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Meuleman MS, Petitprez F, Pickering MC, Le Quintrec M, Artero MR, Duval A, Rabant M, Gilmore A, Boyer O, Hogan J, Servais A, Provot F, Gnemmi V, Eloudzeri M, Grunenwald A, Buob D, Boffa JJ, Moktefi A, Audard V, Goujon JM, Bridoux F F, Thervet E, Karras A, Roumenina LT, Bacchi VF, Duong Van Huyen JP, Chauvet S. Complement Terminal Pathway Activation and Intrarenal Immune Response in C3 Glomerulopathy. J Am Soc Nephrol 2024:00001751-990000000-00310. [PMID: 38709564 DOI: 10.1681/asn.0000000000000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/29/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND C3 glomerulopathy is a rare disease resulting from an overactivation of the complement alternative pathway. Although there is also evidence of terminal pathway activation, its occurrence and consequences on the disease have been poorly studied. METHODS We retrospectively studied a cohort of 42 patients diagnosed with C3 glomerulopathy. We performed centralized extensive characterization of histological parameters. Kidney C5b-9 staining was performed as a marker of terminal pathway activation, intra-renal immune response was characterised through transcriptomic analysis. RESULTS Eighty-eight percent of biopsies showed C5b-9 deposits in glomeruli. Biopsies were grouped according to the amount of C5b-9 deposits (no or low n=15/42, 36%, intermediate n=15/42, 36%, and high n=12/42, 28%). Patients with high C5b-9 deposits significantly differed from the 2 other groups patients and were characterized by a significant higher histological chronicity score (p=0.005) and lower outcome-free survival (p=0.001). In multivariable analysis, higher glomerular C5b-9 remained associated with poor kidney prognosis after adjustment. One third of the 847 studied immune genes were upregulated in C3 glomerulopathy biopsies compared to controls. Unsupervised clustering on differentially expressed genes identified a group of kidney biopsies enriched in high glomerular C5b-9 with high immune and fibroblastic signature and showed high chronicity scores on histological examination. CONCLUSIONS In a cohort of patients with C3 glomerulopathy, intra-renal terminal pathway activation was associated with specific histological phenotype and disease prognosis.
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Affiliation(s)
- Marie-Sophie Meuleman
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Inflammation, Complement and Cancer team, Paris, France
| | - Florent Petitprez
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, UK
| | - Matthew C Pickering
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, United Kingdom
| | - Moglie Le Quintrec
- Department of Nephrology, Montpellier University Hospital, Montpellier, France
| | - Mikel Rezola Artero
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Inflammation, Complement and Cancer team, Paris, France
| | - Anna Duval
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Inflammation, Complement and Cancer team, Paris, France
- Department of Nephrology, Strasbourg University Hospital, Strasbourg, France
| | - Marion Rabant
- Department of Anathomopathology, Necker Hospital, APHP,Paris
- INSERM U1151, CNRS UMR 8253, Institut Necker-Enfants Malades, Département Croissance et Signalisation, Paris, France
| | - Alyssa Gilmore
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, United Kingdom
| | - Olivia Boyer
- Pediatric Nephrology, Necker-Enfants Malades University Hospital, MARHEA reference center, APHP, Institut Imagine, Université Paris Cité, Paris, France
| | - Julien Hogan
- Department of pediatric Nephrology, Robert Debré Hospital, APHP, Paris, France
| | - Aude Servais
- Department of Nephrology, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - François Provot
- Department of Nephrology, Lille University Hospital, Lille, France
| | - Vivianne Gnemmi
- Department of Pathology, Lille University Hospital, Lille, France
| | - Maeva Eloudzeri
- INSERM U1151, CNRS UMR 8253, Institut Necker-Enfants Malades, Département Croissance et Signalisation, Paris, France
| | - Anne Grunenwald
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Inflammation, Complement and Cancer team, Paris, France
- Department of Nephrology, Poissy Intercommunal Hospital, Poissy, France
| | - David Buob
- Department of Pathology, Tenon Hospital, APHP, Paris, France
| | | | - Anissa Moktefi
- Department of Pathology, Henri Mondor Hospital, APHP, Créteil, France
| | - Vincent Audard
- Assistance Publique des Hôpitaux de Paris (AP-HP), Nephrology and Renal Transplantation Department, Henri Mondor Hospital University, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders, Créteil, France
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | | | - Frank Bridoux F
- Department of Nephrology, Poitiers University Hospital, Poitiers, France
| | - Eric Thervet
- Department of Nephrology, European Hospital Georges Pompidou, APHP, Paris, France
- Paris Cité University, Paris, France
| | - Alexandre Karras
- Department of Nephrology, European Hospital Georges Pompidou, APHP, Paris, France
- Paris Cité University, Paris, France
| | - Lubka T Roumenina
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Inflammation, Complement and Cancer team, Paris, France
| | - Véronique Frémeaux- Bacchi
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Inflammation, Complement and Cancer team, Paris, France
- Department of Immunology, European Hospital Georges Pompidou, APHP, Paris, France
| | - Jean-Paul Duong Van Huyen
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Inflammation, Complement and Cancer team, Paris, France
- Department of Anathomopathology, Necker Hospital, APHP,Paris
- Paris Cité University, Paris, France
| | - Sophie Chauvet
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Inflammation, Complement and Cancer team, Paris, France
- Department of Nephrology, European Hospital Georges Pompidou, APHP, Paris, France
- Paris Cité University, Paris, France
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Gosselink ME, Snoek R, Cerkauskaite-Kerpauskiene A, van Bakel SPJ, Vollenberg R, Groen H, Cerkauskiene R, Miglinas M, Attini R, Tory K, Claes KJ, van Calsteren K, Servais A, de Jong MFC, Gillion V, Vogt L, Mastrangelo A, Furlano M, Torra R, Bramham K, Wiles K, Ralston ER, Hall M, Liu L, Hladunewich MA, Lely AT, van Eerde AM. Reassuring pregnancy outcomes in women with mild COL4A3-5-related disease (Alport syndrome) and genetic type of disease can aid personalized counseling. Kidney Int 2024; 105:1088-1099. [PMID: 38382843 DOI: 10.1016/j.kint.2024.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 02/25/2023] [Revised: 12/22/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024]
Abstract
Individualized pre-pregnancy counseling and antenatal care for women with chronic kidney disease (CKD) require disease-specific data. Here, we investigated pregnancy outcomes and long-term kidney function in women with COL4A3-5 related disease (Alport Syndrome, (AS)) in a large multicenter cohort. The ALPART-network (mAternaL and fetal PregnAncy outcomes of women with AlpoRT syndrome), an international collaboration of 17 centers, retrospectively investigated COL4A3-5 related disease pregnancies after the 20th week. Outcomes were stratified per inheritance pattern (X-Linked AS (XLAS)), Autosomal Dominant AS (ADAS), or Autosomal Recessive AS (ARAS)). The influence of pregnancy on estimated glomerular filtration rate (eGFR)-slope was assessed in 192 pregnancies encompassing 116 women (121 with XLAS, 47 with ADAS, and 12 with ARAS). Median eGFR pre-pregnancy was over 90ml/min/1.73m2. Neonatal outcomes were favorable: 100% live births, median gestational age 39.0 weeks and mean birth weight 3135 grams. Gestational hypertension occurred during 23% of pregnancies (reference: 'general' CKD G1-G2 pregnancies incidence is 4-20%) and preeclampsia in 20%. The mean eGFR declined after pregnancy but remained within normal range (over 90ml/min/1.73m2). Pregnancy did not significantly affect eGFR-slope (pre-pregnancy β=-1.030, post-pregnancy β=-1.349). ARAS-pregnancies demonstrated less favorable outcomes (early preterm birth incidence 3/11 (27%)). ARAS was a significant independent predictor for lower birth weight and shorter duration of pregnancy, next to the classic predictors (pre-pregnancy kidney function, proteinuria, and chronic hypertension) though missing proteinuria values and the small ARAS-sample hindered analysis. This is the largest study to date on AS and pregnancy with reassuring results for mild AS, though inheritance patterns could be considered in counseling next to classic risk factors. Thus, our findings support personalized reproductive care and highlight the importance of investigating kidney disease-specific pregnancy outcomes.
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Affiliation(s)
- Margriet E Gosselink
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Obstetrics, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Rozemarijn Snoek
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Obstetrics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Agne Cerkauskaite-Kerpauskiene
- Clinic of Gastroenterology, Nephro-Urology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Sophie P J van Bakel
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Obstetrics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Renee Vollenberg
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Obstetrics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Rimante Cerkauskiene
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Marius Miglinas
- Clinic of Gastroenterology, Nephro-Urology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rossella Attini
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza, Sant'Anna Hospital, Turin, Italy
| | - Kálmán Tory
- MTA-SE Lendulet Nephrogenetic Laboratory, Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Kathleen J Claes
- Department of Nephrology, University Hospital Leuven, Leuven, Belgium
| | - Kristel van Calsteren
- Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven, Belgium
| | - Aude Servais
- Department of Nephrology and Transplantation, Necker Enfants Maladies University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Margriet F C de Jong
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands
| | - Valentine Gillion
- Department of Nephrology, Cliniques Universitaires Saint-Luc (Université Catholique de Louvain), Brussels, Belgium
| | - Liffert Vogt
- Section Nephrology, Department of Internal Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Antonio Mastrangelo
- Pediatric Nephrology, Dialysis, and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Furlano
- Department of Nephrology, Inherited Kidney Diseases, Fundació Puigvert, Institut d'Investigacions Biomèdiques Sant Pau Universitat Autònoma de Barcelona, RICORS2040 (Kidney Disease), Barcelona, Spain
| | - Roser Torra
- Department of Nephrology, Inherited Kidney Diseases, Fundació Puigvert, Institut d'Investigacions Biomèdiques Sant Pau Universitat Autònoma de Barcelona, RICORS2040 (Kidney Disease), Barcelona, Spain
| | - Kate Bramham
- Department of Women and Children's Health, King's College London, London, UK
| | - Kate Wiles
- Department of Women and Children, Barts National Health Service Trust and Queen Mary University of London, London, UK
| | - Elizabeth R Ralston
- Department of Women and Children's Health, King's College London, London, UK
| | - Matthew Hall
- Department of Nephrology, Nottingham University Hospitals, Nottingham, UK
| | - Lisa Liu
- Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Michelle A Hladunewich
- Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - A Titia Lely
- Department of Obstetrics, University Medical Center Utrecht, Utrecht, the Netherlands
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3
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Maisons V, Duval A, Mesnard L, Frimat M, Fakhouri F, Grangé S, Servais A, Cartery C, Fauchier L, Coppo P, Titeca-Beauport D, Fage N, Delmas Y, Quérard AH, Seret G, Bobot M, Le Quintrec M, Ville S, von Tokarski F, Chauvet S, Wynckel A, Martins M, Schurder J, Barbet C, Sautenet B, Gatault P, Caillard S, Vuiblet V, Halimi JM. Assessment of epidemiology and outcomes of adult patients with kidney-limited thrombotic microangiopathies. Kidney Int 2024; 105:1100-1112. [PMID: 38431217 DOI: 10.1016/j.kint.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 11/12/2023] [Revised: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
Thrombotic microangiopathies (TMA) are usually associated with hematological features (RH-TMA). The epidemiology of TMA limited to kidneys (RL-TMA) is unclear Therefore, patients with TMA and native kidney biopsies were identified during 2009-2022 in 20 French hospitals and results evaluated. RL-TMA was present in 341/757 (45%) patients and associated with lower creatinine levels (median 184 vs 346 μmol/L) than RH-TMA. RL-TMA resulted from virtually all identified causes, more frequently from anti-VEGF treatment and hematological malignancies but less frequently from shigatoxin-associated hemolytic uremic syndrome (HUS), systemic sclerosis, gemcitabine and bacterial infection, and even less frequently when three or more causes/triggers were combined (RL-TMA: 5%; RH-TMA: 12%). RL-TMA was associated with significantly lower major cardiovascular events (10% vs 20%), kidney replacement therapy (23% vs 43%) and death (12% vs 20%) than RH-TMA during follow-up (median 28 months). Atypical HUS (aHUS) was found in 326 patients (RL-TMA: 43%, RH-TMA: 44%). Among the 69 patients with proven complement-mediated aHUS, eculizumab (anti-C5 therapy) was used in 43 (62%) (RL-TMA: 35%; RH-TMA: 71%). Among the 257 other patients with aHUS, including 51% with RL-TMA, eculizumab was used in 29 but with unclear effects of this treatment. Thus, RL-TMA represents a very high proportion of patients with TMA and results from virtually all known causes of TMA and includes 25% of patients with complement-mediated aHUS. Adverse outcomes of RL-TMA are lower compared to RH-TMA but remain significant. Anti-C5 therapy was rarely used in RL-TMA, even in proven complement-mediated aHUS, and its effects remain to be assessed.
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Affiliation(s)
- Valentin Maisons
- Service de Néphrologie, CHU de Tours, Tours, France; U1246, INSERM, SPHERE, Université de Tours, Université de Nantes, Tours, Nantes, France
| | - Anna Duval
- Service de Néphrologie, CHU de Strasbourg, Strasbourg, France
| | | | - Marie Frimat
- Service de Néphrologie, CHU de Lille, Lille, France
| | - Fadi Fakhouri
- Service de Néphrologie, CHU Vaudois, Lausanne, Switzerland
| | | | - Aude Servais
- Service de Néphrologie, APHP Hopital Necker, Paris, France
| | - Claire Cartery
- Service de Néphrologie, CH de Valenciennes, Valenciennes, France
| | | | - Paul Coppo
- Service d'Hématologie, Centre de référence pour les microangiopathies thrombotiques (CNR-MAT), APHP Hopital Saint-Antoine, Paris, France
| | | | - Nicolas Fage
- Service de Néphrologie, Département de médecine intensive reanimation-médecine hyperbare, CHU d'Angers, Angers, France
| | - Yahsou Delmas
- Service de Néphrologie, CHU de Bordeaux, Bordeaux, France
| | | | - Guillaume Seret
- Service de Néphrologie, Pole Santé Sud Echo Le Mans, Le Mans, France
| | - Mickaël Bobot
- Service de Néphrologie, CHU de Marseille; Aix, Marseille Université, INSERM 1263, INRAE 1260, C2VN, CERIMED, Marseille, France
| | | | - Simon Ville
- Service de Néphrologie, CHU de Nantes, Nantes, France
| | | | - Sophie Chauvet
- Service de Néphrologie, APHP Hopital Européen Georges Pompidou, Paris, France
| | | | - Manon Martins
- Service de Néphrologie, CHU de Rennes, Rennes, France
| | - Juliet Schurder
- Service de Néphrologie, CH de Saint-Malo, Saint-Malo, France
| | | | | | - Philippe Gatault
- Service de Néphrologie, CHU de Tours, U1327, INSERM, ISCHEMIA, Université de Tours, Tours, France
| | - Sophie Caillard
- U1246, INSERM, SPHERE, Université de Tours, Université de Nantes, Tours, Nantes, France
| | - Vincent Vuiblet
- Service de Pathologie, Institut d'Intelligence Artificielle en Santé, CHU de Reims et Université de Reims Champagne Ardenne, Reims, France
| | - Jean-Michel Halimi
- Service de Néphrologie, CHU de Tours, U1327, INSERM, ISCHEMIA, Université de Tours, Tours, France.
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4
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Regnier M, Flammier S, Boutaba M, Ndongo AA, Servais A, Schaefer F, Levtchenko E, Bacchetta J, Bertholet-Thomas A. Worldwide disparities in access to treatment and investigations for nephropathic cystinosis: a 2023 perspective. Pediatr Nephrol 2024; 39:1113-1123. [PMID: 37978055 PMCID: PMC10899370 DOI: 10.1007/s00467-023-06179-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/18/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Nephropathic cystinosis (NC) is a rare lysosomal disease, leading to early kidney failure and extra-renal comorbidities. Its prognosis strongly relies on early diagnosis and treatment by cysteamine. Developing economies (DEing) face many challenges when treating patients for rare and chronic diseases. The aim here is to evaluate the access to investigations and treatment in DEing, and to assess for potential inequalities with Developed Economies (DEed). METHODS In this international cross-sectional study, a questionnaire on access, price and reimbursement of genetic, biological analyses, and treatment was sent to nephrology centers worldwide during 2022. RESULTS A total of 109 centers responded, coming from 49 countries and managing 741 patients: 43 centers from 30 DEing and Economies in transition (TrE), and 66 from 19 DEed. In 2022, genetics availability was 63% in DEing and 100% in DEed, whereas intra leukocytes cystine levels (IL-CL) were available for 30% of DEing patients, and 94% of DEed patients, both increasing over the last decade, as has access to immediate release cysteamine and to cysteamine eye drops in DEing. However, delayed released cysteamine can be delivered to only 7% vs. 74% of patients from DEing and DEed, respectively, and is still poorly reimbursed in DEing. CONCLUSIONS Over the last decade, access to investigations (namely genetics and IL-CL) and to cysteamine have improved in DEing and TrE. However, discrepancies remain with DEed: access to delayed released cysteamine is limited, and reimbursement is still profoundly insufficient, therefore limiting their current use.
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Affiliation(s)
- Maitena Regnier
- Centre de Référence Des Maladies Rénales Rares Néphrogones, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon & Université Claude-Bernard, Lyon 1, Lyon, France
- Service de Néphrologie, Rhumatologie Et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Boulevard Pinel, 69677, Bron Cedex, France
- Faculté de Médecine Lyon Est, Université Claude Bernard, Lyon 1, Lyon, France
| | - Sacha Flammier
- Centre de Référence Des Maladies Rénales Rares Néphrogones, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon & Université Claude-Bernard, Lyon 1, Lyon, France
- Service de Néphrologie, Rhumatologie Et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Boulevard Pinel, 69677, Bron Cedex, France
| | - Mounia Boutaba
- Department of Pediatrics A, Hussein Dey University Hospital Center, University of Algiers 1, Algiers, Algeria
| | - Aliou Abdoulaye Ndongo
- Pediatric Unit, Aristide Le Dantec Hospital Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Aude Servais
- Service de Néphrologie Et Maladies Métaboliques Adulte Hôpital Necker 149, Paris, France
| | - Franz Schaefer
- Division of Pediatric Nephrology, University Children's Hospital Heidelberg, Heidelberg, Germany
- International Pediatric Nephrology Association (IPNA), C/o Nationwide Children's Center for Faculty Development (ED-5081), 700 Children's Drive, Columbus, OH 43205, USA
- European Rare Kidney Disease Reference Network (ERK-Net) Project Office, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany
| | - Elena Levtchenko
- Division of Pediatric Nephrology, Department of Pediatrics, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Justine Bacchetta
- Centre de Référence Des Maladies Rénales Rares Néphrogones, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon & Université Claude-Bernard, Lyon 1, Lyon, France
- Service de Néphrologie, Rhumatologie Et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Boulevard Pinel, 69677, Bron Cedex, France
- Faculté de Médecine Lyon Est, Université Claude Bernard, Lyon 1, Lyon, France
- European Rare Kidney Disease Reference Network (ERK-Net) Project Office, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany
- ORKID : Filière Orphan Kidney Diseases, Montpellier, France
- Diagnostic Et Traitements Des Maladies Osseuses, INSERM 1033 Physiopathologie, Paris, France
| | - Aurélia Bertholet-Thomas
- Centre de Référence Des Maladies Rénales Rares Néphrogones, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon & Université Claude-Bernard, Lyon 1, Lyon, France.
- Service de Néphrologie, Rhumatologie Et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Boulevard Pinel, 69677, Bron Cedex, France.
- Faculté de Médecine Lyon Est, Université Claude Bernard, Lyon 1, Lyon, France.
