic component and lack of plasma LCAT activity. She has proteinuria, HTA, hematuria, no renal insufficiency. Signs previously unreported were noted: sensorineural hearing loss and platelet environment disorder. Histological abnormalities of two types are found: foam cells and subendothelial deposits, of which the tinctorial characteristics indicate a lipid composition. The lack of glomerular fluorescent staining observed is not in favor of an immune complex nephropathy. The study of this case suggests the determining role of lipid abnormalities in the genesis of anemia and of the vascular depositions in the induction of renal failure encountered in several cases of LCAT deficiency.

Adult↗