Les nouveaux outils de diagnostic et de pronostic de la myopathie atypique
Habyarimana, Jean ; BOEMER, François ; Amory, Hélène et al
in Proceeding de la 41ème Journée de la Recherche équine (2015)
In equines, ingestion of hypoglycin A, a toxin produced in the seeds (samaras) of sycamore maple (Acer pseudoplatanus) tree alters the energetic metabolism of muscle cells and results in atypical myopathy ... [more ▼]
In equines, ingestion of hypoglycin A, a toxin produced in the seeds (samaras) of sycamore maple (Acer pseudoplatanus) tree alters the energetic metabolism of muscle cells and results in atypical myopathy (AM). This alterations leads to a characteristic biochemical profile of acylcarnitines (AC) that enables to confirm the diagnosis of AM. This study aims at validating a methodology for the dosage of hypoglycin A in vegetal extracts but also in blood. In addition, the biochemical profile in AC has been determined in AM cases (5 survivors and 13 deceased) and in 5 horses suffering from exercise-induced myopathy. The AC profiles of these horses have been compared to the one of healthy horses (n = 35). This study showed that hypoglycin A was present in seeds and spring seedlings of sycamore and also in blood of AM cases horses. In addition, the establishment of AC profile contributes to the diagnostic and helps to assess the prognosis of AM cases. [less ▲]Detailed reference viewed: 80 (26 ULg)
Tacrolimus combined with two different corticosteroid-free regimens compared with a standard triple regimen in renal transplantation: one year observational results.
; ; et al
in Clinical Transplantation (2009)
Side effects of steroid use have led to efforts to minimize their use in transplantation. Two corticosteroid-free regimens were compared with a triple immunosuppressive therapy. Data from the original ... [more ▼]
Side effects of steroid use have led to efforts to minimize their use in transplantation. Two corticosteroid-free regimens were compared with a triple immunosuppressive therapy. Data from the original intent-to-treat (ITT) population (153 tacrolimus/basiliximab [Tac/Bas], 151 tacrolimus/MMF [Tac/MMF], and 147 tacrolimus/MMF/steroids [control]) were analyzed in a 12-month follow-up. Percentage of graft survival were 92.8%, 95.4%, and 95.9% (KM estimates 89.9%, 95.3%, 95.9%), percentage of surviving patients were 98.7%, 98.0%, and 100% (KM estimates 95.9%, 92.8%, and 100%). During months 7-12, graft loss occurred in 3 Tac/Bas, 2 Tac/MMF, and zero control patients, patient deaths in 1 Tac/Bas, 2 Tac/MMF, and zero control, and biopsy-proven acute rejection episodes in 4 Tac/Bas, 3 Tac/MMF, and zero control. Mean serum creatinine at month 12 was 141.9 +/- 69.6 muM, 144.0 +/- 82.1 muM, and 134.5 +/- 71.2 muM (ns). New-onset insulin use in previously non-diabetic patients at month 12 was 1/138, 6/127, and 4/126. Patient and graft survival as well as renal function at 12 months were not different between patient groups, despite considerably higher rates of acute rejection occurring within the first six months after transplantation in both steroid-free patient groups. Tac/Bas therapy might offer benefits in terms of a trend for a more favorable cardiovascular risk profile. [less ▲]Detailed reference viewed: 32 (8 ULg)
Erythropoiesis in multiple myeloma: defective red cell production due to inappropriate erythropoietin production.
Beguin, Yves ; ; et al
in British Journal of Haematology (1992), 82(4), 648-53
We investigated the pathophysiology of erythropoiesis in 62 patients with multiple myeloma and examined whether it would establish a rational basis for the treatment of their anaemia with recombinant ... [more ▼]
We investigated the pathophysiology of erythropoiesis in 62 patients with multiple myeloma and examined whether it would establish a rational basis for the treatment of their anaemia with recombinant human erythropoietin. Erythropoietin (Epo) production was evaluated by serum levels and erythropoiesis was quantitated by serum transferrin receptor (TfR) levels, both assessed relative to the degree of anaemia. Instead of the expected stimulation of erythropoiesis in response to anaemia, haematocrit correlated positively with marrow erythropoietic activity, indicating that the mechanism of anaemia was primarily defective red cell production. Erythropoiesis decreased and anaemia worsened significantly with advancing clinical stage. 25% of the patients had inadequate Epo production and this proportion increased to 50% in stage 3. Inappropriate Epo production was seen in 60% of patients with renal impairment but was also observed in a number of patients with normal renal function. Erythropoiesis correlated strongly with the adequacy of Epo production, particularly in advanced disease. We conclude that most myeloma patients have defective red cell production even in the absence of massive marrow infiltration and that inappropriate Epo production contributes to their anaemia. [less ▲]Detailed reference viewed: 27 (6 ULg)