- European Rare Kidney Disease Reference Network (ERK-Net) Project Office, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany.
- ORKID : Filière Orphan Kidney Diseases, Montpellier, France.
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5
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Busiah K, Roda C, Crosnier AS, Brassier A, Servais A, Wicker C, Dubois S, Assoun M, Belloche C, Ottolenghi C, Pontoizeau C, Souberbielle JC, Piketty ML, Perin L, Le Bouc Y, Arnoux JB, Netchine I, Imbard A, de Lonlay P. Pubertal origin of growth retardation in inborn errors of protein metabolism: A longitudinal cohort study. Mol Genet Metab 2024; 141:108123. [PMID: 38219674 DOI: 10.1016/j.ymgme.2023.108123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVES Inherited amino-acid metabolism disorders (IAAMDs) require lifelong protein-restricted diet. We aimed to investigate: 1/ whether IAAMDs was associated with growth, pubertal, bone mineral apparent density (BMAD) or body composition impairments; 2/ associations linking height, amino-acid mixture (AAM), plasma amino-acids and IGF1 concentrations. DESIGN Retrospective longitudinal study of 213 patients with neonatal-onset urea cycle disorders (UCD,n = 77), organic aciduria (OA,n = 89), maple syrup urine disease (MSUD,n = 34), or tyrosinaemia type 1 (n = 13). METHODS We collected growth parameters, pubertal status, BMAD, body composition, protein-intake, and IGF1 throughout growth. RESULTS Overall final height (n = 69) was below target height (TH): -0.9(1.4) vs. -0.1(0.9) SD, p < 0.001. Final height was ≤ TH-2SD in 12 (21%) patients. Height ≤ - 2SD was more frequent during puberty than during early-infancy and pre-puberty: 23.5% vs. 6.9%, p = 0.002; and vs. 10.7%, p < 0.001. Pubertal delay was frequent (26.7%). Height (SD) was positively associated with isoleucine concentration: β, 0.008; 95%CI, 0.003 to 0.012; p = 0.001. In the pubertal subgroup, height (SD) was lower in patients with vs. without AAM supplementation: -1.22 (1.40) vs. -0.63 (1.46) (p = 0.02). In OA, height and median (IQR) isoleucine and valine concentrations(μmol/L) during puberty were lower in patients with vs. without AAM supplementation: -1.75 (1.30) vs. -0.33 (1.55) SD, p < 0.001; and 40 (23) vs. 60 (25) (p = 0.02) and 138 (92) vs. 191 (63) (p = 0.01), respectively. No correlation was found with IGF1. Lean-mass index was lower than fat-mass index: -2.03 (1.15) vs. -0.44 (0.89), p < 0.001. CONCLUSIONS In IAAMDs, growth retardation worsened during puberty which was delayed in all disease subgroups. Height seems linked to the disease, AAM composition and lower isoleucine concentration, independently of the GH-IGF1 pathway. We recommend close monitoring of diet during puberty.
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Affiliation(s)
- Kanetee Busiah
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France; Paediatric endocrinology, diabetology and obesity unit, Women-Mothers-Children Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
| | - Célina Roda
- Université Paris Cité, HERA Team, CRESS, INSERM, INRAE, F-75004 Paris, France
| | - Anne-Sophie Crosnier
- Endocrine function testing department, Assistance Publique-Hôpitaux de Paris, Trousseau University Hospital, Paris, France
| | - Anaïs Brassier
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France
| | - Aude Servais
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France
| | - Camille Wicker
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France; Pediatric Inherited Metabolic Diseases department, University Hospital of Strasbourg- Hautepierre, Strasbourg, France
| | - Sandrine Dubois
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France
| | - Murielle Assoun
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France
| | - Claire Belloche
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France
| | - Chris Ottolenghi
- Metabolic biochemistry, Necker Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Imagine Institute, Filière G2M, MetabERN, Medical School, Université Paris Cité, Paris, France
| | - Clément Pontoizeau
- Metabolic biochemistry, Necker Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Imagine Institute, Filière G2M, MetabERN, Medical School, Université Paris Cité, Paris, France
| | - Jean-Claude Souberbielle
- Hormonology laboratory, Physiology department, Necker-Enfants Malades Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Liesse Piketty
- Hormonology laboratory, Physiology department, Necker-Enfants Malades Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Laurence Perin
- Endocrine function testing department, Assistance Publique-Hôpitaux de Paris, Trousseau University Hospital, Paris, France
| | - Yves Le Bouc
- Endocrine function testing department, Assistance Publique-Hôpitaux de Paris, Trousseau University Hospital, Paris, France; Sorbonne University, INSERM, Saint Antoine research centre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Baptiste Arnoux
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France
| | - Irène Netchine
- Endocrine function testing department, Assistance Publique-Hôpitaux de Paris, Trousseau University Hospital, Paris, France; Sorbonne University, INSERM, Saint Antoine research centre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Apolline Imbard
- Metabolic biochemistry, Necker Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Imagine Institute, Filière G2M, MetabERN, Medical School, Université Paris Cité, Paris, France
| | - Pascale de Lonlay
- Inherited Metabolic Diseases Reference Center, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Filière G2M, MetabERN, Université Paris Cité, Paris, France; INSERM U1151, Necker-Enfants Malades Institute (INEM), Paris, France
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6
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Lodewyckx P, Issa J, Gaschignard M, Lamireau D, De Lonlay P, Servais A, Barth M, Courapied S, Morin G, Benbrik N, Maillot F, Babuty D, Labarthe F, Lefort B. Systemic primary carnitine deficiency induces severe arrhythmia due to shortening of QT interval. Mol Genet Metab 2023; 140:107733. [PMID: 37979236 DOI: 10.1016/j.ymgme.2023.107733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Systemic primary carnitine deficiency (PCD) is characterized by cardiomyopathy and arrhythmia. Without carnitine supplementation, progression is usually towards fatal cardiac decompensation. While the cardiomyopathy is most likely secondary to energy deficiency, the mechanism of arrhythmia is unclear, and may be related to a short QT interval. OBJECTIVE We aim to describe rhythmic manifestations at diagnosis and with carnitine supplementation. METHODS French patients diagnosed for PCD were retrospectively included. Clinical and para clinical data at diagnosis and during follow-up were collected. Electrocardiograms with QT interval measurements were blinded reviewed by two paediatric cardiologists. RESULTS Nineteen patients (median age at diagnosis 2.3 years (extremes 0.3-28.9)) followed in 8 French centres were included. At diagnosis, 21% of patients (4/19) had arrhythmia (2 ventricular fibrillations, 1 ventricular tachycardia and 1 sudden death), and 84% (16/19) had cardiomyopathy. Six electrocardiograms before treatment out of 11 available displayed a short QT (QTc < 340 ms). Median corrected QTc after carnitine supplementation was 404 ms (extremes 341-447) versus 350 ms (extremes 282-421) before treatment (p < 0.001). The whole QTc was prolonged, and no patient reached the criterion of short QT syndrome with carnitine supplementation. Three patients died, probably from rhythmic cause without carnitine supplementation (two extra-hospital sudden deaths and one non-recoverable rhythmic storm before carnitine supplementation), whereas no rhythmic complication occurred in patients with carnitine supplementation. CONCLUSION PCD is associated with shortening of the QT interval inducing severe arrhythmia. A potential explanation would be a toxic effect of accumulated fatty acid and metabolites on ionic channels embedded in the cell membrane. Carnitine supplementation normalizes the QTc and prevents arrhythmia. Newborn screening of primary carnitine deficiency would prevent avoidable deaths.
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Affiliation(s)
- Pierre Lodewyckx
- Institut des Cardiopathies Congénitales de Tours and FHU PRECICARE, CHU Tours, Tours, France
| | - Jean Issa
- Institut des Cardiopathies Congénitales de Tours and FHU PRECICARE, CHU Tours, Tours, France
| | | | | | - Pascale De Lonlay
- Maladie métabolique, Hôpital Necker Enfant Malade, APHP, Université Paris Cité, Filière G2M, MetabERN, Paris, France
| | - Aude Servais
- Maladie métabolique, Hôpital Necker Enfant Malade, APHP, Université Paris Cité, Filière G2M, MetabERN, Paris, France
| | | | - Sandy Courapied
- Maladie métabolique, CHU Lille, Filière G2M, MetabERN, Lille, France
| | | | - Nadir Benbrik
- Fédération cardiologie pédiatrique, CHU Nantes, Nantes, France
| | - François Maillot
- CRMR Maladies Héréditaires du Métabolisme ToTeM, CHU Tours, Tours, France
| | | | - François Labarthe
- CRMR Maladies Héréditaires du Métabolisme ToTeM, CHU Tours, Tours, France; INSERM UMR 1069, Université de Tours, Tours, France
| | - Bruno Lefort
- Institut des Cardiopathies Congénitales de Tours and FHU PRECICARE, CHU Tours, Tours, France; INSERM UMR 1069, Université de Tours, Tours, France.
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7
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Otiniano A, Tassin C, Serris A, Guennouni N, Lanternier F, Servais A, Parize P, Guinebert S, Van Huyen JPD, Bodard S, Boudhabhay I. Emphysematous pyelonephritis in a diabetic patient. J Nephrol 2023; 36:2621-2624. [PMID: 37193924 DOI: 10.1007/s40620-023-01639-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/03/2023] [Indexed: 05/18/2023]
Affiliation(s)
- Armelle Otiniano
- Department of Nephrology and Transplantation, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, 149 rue de Sèvres, 75015, Paris, France
| | - Claire Tassin
- Department of Pathology, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, Paris, France
| | - Alexandra Serris
- Department of Infectious and Tropical Diseases, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, Paris, France
- Université Paris Cité, 75006, Paris, France
| | - Nadia Guennouni
- Department of Microbiology, Parasitology and Mycology, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, Paris, France
| | - Fanny Lanternier
- Department of Infectious and Tropical Diseases, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, Paris, France
- Université Paris Cité, 75006, Paris, France
| | - Aude Servais
- Department of Nephrology and Transplantation, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, 149 rue de Sèvres, 75015, Paris, France
| | - Perrine Parize
- Department of Infectious and Tropical Diseases, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, Paris, France
| | - Sylvain Guinebert
- Université Paris Cité, 75006, Paris, France
- Department of Adult Radiology, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, Paris, France
| | - Jean Paul Duong Van Huyen
- Department of Pathology, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, Paris, France
- Université Paris Cité, 75006, Paris, France
| | - Sylvain Bodard
- Université Paris Cité, 75006, Paris, France
- Department of Adult Radiology, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, Paris, France
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Idris Boudhabhay
- Department of Nephrology and Transplantation, Necker Enfant-Malades University Hospital, Assistance Publique Des Hôpitaux de Paris, 149 rue de Sèvres, 75015, Paris, France.
- Université Paris Cité, 75006, Paris, France.
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8
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Meuleman MS, Vieira-Martins P, El Sissy C, Audard V, Baudouin V, Bertrand D, Bridoux F, Louillet F, Dossier C, Esnault V, Jourde-Chiche N, Karras A, Morin MP, Provot F, Remy P, Ribes D, Rousset-Rouviere C, Servais A, Thervet E, Tricot L, Zaidan M, Wynckel A, Zuber J, Le Quintrec M, Frémeaux-Bacchi V, Chauvet S. Rare Variants in Complement Gene in C3 Glomerulopathy and Immunoglobulin-Mediated Membranoproliferative GN. Clin J Am Soc Nephrol 2023; 18:1435-1445. [PMID: 37615951 PMCID: PMC10637453 DOI: 10.2215/cjn.0000000000000252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 03/14/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND C3 glomerulopathy and idiopathic immunoglobulin-mediated membranoproliferative GN (Ig-MPGN) are rare complement-mediated kidney diseases. Inherited forms of C3 glomerulopathy/Ig-MPGN are rarely described. METHODS Three hundred ninety-eight patients with C3 glomerulopathy ( n =296) or Ig-MPGN ( n =102) from a national registry were screened for three complement genes: factor H ( CFH ), factor I ( CFI ), and C3 . Patients with rare variant (minor allele frequency <0.1%) were included. Epidemiologic, clinical, and immunologic data at diagnosis and kidney outcomes of patients were retrospectively collected. RESULTS Fifty-three different rare variants, including 30 (57%), 13 (24%), and ten (19%) in CFH , CFI , and C3 variants, were identified in 66/398 (17%) patients. Thirty-eight (72%) variants were classified as pathogenic, including 20/30 (66%) and 11/13 (84%) variants in CFH and CFI , respectively, impairing synthesis of factor H or factor I regulators. Fifteen of 53 (27%) variants were of unknown significance. At diagnosis, 69% of patients were adult (median age of 31 years). With the exception of biologic stigma of thrombotic microangiopathy, which was more frequent in patients with CFI variants (5/14 [36%] versus 1/37 [3%] and 0% in the CFH group and C3 group, respectively, P < 0.001), the clinical and histologic features were similar among the three variants groups. The kidney outcome was poor regardless of the age at onset and treatment received. Sixty-five percent (43/66) of patients with rare variant reach kidney failure after a median delay of 41 (19-104) months, compared with 28% (55/195) after a median delay of 34 (12-143) months in the nonvariant group. Among 36 patients who received a kidney transplant, 2-year recurrence was frequent, occurring in 39% (12/31), without difference between variant groups, and led to graft failure in three cases. CONCLUSIONS In our cohort, 17% of C3 glomerulopathy/Ig-MPGN cases were associated with rare variants in the CFH , CFI , or C3 genes. In most cases, a quantitative deficiency in factor H or factor I was identified. The presence of a rare variant was associated with poor kidney survival. PODCAST This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/CJASN/2023_11_08_CJN0000000000000252.mp3.
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Affiliation(s)
- Marie Sophie Meuleman
- Team “Inflammation, Complement and Cancer,” INSERM UMRS1138, Centre de Recherche des Cordeliers, Paris, France
| | - Paula Vieira-Martins
- Department of Immunology Biology, Assistance Publique-Hôpitaux de Paris, European Hospital Georges Pompidou, Paris, France
| | - Carine El Sissy
- Team “Inflammation, Complement and Cancer,” INSERM UMRS1138, Centre de Recherche des Cordeliers, Paris, France
- Department of Immunology Biology, Assistance Publique-Hôpitaux de Paris, European Hospital Georges Pompidou, Paris, France
| | - Vincent Audard
- Department of Nephrology and Transplantation, Assistance Publique-Hôpitaux de Paris, Henri-Mondor Hospital, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Véronique Baudouin
- Department of Pediatric Nephrology, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Paris, France
| | | | - Frank Bridoux
- Department of Nephrology, Poitiers University Hospital, Poitiers, France
| | | | - Claire Dossier
- Department of Pediatric Nephrology, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Paris, France
| | - Vincent Esnault
- Department of Nephrology, Nice University Hospital, Nice, France
| | - Noémie Jourde-Chiche
- Department of Nephrology, Assistance Publique-Hôpitaux de Marseille, CHU Conception, Marseille, France
- INSERM, INRAE, C2VN, Aix-Marseille University, Marseille, France
| | - Alexandre Karras
- Department of Nephrology, Assistance Publique-Hôpitaux de Paris, European Hospital Georges Pompidou, Paris, France
| | | | - François Provot
- Department of Nephrology, Lille University Hospital, Lille, France
| | - Philippe Remy
- Department of Nephrology and Transplantation, Assistance Publique-Hôpitaux de Paris, Henri-Mondor Hospital, Créteil, France
| | - David Ribes
- Department of Nephrology, Toulouse University Hospital, Toulouse, France
| | - Caroline Rousset-Rouviere
- Department of Pediatric Nephrology, Assistance Publique-Hôpitaux de Marseille, Timone Hospital, Marseille, France
| | - Aude Servais
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris, Necker Hospital, Paris, France
| | - Eric Thervet
- Department of Nephrology, Assistance Publique-Hôpitaux de Paris, European Hospital Georges Pompidou, Paris, France
| | - Leila Tricot
- Department of Nephrology, Foch Hospital, Suresnes, France
| | - Mohamad Zaidan
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris, Bicetre Hospital, Le Kremlin-Bicêtre, France
| | - Alain Wynckel
- Department of Nephrology, Reims University Hospital, Reims, France
| | - Julien Zuber
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris, Necker Hospital, Paris, France
| | - Moglie Le Quintrec
- Department of Nephrology, Montpellier University Hospital, Montpellier, France
| | - Véronique Frémeaux-Bacchi
- Team “Inflammation, Complement and Cancer,” INSERM UMRS1138, Centre de Recherche des Cordeliers, Paris, France
- Department of Immunology Biology, Assistance Publique-Hôpitaux de Paris, European Hospital Georges Pompidou, Paris, France
| | - Sophie Chauvet
- Team “Inflammation, Complement and Cancer,” INSERM UMRS1138, Centre de Recherche des Cordeliers, Paris, France
- Department of Nephrology, Assistance Publique-Hôpitaux de Paris, European Hospital Georges Pompidou, Paris, France
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9
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Petzold F, Billot K, Chen X, Henry C, Filhol E, Martin Y, Avramescu M, Douillet M, Morinière V, Krug P, Jeanpierre C, Tory K, Boyer O, Burgun A, Servais A, Salomon R, Benmerah A, Heidet L, Garcelon N, Antignac C, Zaidan M, Saunier S. The genetic landscape and clinical spectrum of nephronophthisis and related ciliopathies. Kidney Int 2023:S0085-2538(23)00377-0. [PMID: 37230223 DOI: 10.1016/j.kint.2023.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023]
Abstract
Nephronophthisis (NPH) is an autosomal-recessive ciliopathy representing one of the most frequent causes of kidney failure in childhood characterized by a broad clinical and genetic heterogeneity. Applied to one of the worldwide largest cohorts of patients with NPH, genetic analysis encompassing targeted and whole exome sequencing identified disease-causing variants in 600 patients from 496 families with a detection rate of 71%. Of 788 pathogenic variants, 40 known ciliopathy genes were identified. However, the majority of patients (53%) bore biallelic pathogenic variants in NPHP1. NPH-causing gene alterations affected all ciliary modules defined by structural and/or functional subdomains. Seventy six percent of these patients had progressed to kidney failure, of which 18% had an infantile form (under five years) and harbored variants affecting the Inversin compartment or intraflagellar transport complex A. Forty eight percent of patients showed a juvenile (5-15 years) and 34% a late-onset disease (over 15 years), the latter mostly carrying variants belonging to the Transition Zone module. Furthermore, while more than 85% of patients with an infantile form presented with extra-kidney manifestations, it only concerned half of juvenile and late onset cases. Eye involvement represented a predominant feature, followed by cerebellar hypoplasia and other brain abnormalities, liver and skeletal defects. The phenotypic variability were in a large part associated with mutation types, genes and corresponding ciliary modules with hypomorphic variants in ciliary genes playing a role in early steps of ciliogenesis associated with juvenile-to-late onset NPH forms. Thus, our data confirm a considerable proportion of late-onset NPH suggesting an underdiagnosis in adult chronic kidney disease.
