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Suzon B, Louis-Sidney F, Aglaé C, Henry K, Bagoée C, Wolff S, Moinet F, Emal-Aglae V, Polomat K, Debandt M, Deligny C, Couturier A. La néphropathie lupique en Martinique : un exemple de bon pronostic à long terme dans une population afro-descendante. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Garo F, Aglaé C, Cariou S, Reboul P, Gerbal M, Renaud S, Pambrun E, Messikh Z, Moranne O. Performance technique, diagnostic et complications de la biopsie rénale dans la cohorte monocentrique CKD-Caremeau. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Suzon B, Louis-Sidney F, Aglaé C, Henry K, Bagoée C, Wolff S, Moinet F, Emal-Aglaé V, Polomat K, DeBandt M, Deligny C, Couturier A. Good Long-Term Prognosis of Lupus Nephritis in the High-Income Afro-Caribbean Population of Martinique with Free Access to Healthcare. J Clin Med 2022; 11:jcm11164860. [PMID: 36013099 PMCID: PMC9410092 DOI: 10.3390/jcm11164860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Lupus nephritis (LN) has been described as having worse survival and renal outcomes in African-descent patients than Caucasians. We aimed to provide long-term population-based data in an Afro-descendant cohort of LN with high income and easy and free access to specialized healthcare. Study design: We performed a retrospective population-based analysis using data from 2002–2015 of 1140 renal biopsies at the University Hospital of Martinique (French West Indies). All systemic lupus erythematosus patients with a diagnosis of LN followed for at least 12 months in Martinique or who died during this period were included. Results: A total of 89 patients were included, of whom 68 (76.4%) had proliferative (class III or IV), 17 (19.1%) had membranous (class V), and 4 (4.5%) had class I or II lupus nephritis according to the ISN/RPS classification. At a mean follow-up of 118.3 months, 51.7% of patients were still in remission. The rates of end-stage renal disease were 13.5%, 19.1%, and 21.3% at 10, 15, and 20 years of follow-up, respectively, and mortality rates were 4.5%, 5.6%, and 7.9% at 10, 15, and 20 years of follow-up, respectively. Conclusions: The good survival of our Afro-descendant LN patients, similar to that observed in Caucasians, shades the burden of ethnicity but rather emphasizes and reinforces the importance of optimizing all modifiable factors associated with poor outcome, especially socioeconomics.
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Affiliation(s)
- Benoit Suzon
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
- Correspondence:
| | - Fabienne Louis-Sidney
- Department of Rheumatology, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Cédric Aglaé
- Department of Nephrology, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Kim Henry
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Cécile Bagoée
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Sophie Wolff
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Florence Moinet
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Violaine Emal-Aglaé
- Department of Nephrology, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Katlyne Polomat
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Michel DeBandt
- Department of Rheumatology, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Christophe Deligny
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Aymeric Couturier
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
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Prouvot J, Aglaé C, Daniel L, Moranne O. A catastrophic antiphospholipid syndrome complicated with heparin-induced thrombocytopaenia, successfully managed with double filtration plasmapheresis, steroids and a direct thrombin inhibitor. BMJ Case Rep 2019; 12:e231161. [PMID: 31527216 PMCID: PMC6754638 DOI: 10.1136/bcr-2019-231161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2019] [Indexed: 01/08/2023] Open
Abstract
A middle-aged woman with history of antiphospholipid syndrome, admitted to our hospital for lethargy and persistent chest pain, developed during hospitalisation intracerebral transverse sinus and sigmoid vein thromboses, retinal thromboses, acute renal failure and cardiac involvement associated with thrombocytopaenia. Diagnosis of catastrophic antiphospholipid syndrome was made and treated with IV steroids, heparin infusion and double filtration plasmapheresis (DFPP) without fresh frozen plasma. Heparin-induced thrombocytopaenia was second diagnosed because of persistent severe thrombocytopaenia after 2 weeks of treatment associated with positive conversion of antibodies against platelet factor 4, and a positive functional assay. The clinical course was complicated by cerebellar haematomas that appeared a few days after the last session of DFPP. Heparin-induced thrombocytopaenia was managed by administration of argatroban, a direct thrombin inhibitor with an increase in platelet count. Neurologically, the patient recovered completely and was discharged on vitamin K antagonist treatment and regular dialysis.
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Affiliation(s)
- Julien Prouvot
- Service de Néphrologie-Dialyse-Aphérèse, Centre Hospitalier Universitaire Caremeau, Nîmes, France
- Faculté de Médecine, Université de Montpellier, Montpellier, France
| | - Cédric Aglaé
- Service de Néphrologie-Dialyse-Aphérèse, Centre Hospitalier Universitaire Caremeau, Nîmes, France
- Faculté de Médecine, Université de Montpellier, Montpellier, France
| | - Laurent Daniel
- Laboratoire d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire de la Timone, Marseille, France
| | - Olivier Moranne
- Service de Néphrologie-Dialyse-Aphérèse, Centre Hospitalier Universitaire Caremeau, Nîmes, France
- Faculté de Médecine, Université de Montpellier, Montpellier, France
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