La prévalence du prurit chez les patients hémodialysés chroniques varie de 60 à 90%. Le but de ce... more La prévalence du prurit chez les patients hémodialysés chroniques varie de 60 à 90%. Le but de cette étude était d'évaluer la fréquence du prurit ainsi que ses caractéristiques parmi une population de patients marocains traités par hémodialyse. Les patients ayant un prurit d'une autre cause que l'insuffisance rénale chronique étaient exclus. Les paramètres cliniques et biologiques des patients avec ou sans prurit ont été comparés.
Strongyloidiasis can result in severe forms in immunodepressed patients or those treated with pro... more Strongyloidiasis can result in severe forms in immunodepressed patients or those treated with prolonged corticosteroids. A 59 year-old woman suffering from chronic kidney failure, treated for the past year by haemodialysis, was hospitalized for alteration in her general status of health and severe digestive problems. Three parasitological examinations of the faeces revealed the presence of Strongyloides stercoralis larvae, although she had never spent time in the Tropics. The outcome was rapidly good following treatment with thiabendazole. Some severe forms of strongyloidiasis occurring in immunodepressed or chronic dialysed patients can be fatal in the absence of early management.
Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
Sexual dysfunction impairs the quality of life of patients undergoing hemodialysis (HD). The aim ... more Sexual dysfunction impairs the quality of life of patients undergoing hemodialysis (HD). The aim of this study was to evaluate the prevalence and the nature of sexual dysfunction in a Moroccan cohort of patients with chronic renal failure (CRF) on HD. This cross-sectional study was carried out with a questionnaire in 86 patients undergoing hemodialysis. Clinical and biological investigations were done. The mean age of our patients was 46.27 +/- 15.68 years old. 81.4% of the cases suffered from a decrease in sexual activity after the onset of HD. The decrease or the loss of libido was noted in 59.3% of the cases. Total impotence was present in 22.1% of the cases and 36% reported partial impotence. Ejaculation was present in 86% of the cases. The comparison between the group of patients who had no sexual dysfunction (group I) and the group of those who had this problem (group II) showed significant differences of age, social status and sexual life before HD. Other significant differen...
Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparat... more Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparathyroidism (HPT). In patients with end-stage renal disease (ESRD), brown tumors are classic skeletal manifestations usually seen in severe forms of secondary HPT. However, involvement of the spine is considered extremely rare. We report a long-term hemodialysis case, in which cauda equina compression developed due to a sacral brown tumor. A decompressive surgery and subtotal parathyroidectomy were indicated to preserve neurologic function, and to ensure remineralization of the lesion. This case illustrates that, though rare, brown tumors should be considered in uremic patients with neurological symptoms. Emergent decompressive surgery is required to remove pressure on neurological structures and to stabilize the spine.
Langerhans' cell histiocytosis (LCH) is a clonal disorder of proliferating histiocytes, which... more Langerhans' cell histiocytosis (LCH) is a clonal disorder of proliferating histiocytes, which can affect various organs. The clinical picture ranges from localized to disseminated disease with multiple organ involvement and severe organ dysfunction. Renal involvement is uncommon and the association with glomerulonephritis is unusual. We report here a case of nephrotic syndrome caused by membranoproliferative glomerulonephritis (MPGN) in a 20-year-old woman, which revealed a disseminated form of LCH. Surgical removal of the LCH process and high doses of corticosteroids led to the remission of the basic disease and the renal involvement. The occurence of membranoproliferative glomerulonephritis in the course of LCH might be mediated by circulating immune complexes, composed at least in part of antigens or neoantigenes which may cause the abnormal proliferation of the Langerhans' cells.