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Affiliation(s)
- Friederike Petzold
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France; Division of Nephrology, Department of Endocrinology, Nephrology, and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Katy Billot
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Xiaoyi Chen
- Université de Paris, Imagine Institute, Data Science Platform, INSERM UMR 1163, Paris, France; Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Paris, France
| | - Charline Henry
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Emilie Filhol
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Yoann Martin
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Marina Avramescu
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France; Department of Pediatry, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Maxime Douillet
- Université de Paris, Imagine Institute, Data Science Platform, INSERM UMR 1163, Paris, France; Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Paris, France
| | - Vincent Morinière
- APHP, Génétique moléculaire, Hôpital universitaire Necker-Enfants malades, Paris, France
| | - Pauline Krug
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France; Department of Pediatry, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Cécile Jeanpierre
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Kalman Tory
- Ist Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary
| | - Olivia Boyer
- Department of Pediatry, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Nephrology and Transplantation Department, Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Necker Hospital, APHP, Université de Paris, France
| | - Anita Burgun
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Paris, France; Hôpital Necker-Enfants Malades, Department of Medical Informatics, AP-HP, Paris, France; PaRis Artificial Intelligence Research InstitutE (PRAIRIE), France
| | - Aude Servais
- Nephrology and Transplantation Department, Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Necker Hospital, APHP, Université de Paris, France
| | - Remi Salomon
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France; Department of Pediatry, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France
| | - Alexandre Benmerah
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Laurence Heidet
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France; Department of Pediatry, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Nephrology and Transplantation Department, Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Necker Hospital, APHP, Université de Paris, France
| | - Nicolas Garcelon
- Université de Paris, Imagine Institute, Data Science Platform, INSERM UMR 1163, Paris, France; Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Paris, France
| | - Corinne Antignac
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Mohamad Zaidan
- Assistance Publique des Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Hôpital de Bicêtre, Service de Néphrologie et Transplantation, Le Kremlin-Bicêtre, France; Centre de Compétence Maladies Rares « Syndrome Néphrotique Idiopathique », Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Sophie Saunier
- Laboratory of Hereditary Kidney Diseases, Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France.
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10
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Leon J, LeStang MB, Sberro-Soussan R, Servais A, Anglicheau D, Frémeaux-Bacchi V, Zuber J. Complement-driven hemolytic uremic syndrome. Am J Hematol 2023; 98 Suppl 4:S44-S56. [PMID: 36683290 DOI: 10.1002/ajh.26854] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023]
Abstract
Overactivation of the complement alternative pathway drives the pathogenesis of primary atypical hemolytic uremic syndrome (aHUS). Genetically-determined or acquired dysregulation of the complement is frequently identified in patients with aHUS, pregnancy-related hemolytic uremic syndrome (HUS) and severe hypertension-associated HUS. In contrast, it is still unclear whether self-limited complement activation, which frequently occurs in other forms of HUS, provides key mechanistic clues or results from endothelium damage. Development of novel biomarkers is underway to firmly establish complement-driven pathogenesis. C5 blockade therapy has revolutionized the management of aHUS patients, resulting in a halving of the subpopulation under chronic dialysis over the course of a few years. On the other hand, the efficacy of C5 blockade in secondary forms of HUS, as assessed by small and uncontrolled case series, is less compelling and should be investigated through properly-designed prospective clinical trials. The increased risk of meningococcal infection, related to C5 inhibition, must be rigorously addressed with suitable prophylaxis. Treatment duration should be determined based on an individualized benefit/risk assessment. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Juliette Leon
- Department of Kidney and Metabolic Diseases, Transplantation and Clinical Immunology, Necker Hospital, Paris, AP-HP, France.,Université Paris-Cité, Paris, France.,Inserm UMR_S1163, IHU IMAGINE.,Centre of expertise for the French nationwide TMA network (CNR-MAT), Paris, France
| | - Marie-Bénédicte LeStang
- Department of Kidney and Metabolic Diseases, Transplantation and Clinical Immunology, Necker Hospital, Paris, AP-HP, France.,Centre of expertise for the French nationwide TMA network (CNR-MAT), Paris, France
| | - Rebecca Sberro-Soussan
- Department of Kidney and Metabolic Diseases, Transplantation and Clinical Immunology, Necker Hospital, Paris, AP-HP, France.,Centre of expertise for the French nationwide TMA network (CNR-MAT), Paris, France
| | - Aude Servais
- Department of Kidney and Metabolic Diseases, Transplantation and Clinical Immunology, Necker Hospital, Paris, AP-HP, France.,Centre of expertise for the French nationwide TMA network (CNR-MAT), Paris, France
| | - Dany Anglicheau
- Department of Kidney and Metabolic Diseases, Transplantation and Clinical Immunology, Necker Hospital, Paris, AP-HP, France.,Université Paris-Cité, Paris, France.,Centre of expertise for the French nationwide TMA network (CNR-MAT), Paris, France
| | | | - Julien Zuber
- Department of Kidney and Metabolic Diseases, Transplantation and Clinical Immunology, Necker Hospital, Paris, AP-HP, France.,Université Paris-Cité, Paris, France.,Inserm UMR_S1163, IHU IMAGINE.,Centre of expertise for the French nationwide TMA network (CNR-MAT), Paris, France
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11
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Veys K, Zadora W, Hohenfellner K, Bockenhauer D, Janssen MCH, Niaudet P, Servais A, Topaloglu R, Besouw M, Novo R, Haffner D, Kanzelmeyer N, Pape L, Wühl E, Harms E, Awan A, Sikora P, Ariceta G, van den Heuvel B, Levtchenko E. Outcome of infantile nephropathic cystinosis depends on early intervention, not genotype: A multicenter sibling cohort study. J Inherit Metab Dis 2023; 46:43-54. [PMID: 36117148 DOI: 10.1002/jimd.12562] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/01/2022] [Accepted: 09/16/2022] [Indexed: 01/19/2023]
Abstract
Infantile nephropathic cystinosis (INC) is an inheritable lysosomal storage disorder characterized by lysosomal cystine accumulation, progressive kidney disease, and multiple extrarenal complications (ERCs). Cysteamine postpones the onset of end-stage kidney disease (ESKD) and reduces the incidence of ERCs; however, cysteamine is generally initiated upon establishment of the renal Fanconi syndrome (FS) and partial loss of kidney function, whereas data on long-term effects of cysteamine administered from neonatal age are lacking. An international multicenter retrospective cohort study of siblings with INC was set up to investigate the outcome in relation to age at initiation of cysteamine versus CTNS genotype, with attention to patients treated with cysteamine from neonatal age. None of the siblings treated from neonatal age (n = 9; age 10 ± 6 years) had reached ESKD, while 22% of their index counterparts (n = 9; age 14 ± 5 years) had commenced renal replacement therapy. Siblings treated with cysteamine from the onset of symptoms at a younger age compared with their index counterparts, reached ESKD at a significant older age (13 ± 3 vs. 10 ± 3 years, p = 0.002). In contrast, no significant difference in ERCs was observed between sibling and index patients, independently from the age at initiation of cysteamine. The CTNS genotype had no impact on the overall outcome in this cohort. In INC, presymptomatic treatment with cysteamine results in a better renal outcome in comparison to treatment initiated from the onset of symptoms. This justifies including cystinosis into newborn screening programs. SYNOPSIS: In infantile nephropathic cystinosis, presymptomatic treatment with cysteamine improves the renal outcome which justifies the inclusion of cystinosis into newborn screening programs.
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Affiliation(s)
- Koenraad Veys
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Development & Regeneration, Laboratory of Pediatric Nephrology, KU Leuven, Leuven, Belgium
| | - Ward Zadora
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Detlef Bockenhauer
- Department of Pediatric Nephrology, Great Ormond Street Hospital for Sick Children NHS Foundation Trust (GOSH) and Department of Renal Medicine, University College London, London, UK
| | - Mirian C H Janssen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Patrick Niaudet
- Department of Pediatric Nephrology, Hôpital Necker-Enfants Malades, Paris, France
| | - Aude Servais
- Department of Adult Nephrology and Transplantation, Hôpital Necker, Paris, France
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Martine Besouw
- Department of Pediatric Nephrology, University of Groningen, Groningen, The Netherlands
| | - Robert Novo
- Pediatric Nephrology, Hôpital Jeanne de Flandre, University Hospital Lille, Lille, France
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Nele Kanzelmeyer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Lars Pape
- Department of Pediatrics, University Hospital Essen, Essen, Germany
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Erik Harms
- Children's University Hospital Münster, Münster, Germany
| | - Atif Awan
- Paediatric Nephrology and Transplantation, Temple Street Children's University Hospital, Dublin, Ireland
| | - Przemyslaw Sikora
- Department of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland
| | - Gema Ariceta
- Department of Pediatric Nephrology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Bert van den Heuvel
- Department of Development & Regeneration, Laboratory of Pediatric Nephrology, KU Leuven, Leuven, Belgium
| | - Elena Levtchenko
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Development & Regeneration, Laboratory of Pediatric Nephrology, KU Leuven, Leuven, Belgium
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12
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Servais A. Cystinosis: a rare multisystem disease. Pol Arch Intern Med 2022; 132. [PMID: 36426771 DOI: 10.20452/pamw.16363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Aude Servais
- Department of Nephrology and Transplantation, Reference Center for Hereditary Renal Diseases of Children and Adults, Necker Hospital, APHP, Paris, France; Inserm U1163, Imagine Institute, Paris University, Paris, France.
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13
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Chauvet S, Hauer JJ, Petitprez F, Rabant M, Martins PV, Baudouin V, Delmas Y, Jourde-Chiche N, Cez A, Ribes D, Cloarec S, Servais A, Zaidan M, Daugas E, Delahousse M, Wynckel A, Ryckewaert A, Sellier-Leclerc AL, Boyer O, Thervet E, Karras A, Smith RJH, Frémeaux-Bacchi V. Results from a nationwide retrospective cohort measure the impact of C3 and soluble C5b-9 levels on kidney outcomes in C3 glomerulopathy. Kidney Int 2022; 102:904-916. [PMID: 35752323 PMCID: PMC10588728 DOI: 10.1016/j.kint.2022.05.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 04/14/2022] [Accepted: 05/26/2022] [Indexed: 10/17/2022]
Abstract
C3 glomerulopathy (C3G) is a rare complement-mediated disease. Specific treatments are not yet available and factors predictive of kidney survival such as age, kidney function and proteinuria are not specific to C3G. The prognostic value of biomarkers of complement activation, which are pathognomonic of the diseases, remains unknown. In a large cohort of 165 patients from the French National registry, we retrospectively assess the prognostic value of C3, soluble C5b-9 (sC5b-9), C3 nephritic factor, and rare disease-predicting variants in complement genes in predicting clinical outcome of patients. By multivariate analysis age (adult onset), reduced kidney function (defined by estimated glomerular filtration rate under 60ml/min) and presence of rare disease-predicting variants in complement genes predicted risk of progression to kidney failure. Moreover, by multivariate analysis, normal C3/high sC5b-9 levels or low C3/normal sC5b-9 levels remained independently associated with a worse kidney prognosis, with the relative risk 3.7- and 8-times higher, respectively. Subgroup analysis indicated that the complement biomarker profiles independently correlated to kidney prognosis in patients with adult but not pediatric onset. In this subgroup, we showed that profiles of biomarkers C3 and/or sC5b-9 correlated with intra glomerular inflammation and may explain kidney outcomes. In children, only the presence of rare disease-predicting variants correlated with kidney survival. Thus, in an adult population, we propose a three-point C3G prognostic score based on biomarker profiles at risk, estimated glomerular filtration rate at presentation and genetic findings, which may help stratify adult patients into subgroups that require close monitoring and more aggressive therapy.
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Affiliation(s)
- Sophie Chauvet
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMRS1138, Centre de Recherche des Cordeliers, Team "Inflammation, Complement and cancer", Paris, France; Paris Cité University, Paris, France.
| | - Jill J Hauer
- Molecular Otolaryngology and Renal Research Laboratories, University of Iowa, Iowa City, Iowa, USA
| | - Florent Petitprez
- Programme Cartes d'Identités des Tumeurs, Ligue Nationale Contre le Cancer, Paris, France
| | - Marion Rabant
- Department of Renal Pathology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Paula Vieira Martins
- Department of Immunology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Véronique Baudouin
- Department of Pediatric Nephrology, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Yahsou Delmas
- Department of Nephrology, CH Bordeaux, Bordeaux, France
| | | | - Alexandre Cez
- Department of Nephrology, Tenon Hospital, Assistance Publique-hopitaux de Paris, Paris, France
| | - David Ribes
- Department of Nephrology, CHU Toulouse, Toulouse, France
| | - Sylvie Cloarec
- Department of Pediatric Nephrology, CHU Tours, Tours, France
| | - Aude Servais
- Department of Nephrology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Mohamad Zaidan
- Department of Nephrology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Eric Daugas
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Department of Nephrology, Paris, France
| | | | | | | | | | - Olivia Boyer
- Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Department of Pediatric Nephrology, Paris, France
| | - Eric Thervet
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alexandre Karras
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Richard J H Smith
- Molecular Otolaryngology and Renal Research Laboratories, University of Iowa, Iowa City, Iowa, USA
| | - Véronique Frémeaux-Bacchi
- INSERM UMRS1138, Centre de Recherche des Cordeliers, Team "Inflammation, Complement and cancer", Paris, France; Department of Immunology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
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14
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Dao M, Decramer S, Llanas B, Chauveau D, Nobili F, Ranchin B, Rieu P, Knebelmann B, Hummel A, Servais A. Devenir à l’âge adulte des patients suivis pour un syndrome de Lowe. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.194] [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: 10/14/2022]
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15
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Marelli C, Fouilhoux A, Benoist J, De Lonlay P, Guffon‐Fouilhoux N, Brassier A, Cano A, Chabrol B, Pennisi A, Schiff M, Acquaviva C, Murphy E, Servais A, Lachmann R. Very long-term outcomes in 23 patients with cblA type methylmalonic acidemia. J Inherit Metab Dis 2022; 45:937-951. [PMID: 35618652 PMCID: PMC9540587 DOI: 10.1002/jimd.12525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To present the very long-term follow up of patients with cobalamin A (cblA) deficiency. METHODS A retrospective case series of adult (>16 years) patients with molecular or enzymatic diagnosis of cblA deficiency. RESULTS We included 23 patients (mean age: 27 ± 7.6 years; mean follow-up: 24.9 ± 7.6 years). Disease onset was mostly pediatric (78% < 1 year, median = 4 months) with acute neurologic deterioration (65%). Eight patients presented with chronic symptoms, and one had an adult-onset mild cblA deficiency. Most of the patients (61%) were initially classified as vitamin B12-unresponsive methylmalonic aciduria (MMA); in vitro B12 responsiveness was subsequently found in all the tested patients (n = 13). Initial management consisted of protein restriction (57%), B12 (17%), or both (26%). The main long-term problems were intellectual disability (39%) and renal failure (30%). However, 56.5% of the patients were living independently. Intellectual disability was equally distributed among the initial treatment groups, while renal failure (moderate and beginning at the age of 38 years) was present in only one out of seven patients initially treated with B12. CONCLUSIONS We provide a detailed picture of the long-term outcome of a series of adult cblA patients, mostly diagnosed before the enzymatic and molecular era. We confirm that about 35% of the patients do not present acutely, underlining the importance of measuring MMA in any case of unexplained chronic renal failure, intellectual disability, or growth delay. In addition, we describe a patient with a milder adult-onset form. Early B12 supplementation seems to protect from severe renal insufficiency.
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Affiliation(s)
- Cecilia Marelli
- Expert Centre for Neurogenetic Diseases and Adult Mitochondrial and Metabolic DiseasesUniversity Hospital of MontpellierMontpellierFrance
- MMDNUniversity of Montpellier, Ecole Pratique des Hautes Etudes, InsermMontpellierFrance
| | - Alain Fouilhoux
- Reference Center for Inborn Error of MetabolismHôpital Femme Mère Enfant, Hospices Civils de LyonBronFrance
| | - Jean‐Francois Benoist
- Inserm UMR_S1163Institut ImagineParisFrance
- Biochemistry DepartmentHôpital Necker Enfants Malades, Assistance Publique – Hôpitaux de ParisParisFrance
| | - Pascale De Lonlay
- Necker Hospital, Assistance Publique – Hôpitaux de Paris, Reference Center for Inborn Error of Metabolism and Filière G2M, Pediatrics DepartmentUniversity of ParisParisFrance
| | - Nathalie Guffon‐Fouilhoux
- Reference Center for Inborn Error of MetabolismHôpital Femme Mère Enfant, Hospices Civils de LyonBronFrance
| | - Anais Brassier
- Necker Hospital, Assistance Publique – Hôpitaux de Paris, Reference Center for Inborn Error of Metabolism and Filière G2M, Pediatrics DepartmentUniversity of ParisParisFrance
| | - Aline Cano
- Reference Center for Inherited Metabolic Disorders, Assistance Publique Hôpitaux de MarseilleCentre Hospitalier Universitaire de La Timone EnfantsMarseilleFrance
| | - Brigitte Chabrol
- Reference Center for Inherited Metabolic Disorders, Assistance Publique Hôpitaux de MarseilleCentre Hospitalier Universitaire de La Timone EnfantsMarseilleFrance
| | - Alessandra Pennisi
- Necker Hospital, Assistance Publique – Hôpitaux de Paris, Reference Center for Inborn Error of Metabolism and Filière G2M, Pediatrics DepartmentUniversity of ParisParisFrance
| | - Manuel Schiff
- Inserm UMR_S1163Institut ImagineParisFrance
- Necker Hospital, Assistance Publique – Hôpitaux de Paris, Reference Center for Inborn Error of Metabolism and Filière G2M, Pediatrics DepartmentUniversity of ParisParisFrance
| | - Cecile Acquaviva
- Center for Inherited Metabolic Disorders and Neonatal Screening, Est Biology and Pathology Department, Groupement Hospitalier Est (GHE)Hospices Civils de LyonBronFrance
| | - Elaine Murphy
- C. Dent Adult Metabolic UnitNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Aude Servais
- Necker Hospital, Assistance Publique – Hôpitaux de Paris, Reference Center for Inborn Error of Metabolism and Filière G2M, Pediatrics DepartmentUniversity of ParisParisFrance
- Adult Nephrology and Transplantation DepartmentHôpital Necker Enfants Malades, APHPParisFrance
| | - Robin Lachmann
- C. Dent Adult Metabolic UnitNational Hospital for Neurology and NeurosurgeryLondonUK
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16
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Servais A, Janssen MCH, Blakey H, Greco M, Lemoine S, Martin-Moreno PL, Game D, Levtchenko E, Lipkin G. Pregnancy in cystinosis patients with chronic kidney disease: A European case series. J Inherit Metab Dis 2022; 45:963-968. [PMID: 35713960 DOI: 10.1002/jimd.12529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 11/11/2022]
Abstract
Cystinosis is a rare autosomal recessive disease leading to end-stage renal disease within the second or third decade of life. Since the era of specific treatment with cysteamine, prognosis has substantially improved and pregnancy becomes an increasing concern. Pregnancy data in patients with cystinosis were collected through an anonymized survey. We collected data for 19 pregnancies in 12 women. Seventeen patients were transplanted, 1 was on hemodialysis and 1 had chronic kidney disease (CKD) stage 4. These 19 pregnancies resulted in 13 live births (68.4%): 3 spontaneous early miscarriages, 1 ectopic pregnancy, 1 early pre-eclampsia (at 21 weeks), and 1 preterm birth with neonatal death at 24 weeks were reported. After exclusion of early miscarriage or termination, pregnancy success rate was 86.7%. In successful pregnancies, median gestational age at delivery was 34 weeks (24-37). Preeclampsia occurred in seven pregnancies (7/15, 46.7%). A cesarean section was performed in all pregnancies. Median baby weight at delivery was 2175 g (620-3374 g). After pregnancy, one patient reached end-stage renal disease, but she already had advanced CKD before pregnancy (creatinine 239 μmol/L, eGFR 23 ml/min/1.73 m2 ). In three other patients, there was a decrease of eGFR of 8, 20, and 53 ml/min/1.73 m2 , respectively. The majority of pregnancies were successful, but severe antenatal and post-natal complications may occur, in particular preeclampsia that was noticed in nearly half of patients and fetal loss in one-third of them. These results may help pre-pregnancy counseling and pregnancy management.
