Au cours de l'amylose, l'atteinte renale est frequente et conditionne le pronostic de la ... more Au cours de l'amylose, l'atteinte renale est frequente et conditionne le pronostic de la maladie. Les depots amyloides sont egalement frequents au niveau des surrenales mais l'atteinte est le plus souvent asymptomatique. Nous rapportons le cas d'un patient âge de 63 ans atteint d'insuffisance renale chronique debutante (202 μmol/l de creatinine serique) secondaire a une amylose renale. Ce patient etait hospitalise pour vomissements avec deshydratation associee a un syndrome nephrotique. Le bilan biologique initial montrait une acidose majeure, avec hyponatremie a 121 mmol/l et hyperkaliemie a 7,1 mmol/l. Ces resultats ont conduit a poser le diagnostic d'insuffisance surrenale confirmee par un test au Synacthene. Malgre un traitement substitutif adapte, le patient est decede un mois plus tard lors d'une deuxieme poussee d'insuffisance surrenale faisant suite a une infection urinaire grave. Cette observation souligne l'importance de la detection sys...
Introduction Le syndrome de Claude est un syndrome rare qui comporte une paralysie de la troisiem... more Introduction Le syndrome de Claude est un syndrome rare qui comporte une paralysie de la troisieme paire crânienne et un syndrome cerebelleux. La lesion en cause est encore un sujet controverse. Observation Nous rapportons les cas de 3 patients : un jeune âge de 23 ans et deux autres âges respectivement de 72 ans et 77 ans. Le motif de consultation etait commun : instabilite a la marche avec des troubles visuels (ptosis, diplopie) d’installation aigue avec un examen neurologique qui montrait un syndrome cerebelleux statique et cinetique d’un cote et une atteinte extrinseque de troisiemes paires crâniennes de l’autre cote. L’imagerie par resonance magnetique (IRM) cerebrale chez chaque patient etait en faveur d’un accident vasculaire cerebral (AVC) ischemique mesencephalique paramedian de meme cote que l’ophtalmoplegie. Le bilan etiologique etait en faveur de l’atherosclerose pour les deux patients âges alors que pour le patient jeune le bilan etiologique etait negatif. La conduite etait de mettre tous les patients sous antiagregants plaquettaires avec controle des facteurs de risque cardiovasculaires. L’evolution etait favorable avec regression des symptomes au bout de quelques jours. Discussion Il s’agit d’un syndrome alterne rare du sujet âge souvent meconnu. L’etiologie est le plus souvent vasculaire avec une bonne evolution. La lesion anatomique decrite initialement est au niveau du noyau rouge, mais elle peut interesser, comme le cas de nos patients, le pedoncule cerebelleux superieur. Conclusion Vu la rarete des cas rapportes du syndrome de Claude, le siege exact de la lesion reste mal elucide. Ainsi, d’autres observations sont necessaires pour mieux comprendre les lesions anatomiques.
L'insuffisance renale aigue metastatique reste mal connue. Nous rapportons le cas d'un pa... more L'insuffisance renale aigue metastatique reste mal connue. Nous rapportons le cas d'un patient âge de 42 ans qui a ete admis pour insuffisance renale oligoanurique: creatinine plasmatique a 518μmol/L (soit une clairance de la creatinine a 13 ml/mn selon la formule de Cockcroft et Gault). La ponction biopsie renale (PBR), indiquee devant une insuffisance renale rapidement progressive avec oligo-anurie, montrait l'aspect d'une infiltration renale massive par des cellules tumorales d'un adenocarcinome peu differencie avec emboles vasculaires tumoraux. Les cellules tumorales etaient probablement d'origine bronchique puisqu'elles n'exprimaient, a l'immuno-histochimie que l'antigene epithelial et le malade presentait au scanner thoraco-abdominal un foyer de condensation alveolaire au niveau du segment superieur de la lingula associe a une pleuresie. Ce dernier examen radiologique a ete fait dans le cadre du bilan etiologique d'une alteration de ...
: Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, ... more : Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, elsewhere a good hemodialysis improve these disturbances pathogenesis of there; derived from central gonado stimuline dysfunction. We stated 13 pregnancies in our hemodialysed population. Only one successful delivery of a (baby alive and in due time) is registered. Residual diuresis and blood pressure are the most important predictor pregnancy factors in spite of a good dialysance the fetal prognosis in still unclear. Complications were observed in the mother as well as new babies.
Association between auto-immune dysthyroidism and glomerulonephritis is quite rare. The authors r... more Association between auto-immune dysthyroidism and glomerulonephritis is quite rare. The authors report 3 cases with proteinuria varying from 2.72 to 6.06 g/day and hypothyroidism. Nephrotic syndrome was found in 2 cases and thyroid auto-antibodies (microsomal and thyroglobulin) and circulating immun complexes (C.I.C.) in 1 case, complement fractions C3 and C4 were normal in all cases. Renal biopsy showed membranous glomerulonephritis in 2 cases and minimal lesions in the third case. Proteinuria disappeared with glucocorticoids and thyroxine in 1 case, with thyroxine alone in an other case and persisted in the third case with normal thyroid function.
Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, el... more Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, elsewhere a good hemodialysis improve these disturbances pathogenesis of there; derived from central gonado stimuline dysfunction. We stated 13 pregnancies in our hemodialysed population. Only one successful delivery of a (baby alive and in due time) is registered. Residual diuresis and blood pressure are the most important predictor pregnancy factors in spite of a good dialysance the fetal prognosis in still unclear. Complications were observed in the mother as well as new babies.
Hypertension in focal segmental glomerulosclerosis is frequent and responsible for the progressio... more Hypertension in focal segmental glomerulosclerosis is frequent and responsible for the progression of the disease. It could be a circumstance of the diagnosis of FSG or a complication of the nephrotic syndrome. To determine the prevalence of hypertension among patients with FSG diagnosed in Tunisia and to describe the profile of patients with FSG having hypertension in contrast with who do not. It was a retrospective multicentric study based on 116 patient files having FSG located in 5 specialized centers in Tunisia. The prevalence of hypertension among our patients was 41%, with a feminine predominance, their mean age was 36.34 ± 15.71 years. The systolic blood pressure among the patients with hypertension was 153.18 mmHg. The nephrotic syndrome was impure due to hypertension in 14.5% of the cases. The patients affected by hypertension were more obese. Proteinuria was higher among those not having hypertension than those with it, who score an average value of 5.67 ± 4.51 g/24h, with an insignificant difference. Serum creatinine at presentation was significantly higher among patients with hypertension. Vascular lesions were present at the renal biopsy among 39.45% of patients affected by hypertension, associated with renal failure in 58.50% of patients. The etiopathogenic treatment of FSG was essentially based on steroids full dose. Hypertension is often present in FSG and its' treatment must be as soon as possible in order to slow the progression of kidney chronic disease.
Renal involvement in amyloidosis leads to chronic renal failure. Prognosis is poor. Although amyl... more Renal involvement in amyloidosis leads to chronic renal failure. Prognosis is poor. Although amyloid deposits are frequent in adrenal glands, symptomatic adrenal dysfunction is uncommon. We report the case of a 63-year-old man with chronic renal failure (serum creatinine: 202 micromol/L) subsequent to amyloidosis who was referred to our unit for vomiting, dehydration despite a persistent nephrotic syndrome, acidosis, hyponatremia (121 mmol/l) and hyperkaliemia (7.1 mmol/l). A synacthen test was performed and disclosed adrenal insufficiency. Despite the initiation of substitution therapy, the patient died one month later from Addisonian crisis. Features of adrenal insufficiency may be masked by those of chronic renal failure, emphasizing the importance of adrenal explorations in patients with chronic renal failure due to amyloidosis.
... Abdel-Hamid IA, Eraky I, Fouda MA, Mansour OE (2002) Role of penile vascular insufficiency in... more ... Abdel-Hamid IA, Eraky I, Fouda MA, Mansour OE (2002) Role of penile vascular insufficiency in erectile dysfunction in renal transplant ... Eid MM, Abdel-Hamid IA, Sobh MA, El-Saied MA (1996) Assessment of sperm motion characteristics in infertile renal transplant recipients ...