Compression de la queue-de-cheval révélant une tumeur brune rachidienne chez un patient en hémodi... more Compression de la queue-de-cheval révélant une tumeur brune rachidienne chez un patient en hémodialyse chronique Cauda equina compression revealing brown tumor of the spine in a long-term hemodialysis patient ◊ Reçu le 22 avril 2005 ; accepté le 9 janvier 2006 Disponible sur internet le 21 juillet 2006
Reçu le 28 novembre 2001 ; accepté le 23 juin 2002 Résumé Propos. -Analyser les aspects anatomocl... more Reçu le 28 novembre 2001 ; accepté le 23 juin 2002 Résumé Propos. -Analyser les aspects anatomocliniques et évolutifs de l'atteinte rénale associée à la maladie de Behçet à travers 6 observations colligées dans le service de néphrologie de 1985 à 2000 et faire une revue de la littérature.
... Mohamed I. HAMDOUK1, Salma M. SULEIMAN1, Hatem KALLEL2, Mounir BOUAZIZ2, Said MOUTAOUAKKIL3,... more ... Mohamed I. HAMDOUK1, Salma M. SULEIMAN1, Hatem KALLEL2, Mounir BOUAZIZ2, Said MOUTAOUAKKIL3, Marc E. DE BROE4 and Driss ... dye formulations to a maximum of 6% [3]. Systemic intoxication is not well studied al-though there ... 5. Singh S, Modi NT, Saifi AGQ. ...
Kidney cells are an important source of immunoregulatory molecules that regulate cell-to-cell int... more Kidney cells are an important source of immunoregulatory molecules that regulate cell-to-cell interactions, which is the key step in the generation of the immunoresponse to alloantigens. In this study we identified the cytokines that are produced by both lymphoid cells and kidney cells when coincubated in mixed kidney lymphocyte cultures (MKLC). The capacity of kidney cells to stimulate the proliferation of effector allogeneic lymphocytes was assayed by incubating irradiated kidney cells and lymphocyte. The cytokine secretion profile in MKLC was investigated by incubating monolayers of kidney cells with effector peripheral blood mononuclear cells (PBMC). The culture supernatants were harvested on days 1, 2, 3, 4, 5, 6, 7, and 8 and assayed for IL-1beta, IL-2, IL-6, and TNF alpha using an ELISA. Kidney cells, in comparison to PBMC stimulator cells were poor stimulators of the alloproliferation even when HLA expression was increased by IFN gamma treatment. Compared to lymphocyte or kidney cells incubated alone, MKLC induced a considerable stimulation of cytokine production. This increase in cytokine production was observed essentially for IL-2 and IL-6 (at day 3, a 10-fold increase in IL-2 and a 5-fold increase in IL-6). This study provided evidence that target kidney cells and effector lymphocyte interactions generate a number of cytokines such as IL-1beta, IL-2, IL-6, or TNF alpha. These cytokines are known to modulate allo-proliferation and generation of cytotoxic T lymphocytes (CTL).
The interaction of interleukin-6 (IL-6) with its receptor (IL-6R) is not well understood. In the ... more The interaction of interleukin-6 (IL-6) with its receptor (IL-6R) is not well understood. In the present study, we investigated the effect of different immunosuppressive agents on the expression of the couple IL-6/IL-6R on cultured lymphocytes and monocytes. IL-6 in culture supernatants from cultured monocytes were analyzed by ELISA. The expression of IL-6R was studied by flow cytometry. Dexamethazone, cyclosporin (CyA), and FK 506 at immunosuppressive concentrations induced a dose-dependent inhibition of IL-6 secretion from adherent monocytes (MO) stimulated with phytohemagglutinin (PHA). Dexamethazone was the most effective agent in inhibiting IL-6 secretion, while the inhibitory effect observed with 1 ng/ml FK 506 was comparable with that obtained with 100 ng/ml CyA. Unstimulated MO strongly expressed IL-6R (80% positive cells). Stimulation of MO with PHA resulted in a significant downregulation of IL-6R expression. Treatment of PHA-stimulated adherent MO with different concentrations of CyA and FK 506 induced a restoration of IL-6R expression. FK 506 was 100 time more effective in restoring IL-6R than CyA. This restoration of IL-6R was incomplete. FK 506, CyA, and steroids may exert their immunosuppressive effect by inhibiting IL-6 secretion and partially restoring MO IL-6R, which may be important in protecting the cell target against IL-6 autocrine stimulation.