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Affiliation(s)
- Aude Servais
- Nephrology and Transplantation Department, Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Necker Hospital, APHP, Université de Paris, Paris, France
| | - Mirian C H Janssen
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Hannah Blakey
- Department of Renal Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Marcella Greco
- Division of Nephrology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Sandrine Lemoine
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, University of Lyon, Centre de Reference des Maladies Rénales et Phosphocalciques Rares Néprhogones, Lyon, France
| | - Paloma L Martin-Moreno
- Department of Nephrology, Clinica Universidad de Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - David Game
- Department of Nephrology and Transplantation, Guy's and St Thomas' Hospital, London, UK
| | - Elena Levtchenko
- Division of Pediatric Nephrology, University Hospitals Leuven & Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Graham Lipkin
- Department of Renal Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
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17
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Mütze U, Gleich F, Garbade SF, Plisson C, Aldámiz-Echevarría L, Arrieta F, Ballhausen D, Zielonka M, Petković Ramadža D, Baumgartner MR, Cano A, García Jiménez MC, Dionisi-Vici C, Ješina P, Blom HJ, Couce ML, Meavilla Olivas S, Mention K, Mochel F, Morris AAM, Mundy H, Redonnet-Vernhet I, Santra S, Schiff M, Servais A, Vitoria I, Huemer M, Kožich V, Kölker S. Postauthorization safety study of betaine anhydrous. J Inherit Metab Dis 2022; 45:719-733. [PMID: 35358327 DOI: 10.1002/jimd.12499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/06/2022]
Abstract
Patient registries for rare diseases enable systematic data collection and can also be used to facilitate postauthorization safety studies (PASS) for orphan drugs. This study evaluates the PASS for betaine anhydrous (Cystadane), conducted as public private partnership (PPP) between the European network and registry for homocystinurias and methylation defects and the marketing authorization holder (MAH). Data were prospectively collected, 2013-2016, in a noninterventional, international, multicenter, registry study. Putative adverse and severe adverse events were reported to the MAH's pharmacovigilance. In total, 130 individuals with vitamin B6 nonresponsive (N = 54) and partially responsive (N = 7) cystathionine beta-synthase (CBS) deficiency, as well as 5,10-methylenetetrahydrofolate reductase (MTHFR; N = 21) deficiency and cobalamin C (N = 48) disease were included. Median (range) duration of treatment with betaine anhydrous was 6.8 (0-9.8) years. The prescribed betaine dose exceeded the recommended maximum (6 g/day) in 49% of individuals older than 10 years because of continued dose adaptation to weight; however, with disease-specific differences (minimum: 31% in B6 nonresponsive CBS deficiency, maximum: 67% in MTHFR deficiency). Despite dose escalation no new or potential risk was identified. Combined disease-specific treatment decreased mean ± SD total plasma homocysteine concentrations from 203 ± 116 to 81 ± 51 μmol/L (p < 0.0001), except in MTHFR deficiency. Recommendations for betaine anhydrous dosage were revised for individuals ≥ 10 years. PPPs between MAH and international scientific consortia can be considered a reliable model for implementing a PASS, reutilizing well-established structures and avoiding data duplication and fragmentation.
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Affiliation(s)
- Ulrike Mütze
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
| | - Florian Gleich
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
| | - Sven F Garbade
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
| | | | | | - Francisco Arrieta
- Endocrinology & Nutrition, Metabolic Congenital Disease, H.U. Ramon y Cajal, Madrid, Spain
| | - Diana Ballhausen
- Pediatric Unit for Metabolic Diseases, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Matthias Zielonka
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
| | - Danijela Petković Ramadža
- Department of Pediatrics, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Matthias R Baumgartner
- Division of Metabolism and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Aline Cano
- Centre de Référence des Maladies Héréditaires du Métabolisme, CHU La Timone Enfants, Marseille, France
| | | | - Carlo Dionisi-Vici
- Division of Metabolism, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Pavel Ješina
- Department of Pediatrics and Inherited Metabolic Disorders, Charles University-First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Henk J Blom
- Department of Clinical Genetics, Center for Lysosomal and Metabolic Diseases, Erasmus Medical Center, Rotterdam, Netherlands
| | - Maria Luz Couce
- Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Service of Neonatology, Department of Pediatrics, Hospital Clínico Universitario de Santiago, CIBERER, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Silvia Meavilla Olivas
- Pediatrics, Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Karine Mention
- Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Jeanne de Flandre, Lille, France
| | - Fanny Mochel
- Ap.HP, Sorbonne University, Reference Center for Adult Neurometabolic Diseases, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Andrew A M Morris
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Trust, Manchester, UK
| | - Helen Mundy
- Evelina London Children's Hospital, London, UK
| | - Isabelle Redonnet-Vernhet
- Endocrinology, Nutrition and Metabolic Diseases, Haut-Lévêque Hospital, Bordeaux University, Bordeaux, France
| | - Saikat Santra
- Department of Clinical Inherited Metabolic Disorders, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Manuel Schiff
- Necker Hospital, APHP, Reference Center for Inborn Error of Metabolism and Filière G2M, Pediatrics Department, University of Paris, Paris, France
- Inserm UMR_S1163, Institut Imagine, Paris, France
| | - Aude Servais
- Nephrology and Transplantation, MAMEA Reference Center, Necker hospital, APHP, Paris, France
| | - Isidro Vitoria
- Unit of Metabolic Disorders, Universitary Hospital La Fe, Valencia, Spain
| | - Martina Huemer
- Division of Metabolism and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
- Department of Pediatrics, Landeskrankenhaus Bregenz, Bregenz, Austria
| | - Viktor Kožich
- Department of Pediatrics and Inherited Metabolic Disorders, Charles University-First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Stefan Kölker
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
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18
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Bedin M, Boyer O, Servais A, Li Y, Villoing-Gaudé L, Tête MJ, Cambier A, Hogan J, Baudouin V, Krid S, Bensman A, Lammens F, Louillet F, Ranchin B, Vigneau C, Bouteau I, Isnard-Bagnis C, Mache CJ, Schäfer T, Pape L, Gödel M, Huber TB, Benz M, Klaus G, Hansen M, Latta K, Gribouval O, Morinière V, Tournant C, Grohmann M, Kuhn E, Wagner T, Bole-Feysot C, Jabot-Hanin F, Nitschké P, Ahluwalia TS, Köttgen A, Andersen CBF, Bergmann C, Antignac C, Simons M. Human C-terminal CUBN variants associate with chronic proteinuria and normal renal function. J Clin Invest 2022; 132:161852. [PMID: 35642643 PMCID: PMC9151686 DOI: 10.1172/jci161852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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19
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Alili JM, Berleur MP, Husson MC, Mention K, Schiff M, Arnoux JB, Brassier A, Guemman AS, Grisel C, Dubois S, Abi-Wardé MT, Broissand C, Servais A, Dao M, de Lonlay P. Intravenous administration of a branched-chain amino-acid-free solution in children and adults with acute decompensation of maple syrup urine disease: a prospective multicentre observational study. Orphanet J Rare Dis 2022; 17:202. [PMID: 35578286 PMCID: PMC9112564 DOI: 10.1186/s13023-022-02353-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Patients with maple syrup urine disease (MSUD) experiencing metabolic decompensations have traditionally been treated with branched-chain amino acid (BCAA)-free mixture via oral or nasogastric administration routes. In some patients, enteral administration is not possible, either because the patient presents with vomiting, coma, or refuses nasogastric administration, thus intravenous (IV) BCAA-free solution is an appropriate intervention for these challenging cases.
Aims
This study aimed to evaluate the effectiveness and safety of managing metabolic decompensations by administering an IV BCAA-free solution.
Methods
This is an observational prospective study of data from MSUD patients hospitalised for decompensation episodes between 2010 and 2016 at 6 centres for rare metabolic diseases in France.
Results
A total of 24 patients (16 males; 8 females) experiencing 126 MSUD metabolic decompensation episodes (39 in children; 87 in adults) were admitted to hospital. At presentation, mean leucine plasma concentration was ≥ 381 µmol/L in 113/126 (89.7%) episodes. Children were treated with continuous IV BCAA-free solution at doses of 0.8 to 2.0 g/kg/day, for 4.8 days and adults for 3.8 days at doses of 0.5 to 2.6 g/kg/day. In the efficacy set of 102 analysable episodes leucine concentrations were normalised (to below 381 µmol/L) in 82% (n = 18/22) of episodes in children and in 84% (n = 67/80) of episodes in adults. Mean time to leucine normalisation was 3.0 days. This was significantly (p < 0.001) shorter than the algorithmically predicted time to leucine normalisation with traditional BCAA-free mixture. Duration of hospitalisation was significantly longer for children than for adults (7.1 days in children vs 5.2 days in adults, p = 0.012). No treatment-related adverse events were reported in any patients on IV BCAA-free solution.
Conclusion
The IV BCAA-free solution is safe and effective in normalising leucine concentrations during MSUD decompensation episodes in both children and adults, offering a practical treatment alternative for those patients who cannot receive BCAA-free mixture via oral or nasogastric routes.
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20
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Hummel A, Oniszczuk J, Kervella D, Charbit M, Guerrot D, Testa A, Philipponnet C, Chauvet C, Guincestre T, Brochard K, Benezech A, Figueres L, Belenfant X, Guarnieri A, Demoulin N, Benetti E, Miglinas M, Dessaix K, Morelle J, Angeletti A, Sellier-Leclerc AL, Ranchin B, Goussard G, Hudier L, Bacchetta J, Servais A, Audard V. Idiopathic nephrotic syndrome relapse following SARS-CoV-2 vaccination: a series of 25 cases. Clin Kidney J 2022; 15:1574-1582. [PMID: 35979142 PMCID: PMC9129143 DOI: 10.1093/ckj/sfac134] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Several cases of idiopathic nephrotic syndrome (INS) relapse following the administration of coronavirus disease 2019 (COVID-19) vaccines have recently been reported, raising questions about the potential relationship between the immune response to COVID-19 vaccination and INS pathogenesis. Methods We performed a retrospective multicentre survey describing the clinical and biological characteristics of patients presenting a relapse of INS after COVID-19 vaccination, with an assessment of outcome under treatment. Results We identified 25 patients (16 men and 9 women) presenting a relapse within 1 month of a COVID-19 vaccine injection. The glomerular disease was of childhood onset in half of the patients and most patients (21/25) had received at least one immunosuppressive drug in addition to steroids for frequently relapsing or steroid-dependent nephrotic syndrome (NS). All patients were in a stable condition at the time of injection and 11 had no specific treatment. In five patients, the last relapse was reported >5 years before vaccine injection. The Pfizer-BioNTech (BNT162b2) vaccine was used in 80% of the patients. In 18 cases, INS relapse occurred after the first injection, a mean of 17.5 days after vaccination. A second injection was nevertheless administered in 14 of these patients. Five relapses occurred after administration of the second dose and two relapses after the administration of the third dose. All but one of the patients received steroids as first-line treatment, with an additional immunosuppressive agent in nine cases. During follow-up, complete remission was achieved in 21 patients, within 1 month in 17 cases. Only one patient had not achieved at least partial remission after 3 months of follow-up. Conclusions This case series suggests that, in rare patients, COVID-19 vaccination may trigger INS relapse that is generally easy to control. These findings should encourage physicians to persuade their patients to complete the COVID-19 vaccination schedule.
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Affiliation(s)
- Aurélie Hummel
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique » (SNI), Paris, France
| | - Julie Oniszczuk
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare SNI, Créteil, France
- Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Delphine Kervella
- Institut de Transplantation Urologie Néphrologie, Centre Hospitalo Universitaire (CHU) Nantes, Nantes, France
- Centre de Recherche en Transplantation et Immunologie, Unité Mixte de Recherche (UMR) 1064, INSERM, Université de Nantes, Nantes, France
| | - Marina Charbit
- AP-HP, Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie pédiatrique, Centre de référence MARHEA, centre de référence SNI, Institut Imagine, Université de Paris, Paris, France
| | - Dominique Guerrot
- Department of Nephrology, Hemodialysis and Transplantation, Rouen University Hospital, Rouen, France
- Normandy University, UNIROUEN, INSERM U1096, Rouen, France
| | - Angelo Testa
- E.C.H.O. (Expansion Centre Hémodialyse de l'Ouest) Site Confluent REZE, France
| | - Carole Philipponnet
- Service Nephrologie Dialyse et Transplantation rénale CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Cécile Chauvet
- Service de Néphrologie, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France
| | - Thomas Guincestre
- Service de Néphrologie, Centre Hospitalier de Roubaix, Roubaix, France
| | - Karine Brochard
- Service de Néphrologie-Rhumatologie-Médecine Interne pédiatrique, Centre de Référence des Maladies rénales Rares du Sud-Ouest (SORARE), Hôpital des enfants, Toulouse, France
| | - Ariane Benezech
- Service de Néphrologie-Rhumatologie-Médecine Interne pédiatrique, Centre de Référence des Maladies rénales Rares du Sud-Ouest (SORARE), Hôpital des enfants, Toulouse, France
| | - Lucile Figueres
- Institut de Transplantation Urologie Néphrologie, Centre Hospitalo Universitaire (CHU) Nantes, Nantes, France
- Centre de Recherche en Transplantation et Immunologie, Unité Mixte de Recherche (UMR) 1064, INSERM, Université de Nantes, Nantes, France
| | - Xavier Belenfant
- Groupe Hospitalier Grand Paris Nord Est, Hôpital André Grégoire, Service de Néphrologie-Dialyse, Montreuil, France
| | | | - Nathalie Demoulin
- Nephrology Division, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Elisa Benetti
- Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy
| | - Marius Miglinas
- Nephrology Center, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Kathleen Dessaix
- Université de Montpellier, Service de Nephrologie, CHU Montpellier, Hôpital Lapeyronie, Montpellier, France
| | - Johann Morelle
- Nephrology Division, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Andrea Angeletti
- Division of Nephrology, Dialysis, Transplantation, IRCCS Giannini Gaslini Children's Hospital, Via Gerolamo Gaslini 5, Genova, Italy
| | - Anne-Laure Sellier-Leclerc
- Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France
| | - Bruno Ranchin
- Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France
| | - Guillaume Goussard
- Service de Néphrologie et Transplantation CHU Poitiers, Poitiers, France
| | - Laurent Hudier
- Service de Néphrologie, Centre Hospitalier Broussais, Saint Malo, France
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France
| | - Aude Servais
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique » (SNI), Paris, France
| | - Vincent Audard
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare SNI, Créteil, France
- Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
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21
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Dao M, Hummel A, Knebelmann B, Joly D, Charbit M, Salomon R, Cornet J, Niaudet P, Boyer O, Servais A. FC067: Long-Term Outcome of Childhood Onset Idiopathic Nephrotic Syndrome. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac111.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Little is known about the long-term outcome during adulthood of childhood onset idiopathic nephrotic syndrome (INS). We aimed to determine which patients require long-term follow up after transition, to identify risk factors of relapse and to analyze treatment strategies.
METHOD
In this monocentric retrospective study, we included all patients admitted in our adult nephrology department with INS diagnosed during childhood. Patients who reached kidney failure during childhood were excluded. Data regarding the outcome at adult age were obtained through clinical database and medical charts.
RESULTS
Eighty-two patients (male/female = 2/1) were included, with a median age at diagnosis of 3.9 years (1.2–16.5). Sixty-eight patients had steroid-sensitive INS, including 52 with steroid-dependent nephrotic syndrome or frequently relapsing nephrotic syndrome. Fourteen patients had steroid-resistant nephrotic syndrome. A total of 89% of patients received corticosteroid sparing treatment during childhood. Median follow-up during adulthood was 6.2 (0.3–25) years. A total of 71% of patients experienced at least one relapse during adulthood. The total number of relapses during childhood and the number of relapses per year during childhood, reflecting disease activity, were significantly higher in patients who experienced relapses during adulthood than in patients who did not (Figure 1). The risk of relapse during adulthood was also significantly associated with the need for immunosuppressive regimen at the time of the transition visit (P = 0.002). To promote the successful transition of young people, we propose to organize a transition visit where the adolescent/young adult is seen jointly by pediatric and adult nephrologists, as it was done for 68% of patients in this study. The relapse rate was significantly lower (50%) in the subgroup of patients who had such a transition visit. We also found that relapse during the first two-years of adulthood follow-up was significantly associated with the risk of further relapse, highlighting the need for a close follow-up during the transition period. A total of 45% of patients received corticosteroid sparing treatment during adulthood, mainly mycophenolate mofetil (N = 23), calcineurin inhibitors (N = 21) and rituximab (N = 12). The main complications were high blood pressure (20/82, 26%) and osteopenia (19/26, 73% when bone densitometry was performed). Only one thrombo-embolic event and three severe infections were reported. At last follow-up, median eGFR was 87.1 (23.4–150.8) mL/min/1.73 m².
CONCLUSION
The incidence of relapses in adulthood is high in patients with active disease during childhood. A long-term follow-up is mandatory in these patients. Whereas renal function remained normal in most patients, high blood pressure and osteopenia were frequent and should be carefully monitored during adulthood. Transition visit should be carefully coordinated to prevent the risk of nonadherence.
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Affiliation(s)
- Myriam Dao
- Hôpital Universitaire Necker Enfants Malades, Néphrologie et Transplantation rénale adulte, Paris, France
| | - Aurélie Hummel
- Hôpital Universitaire Necker Enfants Malades, Néphrologie et Transplantation rénale adulte, Paris, France
| | - Bertrand Knebelmann
- Hôpital Universitaire Necker Enfants Malades, Néphrologie et Transplantation rénale adulte, Paris, France
| | - Dominique Joly
- Hôpital Universitaire Necker Enfants Malades, Néphrologie Pédiatrique, Paris, France
| | - Marina Charbit
- Hôpital Universitaire Necker Enfants Malades, Néphrologie Pédiatrique, Paris, France
| | - Rémi Salomon
- Hôpital Universitaire Necker Enfants Malades, Néphrologie Pédiatrique, Paris, France
| | - Joséphine Cornet
- Hôpital Universitaire Necker Enfants Malades, Néphrologie et Transplantation rénale adulte, Paris, France
| | - Patrick Niaudet
- Hôpital Universitaire Necker Enfants Malades, Néphrologie Pédiatrique, Paris, France
| | - Olivia Boyer
- Hôpital Universitaire Necker Enfants Malades, Néphrologie Pédiatrique, Paris, France
| | - Aude Servais
- Hôpital Universitaire Necker Enfants Malades, Néphrologie et Transplantation rénale adulte, Paris, France
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22
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Levtchenko E, Servais A, Hulton SA, Ariceta G, Emma F, Game DS, Lange K, Lapatto R, Liang H, Sberro-Soussan R, Topaloglu R, Das AM, Webb NJA, Wanner C. Expert guidance on the multidisciplinary management of cystinosis in adolescent and adult patients. Clin Kidney J 2022; 15:1675-1684. [PMID: 36003666 PMCID: PMC9394719 DOI: 10.1093/ckj/sfac099] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 02/09/2022] [Indexed: 11/23/2022] Open
Abstract
Cystinosis, a rare autosomal recessive lysosomal storage disorder, results in an abnormal accumulation of the amino acid cystine in multiple organs and tissues of the body. Renal symptoms typically develop in the first few months of life, with extra-renal manifestations becoming apparent over the next 10–20 years, which require coordinated multidisciplinary care. Here, we describe a consensus-based guidance to support the management of adolescents and adults living with cystinosis. The programme was led by a Steering Committee (SC) of six experts in the management of patients with cystinosis, who identified a list of 15 key questions reflecting the multi-organ effects of cystinosis. An Extended Faculty (EF) of eight additional specialists was invited to answer the questions via an online digital platform using a quasi-Delphi approach. The consolidated answers were summarized into recommendations. Where evidence was lacking, recommendations were developed using collective expert consensus. The EF was asked to agree/disagree with the clinical recommendations. The expert-agreed clinical recommendations provide guidance that considers both renal and extra-renal systems. The topics covered are advice on fertility and family planning, consideration of the nervous, muscular, ophthalmic, cardio-respiratory, endocrine, dermatological and gastrointestinal systems, as well as guidance on dental care, diet, lifestyle, and improving quality of life and psychological well-being. In summary, this work outlines recommendations and a checklist for clinicians with a vision for improving and standardizing the multidisciplinary care for patients with cystinosis.