Au cours de l'amylose, l'atteinte renale est frequente et conditionne le pronostic de la ... more Au cours de l'amylose, l'atteinte renale est frequente et conditionne le pronostic de la maladie. Les depots amyloides sont egalement frequents au niveau des surrenales mais l'atteinte est le plus souvent asymptomatique. Nous rapportons le cas d'un patient âge de 63 ans atteint d'insuffisance renale chronique debutante (202 μmol/l de creatinine serique) secondaire a une amylose renale. Ce patient etait hospitalise pour vomissements avec deshydratation associee a un syndrome nephrotique. Le bilan biologique initial montrait une acidose majeure, avec hyponatremie a 121 mmol/l et hyperkaliemie a 7,1 mmol/l. Ces resultats ont conduit a poser le diagnostic d'insuffisance surrenale confirmee par un test au Synacthene. Malgre un traitement substitutif adapte, le patient est decede un mois plus tard lors d'une deuxieme poussee d'insuffisance surrenale faisant suite a une infection urinaire grave. Cette observation souligne l'importance de la detection sys...
Introduction Le syndrome de Claude est un syndrome rare qui comporte une paralysie de la troisiem... more Introduction Le syndrome de Claude est un syndrome rare qui comporte une paralysie de la troisieme paire crânienne et un syndrome cerebelleux. La lesion en cause est encore un sujet controverse. Observation Nous rapportons les cas de 3 patients : un jeune âge de 23 ans et deux autres âges respectivement de 72 ans et 77 ans. Le motif de consultation etait commun : instabilite a la marche avec des troubles visuels (ptosis, diplopie) d’installation aigue avec un examen neurologique qui montrait un syndrome cerebelleux statique et cinetique d’un cote et une atteinte extrinseque de troisiemes paires crâniennes de l’autre cote. L’imagerie par resonance magnetique (IRM) cerebrale chez chaque patient etait en faveur d’un accident vasculaire cerebral (AVC) ischemique mesencephalique paramedian de meme cote que l’ophtalmoplegie. Le bilan etiologique etait en faveur de l’atherosclerose pour les deux patients âges alors que pour le patient jeune le bilan etiologique etait negatif. La conduite etait de mettre tous les patients sous antiagregants plaquettaires avec controle des facteurs de risque cardiovasculaires. L’evolution etait favorable avec regression des symptomes au bout de quelques jours. Discussion Il s’agit d’un syndrome alterne rare du sujet âge souvent meconnu. L’etiologie est le plus souvent vasculaire avec une bonne evolution. La lesion anatomique decrite initialement est au niveau du noyau rouge, mais elle peut interesser, comme le cas de nos patients, le pedoncule cerebelleux superieur. Conclusion Vu la rarete des cas rapportes du syndrome de Claude, le siege exact de la lesion reste mal elucide. Ainsi, d’autres observations sont necessaires pour mieux comprendre les lesions anatomiques.
L'insuffisance renale aigue metastatique reste mal connue. Nous rapportons le cas d'un pa... more L'insuffisance renale aigue metastatique reste mal connue. Nous rapportons le cas d'un patient âge de 42 ans qui a ete admis pour insuffisance renale oligoanurique: creatinine plasmatique a 518μmol/L (soit une clairance de la creatinine a 13 ml/mn selon la formule de Cockcroft et Gault). La ponction biopsie renale (PBR), indiquee devant une insuffisance renale rapidement progressive avec oligo-anurie, montrait l'aspect d'une infiltration renale massive par des cellules tumorales d'un adenocarcinome peu differencie avec emboles vasculaires tumoraux. Les cellules tumorales etaient probablement d'origine bronchique puisqu'elles n'exprimaient, a l'immuno-histochimie que l'antigene epithelial et le malade presentait au scanner thoraco-abdominal un foyer de condensation alveolaire au niveau du segment superieur de la lingula associe a une pleuresie. Ce dernier examen radiologique a ete fait dans le cadre du bilan etiologique d'une alteration de ...
: Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, ... more : Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, elsewhere a good hemodialysis improve these disturbances pathogenesis of there; derived from central gonado stimuline dysfunction. We stated 13 pregnancies in our hemodialysed population. Only one successful delivery of a (baby alive and in due time) is registered. Residual diuresis and blood pressure are the most important predictor pregnancy factors in spite of a good dialysance the fetal prognosis in still unclear. Complications were observed in the mother as well as new babies.
Association between auto-immune dysthyroidism and glomerulonephritis is quite rare. The authors r... more Association between auto-immune dysthyroidism and glomerulonephritis is quite rare. The authors report 3 cases with proteinuria varying from 2.72 to 6.06 g/day and hypothyroidism. Nephrotic syndrome was found in 2 cases and thyroid auto-antibodies (microsomal and thyroglobulin) and circulating immun complexes (C.I.C.) in 1 case, complement fractions C3 and C4 were normal in all cases. Renal biopsy showed membranous glomerulonephritis in 2 cases and minimal lesions in the third case. Proteinuria disappeared with glucocorticoids and thyroxine in 1 case, with thyroxine alone in an other case and persisted in the third case with normal thyroid function.
Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, el... more Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, elsewhere a good hemodialysis improve these disturbances pathogenesis of there; derived from central gonado stimuline dysfunction. We stated 13 pregnancies in our hemodialysed population. Only one successful delivery of a (baby alive and in due time) is registered. Residual diuresis and blood pressure are the most important predictor pregnancy factors in spite of a good dialysance the fetal prognosis in still unclear. Complications were observed in the mother as well as new babies.
Hypertension in focal segmental glomerulosclerosis is frequent and responsible for the progressio... more Hypertension in focal segmental glomerulosclerosis is frequent and responsible for the progression of the disease. It could be a circumstance of the diagnosis of FSG or a complication of the nephrotic syndrome. To determine the prevalence of hypertension among patients with FSG diagnosed in Tunisia and to describe the profile of patients with FSG having hypertension in contrast with who do not. It was a retrospective multicentric study based on 116 patient files having FSG located in 5 specialized centers in Tunisia. The prevalence of hypertension among our patients was 41%, with a feminine predominance, their mean age was 36.34 ± 15.71 years. The systolic blood pressure among the patients with hypertension was 153.18 mmHg. The nephrotic syndrome was impure due to hypertension in 14.5% of the cases. The patients affected by hypertension were more obese. Proteinuria was higher among those not having hypertension than those with it, who score an average value of 5.67 ± 4.51 g/24h, with an insignificant difference. Serum creatinine at presentation was significantly higher among patients with hypertension. Vascular lesions were present at the renal biopsy among 39.45% of patients affected by hypertension, associated with renal failure in 58.50% of patients. The etiopathogenic treatment of FSG was essentially based on steroids full dose. Hypertension is often present in FSG and its' treatment must be as soon as possible in order to slow the progression of kidney chronic disease.
Renal involvement in amyloidosis leads to chronic renal failure. Prognosis is poor. Although amyl... more Renal involvement in amyloidosis leads to chronic renal failure. Prognosis is poor. Although amyloid deposits are frequent in adrenal glands, symptomatic adrenal dysfunction is uncommon. We report the case of a 63-year-old man with chronic renal failure (serum creatinine: 202 micromol/L) subsequent to amyloidosis who was referred to our unit for vomiting, dehydration despite a persistent nephrotic syndrome, acidosis, hyponatremia (121 mmol/l) and hyperkaliemia (7.1 mmol/l). A synacthen test was performed and disclosed adrenal insufficiency. Despite the initiation of substitution therapy, the patient died one month later from Addisonian crisis. Features of adrenal insufficiency may be masked by those of chronic renal failure, emphasizing the importance of adrenal explorations in patients with chronic renal failure due to amyloidosis.
... Abdel-Hamid IA, Eraky I, Fouda MA, Mansour OE (2002) Role of penile vascular insufficiency in... more ... Abdel-Hamid IA, Eraky I, Fouda MA, Mansour OE (2002) Role of penile vascular insufficiency in erectile dysfunction in renal transplant ... Eid MM, Abdel-Hamid IA, Sobh MA, El-Saied MA (1996) Assessment of sperm motion characteristics in infertile renal transplant recipients ...
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