Ehlers-Danlos syndrome (EDS), a heterogeneous disease of the connective tissues, is diagnosed by ... more Ehlers-Danlos syndrome (EDS), a heterogeneous disease of the connective tissues, is diagnosed by a triad of symptoms that include skin hyperextensibility, joint hypermobility and connective tissue fragility. Nephronophtisis (NPH) is an autosomal recessive interstitial nephritis leading to terminal renal insufficiency around puberty. The occurrence of these two rare diseases together is unusual. A review of the literature discloses no case of this association. We report here on a 16-year-old man with undiagnosed EDS, who was referred to our hospital because of renal insufficiency, history of polyuria and polydipsia. Renal ultrasound showed normal kidney size, with a lack of corticomedullary differentiation. Renal biopsy specimen disclosed chronic tubulointerstitial nephritis resembling NPH. Further evaluation identified hypermobile joints and hyperextensible skin, which led to the diagnosis of the EDS. These data suggest that patients with EDS need to be evaluated carefully for the presence of renal anomalies.
Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparat... more Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparathyroidism (HPT). In patients with end-stage renal disease (ESRD), brown tumors are classic skeletal manifestations usually seen in severe forms of secondary HPT. However, involvement of the spine is considered extremely rare. We report a long-term hemodialysis case, in which cauda equina compression developed due to a sacral brown tumor. A decompressive surgery and subtotal parathyroidectomy were indicated to preserve neurologic function, and to ensure remineralization of the lesion. This case illustrates that, though rare, brown tumors should be considered in uremic patients with neurological symptoms. Emergent decompressive surgery is required to remove pressure on neurological structures and to stabilize the spine.
Renal transplantation from a living donor is now considered the best treatment for chronic renal ... more Renal transplantation from a living donor is now considered the best treatment for chronic renal failure. We reviewed the operative complications in 38 living related donor nephrectomies performed at our institution over the past 14 years. The mean age of our donors was 30 years old with age range between 18 and 58 years old and female predominance (55.2%). These
ABSTRACT ProposRechercher la corrélation entre quelques paramètres biologiques et les troubles se... more ABSTRACT ProposRechercher la corrélation entre quelques paramètres biologiques et les troubles sexuels chez 78 patients en hémodialyse périodique au Service de néphrologie-hémodialyse du CHU Ibn Rochd (Casablanca-Maroc).MéthodesRéalisation d’une étude transversale chez des patients hémodialysés de sexe masculin présentant des troubles sexuels et dosage des hormones sexuels, de la parathormone, du zinc et de la ferritine.RésultatsNous avons observé des troubles d’érection (44,9 %), de la libido (44,9 %), d’éjaculation (26,8 %) et d’orgasme (21,8 %). Nous avons également rapporté une gynécomastie chez 17,9 % des patients étudiés. Nos résultats n’ont montré aucune corrélation ni avec le poids, ni avec la nature de la néphropathie causale ou la durée de dialyse. Nous avons mis en évidence une augmentation des taux plasmatiques des gonadotrophines (FSH, LH) de la prolactine et de la parathormone associée à une diminution de ceux de la testostérone. D’autre part, une augmentation de la ferritinémie a été notée ; cependant aucune variation significative de la zincémie n’a été observée. Notre étude a montré une corrélation négative d’une part, entre la testostéronémie et les troubles sexuels, et d’autre part entre la gynécomastie et la ferritinémie. Cependant, les taux plasmatiques de la LH et de la prolactine ont été positivement corrélés avec la gynécomastie.ConclusionLes perturbations des taux plasmatiques des hormones sexuelles et la surcharge en fer pourraient contribuer, au moins en partie, à la compréhension de l’étiopathologie des troubles sexuels chez les patients hémodialysés chroniques.PurposeTo investigate the correlation between biochemical and endocrine variables with sexual disorders in 78 male patients on chronic hemodialysis at the Ibn Rochd University Hospital (Casablanca-Morocco).MethodsSeventy-eight male hemodialysis patients with chronic renal failure were evaluated with regard to their sexual function. All patients answered a personal questionnaire on their sexual activity. Hormone (FSH, LH, prolactin, testosterone, and parathyroid hormone) and zinc and ferritin assays were also performed.ResultsThe men reported erection (44.9%), libido (44.9%), ejaculation (26.8%), and orgasm (21.8%) disorders. Gynecomastia was observed in 17.9% of the patients. There was no correlation with weight nor the nature of the causal nephropathy nor with duration of dialysis. Levels of gonadotropins (FSH, LH), prolactin, and parathyroid hormone were elevated. Testosterone levels were low. Ferritinemia was elevated but there was no significant variation in zincemia. There was a negative curvilinear relationship between serum testosterone and sexual disorders, and between gynecomastia and ferritinemia. LH and prolactin levels were positively correlated with gynecomastia.ConclusionAbnormal hormonal and iron overload could be important factors involved in the complex pathogenesis of sexual dysfunction in chronic renal failure patients undergoning hemodialysis.