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Affiliation(s)
| | - Aude Servais
- Nephrology and Transplantation Department, Hôpital Necker Enfants Malades APHP, Paris, France
| | - Sally A Hulton
- Birmingham Women's and Children's Hospital NHS Foundation Trust, Steelhouse Lane, B4 6NH, Birmingham, UK
| | - Gema Ariceta
- Paediatric Nephrology Department, University Hospital Vall d'Hebron, Professor of Paediatrics, The Autonomous University of Barcelona, Barcelona, Spain
| | - Francesco Emma
- Division of Nephrology and Dialysis, Ospedale Pediatrico Bambino Gesù-IRCCS, Rome, Italy
| | - David S Game
- Department of Renal Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Karin Lange
- Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Risto Lapatto
- Department of Pediatrics, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hong Liang
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU ForeSight, Paris, France; Inserm-DHOS CIC 1423CHNO des Quinze-Vingts, IHU ForeSight, Paris, France; Inserm, U968; UPMC, université Paris 06, UMR_S968, institut de la vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, Inserm-DHOS CIC 503, Paris, France
| | - Rebecca Sberro-Soussan
- Department of Nephrology and Kidney Transplantation, University Hospital Center (CHU) Necker, Paris Descartes University-Sorbonne Paris Cité, Paris, France
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Anibh M Das
- Clinic for Paediatric Kidney-, Liver- and Metabolic Diseases, Hannover, Germany
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23
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Postel-Vinay N, Shao JD, Pinton A, Servais A, Gebara N, Amar L. Home Blood Pressure Measurement and Self-Interpretation of Blood Pressure Readings During Pregnancy: Hy-Result e-Health Prospective Study. Vasc Health Risk Manag 2022; 18:277-287. [PMID: 35449534 PMCID: PMC9017708 DOI: 10.2147/vhrm.s350478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/05/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Hy-Result is a rule management system designed to help patients to be compliant with the home blood pressure measurement (HBPM) monitoring schedule and to understand their BP readings. The aim of the Hy-Result e-Health prospective study is to evaluate the practice and experience of women using the Hy-Result coaching app for self-interpretation of BP readings during and after pregnancy. Methods Participants were asked to: i) measure their BP at home; ii) use the Hy-Result app and send their PDF report to the researcher; iii) answer anonymously to 3 online independent questionnaires (Q). Results A total of 107 women accepted to measure their BP and use the app. Among them 82 (77%) performed HBPM and used successfully the system and 72 (88%) shared to the investigator their PDF report by email. Of these, 95% declared the software was “easy” or “very easy” to use; 93% believe the software helps them to monitor their BP more effectively (74% agree, 18% somewhat agree); 94% that the color code classification was “clear”; 76 (93%) affirmed that the app helped them when consulting their physician for their BP evaluation. Majority (87%) perceived the software to be reliable. Furthermore, 71 (87%) said they trust the system and 51 (62%) declared that performing HBPM and self-interpret their readings was “reassuring” whereas 6 (7%) felt that it was “a concern”. Conclusion This study shows that the majority (88%) of pregnant women performed HBPM and successfully used the Hy-Result software for self-interpretation of the BP readings. The use of the validated Hy-Result system by pregnant women may thus be recommended in common practice by healthcare professionals and patient associations.
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Affiliation(s)
- Nicolas Postel-Vinay
- Hypertension Unit, ESH Excellence Center, Hôpital Européen Georges Pompidou, APHP, Paris, France
- Hospital at Home, Fondation Santé Service, Levallois, France
- Correspondence: Nicolas Postel-Vinay, Email
| | - Jiali-Delphine Shao
- Faculté de médecine de l’Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Anne Pinton
- Department of Obstetrics and Gynecology, Trousseau Hospital, APHP, Sorbonne University, Paris, France
| | - Aude Servais
- Nephrology and Transplantation Department, Necker Hospital, APHP, Paris, France
| | - Nicole Gebara
- Hypertension Unit, ESH Excellence Center, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - Laurence Amar
- Hypertension Unit, ESH Excellence Center, Hôpital Européen Georges Pompidou, APHP, Paris, France
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24
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Dorval G, Servais A, Boyer O. The genetics of steroid-resistant nephrotic syndrome in children. Nephrol Dial Transplant 2022; 37:648-651. [DOI: 10.1093/ndt/gfaa221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Guillaume Dorval
- Service de génétique moléculaire, Hôpital Necker - Enfants Malades, APHP, Paris, France
- Inserm U1163, Institut Imagine, Université de Paris, Paris, France
| | - Aude Servais
- Inserm U1163, Institut Imagine, Université de Paris, Paris, France
- Néphrologie et Transplantation, centre de référence MARHEA, Hôpital Necker - Enfants Malades, APHP, Paris, France
| | - Olivia Boyer
- Inserm U1163, Institut Imagine, Université de Paris, Paris, France
- Néphrologie pédiatrique, centre de référence MARHEA, centre de référence du syndrome néphrotique idiopathique de l’enfant et de l’adulte, Hôpital Necker - Enfants Malades, APHP, Paris, France
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25
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Corthier A, Jachiet M, Bertin D, Servais A, Barbet C, Bigot A, Doutre MS, Bessis D, Bouffandeau A, Moranne O, Jarrot PA, Bardin N, Terrier B, Burtey S, Puéchal X, Daniel L, Jourde-Chiche N. Biopsy-proven kidney involvement in hypocomplementemic urticarial vasculitis. BMC Nephrol 2022; 23:67. [PMID: 35172758 PMCID: PMC8851735 DOI: 10.1186/s12882-022-02689-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypocomplementemic urticarial vasculitis (HUV) is a rare systemic vasculitis. We aimed to describe the kidney involvement of HUV in a multicenter national cohort with an extended follow-up. METHODS All patients with HUV (international Schwartz criteria) with a biopsy-proven kidney involvement, identified through a survey of the French Vasculitis Study Group (FVSG), were included. A systematic literature review on kidney involvement of HUV was performed. RESULTS Twelve patients were included, among whom 8 had positive anti-C1q antibodies. All presented with proteinuria, from mild to nephrotic, and 8 displayed acute kidney injury (AKI), requiring temporary haemodialysis in 2. Kidney biopsy showed membrano-proliferative glomerulonephritis (MPGN) in 8 patients, pauci-immune crescentic GN or necrotizing vasculitis in 3 patients (with a mild to severe interstitial inflammation), and an isolated interstitial nephritis in 1 patient. C1q deposits were observed in the glomeruli (n = 6), tubules (n = 4) or renal arterioles (n = 3) of 8 patients. All patients received corticosteroids, and 9 were also treated with immunosuppressants or apheresis. After a mean follow-up of 8.9 years, 6 patients had a preserved renal function, but 2 patients had developed stage 3-4 chronic kidney disease (CKD) and 4 patients had reached end-stage kidney disease (ESKD), among whom 1 had received a kidney transplant. CONCLUSION Renal involvement of HUV can be responsible for severe AKI, CKD and ESRD. It is not always associated with circulating anti-C1q antibodies. Kidney biopsy shows mostly MPGN or crescentic GN, with frequent C1q deposits in the glomeruli, tubules or arterioles.
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Affiliation(s)
- Alice Corthier
- Department of Nephrology, Aix-Marseille Univ, Hôpital de la Conception, AP-HM, 147 Bd Baille, 13005, Marseille, France
| | - Marie Jachiet
- Department of Dermatology, Hôpital Saint Louis, AP-HP, Université Paris Diderot, Paris, France
| | - Daniel Bertin
- Laboratory of Immunology, Hôpital de la Conception, AP-HM, Marseille, France
| | - Aude Servais
- Department of Nephrology, Hôpital Necker, AP-HP, Paris, France
| | | | - Adrien Bigot
- Department of Internal Medicine, CHU de Tours, Tours, France
| | | | - Didier Bessis
- Department of Dermatology, Hôpital Saint Eloi, Université de Montpellier, Montpellier, France
| | | | - Olivier Moranne
- Department of Nephrology, Dialysis, Apheresis, CHU Caremeau, Nimes, France.,Université de Montpellier-Nîmes, Nîmes, France
| | - Pierre-André Jarrot
- Department of Internal Medicine and Clinical Immunology, Hôpital de la Conception, AP-HM, Marseille, France.,Aix-Marseille Univ, C2VN, INSERM 1263, INRA 1260, Marseille, France
| | - Nathalie Bardin
- Laboratory of Immunology, Hôpital de la Conception, AP-HM, Marseille, France.,Aix-Marseille Univ, C2VN, INSERM 1263, INRA 1260, Marseille, France
| | - Benjamin Terrier
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Cochin Hospital, Paris, France.,Paris Descartes University, Paris, France
| | - Stephane Burtey
- Department of Nephrology, Aix-Marseille Univ, Hôpital de la Conception, AP-HM, 147 Bd Baille, 13005, Marseille, France.,Aix-Marseille Univ, C2VN, INSERM 1263, INRA 1260, Marseille, France
| | - Xavier Puéchal
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Cochin Hospital, Paris, France.,Paris Descartes University, Paris, France
| | - Laurent Daniel
- Aix-Marseille Univ, C2VN, INSERM 1263, INRA 1260, Marseille, France.,Department of Pathology, Aix-Marseille Univ, Hôpital de la Timone, AP-HM, Marseille, France
| | - Noémie Jourde-Chiche
- Department of Nephrology, Aix-Marseille Univ, Hôpital de la Conception, AP-HM, 147 Bd Baille, 13005, Marseille, France. .,Aix-Marseille Univ, C2VN, INSERM 1263, INRA 1260, Marseille, France.
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26
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Montealegre S, Lebigot E, Debruge H, Romero N, Héron B, Gaignard P, Legendre A, Imbard A, Gobin S, Lacène E, Nusbaum P, Hubas A, Desguerre I, Servais A, Laforêt P, van Endert P, Authier FJ, Gitiaux C, de Lonlay P. FDX2 and ISCU Gene Variations Lead to Rhabdomyolysis With Distinct Severity and Iron Regulation. Neurol Genet 2022; 8:e648. [PMID: 35079622 PMCID: PMC8771665 DOI: 10.1212/nxg.0000000000000648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/23/2021] [Accepted: 10/18/2021] [Indexed: 01/04/2023]
Abstract
Background and Objectives To determine common clinical and biological traits in 2 individuals with
variants in ISCU and FDX2, displaying
severe and recurrent rhabdomyolyses and lactic acidosis. Methods We performed a clinical characterization of 2 distinct individuals with
biallelic ISCU or FDX2 variants from 2
separate families and a biological characterization with muscle and cells
from those patients. Results The individual with FDX2 variants was clinically more
affected than the individual with ISCU variants. Affected
FDX2 individual fibroblasts and myoblasts showed reduced oxygen consumption
rates and mitochondrial complex I and PDHc activities, associated with high
levels of blood FGF21. ISCU individual fibroblasts showed no oxidative
phosphorylation deficiency and moderate increase of blood FGF21 levels
relative to controls. The severity of the FDX2 individual was not due to
dysfunctional autophagy. Iron was excessively accumulated in ISCU-deficient
skeletal muscle, which was accompanied by a downregulation of
IRP1 and mitoferrin2 genes and an
upregulation of frataxin (FXN) gene expression. This
excessive iron accumulation was absent from FDX2 affected muscle and could
not be correlated with variable gene expression in muscle cells. Discussion We conclude that FDX2 and ISCU variants
result in a similar muscle phenotype, that differ in severity and skeletal
muscle iron accumulation. ISCU and FDX2 are not involved in mitochondrial
iron influx contrary to frataxin.
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Affiliation(s)
- Sebastian Montealegre
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Elise Lebigot
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Hugo Debruge
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Norma Romero
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Bénédicte Héron
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Pauline Gaignard
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Antoine Legendre
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Apolline Imbard
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Stéphanie Gobin
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Emmanuelle Lacène
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Patrick Nusbaum
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Arnaud Hubas
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Isabelle Desguerre
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Aude Servais
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Pascal Laforêt
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Peter van Endert
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - François Jérome Authier
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Cyril Gitiaux
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
| | - Pascale de Lonlay
- Inserm U1151 (S.M., H.D., P.E., P.d.L.), Institut Necker Enfants-Malades, Paris; Reference Center of Inherited Metabolic Diseases (S.M., A.I., A.S., P.d.L.), Necker-Enfants-Malades University Hospital, APHP, Imagine Institute, Paris University, Filière G2M; Biochemistry Laboratory (E. Lebigot, P.G.), Filière G2M, Bicêtre Hospital, APHP Paris Saclay, Le Kremlin Bicêtre; Sorbonne Universié (E. Lacène), UPMC, INSERM UMR974, Center for Research in Myology, Neuromuscular Morphology Unit, Myology Institute, AP-HP, East-Paris Reference Center of Neuromuscular Diseases, GHU Pitié-Salpêtrière; Neurology Unit (N.R., B.H.), Trousseau Hospital, APHP, Filière G2M; M3C-Necker (A.L.), Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades; Biochemistry Department (A.I.), Necker-Enfants-Malades University Hospital, APHP, Paris University; Genetics Department (S.G.), Necker-Enfants-Malades University Hospital, APHP; Genetics and Molecular Biology (P.N., A.H.), Laboratoire de Culture Cellulaire, Hôpital Cochin, Paris; Reference Center of Neuromuscular Diseases (I.D., C.G.), Necker-Enfants-Malades University Hospital, APHP, Filière Filnemus; Adult Nephrology & Transplantation (A.S.), Necker-Enfants-Malades University Hospital, APHP, Inserm U1163, Imagine Institute, Paris Descartes University; Department of Neurology (P.L.), Raymond-Poincaré Hospital, Garches, and Inserm U1179 Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux; and Reference Center for Neuromuscular Disorders (F.J.A., C.G.), Department de Pathologie, Henri Mondor Hospital, APHP, IMRB U955, Faculty of Medicine, Creteil, France
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Boudhabhay I, Serris A, Servais A, Planas D, Hummel A, Guery B, Parize P, Aguilar C, Dao M, Rouzaud C, Ferriere E, Knebelmann B, Sakhi H, Leruez M, Joly D, Schwartz O, Lanternier F, Bruel T. OUP accepted manuscript. Nephrol Dial Transplant 2022; 37:1357-1365. [PMID: 35104884 PMCID: PMC8903345 DOI: 10.1093/ndt/gfac016] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Patients on maintenance hemodialysis have an increased risk of severe COVID-19 and a reduced response to vaccines. Data are needed to identify immune correlates of protection in this population. Methods Following a COVID-19 outbreak among vaccinated patients in a hemodialysis unit, clinical data and serological response to BNT162b2 vaccine were retrospectively recorded. Results Among fifty-three patients present in the dialysis room, fourteen were infected by SARS-CoV-2 alpha variant (COVID_Pos) and 39 were not. In comparison to uninfected patients, COVID_Pos patients more frequently had additional causes of immunosuppression (50% vs 21%, p = 0.046), and were more often scheduled on the Monday-Wednesday-Friday (MWF) shift (86% vs 39%, p = 0.002). Moreover, COVID_pos had lower anti-Spike IgG titers than uninfected patients (24 BAU/ml [3–1163] vs 435 BAU/mL [99–2555], p = 0.001) and lower neutralization titers (108 [17–224] vs 2483 [481–43 908], p = 0.007). Anti-Spike and neutralization antibody titers are correlated (r = 0.92, p < 0.001). In multivariable analysis, MWF schedule (OR = 10.74 (1.9–93.5), p = 0.014) and anti-spike IgG titers one month before the outbreak (<205 BAU/ml: OR = 0.046 (0.002–0.29), p = 0.006) were independently associated with COVID-19 infection. None of the patients with anti-Spike IgG above 284 BAU/mL got infected. Ten out of fourteen COVID_Pos patients were treated with Casirivimab and Imdevimab. No patient developed severe disease. Conclusions Anti-spike IgG titer measured prior to exposure correlates to protection from SARS-CoV-2 infection in hemodialysis patients. BNT162b2 vaccination alone or in combination with monoclonal antibodies prevented severe COVID-19.
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Affiliation(s)
| | | | - Aude Servais
- Service de Néphrologie et Transplantation rénale, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Delphine Planas
- Institut Pasteur, Université de Paris, CNRS UMR 3569, Virus and Immunity Unit, Paris, France
- Vaccine Research Institute, Creteil, France
| | - Aurélie Hummel
- Service de Néphrologie et Transplantation rénale, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Bruno Guery
- Service de Néphrologie et Transplantation rénale, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Perrine Parize
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Claire Aguilar
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Myriam Dao
- Service de Néphrologie et Transplantation rénale, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Claire Rouzaud
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Elsa Ferriere
- Service de Néphrologie et Transplantation rénale, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Bertrand Knebelmann
- Service de Néphrologie et Transplantation rénale, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Hamza Sakhi
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Department of Nephrology, Centre de Référence Maladie Rare «Syndrome Néphrotique Idiopathique», Fédération Hospitalo-Universitaire «Innovative therapy for immune disorders», Créteil, France
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médical, (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Marianne Leruez
- Virology Laboratory, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris, Paris, France
| | - Dominique Joly
- Service de Néphrologie et Transplantation rénale, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Olivier Schwartz
- Institut Pasteur, Université de Paris, CNRS UMR 3569, Virus and Immunity Unit, Paris, France
- Vaccine Research Institute, Creteil, France
| | - Fanny Lanternier
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Timothée Bruel
- Institut Pasteur, Université de Paris, CNRS UMR 3569, Virus and Immunity Unit, Paris, France
- Vaccine Research Institute, Creteil, France
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Müller RU, Messchendorp AL, Birn H, Capasso G, Cornec-Le Gall E, Devuyst O, van Eerde A, Guirchoun P, Harris T, Hoorn EJ, Knoers NVAM, Korst U, Mekahli D, Le Meur Y, Nijenhuis T, Ong ACM, Sayer JA, Schaefer F, Servais A, Tesar V, Torra R, Walsh SB, Gansevoort RT. An update on the use of tolvaptan for ADPKD: Consensus statement on behalf of the ERA Working Group on Inherited Kidney Disorders (WGIKD), the European Rare Kidney Disease Reference Network (ERKNet) and Polycystic Kidney Disease International (PKD-International). Nephrol Dial Transplant 2021; 37:825-839. [PMID: 35134221 PMCID: PMC9035348 DOI: 10.1093/ndt/gfab312] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Indexed: 12/02/2022] Open
Abstract
Approval of the vasopressin V2 receptor antagonist tolvaptan—based on the landmark TEMPO 3:4 trial—marked a transformation in the management of autosomal dominant polycystic kidney disease (ADPKD). This development has advanced patient care in ADPKD from general measures to prevent progression of chronic kidney disease to targeting disease-specific mechanisms. However, considering the long-term nature of this treatment, as well as potential side effects, evidence-based approaches to initiate treatment only in patients with rapidly progressing disease are crucial. In 2016, the position statement issued by the European Renal Association (ERA) was the first society-based recommendation on the use of tolvaptan and has served as a widely used decision-making tool for nephrologists. Since then, considerable practical experience regarding the use of tolvaptan in ADPKD has accumulated. More importantly, additional data from REPRISE, a second randomized clinical trial (RCT) examining the use of tolvaptan in later-stage disease, have added important evidence to the field, as have post hoc studies of these RCTs. To incorporate this new knowledge, we provide an updated algorithm to guide patient selection for treatment with tolvaptan and add practical advice for its use.
