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H Ton That

Publications and source records attributed to H Ton That.

At least 19 recordsLinked to original sources
PubMed1994

[Guillain-Barré syndrome associated with cytomegalovirus infection after kidney transplantation].

The Guillain-Barré syndrome associated with cytomegalovirus infection is a recognized entity of unknown pathogenesis. We observed two characteristic cases with acute polyradiculoneuropathy which occurred after renal transplantation. Both patients fulfilled the diagnostic criteria for Guillain-Barré syndrome: tetraparesis with diffuse areflexia and moderate sensorial signs, high protein level in cerebrospinal fluid without cellular reaction, slow or blocked nerve conduction and partial cure after several months delay. In two-thirds of such cases, the syndrome follows an episode of infection. Cytomegalovirus has been recognized as a possible association. The demyelinating polyradiculoneuropathy induced by cytomegalovirus has been reported essentially in immunodepressed patients infected with the human immunodeficiency virus in whom a pathogenic role for cytomegalovirus in peripheral nerves has been suggested. In our two cases, the cytomegalovirus infection occurred before onset of the acute polyradiculoneuropathy. In both cases, specific IgM antibodies and clear IgG positivization occurred before the first signs of neurological impairment even though neither the virus nor specific antibodies could be concomitantly detected in the cerebrospinal fluid. Despite the frequency of cytomegalovirus infections in transplant recipients, to our knowledge, only 9 cases of Guillain-Barré syndrome after transplantation have been reported and the exact mechanism remains to be ascertained. These two cases suggest that the onset of the Guillain-Barré syndrome after renal transplantation was closely related to cytomegalovirus infection. Adequate measures should be taken to quickly diagnose such cases in order to instore rapid treatment for the polyradiculoneuropathy. In addition, this particular situation of post-transplantation onset might help better understand the exact role of cytomegalovirus infection in the Guillain-Barré syndrome.

Cytomegalovirus Infections↗
PubMed1992

[The heart in chronic kidney failure patients].

Risk factors for heart disease in patients with chronic renal failure (CRF) are the same as in general population; moreover CRF and renal replacement therapies (dialysis, immunosuppressive drugs for kidney transplantation) induce further specific cardiac risks. In practice, the commonest heart diseases associated with CRF are coronary artery diseases, myocardiopathies from various aetiologies, valve diseases and arrhythmias. Uremic pericarditis are quite unusual nowadays. Advances in therapy authorize easier control of congestive heart failure, the major complication of heart disease in CRF patients. Furthermore, it was observed that correction of anemia with erythropoietin therapy or kidney transplantation can ameliorate or reverse partially some cardiac diseases.

Arrhythmias, Cardiac↗
PubMed1992

Combined liver kidney transplantation in primary hyperoxaluria type I. Prevention of the recidive of calcium oxalate deposits in the renal graft.

We report the case of a 31-year-old patient who underwent combined liver and kidney transplantation for primary hyperoxaluria type I. Intensive hemodialysis was performed before the intervention and post-operatively in order to maintain plasma oxalate levels near the normal range. In spite of the correction of the liver enzyme deficiency, oxalate removal from the tissular stores led to prolonged hyperoxaluria, more longer than one year after the transplantation, as already reported. This increased urinary oxalate excretion exposes the renal graft to the risk of recurrence of calcium oxalate deposits and stone formation during a prolonged period. Hemodialysis in the postoperative period and fluid intake allowing a large urine volume might be able to decrease the concentration of urinary oxalate under the critical value of 300 mumol/l, at which supersaturation of urine in respect of calcium oxalate occurs.

Adult↗
PubMed1991

[The European experience of liver-kidney transplantation for primary hyperoxaluria type I. Prevention of recurrent intrarenal oxalate deposits].

Following simultaneous liver-kidney transplantation for primary hyperoxaluria type I, although the missing enzyme is provided by the liver transplant, there is a risk of recurrent calcium oxalate crystal formation in the implanted kidney. The necessary kidney protection methods are extrarenal blood purification, principally haemodialysis and haemofiltration, and an abundant diuresis ensured by copious fluid intakes together with prescription of diuretics. These therapeutic measures reduce the oxalate concentrations in both blood and urine. Oxalates are excreted in large amounts over a long period, owing to the formation of important tissue deposits during systemic oxalosis.

Follow-Up Studies↗
PubMed1991

[Extrarenal purification techniques in acute kidney failure].

During the last few years much progress has been achieved in extrarenal blood purification, notably since continuous dialysis techniques have been developed. All forms of acute renal failure can now be treated specifically and safely. Conventional haemodialysis is still widely used, particularly when acute renal failure is of long duration or when it occurs in a context of renal disease. Continuous blood purification is in full development: it is relatively easy to perform, well tolerated in terms of haemodynamics and better than haemodialysis in modulating fluid subtraction. It has become the method of choice in high-risk patients, notably elderly people or subjects with multiple visceral impairment. These advances have made it possible to treat efficiently a greater number of patients, but the benefit obtained must be evaluated in relation to a prognosis which is still determined by the acute renal failure. When several organs are involved, the mortality rate is above sixty percent.

Acute Kidney Injury↗
PubMed1989

[Non-neoplastic hypercalcemia].