The occurrence of membranous glomerulonephritis (MGN) in patients with type 2 diabetes mellitus (... more The occurrence of membranous glomerulonephritis (MGN) in patients with type 2 diabetes mellitus (DM) is a rare event and of pathogenetic interest. We report two males (52 and 64 years old) with type 2 DM and nephrotic syndrome of recent onset. Renal biopsy was performed because of the unusual clinical pictures: microscopic hematuria; heavy proteinuria without evidence of diabetic retinopathy; and, in one case, a sudden onset of renal failure. Renal biopsy disclosed pure MGN without glomerulosclerosis. In both cases, clinical history, physical examination and biologic assessment failed to reveal the cause; MGN was thus considered idiopathic. Treatment, including glycemic control and angiotensin-II receptor blockers, led to resolution of proteinuria in one case. We suggest that renal biopsies should be performed in diabetic patients with a sudden onset of renal failure, proteinuria without retinopathy, or other evidence of microvascular disease. [Hong Kong J Nephrol 2005;7(1):
La prévalence du prurit chez les patients hémodialysés chroniques varie de 60 à 90%. Le but de ce... more La prévalence du prurit chez les patients hémodialysés chroniques varie de 60 à 90%. Le but de cette étude était d'évaluer la fréquence du prurit ainsi que ses caractéristiques parmi une population de patients marocains traités par hémodialyse. Les patients ayant un prurit d'une autre cause que l'insuffisance rénale chronique étaient exclus. Les paramètres cliniques et biologiques des patients avec ou sans prurit ont été comparés.
Strongyloidiasis can result in severe forms in immunodepressed patients or those treated with pro... more Strongyloidiasis can result in severe forms in immunodepressed patients or those treated with prolonged corticosteroids. A 59 year-old woman suffering from chronic kidney failure, treated for the past year by haemodialysis, was hospitalized for alteration in her general status of health and severe digestive problems. Three parasitological examinations of the faeces revealed the presence of Strongyloides stercoralis larvae, although she had never spent time in the Tropics. The outcome was rapidly good following treatment with thiabendazole. Some severe forms of strongyloidiasis occurring in immunodepressed or chronic dialysed patients can be fatal in the absence of early management.
Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
Sexual dysfunction impairs the quality of life of patients undergoing hemodialysis (HD). The aim ... more Sexual dysfunction impairs the quality of life of patients undergoing hemodialysis (HD). The aim of this study was to evaluate the prevalence and the nature of sexual dysfunction in a Moroccan cohort of patients with chronic renal failure (CRF) on HD. This cross-sectional study was carried out with a questionnaire in 86 patients undergoing hemodialysis. Clinical and biological investigations were done. The mean age of our patients was 46.27 +/- 15.68 years old. 81.4% of the cases suffered from a decrease in sexual activity after the onset of HD. The decrease or the loss of libido was noted in 59.3% of the cases. Total impotence was present in 22.1% of the cases and 36% reported partial impotence. Ejaculation was present in 86% of the cases. The comparison between the group of patients who had no sexual dysfunction (group I) and the group of those who had this problem (group II) showed significant differences of age, social status and sexual life before HD. Other significant differen...
Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparat... more Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparathyroidism (HPT). In patients with end-stage renal disease (ESRD), brown tumors are classic skeletal manifestations usually seen in severe forms of secondary HPT. However, involvement of the spine is considered extremely rare. We report a long-term hemodialysis case, in which cauda equina compression developed due to a sacral brown tumor. A decompressive surgery and subtotal parathyroidectomy were indicated to preserve neurologic function, and to ensure remineralization of the lesion. This case illustrates that, though rare, brown tumors should be considered in uremic patients with neurological symptoms. Emergent decompressive surgery is required to remove pressure on neurological structures and to stabilize the spine.
Langerhans' cell histiocytosis (LCH) is a clonal disorder of proliferating histiocytes, which... more Langerhans' cell histiocytosis (LCH) is a clonal disorder of proliferating histiocytes, which can affect various organs. The clinical picture ranges from localized to disseminated disease with multiple organ involvement and severe organ dysfunction. Renal involvement is uncommon and the association with glomerulonephritis is unusual. We report here a case of nephrotic syndrome caused by membranoproliferative glomerulonephritis (MPGN) in a 20-year-old woman, which revealed a disseminated form of LCH. Surgical removal of the LCH process and high doses of corticosteroids led to the remission of the basic disease and the renal involvement. The occurence of membranoproliferative glomerulonephritis in the course of LCH might be mediated by circulating immune complexes, composed at least in part of antigens or neoantigenes which may cause the abnormal proliferation of the Langerhans' cells.
Compression de la queue-de-cheval révélant une tumeur brune rachidienne chez un patient en hémodi... more Compression de la queue-de-cheval révélant une tumeur brune rachidienne chez un patient en hémodialyse chronique Cauda equina compression revealing brown tumor of the spine in a long-term hemodialysis patient ◊ Reçu le 22 avril 2005 ; accepté le 9 janvier 2006 Disponible sur internet le 21 juillet 2006
Reçu le 28 novembre 2001 ; accepté le 23 juin 2002 Résumé Propos. -Analyser les aspects anatomocl... more Reçu le 28 novembre 2001 ; accepté le 23 juin 2002 Résumé Propos. -Analyser les aspects anatomocliniques et évolutifs de l'atteinte rénale associée à la maladie de Behçet à travers 6 observations colligées dans le service de néphrologie de 1985 à 2000 et faire une revue de la littérature.
... Mohamed I. HAMDOUK1, Salma M. SULEIMAN1, Hatem KALLEL2, Mounir BOUAZIZ2, Said MOUTAOUAKKIL3,... more ... Mohamed I. HAMDOUK1, Salma M. SULEIMAN1, Hatem KALLEL2, Mounir BOUAZIZ2, Said MOUTAOUAKKIL3, Marc E. DE BROE4 and Driss ... dye formulations to a maximum of 6% [3]. Systemic intoxication is not well studied al-though there ... 5. Singh S, Modi NT, Saifi AGQ. ...
Kidney cells are an important source of immunoregulatory molecules that regulate cell-to-cell int... more Kidney cells are an important source of immunoregulatory molecules that regulate cell-to-cell interactions, which is the key step in the generation of the immunoresponse to alloantigens. In this study we identified the cytokines that are produced by both lymphoid cells and kidney cells when coincubated in mixed kidney lymphocyte cultures (MKLC). The capacity of kidney cells to stimulate the proliferation of effector allogeneic lymphocytes was assayed by incubating irradiated kidney cells and lymphocyte. The cytokine secretion profile in MKLC was investigated by incubating monolayers of kidney cells with effector peripheral blood mononuclear cells (PBMC). The culture supernatants were harvested on days 1, 2, 3, 4, 5, 6, 7, and 8 and assayed for IL-1beta, IL-2, IL-6, and TNF alpha using an ELISA. Kidney cells, in comparison to PBMC stimulator cells were poor stimulators of the alloproliferation even when HLA expression was increased by IFN gamma treatment. Compared to lymphocyte or kidney cells incubated alone, MKLC induced a considerable stimulation of cytokine production. This increase in cytokine production was observed essentially for IL-2 and IL-6 (at day 3, a 10-fold increase in IL-2 and a 5-fold increase in IL-6). This study provided evidence that target kidney cells and effector lymphocyte interactions generate a number of cytokines such as IL-1beta, IL-2, IL-6, or TNF alpha. These cytokines are known to modulate allo-proliferation and generation of cytotoxic T lymphocytes (CTL).