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Affiliation(s)
| | - A Lianne Messchendorp
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henrik Birn
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Departments of Clinical Medicine and Biomedicine, Aarhus University, Aarhus, Denmark
| | - Giovambattista Capasso
- Department of Translational Medical Sciences, Vanvitelli University, Naples, Italy
- Biogem Institute for Molecular Biology and Genetics, Ariano Irpino, Italy
| | | | - Olivier Devuyst
- Institute of Physiology, University of Zurich, Zurich, Switzerland
- Division of Nephrology, UCL Medical School, Brussels, Belgium
| | - Albertien van Eerde
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Ewout J Hoorn
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nine V A M Knoers
- Department Genetics, University Medical Centre Groningen, Groningen, The Netherlands
| | - Uwe Korst
- PKD Familiäre Zystennieren e.V., Bensheim, Germany
| | - Djalila Mekahli
- PKD Research Group, Laboratory of Pediatrics, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Pediatric Nephrology and Organ Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Yannick Le Meur
- Department of Nephrology, Hemodialysis and Renal Transplantation, CHU and University of Brest, Brest, France
| | - Tom Nijenhuis
- Department of Nephrology, Radboud Institute for Molecular Life Sciences, Radboudumc Center of Expertise for Rare Kidney Disorders, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Albert C M Ong
- Academic Nephrology Unit, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
- Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - John A Sayer
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Aude Servais
- Nephrology and Transplantation Department, Necker University Hospital, APHP, Paris, France
| | - Vladimir Tesar
- Department of Nephrology, 1st Faculty of Medicine, General University Hospital, Prague, Czech Republic
| | - Roser Torra
- Inherited Kidney Diseases Nephrology Department, Fundació Puigvert Instituto de Investigaciones Biomédicas Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- REDINREN, Barcelona, Spain
| | - Stephen B Walsh
- Department of Renal Medicine, University College London, London, UK
| | - Ron T Gansevoort
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Toquet S, Spodenkiewicz M, Douillard C, Maillot F, Arnoux JB, Damaj L, Odent S, Moreau C, Redonnet-Vernhet I, Mesli S, Servais A, Noel E, Charriere S, Rigalleau V, Lavigne C, Kaphan E, Roubertie A, Besson G, Bigot A, Servettaz A, Mochel F, Garnotel R. Adult-onset diagnosis of urea cycle disorders: Results of a French cohort of 71 patients. J Inherit Metab Dis 2021; 44:1199-1214. [PMID: 34014557 DOI: 10.1002/jimd.12403] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 12/19/2022]
Abstract
Urea cycle disorders (UCD) are rare diseases that usually affect neonates or young children. During decompensations, hyperammonemia is neurotoxic, leading to severe symptoms and even coma and death if not treated rapidly. The aim was to describe a cohort of patients with adult onset of UCDs in a multicentric, retrospective and descriptive study of French adult patients with a diagnosis after 16 years of age of UCDs due to a deficiency in one of the 6 enzymes (arginase, ASL, ASS, CPS1, NAGS, OTC) or the two transporters (ORNT1 or citrin). Seventy-one patients were included (68% female, 32% male). The diagnosis was made in the context of (a) a metabolic decompensation (42%), (b) family history (55%), or (c) chronic symptoms (3%). The median age at diagnosis was 33 years (range 16-86). Eighty-nine percent of patients were diagnosed with OTC deficiency, 7% CPS1 deficiency, 3% HHH syndrome and 1% argininosuccinic aciduria. For those diagnosed during decompensations (including 23 OTC cases, mostly female), 89% required an admission in intensive care units. Seven deaths were attributed to UCD-6 decompensations and 1 epilepsy secondary to inaugural decompensation. This is the largest cohort of UCDs diagnosed in adulthood, which confirms the triad of neurological, gastrointestinal and psychiatric symptoms during hyperammonemic decompensations. We stress that females with OTC deficiency can be symptomatic. With 10% of deaths in this cohort, UCDs in adults remain a life-threatening condition. Physicians working in adult care must be aware of late-onset presentations given the implications for patients and their families.
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Affiliation(s)
- Ségolène Toquet
- Service de Médecine Interne, Hôpital Robert Debré, CHU Reims, France
| | | | - Claire Douillard
- Service d'Endocrinologie et Métabolismes, Hôpital Claude Huriez, Centre de Référence des Maladies Héréditaires du métabolisme, CHU Lille, France
| | - François Maillot
- Service de Médecine Interne, Hôpital Bretonneau, CHRU de Tours, France
| | - Jean-Baptiste Arnoux
- Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Necker-Enfants Malades, CHU Paris, France
| | - Lena Damaj
- Service de Pédiatrie, CHU Hôpital Sud, Rennes, France
| | - Sylvie Odent
- Service de Génétique Clinique, CHU Hôpital Sud, Rennes, France
| | - Caroline Moreau
- Service de Biochimie et Toxicologie, CHU Pontchaillou, Rennes, France
| | | | - Samir Mesli
- Laboratoire de Biochimie, Hôpital Pellegrin, CHU Bordeaux, France
| | - Aude Servais
- Service de Néphrologie adulte, Hôpital Necker-Enfants Malades, CHU Paris, France
| | - Esther Noel
- Service de Médecine Interne, Hôpital Universitaire de Strasbourg, CHRU Strasbourg, France
| | - Sybill Charriere
- Fédération d'endocrinologie, maladies métaboliques, diabète et nutrition, Hôpital Louis Pradel, Centre de Référence des Maladies Héréditaires du Métabolisme, Bron, France
| | | | | | - Elsa Kaphan
- Pôle de Neurosciences Cliniques, CHU Timone, AP-HM, Marseille, France
| | - Agathe Roubertie
- Département de neuropédiatrie, Hôpital Gui de Chauliac, CHU Montpellier, France
| | | | - Adrien Bigot
- Service de Médecine Interne, Hôpital Bretonneau, CHRU de Tours, France
| | - Amélie Servettaz
- Service de Médecine Interne, Hôpital Robert Debré, CHU Reims, France
| | - Fanny Mochel
- Département de génétique, Hôpital Pitié-Salpêtrière, CHU Paris, France
| | - Roselyne Garnotel
- Laboratoire de Biochimie-Pharmacologie-Toxicologie, CHU Reims, France
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30
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Servais A, Karras A, Delmas Y, Pouteil Noble C, Choukroun G, Golbin L, Lemoine S, Provot F, Mathian A, Fremeaux-Bacchi V. Analyse du complément chez des patients ayant une microangiopathie thrombotique associée au lupus : identification de variants rares du facteur I. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.211] [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: 10/20/2022]
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31
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Servais A, Emma F, Deschenes G, Bertholet Thomas A, Ariceta G, Levtchenko E, Novo R, Sandrine L, Chauveau D, Niaudet P. RaDiCo-ECYSCO, une cohorte européenne dédiée à la cystinose. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.293] [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: 11/30/2022]
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Boyer O, Dorval G, Servais A. The genetics of steroid-resistant nephrotic syndrome in adults. Nephrol Dial Transplant 2021; 36:1600-1602. [PMID: 32040156 DOI: 10.1093/ndt/gfz257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Olivia Boyer
- Néphrologie Pédiatrique, Centre de référence MARHEA, Hôpital Necker-Enfants Malades, APHP, Paris, France.,Inserm U1163, Institut Imagine, Université de Paris, Paris, France
| | - Guillaume Dorval
- Néphrologie Pédiatrique, Centre de référence MARHEA, Hôpital Necker-Enfants Malades, APHP, Paris, France.,Inserm U1163, Institut Imagine, Université de Paris, Paris, France
| | - Aude Servais
- Inserm U1163, Institut Imagine, Université de Paris, Paris, France.,Néphrologie et Transplantation, Centre de référence MARHEA, Hôpital Necker-Enfants Malades, APHP, Paris, France
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Dorval G, Servais A, Boyer O. Erratum. Nephrol Dial Transplant 2021; 36:1556. [PMID: 33351149 DOI: 10.1093/ndt/gfaa325] [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: 11/12/2022] Open
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Emma F, Hoff WV, Hohenfellner K, Topaloglu R, Greco M, Ariceta G, Bettini C, Bockenhauer D, Veys K, Pape L, Hulton S, Collin S, Ozaltin F, Servais A, Deschênes G, Novo R, Bertholet-Thomas A, Oh J, Cornelissen E, Janssen M, Haffner D, Ravà L, Antignac C, Devuyst O, Niaudet P, Levtchenko E. An international cohort study spanning five decades assessed outcomes of nephropathic cystinosis. Kidney Int 2021; 100:1112-1123. [PMID: 34237326 DOI: 10.1016/j.kint.2021.06.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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] [Received: 03/02/2021] [Revised: 05/27/2021] [Accepted: 06/07/2021] [Indexed: 11/18/2022]
Abstract
Nephropathic cystinosis is a rare disease secondary to recessive mutations of the CTNS gene encoding the lysosomal cystine transporter cystinosin, causing accumulation of cystine in multiple organs. Over the years, the disease has evolved from being a fatal condition during early childhood into a treatable condition, with patients surviving into adulthood. Data on cystinosis are limited by the rarity of the disease. Here, we have investigated factors associated with kidney and growth outcome in a very large cohort of 453 patients born between 1964 and 2016 and followed in Belgium, Germany, Austria, France, Italy, Spain, The Netherlands, Turkey and United Kingdom. From the 1970s to the 1990s, the median increase in kidney survival was 9.1 years. During these years, cysteamine, a cystine-depleting agent, was introduced for the treatment of cystinosis. Significant risk factors associated with early progression to end-stage kidney disease assessed by Cox proportional multivariable analysis included delayed initiation of cysteamine therapy and higher mean leucocyte cystine levels. No significant effect on kidney function was observed for gender, pathogenic variant of the CTNS gene, and the prescription of indomethacin or renin angiotensin system blockers. Significantly improved linear growth was associated with early use of cysteamine and lower leukocyte cystine levels. Thus, our study provides strong evidence in favor of early diagnosis and optimization of cystine depletion therapy in nephropathic cystinosis.
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Affiliation(s)
- Francesco Emma
- Department of Pediatric Subspecialties, Division of Nephrology, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy.
| | - William Van't Hoff
- Renal Unit, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Katharina Hohenfellner
- Department of Pediatric Nephrology, Children's Hospital RoMed Clinics Rosenheim, Rosenheim, Germany
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Marcella Greco
- Department of Pediatric Subspecialties, Division of Nephrology, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Gema Ariceta
- Division of Pediatric Nephrology, Hospital Universitari Vall d' Hebron, Barcelona, Spain
| | - Chiara Bettini
- Department of Pediatric Subspecialties, Division of Nephrology, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Detlef Bockenhauer
- Renal Unit, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK; Department of Renal Medicine, University College London, London, UK
| | - Koenraad Veys
- Department of Pediatric Nephrology and Development and Regeneration, University Hospitals Leuven, Leuven, Belgium
| | - Lars Pape
- Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sally Hulton
- Department of Paediatric Nephrology, Birmingham Women's and Children's Hospital NHS Trust, Birmingham, UK
| | - Suzanne Collin
- Renal Unit, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Fatih Ozaltin
- Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Turkey; Nephrogenetic Laboratory, Hacettepe University School of Medicine, Ankara, Turkey
| | - Aude Servais
- Paris Descartes University, Imagine Institute, Inserm U1163, Paris, France; Adult Nephrology and Transplantation, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Necker Hospital, Paris, France
| | - Georges Deschênes
- Department of Pediatric Nephrology, Robert Debré Hospital, University of Paris, Paris, France
| | - Robert Novo
- Department of Paediatric Nephrology, University Hospital of Lille, Lille, France
| | | | - Jun Oh
- Department of Pediatric Nephrology, Pediatric Hepatology and Pediatric Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elisabeth Cornelissen
- Department of Pediatric Nephrology, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, the Netherlands
| | - Mirian Janssen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Lucilla Ravà
- Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Corinne Antignac
- Paris Descartes University, Imagine Institute, Laboratory of Hereditary Kidney Diseases, INSERM UMR 1163, Paris, France; Department of Genetics, AP-HP, Hôpital Necker-Enfants Malades, Paris, France
| | - Olivier Devuyst
- Division of Nephrology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium; Mechanisms of Inherited Kidney Disorders Group, University of Zurich, Zurich, Switzerland
| | - Patrick Niaudet
- Pediatric Nephrology, Hôpital Necker-Enfants Malades, Paris University, Paris, France
| | - Elena Levtchenko
- Department of Pediatric Nephrology and Development and Regeneration, University Hospitals Leuven, Leuven, Belgium
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Gendreau S, Servais A, Cohen C. The Case | Atrophic kidney and ocular abnormalities. Kidney Int 2021; 98:1059-1060. [PMID: 32998802 DOI: 10.1016/j.kint.2020.04.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Ségolène Gendreau
- Néphrologie et Transplantation, Centre de référence maladies rénales héréditaires de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Assistance publique - Hôpitaux de Paris, Paris, France
| | - Aude Servais
- Néphrologie et Transplantation, Centre de référence maladies rénales héréditaires de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Assistance publique - Hôpitaux de Paris, Paris, France; Institut national de la santé et de la recherche médicale U1163, Institut Imagine, Université de Paris, Paris, France
| | - Camille Cohen
- Néphrologie et Transplantation, Centre de référence maladies rénales héréditaires de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Assistance publique - Hôpitaux de Paris, Paris, France; Institut national de la santé et de la recherche médicale U1151, Necker Hospital, Paris, France.
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36
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Bassanese G, Wlodkowski T, Servais A, Heidet L, Roccatello D, Emma F, Levtchenko E, Ariceta G, Bacchetta J, Capasso G, Jankauskiene A, Miglinas M, Ferraro PM, Montini G, Oh J, Decramer S, Levart TK, Wetzels J, Cornelissen E, Devuyst O, Zurowska A, Pape L, Buescher A, Haffner D, Marcun Varda N, Ghiggeri GM, Remuzzi G, Konrad M, Longo G, Bockenhauer D, Awan A, Andersone I, Groothoff JW, Schaefer F. The European Rare Kidney Disease Registry (ERKReg): objectives, design and initial results. Orphanet J Rare Dis 2021; 16:251. [PMID: 34078418 PMCID: PMC8173879 DOI: 10.1186/s13023-021-01872-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The European Rare Kidney Disease Reference Network (ERKNet) recently established ERKReg, a Web-based registry for all patients with rare kidney diseases. The main objectives of this core registry are to generate epidemiological information, identify current patient cohort for clinical research, explore diagnostic and therapeutic management practices, and monitor treatment performance and patient's outcomes. The registry has a modular design that allows to integrate comprehensive disease-specific registries as extensions to the core database. The diagnosis (Orphacode) and diagnostic information (clinical, imaging, histopathological, biochemical, immunological and genetic) are recorded. Anthropometric, kidney function, and disease-specific management and outcome items informing a set of 61 key performance indicators (KPIs) are obtained annually. Data quality is ensured by automated plausibility checks upon data entry and regular offline database checks prompting queries. Centre KPI statistics and benchmarking are calculated automatically. RESULTS Within the first 24 months since its launch, 7607 patients were enrolled to the registry at 45 pediatric and 12 specialized adult nephrology units from 21 countries. A kidney disease diagnosis had been established in 97.1% of these patients at time of enrolment. While 199 individual disease entities were reported by Orphacode, 50% of the cohort could be classified with 11, 80% with 43 and 95% with 92 codes. Two kidney diagnoses were assigned in 6.5% of patients; 5.9% suffered from syndromic disease. Whereas glomerulopathies (54.8%) and ciliopathies including autosomal dominant polycystic kidney disease (ADPKD) (31.5%) were the predominant disease groups among adults, the pediatric disease spectrum encompassed congenital anomalies of the kidney and urinary tract (CAKUT) (33.7%), glomerulopathies (30.7%), ciliopathies (14.0%), tubulopathies (9.2%), thrombotic microangiopathies (5.6%), and metabolic nephropathies (4.1%). Genetically confirmed diagnoses were reported in 24% of all pediatric and 12% adult patients, whereas glomerulopathies had been confirmed by kidney biopsy in 80.4% adult versus 38.5% pediatric glomerulopathy cases. CONCLUSIONS ERKReg is a rapidly growing source of epidemiological information and patient cohorts for clinical research, and an innovative tool to monitor management quality and patient outcomes.
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Affiliation(s)
- Giulia Bassanese
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Tanja Wlodkowski
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Aude Servais
- Nephrology and Transplantation Department, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Necker University Hospital, APHP, Université de Paris, Paris, France
| | - Laurence Heidet
- APHP, Pediatric Nephrology Unit, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France
| | - Dario Roccatello
- Nephrology and Dialysis Unit, San Giovanni Hub Hospital and Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Francesco Emma
- Division of Nephrology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Elena Levtchenko
- Department of Pediatric Nephrology and Development and Regeneration, University Hospitals Leuven,, University of Leuven, Leuven, Belgium
| | - Gema Ariceta
- Department of Paediatric Nephrology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Justine Bacchetta
- Department of Paediatric Nephrology, Rheumatology and Dermatology, Reference Center for Rare Renal Diseases, Reference Center for Rare Diseases of Calcium and Phosphorus, University Children's Hospital, Lyon, France
| | - Giovambattista Capasso
- Department of Translational Medical Sciences, University Luigi Vanvitelli, Naples, Italy
| | - Augustina Jankauskiene
- Vilnius University Hospital Santaros Klinikos, Pediatric Center, Vilnius University, Vilnius, Lithuania
| | - Marius Miglinas
- Vilnius University Hospital Santaros Klinikos, Nephrology Center, Vilnius University, Vilnius, Lithuania
| | - Pietro Manuel Ferraro
- U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Montini
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione Ca' Granda IRCCS, Policlinico di Milano, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Jun Oh
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stephane Decramer
- Pediatric Nephrology, Internal Medicine and Rhumatology, Southwest Renal Rares Diseases Centre (SORARE), University Children's Hospital, Toulouse, France
| | - Tanja Kersnik Levart
- Pediatric Nephrology Department, Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Jack Wetzels
- Radboud University Medical Center, Nijmegen, Netherlands
| | - Elisabeth Cornelissen
- Department of Pediatric Nephrology, Radboudumc, Amalia Children's Hospital, Nijmegen, Netherlands
| | - Olivier Devuyst
- Division of Nephrology, UCLouvain Medical School, Brussels, Belgium.,Mechanisms of Inherited Kidney Disorders Group, Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Aleksandra Zurowska
- Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Gdańsk, Poland
| | - Lars Pape
- Department of Pediatrics II, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Anja Buescher
- Department of Pediatrics II, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Natasa Marcun Varda
- Department of Pediatrics, University Medical Center Maribor, Maribor, Slovenia
| | - Gian Marco Ghiggeri
- Division of Nephrology, Dialysis and Transplantation, Scientific Institute for Research and Health Care, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giuseppe Remuzzi
- Clinical Research Centre for Rare Diseases 'Aldo e Cele Daccò', Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Martin Konrad
- Department of Paediatric Nephrology, University Children's Hospital, Muenster, Germany
| | - Germana Longo
- Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy
| | - Detlef Bockenhauer
- Department of Renal Medicine, University College London and Paediatric Nephrology Unit, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Atif Awan
- Department of Nephrology, Children's Health Ireland, Dublin, Ireland
| | - Ilze Andersone
- Pediatric Clinic, Children's Clinical University Hospital, Riga, Latvia
| | - Jaap W Groothoff
- Department of Pediatric Nephrology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany.
