PubMed Health⌕ Search

Biomedical subjects

F Kouki

Publications and source records attributed to F Kouki.

9 recordsLinked to original sources

Clinical significance of anti-Sm antibodies in systemic lupus erythematosus.

Case records of 34 patients with systemic lupus erythematosus (SLE) were analyzed. Twelve patients had both anti-DNA and anti-Sm antibodies (Group I) and 22 had anti-DNA antibodies only (Group II). The disease patterns were comparable, except for (1) cutaneous vasculitis, which was observed in six of 12 patients in Group I and one of 22 in Group II (p less than 0.01); (2) pulmonary manifestations, nine of 12 in Group I and two of 22 in Group II (p less than 0.001); (3) cardiac manifestations, eight of 12 in Group I and four of 22 in Group II (p less than 0.01); and (4) renal biopsy, which showed milder lesions in Group I than in Group II (p less than 0.05). Evolution was fatal in four patients in Group I and in none in Group II. It is suggested that in SLE, the presence of anti-Sm antibody is associated with a much higher incidence of vasculitis, resulting in peculiar visceral manifestations, which can be poorly responsive to therapy. Whether there is a direct association between anti-Sm antibody and vasculitis or whether the common denominator is a genetic selection remains to be determined.

Adolescent↗

[Pheochromocytoma with compression of renal vasculary pedicle and hypoplastic kidney: interest of sulpiride and propranolol tests (author's transl)].

This report concerns two pheochromocytomas of renal vasculary pedicle. Diagnosis is made on clinical features and urinary vanylmandelic acid excretion rate. Localisation is made by arteriography. In one case, there is a renal artery compression, and in the other the tumor is vascularised by lombar artery with hypoplasic ipsilateral kidney. These two cases stress the problem of the respective responsibility of both pheochromocytoma and renovascular disease in hypertension genesis. Beside the clinical and biological context pre-operatively, the sulpiride and propranolol tests may have a discrimination value. Excision of the tumor afforded complete relief of symptoms, the two patients remained normotensive three years later.

Adrenal Gland Neoplasms↗

[Glomerulosclerosis: myeloma or diabetes? (author's transl)].

A 52 year old man was admitted to hospital for persistent back pain, fixed proteinuria of 6g/24 h that lead to the nephrotic syndrome (proteids 40 g/l, albumin 21,2 g/l). Two possible etiologies were envisaged: 1) Myeloma with K light chains as evidenced by biological findings (absence of normal Ig, presence of K light chains both in blood and urine, malignant medullary plasmocytosis) as well as x-rays (small punched out lesions). 2. Diabetes mellitus (blood glucose 2,4 g/l) with retinal and neurological involvement. Percutaneous renal biopsy revealed nodular glomerular sclerosis compatible with both diabetes and myeloma as well as homogeneous refringent thickening of tubular basement membranes more specific of myloma. No amyloid deposits, myelomatous casts were seen and anti-K light chain fixation was negative at immunofluorescence. An evolution of 33 months duration let to chronic renal failure (plasma creatinine 47 mg/l). The respective role of myeloma and diabetes in the genesis of this glomerular nephropathy are discussed.

Biopsy↗

[Diuretics and uric acid (author's transl)].

Long-term diuretic therapy often increases serum uric acid. The renal metabolism of uric acid is recalled and the factors which lead to diuretic-induced hyperuricemia are discussed. Fluid and sodium loss appears to be the main cause of increased serum uric acid. The authors' experience with management of severe hypertension is consistent with this theory. The effect of tienilic acid which lowers serum uric acid levels is discussed.

Adult↗