The interaction of interleukin-6 (IL-6) with its receptor (IL-6R) is not well understood. In the ... more The interaction of interleukin-6 (IL-6) with its receptor (IL-6R) is not well understood. In the present study, we investigated the effect of different immunosuppressive agents on the expression of the couple IL-6/IL-6R on cultured lymphocytes and monocytes. IL-6 in culture supernatants from cultured monocytes were analyzed by ELISA. The expression of IL-6R was studied by flow cytometry. Dexamethazone, cyclosporin (CyA), and FK 506 at immunosuppressive concentrations induced a dose-dependent inhibition of IL-6 secretion from adherent monocytes (MO) stimulated with phytohemagglutinin (PHA). Dexamethazone was the most effective agent in inhibiting IL-6 secretion, while the inhibitory effect observed with 1 ng/ml FK 506 was comparable with that obtained with 100 ng/ml CyA. Unstimulated MO strongly expressed IL-6R (80% positive cells). Stimulation of MO with PHA resulted in a significant downregulation of IL-6R expression. Treatment of PHA-stimulated adherent MO with different concentrations of CyA and FK 506 induced a restoration of IL-6R expression. FK 506 was 100 time more effective in restoring IL-6R than CyA. This restoration of IL-6R was incomplete. FK 506, CyA, and steroids may exert their immunosuppressive effect by inhibiting IL-6 secretion and partially restoring MO IL-6R, which may be important in protecting the cell target against IL-6 autocrine stimulation.
Ehlers-Danlos syndrome (EDS), a heterogeneous disease of the connective tissues, is diagnosed by ... more Ehlers-Danlos syndrome (EDS), a heterogeneous disease of the connective tissues, is diagnosed by a triad of symptoms that include skin hyperextensibility, joint hypermobility and connective tissue fragility. Nephronophtisis (NPH) is an autosomal recessive interstitial nephritis leading to terminal renal insufficiency around puberty. The occurrence of these two rare diseases together is unusual. A review of the literature discloses no case of this association. We report here on a 16-year-old man with undiagnosed EDS, who was referred to our hospital because of renal insufficiency, history of polyuria and polydipsia. Renal ultrasound showed normal kidney size, with a lack of corticomedullary differentiation. Renal biopsy specimen disclosed chronic tubulointerstitial nephritis resembling NPH. Further evaluation identified hypermobile joints and hyperextensible skin, which led to the diagnosis of the EDS. These data suggest that patients with EDS need to be evaluated carefully for the presence of renal anomalies.
Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparat... more Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparathyroidism (HPT). In patients with end-stage renal disease (ESRD), brown tumors are classic skeletal manifestations usually seen in severe forms of secondary HPT. However, involvement of the spine is considered extremely rare. We report a long-term hemodialysis case, in which cauda equina compression developed due to a sacral brown tumor. A decompressive surgery and subtotal parathyroidectomy were indicated to preserve neurologic function, and to ensure remineralization of the lesion. This case illustrates that, though rare, brown tumors should be considered in uremic patients with neurological symptoms. Emergent decompressive surgery is required to remove pressure on neurological structures and to stabilize the spine.