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Dao M, Arnoux JB, Bienaimé F, Brassier A, Brazier F, Benoist JF, Pontoizeau C, Ottolenghi C, Krug P, Boyer O, de Lonlay P, Servais A. Long-term renal outcome in methylmalonic acidemia in adolescents and adults. Orphanet J Rare Dis 2021; 16:220. [PMID: 33985557 PMCID: PMC8120835 DOI: 10.1186/s13023-021-01851-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/04/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is one of the main long-term prognosis factors in methylmalonic acidemia (MMA), a rare disease of propionate catabolism. Our objective was to precisely address the clinical and biological characteristics of long-term CKD in MMA adolescent and adult patients. PATIENTS AND METHODS In this retrospective study, we included MMA patients older than 13 years who had not received kidney and/or liver transplantation. We explored tubular functions, with special attention to proximal tubular function. We measured glomerular filtration rate (mGFR) by iohexol clearance and compared it to estimated glomerular filtration rate (eGFR) by Schwartz formula and CKD-EPI. RESULTS Thirteen patients were included (M/F = 5/8). Median age was 24 years (13 to 32). Median mGFR was 57 mL/min/1.73 m2 (23.3 to 105 mL/min/1.73 m2). Ten out of 13 patients had mGFR below 90 mL/min/1.73 m2. No patient had significant glomerular proteinuria. No patient had complete Fanconi syndrome. Only one patient had biological signs suggestive of incomplete proximal tubulopathy. Four out of 13 patients had isolated potassium loss, related to a non-reabsorbable anion effect of urinary methylmalonate. Both Schwartz formula and CKD-EPI significantly overestimated GFR. Bias were respectively 16 ± 15 mL/min/1.73 m2 and 37 ± 22 mL/min/1.73 m2. CONCLUSION CKD is a common complication of the MMA. Usual equations overestimate GFR. Therefore, mGFR should be performed to inform therapeutic decisions such as dialysis and/or transplantation. Mild evidence of proximal tubular dysfunction was found in only one patient, suggesting that other mechanisms are involved.
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Affiliation(s)
- Myriam Dao
- Adult Nephrology and Transplantation Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.
- Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.
| | - Jean-Baptiste Arnoux
- Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Frank Bienaimé
- Department of Physiology, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Anaïs Brassier
- Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - François Brazier
- Department of Physiology, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Jean-François Benoist
- Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
- Biochemistry Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Clément Pontoizeau
- Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
- Biochemistry Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Chris Ottolenghi
- Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
- Biochemistry Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Pauline Krug
- Pediatric Nephrology Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Olivia Boyer
- Pediatric Nephrology Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Pascale de Lonlay
- Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
| | - Aude Servais
- Adult Nephrology and Transplantation Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
- Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France
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de Lonlay P, Posset R, Mütze U, Mention K, Lamireau D, Schiff M, Servais A, Arnoux JB, Brassier A, Dao M, Douillard C, Ottolenghi C, Pontoizeau C, Miotto F, Le Mouhaër J. Real-world management of maple syrup urine disease (MSUD) metabolic decompensations with branched chain amino acid-free formulas in France and Germany: A retrospective observational study. JIMD Rep 2021; 59:110-119. [PMID: 33977036 PMCID: PMC8100389 DOI: 10.1002/jmd2.12207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/16/2021] [Accepted: 02/03/2021] [Indexed: 11/25/2022] Open
Abstract
Maple syrup urine disease (MSUD) is a rare inborn metabolic disorder, managed with a strict protein-restricted diet. At any time or age patients may still experience metabolic decompensations, requiring administration of branched chain amino acid (BCAA)-free formula to reduce leucine levels. This retrospective observational study of 126 decompensation episodes from 54 MSUD patients treated at five centers in France and Germany from 2010 to 2016, describes episodes and outcomes for patients stratified into groups who received enteral/oral or intravenous (IV) BCAA-free formula, and by pediatric or adult age categories. IV administration of BCAA-free formula was required in cases of gastric intolerance (33%), refusal to undergo nasogastric tubing (31%), "emergency" (14%) or coma patients (8%), and as prophylaxis before surgery (6%). Overall, mean duration of hospitalization was 6.6 days with oral/enteral BCAA-free formula and 5.4 days with IV formula. Leucine levels at discharge decreased by a mean of 548.5 μmol/L (69.3%) in the oral/enteral group and 657.2 μmol/L (71.3%) in the IV group. In the pediatric subgroup, there were no marked differences between administration groups on any outcome. In the adult subgroup, mean time to episode resolution was 15.8 days in the oral/enteral group and 7.7 days in the IV group (P = .008); mean duration of hospitalization was 6 days in the oral/enteral group and 4.6 days in the IV group (P = NS). Overall, seven serious adverse events in two patients were reported, of which only nausea and vomiting were treatment related.
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Affiliation(s)
- Pascale de Lonlay
- Service et Centre de Référence des maladies métaboliquesHôpital Necker – Enfants Malades, APHP, Université de Paris, Filière G2MFrance
| | - Roland Posset
- Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Ulrike Mütze
- Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Karine Mention
- Unité Métabolisme et Centre de RéférencePôle Enfant, CHRU de Lille – Hôpital Jeanne de Flandre, Filière G2MLilleFrance
| | - Delphine Lamireau
- Centre de compétence des maladies métaboliquesCHU de Bordeaux‐GH Pellegrin, Filière G2MBordeauxFrance
| | - Manuel Schiff
- Service et Centre de Référence des maladies métaboliquesHôpital Necker – Enfants Malades, APHP, Université de Paris, Filière G2MFrance
| | - Aude Servais
- Service et Centre de Référence des maladies métaboliquesHôpital Necker – Enfants Malades, APHP, Université de Paris, Filière G2MFrance
| | - Jean Baptiste Arnoux
- Service et Centre de Référence des maladies métaboliquesHôpital Necker – Enfants Malades, APHP, Université de Paris, Filière G2MFrance
| | - Anaïs Brassier
- Service et Centre de Référence des maladies métaboliquesHôpital Necker – Enfants Malades, APHP, Université de Paris, Filière G2MFrance
| | - Myriam Dao
- Service et Centre de Référence des maladies métaboliquesHôpital Necker – Enfants Malades, APHP, Université de Paris, Filière G2MFrance
| | - Claire Douillard
- Service d'endocrinologie‐diabétologie‐métabolisme‐nutritionHôpital Huriez, CHRULilleFrance
| | - Chris Ottolenghi
- Service et Centre de Référence des maladies métaboliquesHôpital Necker – Enfants Malades, APHP, Université de Paris, Filière G2MFrance
| | - Clément Pontoizeau
- Service et Centre de Référence des maladies métaboliquesHôpital Necker – Enfants Malades, APHP, Université de Paris, Filière G2MFrance
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39
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Boyer O, Dorval G, Servais A. Errata. Nephrol Dial Transplant 2021; 36:951. [PMID: 32940696 DOI: 10.1093/ndt/gfaa185] [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: 11/14/2022] Open
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Lemoine S, Radenac J, Baudouin V, Belaiche S, Bertholet-Thomas A, Buebuyck N, Broux F, Burtey S, Champion G, Charbit M, Cochat P, De Parscau L, Delmas Y, Dunand O, Essig M, Guebre-Egziabher F, Langellier-Bellevue B, Leclerc AL, Merieau É, Moulin B, Perrin J, Rousiot D, Sartoris B, Servais A, Nagra A, Novo R. [Recommendations for management of patients from pediatrics unit to adult unit: Transition and transfer program]. Nephrol Ther 2021; 17:137-142. [PMID: 33531259 DOI: 10.1016/j.nephro.2020.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Sandrine Lemoine
- Service de néphrologie et d'exploration fonctionnelle rénale, centre de référence maladies rénales rares néphrogones, hôpital Édouard-Herriot, hospices civils de Lyon, filière ORKiD, Lyon, France
| | | | - Véronique Baudouin
- Service de néphrologie pédiatrique, centre hospitalo-universitaire Robert-Debré, Assistance publique-Hôpitaux de Paris, Paris, France
| | | | - Aurélia Bertholet-Thomas
- Service de néphrologie pédiatrique, hospices civils de Lyon, et centre de référence maladies rénales rares-néphrogones, filière ORKiD, Lyon, France
| | - Nathalie Buebuyck
- Service de néphrologie pédiatrique, hôpital Necker, centre de référence MARHEA, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Paris, France
| | - Françoise Broux
- Service de néphrologie et d'hémodialyse pédiatrique, hôpital Charles-Nicolle, CHU de Rouen, Rouen, France
| | - Stéphane Burtey
- Centre de néphrologie et transplantation rénale, hôpital de la Conception, Marseille, France
| | - Gérard Champion
- Service de néphrologie pédiatrique, CHU d'Angers, Angers, France
| | - Marina Charbit
- Service de néphrologie pédiatrique, hôpital Necker, centre de référence MARHEA, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Paris, France
| | - Pierre Cochat
- Service de néphrologie pédiatrique, hospices civils de Lyon, et centre de référence maladies rénales rares-néphrogones, filière ORKiD, Lyon, France
| | | | - Yahsou Delmas
- Service de néphrologie transplantation dialyse, CHU de Bordeaux, centre de référence SORARE, Bordeaux, France
| | - Olivier Dunand
- Service de néphrologie pédiatrique, CHU F-Guyon, Saint-Denis de La Réunion, La Réunion
| | - Marie Essig
- Service de néphrologie, hôpital Ambroise Paré, Paris, France
| | - Fitsum Guebre-Egziabher
- Service de néphrologie et d'exploration fonctionnelle rénale, centre de référence maladies rénales rares néphrogones, hôpital Édouard-Herriot, hospices civils de Lyon, filière ORKiD, Lyon, France
| | | | - Anne-Laure Leclerc
- Service de néphrologie pédiatrique, hospices civils de Lyon, et centre de référence maladies rénales rares-néphrogones, filière ORKiD, Lyon, France
| | - Élodie Merieau
- Service de néphrologie, hôpital Clocheville, Tours, France
| | - Bruno Moulin
- Service de néphrologie et transplantation, Nouvel Hôpital Civil, Strasbourg, France
| | - Justine Perrin
- Centre de néphrologie et transplantation rénale, hôpital de la Conception, Marseille, France
| | | | | | - Aude Servais
- Service de néphrologie et transplantation, hôpital Necker-Enfants malades, centre de référence MARHEA, Paris, France
| | - Arvind Nagra
- Service de néphrologie, Southampton Children's Hôpital, Southampton, Royaume-Uni
| | - Robert Novo
- Service de néphrologie pédiatrique, hôpital Jeanne-de-Flandre, CHU de Lille, filière ORKiD, Lille, France.
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Bérat CM, Roda C, Brassier A, Bouchereau J, Wicker C, Servais A, Dubois S, Assoun M, Belloche C, Barbier V, Leboeuf V, Petit FM, Gaignard P, Lebigot E, Bérat PJ, Pontoizeau C, Touati G, Talbotec C, Campeotto F, Ottolenghi C, Arnoux JB, de Lonlay Pascale P. Enteral tube feeding in patients receiving dietary treatment for metabolic diseases: A retrospective analysis in a large French cohort. Mol Genet Metab Rep 2021; 26:100655. [PMID: 33473351 PMCID: PMC7803652 DOI: 10.1016/j.ymgmr.2020.100655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 09/22/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 12/31/2022] Open
Abstract
Context A strictly controlled diet (often involving enteral tube feeding (ETF)) is part of the treatment of many inherited metabolic diseases (IMDs). Objective To describe the use of ETF in a large cohort of patients with IMDs. Design A retrospective analysis of ETF in patients with urea cycle disorders (UCDs), organic aciduria (OA), maple syrup disease (MSUD), glycogen storage diseases (GSDs) or fatty acid oxidation disorders (FAODs) diagnosed before the age of 12 months. Setting The reference center for IMDs at Necker Hospital (Paris, France). Results 190 patients born between January 1991 and August 2017 were being treated for OA (n = 60), UCDs (n = 55), MSUD (n = 32), GSDs (n = 26) or FAODs (n = 17). Ninety-eight of these patients (52%) received ETF (OA subgroup: n = 40 (67%); UCDs: n = 12 (22%); MSUD: n = 9 (28%); GSDs: n = 23 (88%); FAODs: n = 14 (82%)). Indications for ETF were feeding difficulties in 64 (65%) patients, cessation of fasting in 39 (40%), and recurrent metabolic decompensation in 14 (14%). Complications of ETF were recorded in 48% of cases, more frequently with nasogastric tube (NGT) than with gastrostomy. Among patients in whom ETF was withdrawn, the mean duration of ETF was 5.9 (SD: 4.8) years (range: 0.6–19.8 years). The duration of ETF was found to vary from one disease subgroup to another (p = 0.051). While the longest median duration was found in the GSD subgroup (6.8 years), the shortest one was found in the UCD subgroup (0.9 years). Conclusion ETF is an integral part of the dietary management of IMDs. The long duration of ETF and the specific risks of NGT highlights the potential value of gastrostomy. In this study at a French tertiary hospital, we documented the indications, modalities, duration and complications of enteral tube feeding in a cohort of patients with inherited metabolic diseases.
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Affiliation(s)
- Claire-Marine Bérat
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Célina Roda
- Université de Paris, CRESS, HERA team, INSERM, INRAE, F-75004 Paris, France
| | - Anais Brassier
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Juliette Bouchereau
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Camille Wicker
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Aude Servais
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Sandrine Dubois
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Murielle Assoun
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Claire Belloche
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Valérie Barbier
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Virginie Leboeuf
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - François M Petit
- Department of Molecular Genetics, Antoine Béclère Hospital, APHP, Université Paris Saclay, 92141 Clamart, Cedex, France
| | - Pauline Gaignard
- Department of Biochemistry, Bicêtre Hospital, APHP, Le Kremlin Bicêtre, France
| | - Elise Lebigot
- Department of Biochemistry, Bicêtre Hospital, APHP, Le Kremlin Bicêtre, France
| | - Pierre-Jean Bérat
- Department of Odontology, Louis Mourier Hospital, APHP, University Paris Descartes University, Paris, France
| | - Clément Pontoizeau
- Department of Biochemistry, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, metabERN, Paris Descartes University, Paris, France
| | - Guy Touati
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Cécile Talbotec
- Department of Gastroenterology, Hospital Necker Enfants Malades, APHP, Paris, France
| | - Florence Campeotto
- Department of Gastroenterology, Hospital Necker Enfants Malades, APHP, Paris, France
| | - Chris Ottolenghi
- Department of Biochemistry, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, metabERN, Paris Descartes University, Paris, France
| | - Jean-Baptiste Arnoux
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
| | - Pascale de Lonlay Pascale
- Reference Center for Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Filière G2M, MetabERN, INEM, University Paris Descartes, Paris, France
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Cambier A, Rabant M, El Karoui K, Peuchmaur M, Servais A, Hertig A, Deschenes G, Salomon R, Hogan J, Robert T. Clinical and histological differences between adults and children in new onset IgA nephropathy. Pediatr Nephrol 2020; 35:1897-1905. [PMID: 32444925 DOI: 10.1007/s00467-020-04614-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Previous reports suggest initial presentation of IgA nephropathy (IgAN) in children is different from adults. No systematic comparison of clinical, biological, and histological childhood- and adult-onset IgAN is currently available. METHODS We compared pediatric and adult clinical and histological characteristics at IgAN diagnosis. Data on 211 consecutive patients from two different centers in Paris (82 children, 129 adults) were reviewed. Kidney biopsies were scored for Oxford classification and podocytopathic (P1) features. RESULTS We report higher eGFR at diagnosis in children compared to adults (89.5 vs. 64 ml/min/1.73 m2; p = 0.0001) but no difference in proteinuria. Histological analysis of kidney biopsy found higher proportions of mesangial (M1) and endocapillary (E1) hypercellularity in children compared with adults (M1 [80.7% vs. 27.9%, p = 0.0001]; E1 [71.3% vs. 30%, p = 0.0001]). Focal glomerulosclerosis (S1), tubular atrophy/interstitial fibrosis ≥ 25% (T1), and P1 were more frequent in adults (S1 [81.5% vs. 61.3%, p = 0.0012], T1 [49.5% vs. 1.35%, p = 0.0001], P1 [33.8% vs. 16.4%, p = 0.008). Proteinuria associated with M1, E1, and C1 in children (M1, p = 0.0001; E1, p = 0.0005; C1, p = 0.0014) but S1, P1, and T1 in adults (S1, p = 0.0001; P1, p = 0.0001; T1, p = 0.001). After steroid treatment (41 children and 28 adults), proteinuria decreased in children (p < 0.001, follow-up 38 months) and adults (p < 0.001, follow-up 76.9 months), whereas eGFR remained stable in adults but increased significantly in children (90.6 to 110 ml/min/1.73m2). CONCLUSION Proteinuria in children with IgAN is a marker of glomerular proliferative lesions whereas its presence in adults often reflects the presence of chronic lesions. This suggests the need for histological assessment.
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Affiliation(s)
- Alexandra Cambier
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Robert-Debré, 48 Boulevard Serrurier, 75019, Paris, France.
| | - Marion Rabant
- Service de Pathologie, Hôpital Universitaire Hôpital Necker, APHP, Paris, France
| | - Khalil El Karoui
- Service de néphrologie et transplantation rénale, Hôpital Universitaire Henri-Mondor, Paris, France
| | - Michel Peuchmaur
- Service de Pathologie, Hôpital Universitaire Robert Debré APHP, Paris et Université Diderot, Paris, France
| | - Aude Servais
- Service de néphrologie et transplantation rénale, Hôpital Necker, APHP, Paris, France
| | - Alexandre Hertig
- Service des urgences néphrologiques et transplantation rénales, APHP, Hôpital Universitaire Tenon, Paris, France.,Université Pierre et Marie Curie Paris 6, Paris, France
| | - Georges Deschenes
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Robert-Debré, 48 Boulevard Serrurier, 75019, Paris, France
| | - Remi Salomon
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Necker, Paris, France
| | - Julien Hogan
- Service de néphrologie pédiatrique, APHP, Hôpital Universitaire Robert-Debré, 48 Boulevard Serrurier, 75019, Paris, France
| | - Thomas Robert
- Centre de néphrologie et transplantation rénale, APHM, Hôpital Universitaire de la Conception, 147 Bd Baille, 13385, Marseille, France.
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Servais A, Thomas K, Dello Strologo L, Sayer JA, Bekri S, Bertholet-Thomas A, Bultitude M, Capolongo G, Cerkauskiene R, Daudon M, Doizi S, Gillion V, Gràcia-Garcia S, Halbritter J, Heidet L, van den Heijkant M, Lemoine S, Knebelmann B, Emma F, Levtchenko E. Cystinuria: clinical practice recommendation. Kidney Int 2020; 99:48-58. [PMID: 32918941 DOI: 10.1016/j.kint.2020.06.035] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Cystinuria (OMIM 220100) is an autosomal recessive hereditary disorder in which high urinary cystine excretion leads to the formation of cystine stones because of the low solubility of cystine at normal urinary pH. We developed clinical practice recommendation for diagnosis, surgical and medical treatment, and follow-up of patients with cystinuria. Elaboration of these clinical practice recommendations spanned from June 2018 to December 2019 with a consensus conference in January 2019. Selected topic areas were chosen by the co-chairs of the conference. Working groups focusing on specific topics were formed. Group members performed systematic literature review using MEDLINE, drafted the statements, and discussed them. They included geneticists, medical biochemists, pediatric and adult nephrologists, pediatric and adult urologists experts in cystinuria, and the Metabolic Nephropathy Joint Working Group of the European Reference Network for Rare Kidney Diseases (ERKNet) and eUROGEN members. Overall 20 statements were produced to provide guidance on diagnosis, genetic analysis, imaging techniques, surgical treatment (indication and modalities), conservative treatment (hydration, dietetic, alkalinization, and cystine-binding drugs), follow-up, self-monitoring, complications (renal failure and hypertension), and impact on quality of life. Because of the rarity of the disease and the poor level of evidence in the literature, these statements could not be graded. This clinical practice recommendation provides guidance on all aspects of the management of both adults and children with cystinuria, including diagnosis, surgery, and medical treatment.