Hypercalcaemia is a frequent situation in clinical practice. An earlier detection is facilitated by routine analysis of serum calcium. The clinical manifestations depend on severity and the rate of onset of hypercalcaemia. Paucisymptomatic and asymptomatic presentations are the most frequent. Causes of hypercalcaemia are numerous and the mechanisms are various. PTH and vit. D play a preponderant part. In first of all iatrogenic cause are eliminated (all vit D preparations, thiazide diuretics, milk-alkali syndrome). Among non neoplastic hypercalcaemia primary hyperparathyroidism is the first diagnosis. Nephrolithiasis and asymptomatic forms are the most frequent presentations actually. The biochemical profile is not always typical. Generally the association of echography and tomodensitometry lead to the topographic diagnosis. Parathyroid surgical exploration is often necessary in difficult cases. Secondary, the other rare causes of hypercalcaemia are studied: sarcoidosis and granulomatosis disease, thyrotoxicosis and dome endocrinopathies, immobilisation hypercalcaemia, familial hypocalciuric, hypercalcaemia. All of this causes of hypercalcaemia are potentially reversible.

Humans↗
PubMed1988

Unsuitable value of abdominal fat tissue aspirate examination for the diagnosis of amyloidosis in long-term hemodialysis patients.

Abdominal fat tissue aspiration was used in 22 long-term hemodialysis patients (5-17 years). Fourteen of these patients had carpal tunnel syndrome and amyloid deposits of beta 2-microglobulin in the synovium. One patient had a spontaneous rupture of the spleen with amyloid deposits in spleen vessels. Seven other patients presented carpal tunnel syndrome and/or articular pains, and radiological lytic lesions in bone, strongly suggesting an amyloid origin. As a control group, in 22 patients with biopsy-proven amyloidosis, abdominal fat tissue aspirates were performed and were studied under the same conditions: by light microscopy these tissues were stained with Congo red and examined with a polarizing microscope; these specimens were also studied by electron microscopy. In all hemodialyzed patients, no amyloid deposit was present in fat tissue with Congo red staining and by electron microscopy. On the contrary, amyloid was observed in 17 of 22 cases in other types of amyloidosis. It seems that this method which has been proved to be simple and sensitive for the diagnosis of systemic amyloidosis is not a good marker for the presence of amyloid in long-term hemodialysis patients.

Abdominal Muscles↗
PubMed1988

[Segmental renal hypoplasia of an adult originating from pseudo-tumor hyperreninism].

A 38 year-old man was admitted for severe hypertension with hypokalemia. Blood pressure was 180-120 mmHg, funduscopic examination revealed grade II retinopathy and left ventricular hypertrophy was present. Laboratory data disclosed: natremia = 140 mmol/ml, kalemia = 2.8 mmol/l, chloride = 105 mmol/l, bicarbonate = 30 mmol/l, creatinine clearance = 100 ml/mn, natriuresis = 140 mmol/day, kaliuresis = 80 mmol/day. Intravenous pyelography was normal. Angiography revealed a defect in the mid third of the right kidney without arterial abnormalities. Study of renin angiotensin aldosterone system showed: plasma renin activity: peripheric blood = 36 ng/ml/h (normal range I to 2), right renal vein = 30 ng/ml/h. Left renal vein = 18 ng/ml/h, inferior cava vein = 19 ng/ml/h. Plasma aldosterone level = 86 ng/100 ml (normal range 10 to 15). Captopril acute administration was followed by a fall of BP to 70-50 mmHg at 2 hours. Right nephrectomy was performed and revealed an ischemic retracted cortical area without necrosis nor tumoral aspect. The day after BP was 140/80 mmHg. Eight days after, kaliemia was 4.2 mmol/l, PRA was 0.5 ng/ml/h. Light microscopy showed that affected area was sharply delimited from surrounding normal tissue. In this area, glomeruli were present and seemed more numerous as usual; interstitial fibrosis and infiltrates of inflammatory cells were also noted. The main fact was tortuosities of intralobular arteries, thickened, with intimal proliferation. There was a pelvic recess near this cortical tissue. Immunofluorescence findings: antirenin serum fixed on JGA but also on interlobular arterial walls and on peritubular interstitium.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Renal cholesterol embolisms: apropos of 6 case reports].

Often unrecognized, renal cholesterol embolization generally results in renal failure and a high rate of death. In the recent years, it was discovered only during autopsy, but now antemortem observations are not exceptional. In the most cases, the existence of a triggering factor may suggest a iatrogenic cause. We report six patients who developed cholesterol atheroembolic renal disease after aortic surgery and/or retrograde catheterization. Cholesterol embolism was demonstrated by the finding of cholesterol crystals in the arteriolar lumens: either on renal biopsies, or on skin biopsy. The five surviving patients required dialysis with recovery of renal function in only one case. Three of four patients on regular dialysis treatment died of unrelated complications. The responsibility of angiography in the origin of acute renal failure appeared major in this report. It is the rupture of an eroded atherosclerotic plaque caused by the catheter which causes the release of large quantity of cholesterol crystals in the circulation. Therefore, in the atheromatous patients, it appears safer to realize a computerized i.v. angiography.

Acute Kidney Injury↗
PubMed1987

[First consultations in nephrology. Comparison of 2 multicenter studies conducted at a 5-year interval].

An investigation of "kidney outpatient" first consultations carried out in 1985 with the cooperation of 19 nephrological teams distributed all over France. Each team had taken part in a similar investigation in 1980. The work allowed to collect 1200 records. Analysis of the main results is presented. The comparison between the 1980th and the 1985th investigations shows a remarkable stability of the results, but suggests two new and interesting features: the progress of Dip-stick studies and serum creatinine concentration in general practice and the decreasing part taken by hypertension in "kidney disease out-patient" activity in 1985.

Adult↗