Renal transplantation from a living donor is now considered the best treatment for chronic renal ... more Renal transplantation from a living donor is now considered the best treatment for chronic renal failure. We reviewed the operative complications in 38 living related donor nephrectomies performed at our institution over the past 14 years. The mean age of our donors was 30 years old with age range between 18 and 58 years old and female predominance (55.2%). These
ABSTRACT ProposRechercher la corrélation entre quelques paramètres biologiques et les troubles se... more ABSTRACT ProposRechercher la corrélation entre quelques paramètres biologiques et les troubles sexuels chez 78 patients en hémodialyse périodique au Service de néphrologie-hémodialyse du CHU Ibn Rochd (Casablanca-Maroc).MéthodesRéalisation d’une étude transversale chez des patients hémodialysés de sexe masculin présentant des troubles sexuels et dosage des hormones sexuels, de la parathormone, du zinc et de la ferritine.RésultatsNous avons observé des troubles d’érection (44,9 %), de la libido (44,9 %), d’éjaculation (26,8 %) et d’orgasme (21,8 %). Nous avons également rapporté une gynécomastie chez 17,9 % des patients étudiés. Nos résultats n’ont montré aucune corrélation ni avec le poids, ni avec la nature de la néphropathie causale ou la durée de dialyse. Nous avons mis en évidence une augmentation des taux plasmatiques des gonadotrophines (FSH, LH) de la prolactine et de la parathormone associée à une diminution de ceux de la testostérone. D’autre part, une augmentation de la ferritinémie a été notée ; cependant aucune variation significative de la zincémie n’a été observée. Notre étude a montré une corrélation négative d’une part, entre la testostéronémie et les troubles sexuels, et d’autre part entre la gynécomastie et la ferritinémie. Cependant, les taux plasmatiques de la LH et de la prolactine ont été positivement corrélés avec la gynécomastie.ConclusionLes perturbations des taux plasmatiques des hormones sexuelles et la surcharge en fer pourraient contribuer, au moins en partie, à la compréhension de l’étiopathologie des troubles sexuels chez les patients hémodialysés chroniques.PurposeTo investigate the correlation between biochemical and endocrine variables with sexual disorders in 78 male patients on chronic hemodialysis at the Ibn Rochd University Hospital (Casablanca-Morocco).MethodsSeventy-eight male hemodialysis patients with chronic renal failure were evaluated with regard to their sexual function. All patients answered a personal questionnaire on their sexual activity. Hormone (FSH, LH, prolactin, testosterone, and parathyroid hormone) and zinc and ferritin assays were also performed.ResultsThe men reported erection (44.9%), libido (44.9%), ejaculation (26.8%), and orgasm (21.8%) disorders. Gynecomastia was observed in 17.9% of the patients. There was no correlation with weight nor the nature of the causal nephropathy nor with duration of dialysis. Levels of gonadotropins (FSH, LH), prolactin, and parathyroid hormone were elevated. Testosterone levels were low. Ferritinemia was elevated but there was no significant variation in zincemia. There was a negative curvilinear relationship between serum testosterone and sexual disorders, and between gynecomastia and ferritinemia. LH and prolactin levels were positively correlated with gynecomastia.ConclusionAbnormal hormonal and iron overload could be important factors involved in the complex pathogenesis of sexual dysfunction in chronic renal failure patients undergoning hemodialysis.
The occurrence of membranous glomerulonephritis (MGN) in patients with type 2 diabetes mellitus (... more The occurrence of membranous glomerulonephritis (MGN) in patients with type 2 diabetes mellitus (DM) is a rare event and of pathogenetic interest. We report two males (52 and 64 years old) with type 2 DM and nephrotic syndrome of recent onset. Renal biopsy was performed because of the unusual clinical pictures: microscopic hematuria; heavy proteinuria without evidence of diabetic retinopathy; and, in one case, a sudden onset of renal failure. Renal biopsy disclosed pure MGN without glomerulosclerosis. In both cases, clinical history, physical examination and biologic assessment failed to reveal the cause; MGN was thus considered idiopathic. Treatment, including glycemic control and angiotensin-II receptor blockers, led to resolution of proteinuria in one case. We suggest that renal biopsies should be performed in diabetic patients with a sudden onset of renal failure, proteinuria without retinopathy, or other evidence of microvascular disease. [Hong Kong J Nephrol 2005;7(1):
Uploads
Papers by Driss Zaid