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Affiliation(s)
- Aude Servais
- Nephrology and Transplantation Department, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Necker Hospital, APHP, Université de Paris, Paris, France.
| | - Kay Thomas
- Stone Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Luca Dello Strologo
- Renal Transplant Clinic, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - John A Sayer
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, UK; The Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK
| | - Soumeya Bekri
- Department of Metabolic Biochemistry, Rouen University Hospital, Rouen, France
| | - Aurelia Bertholet-Thomas
- Centre de Référence des Maladies Rénales Rares, Filière ORKID, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Université Claude-Bernard Lyon 1, Lyon, France
| | | | - Giovanna Capolongo
- Unit of Nephrology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Michel Daudon
- UMR S 1155 and Physiology Unit, AP-HP, Hôpital Tenon, Sorbonne Université and INSERM, Paris, France
| | - Steeve Doizi
- Sorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Service d'Urologie, Hôpital Tenon, AP-HP, Paris, France
| | - Valentine Gillion
- Département de Néphrologie adulte, Cliniques universitaires Saint Luc, Bruxelles, Belgium
| | - Silvia Gràcia-Garcia
- Laboratory of Renal Lithiasis, Clinical Laboratories, Fundació Puigvert, Barcelona, Spain
| | - Jan Halbritter
- Division of Nephrology, Department of Endocrinology, Nephrology, and Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Laurence Heidet
- Néphrologie Pédiatrique, Centre de Référence MARHEA, Hôpital universitaire Necker-Enfants Malades, Paris, France
| | - Marleen van den Heijkant
- Pediatric Renal Center, University Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sandrine Lemoine
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; University of Lyon, Lyon, France
| | - Bertrand Knebelmann
- Nephrology and Transplantation Department, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Necker Hospital, APHP, Université de Paris, Paris, France
| | - Francesco Emma
- Division of Nephrology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Elena Levtchenko
- Division of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
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Pereira LCV, Ercig B, Kangro K, Jamme M, Malot S, Galicier L, Poullin P, Provôt F, Presne C, Kanouni T, Servais A, Benhamou Y, Daguindau N, Vanhoorelbeke K, Azoulay E, Veyradier A, Coppo P. Understanding the Health Literacy in Patients With Thrombotic Thrombocytopenic Purpura. Hemasphere 2020; 4:e462. [PMID: 32885148 PMCID: PMC7430230 DOI: 10.1097/hs9.0000000000000462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/07/2020] [Accepted: 06/29/2020] [Indexed: 12/21/2022] Open
Abstract
Following an acute thrombotic thrombocytopenic purpura (TTP) episode, patients are at risk for relapse, and a careful long-term follow-up is needed. Adherence to the follow-up by patients implies a good understanding of the disease. However, TTP literacy in patients is currently unknown. To explore the TTP literacy in patients and identify factors associated with poor disease understanding, a questionnaire was developed focusing on patient's characteristics, knowledge about TTP and patients’ actions in an emergency. The questionnaire was presented to 120 TTP patients in remission from the French National Registry for Thrombotic Microangiopathies. TTP literacy was low in 24%, intermediate in 43% and high in 33% of the patients. Low TTP literacy was associated with older age and low education level. Among the knowledge gaps identified, few patients knew that plasma exchange in acute phase is mandatory and has to be done daily (39%), 47% of participants did not consider themselves at risk for relapse, and 30% of women did not know that pregnancy exposes them to a greater risk of relapse. Importantly, few patients responded about life-saving actions in an emergency. Hence, the design of educational material should pay special attention to the age and education level of the target population focusing on the events leading to TTP, the importance of the emergency treatment, controllable predisposing factors for TTP development and patient attitude in an emergency.
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Affiliation(s)
- Leydi C Velasquez Pereira
- Laboratory for Thrombosis Research, IRF Life Sciences, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Bogac Ercig
- Department of Plasma Proteins, Sanquin-Academic Medical Center Landsteiner Laboratory, Amsterdam, the Netherlands
| | - Kadri Kangro
- Laboratory for Thrombosis Research, IRF Life Sciences, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Matthieu Jamme
- Médecine Intensive Réanimation-Néphrologie, CH de Poissy Saint Germain en Laye, Poissy, Centre de Recherche en Epidémiologie et Santé des Populations, INSERM U1018, Paris-Sud University, Villejuif, France
| | - Sandrine Malot
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France
| | - Lionel Galicier
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,Department of Clinical Immunology, Hôpital Saint-Louis, AP-HP, Université Paris-Diderot, Paris, France.,National Reference Center for Castleman Disease (CRMdC), Paris, France.,EA3518, Université Paris-Diderot, Paris, France
| | - Pascale Poullin
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,Department of Apheresis, Regional Reference Center for Thrombotic Microangiopathy, Aix-Marseille University, CHU de Marseille-Hôpital de la Conception, Marseille, France
| | - François Provôt
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,Service de Néphrologie, Hôpital Albert Calmette, Lille, France
| | - Claire Presne
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,Service de Néphrologie, Hôpital Sud, CHU Amiens, Amiens, France
| | - Tarik Kanouni
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,Service d'Hématologie, CHU Saint Eloi, Montpellier, France
| | - Aude Servais
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,Service de Néphrologie-Dialyse Adulte, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Ygal Benhamou
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,Service de Médecine Interne, U1096, UNIROUEN, Normandie Universitaire, Rouen, France
| | | | - Karen Vanhoorelbeke
- Laboratory for Thrombosis Research, IRF Life Sciences, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Elie Azoulay
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,Medical ICU, Saint-Louis Hospital, AP-HP, ECSTRA Team, and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics, Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France
| | - Agnès Veyradier
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,service d'Hématologie Biologique, Groupe Hospitalier Saint-Louis-Lariboisière, AP-HP, Université Paris-Diderot, Paris, France.,EA3518 Recherche Clinique en Hématologie, Immunologie et Transplantation, Équipe Microangiopathies Thrombotiques, ADAMTS13 et Facteur Willebrand, Institut de Recherche Saint-Louis, Université Paris-Diderot, Paris, France
| | - Paul Coppo
- Centre de Référence des Microangiopathies Thrombotiques, AP-HP.6, Paris, France.,service d'Hématologie et Sorbonne Université, AP-HP.6, Paris, France.,Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris-Diderot, Paris, France
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Servais A, Gueguen S, Georges D, Aurélia B, Sandrine L, Robert N, Lamia T, Marine R, Serge A, Patrick N. RaDiCo-ECYSCO, une cohorte européenne dédiée à la cystinose. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.147] [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: 11/28/2022]
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Bedin M, Boyer O, Servais A, Li Y, Villoing-Gaudé L, Tête MJ, Cambier A, Hogan J, Baudouin V, Krid S, Bensman A, Lammens F, Louillet F, Ranchin B, Vigneau C, Bouteau I, Isnard-Bagnis C, Mache CJ, Schäfer T, Pape L, Gödel M, Huber TB, Benz M, Klaus G, Hansen M, Latta K, Gribouval O, Morinière V, Tournant C, Grohmann M, Kuhn E, Wagner T, Bole-Feysot C, Jabot-Hanin F, Nitschké P, Ahluwalia TS, Köttgen A, Andersen CBF, Bergmann C, Antignac C, Simons M. Human C-terminal CUBN variants associate with chronic proteinuria and normal renal function. J Clin Invest 2020; 130:335-344. [PMID: 31613795 DOI: 10.1172/jci129937] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/02/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUNDProteinuria is considered an unfavorable clinical condition that accelerates renal and cardiovascular disease. However, it is not clear whether all forms of proteinuria are damaging. Mutations in CUBN cause Imerslund-Gräsbeck syndrome (IGS), which is characterized by intestinal malabsorption of vitamin B12 and in some cases proteinuria. CUBN encodes for cubilin, an intestinal and proximal tubular uptake receptor containing 27 CUB domains for ligand binding.METHODSWe used next-generation sequencing for renal disease genes to genotype cohorts of patients with suspected hereditary renal disease and chronic proteinuria. CUBN variants were analyzed using bioinformatics, structural modeling, and epidemiological methods.RESULTSWe identified 39 patients, in whom biallelic pathogenic variants in the CUBN gene were associated with chronic isolated proteinuria and early childhood onset. Since the proteinuria in these patients had a high proportion of albuminuria, glomerular diseases such as steroid-resistant nephrotic syndrome or Alport syndrome were often the primary clinical diagnosis, motivating renal biopsies and the use of proteinuria-lowering treatments. However, renal function was normal in all cases. By contrast, we did not found any biallelic CUBN variants in proteinuric patients with reduced renal function or focal segmental glomerulosclerosis. Unlike the more N-terminal IGS mutations, 37 of the 41 proteinuria-associated CUBN variants led to modifications or truncations after the vitamin B12-binding domain. Finally, we show that 4 C-terminal CUBN variants are associated with albuminuria and slightly increased GFR in meta-analyses of large population-based cohorts.CONCLUSIONCollectively, our data suggest an important role for the C-terminal half of cubilin in renal albumin reabsorption. Albuminuria due to reduced cubilin function could be an unexpectedly common benign condition in humans that may not require any proteinuria-lowering treatment or renal biopsy.FUNDINGATIP-Avenir program, Fondation Bettencourt-Schueller (Liliane Bettencourt Chair of Developmental Biology), Agence Nationale de la Recherche (ANR) Investissements d'avenir program (ANR-10-IAHU-01) and NEPHROFLY (ANR-14-ACHN-0013, to MS), Steno Collaborative Grant 2018 (NNF18OC0052457, to TSA and MS), Heisenberg Professorship of the German Research Foundation (KO 3598/5-1, to AK), Deutsche Forschungsgemeinschaft (DFG) Collaborative Research Centre (SFB) KIDGEM 1140 (project 246781735, to CB), and Federal Ministry of Education and Research (BMB) (01GM1515C, to CB).
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Affiliation(s)
| | - Olivia Boyer
- Laboratory of Hereditary Kidney Disease, Imagine Institute, INSERM U1163, Université de Paris, Paris, France.,Department of Pediatric Nephrology and
| | - Aude Servais
- Laboratory of Hereditary Kidney Disease, Imagine Institute, INSERM U1163, Université de Paris, Paris, France.,Department of Nephrology, Necker Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Yong Li
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Marie-Josephe Tête
- Laboratory of Hereditary Kidney Disease, Imagine Institute, INSERM U1163, Université de Paris, Paris, France
| | - Alexandra Cambier
- Department of Pediatric Nephrology and Transplantation, Robert-Debré Hospital, APHP, Paris, France
| | - Julien Hogan
- Department of Pediatric Nephrology and Transplantation, Robert-Debré Hospital, APHP, Paris, France
| | - Veronique Baudouin
- Department of Pediatric Nephrology and Transplantation, Robert-Debré Hospital, APHP, Paris, France
| | | | | | - Florie Lammens
- Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | | | - Bruno Ranchin
- Department of Pediatric Nephrology, Hospices Civils de Lyon, Bron, France
| | - Cecile Vigneau
- Centre Hospitalier Universitaire de Rennes, INSERM U1085 IRSET-9, Rennes, France
| | - Iseline Bouteau
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | | | | | - Tobias Schäfer
- Renal Division, University Medical Center Freiburg, Freiburg, Germany
| | - Lars Pape
- Department of Pediatric Kidney, Liver and Metabolic Disease, Hannover Medical School, Hannover, Germany
| | - Markus Gödel
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias B Huber
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Günter Klaus
- Department of Child and Adolescent Medicine, University Medical Center Marburg-Giessen, Marburg, Germany
| | - Matthias Hansen
- KfH-Nierenzentrum für Kinder und Jugendliche und Clementine-Kinderhospital, Frankfurt, Germany
| | - Kay Latta
- KfH-Nierenzentrum für Kinder und Jugendliche und Clementine-Kinderhospital, Frankfurt, Germany
| | - Olivier Gribouval
- Laboratory of Hereditary Kidney Disease, Imagine Institute, INSERM U1163, Université de Paris, Paris, France
| | | | - Carole Tournant
- Department of Genetics, Necker Hospital, APHP, Paris, France
| | - Maik Grohmann
- Center for Human Genetics, Bioscientia, Ingelheim, Germany.,Center for Human Genetics, Mainz, Germany
| | - Elisa Kuhn
- Center for Human Genetics, Bioscientia, Ingelheim, Germany
| | - Timo Wagner
- Center for Human Genetics, Bioscientia, Ingelheim, Germany
| | - Christine Bole-Feysot
- Bioinformatic Platform, INSERM UMR 1163, Institut Imagine, Paris, France.,Bioinformatics Core Facility, Structure Fédérative de Recherche Necker, INSERM US24/CNRS UMS3633, Université de Paris, Paris, France
| | - Fabienne Jabot-Hanin
- Bioinformatic Platform, INSERM UMR 1163, Institut Imagine, Paris, France.,Bioinformatics Core Facility, Structure Fédérative de Recherche Necker, INSERM US24/CNRS UMS3633, Université de Paris, Paris, France
| | - Patrick Nitschké
- Bioinformatic Platform, INSERM UMR 1163, Institut Imagine, Paris, France.,Bioinformatics Core Facility, Structure Fédérative de Recherche Necker, INSERM US24/CNRS UMS3633, Université de Paris, Paris, France
| | | | - Anna Köttgen
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Carsten Bergmann
- Center for Human Genetics, Bioscientia, Ingelheim, Germany.,Center for Human Genetics, Mainz, Germany.,Renal Division, Department of Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Corinne Antignac
- Laboratory of Hereditary Kidney Disease, Imagine Institute, INSERM U1163, Université de Paris, Paris, France.,Department of Genetics, Necker Hospital, APHP, Paris, France
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Webb N, Das AM, Hulton S, Levtchenko E, Servais A, Wanner C. P0075EXPERT OPINION ON THE MULTIDISCIPLINARY MANAGEMENT OF CYSTINOSIS IN ADOLESCENT AND ADULT PATIENTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0075] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Cystinosis is a rare autosomal recessive lysosomal storage disorder caused by mutations in the CTNS gene on chromosome 17p13. It affects between 1:150,000–1:200,000 live births, with a prevalence of approximately 1.6 per million. It is a life-long progressive disease which results in an abnormal lysosomal accumulation of the amino acid cystine in multiple organs and tissues of the body. The most common presentation of cystinosis (95%) is the infantile nephropathic form, with renal symptoms developing in the first few months of life. Over the next 10–20 years, extra-renal manifestations of cystinosis become apparent, which require multidisciplinary care. Here we describe a consensus-based programme with the objective of creating clinical recommendations to support HCPs with the management of adolescents and adults living with the multi-organ effects of cystinosis.
Method
The programme was led by a Steering Committee (SC) of European clinicians with expertise in managing cystinosis. Recommendations were developed using a quasi-Delphi methodology. The SC identified and prioritised a list of key questions. An Extended Faculty (EF) of additional specialists with extensive experience managing cystinosis in patients of all ages, were invited to answer the questions via an online digital platform. The consolidated answers of expert opinion were summarised into recommendations that were supported by evidence-based guidance and additional published data where possible. The EF were invited to agree / disagree with the draft clinical recommendations. Where there was disagreement, the SC members amended the recommendations and the EF re-voted on the revisions. This process continued until consensus was achieved on all final recommendations.
Results
The expert-agreed clinical recommendations reflect the multi-organ effects of cystinosis. Thus, advice on factors relating to the nervous system, muscle involvement, ophthalmology, cardio-respiratory system, dental care and nutrition, dermatology, endocrine system, and gastrointestinal and hepatological involvement, are given, along with renal considerations. Guidance on fertility and family planning that reflect some of the major advances in recent years, are also provided. Ideas on improving psychological well-being and adherence includes recommendations on the use of validated screening tests, increasing access to occupational therapy, and interacting with patient groups. The programme has also produced an online checklist to support HCPs in their daily clinical practice by providing a focus to guide regular consultations with the patient.
Conclusion
These expert recommendations offer HCPs relevant advice that support them in the management of adolescents and adults living with the multi-organ effects of cystinosis. The recommendations complement existing international and local guidance and aim to improve patient outcomes.
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Affiliation(s)
- Nicholas Webb
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Anibh M Das
- Klinik für Päd. Nieren-, Leber- und Stoffwechselerkrankungen, Hannover, Germany
| | - Sally Hulton
- Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Aude Servais
- APHP - Hôpital Necker Enfants Malades Néphrologie, Paris, France
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Pontoizeau C, Roda C, Arnoux JB, Vignolo-Diard P, Brassier A, Habarou F, Barbier V, Grisel C, Abi-Warde MT, Boddaert N, Kuster A, Servais A, Kaminska A, Hennequin C, Dupic L, Lesage F, Touati G, Valayannopoulos V, Chadefaux-Vekemans B, Oualha M, Eisermann M, Ottolenghi C, de Lonlay P. Neonatal factors related to survival and intellectual and developmental outcome of patients with early-onset urea cycle disorders. Mol Genet Metab 2020; 130:110-117. [PMID: 32273051 DOI: 10.1016/j.ymgme.2020.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/14/2020] [Accepted: 03/14/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE We aimed to identify prognostic factors for survival and long-term intellectual and developmental outcome in neonatal patients with early-onset urea cycle disorders (UCD) experiencing hyperammonaemic coma. METHODS We retrospectively analysed ammonia (NH3) and glutamine levels, electroencephalogram and brain images obtained during neonatal coma of UCD patients born between 1995 and 2011 and managed at a single centre and correlated them to survival and intellectual and developmental outcome. RESULTS We included 38 neonates suffering from deficiencies of argininosuccinate synthetase (ASSD, N = 12), ornithine transcarbamylase (OTCD, N = 10), carbamoylphosphate synthetase 1 (CPSD, N = 7), argininosuccinate lyase (ASLD, N = 7), N-acetylglutamate synthase (NAGS, N = 1) or arginase (ARGD, N = 1). Symptoms occurred earlier in mitochondrial than in cytosolic UCD. Sixty-eight percent of patients survived, with a mean (standard deviation-SD) follow-up of 10.4 (5.3) years. Mortality was mostly observed in OTCD (N = 7/10) and CPSD (N = 4/7) patients. Plasma NH3 level during the neonatal period, expressed as area under the curve, but not glutamine level was associated with mortality (p = .044 and p = .610). 62.1% of the patients had normal intellectual and developmental outcome. Intellectual and developmental outcome tended to correlate with UCD subtype (p = .052). No difference in plasma NH3 or glutamine level during the neonatal period among developmental outcomes was identified. EEG severity was linked to UCD subtypes (p = .004), ammonia levels (p = .037), duration of coma (p = .043), and mortality during the neonatal period (p = .020). Status epilepticus was recorded in 6 patients, 3 of whom died neonatally, 1 developed a severe intellectual disability while the 2 last patients had a normal development. CONCLUSION UCD subtypes differed by survival rate, intellectual and developmental outcome and EEG features in the neonatal period. Hyperammonaemia expressed as area under the curve was associated with survival but not with intellectual and developmental outcome whereas glutamine was not associated with one of these outcomes. Prognostic value of video-EEG monitoring and the association between status epilepticus and mortality should be assessed in neonatal hyperammonaemic coma in further studies.
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Affiliation(s)
- Clément Pontoizeau
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France; Metabolomics Unit, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France.
| | - Célina Roda
- Université de Paris, CRESS, INSERM, INRA, HERA team (Health Environmental Risk Assessment), F-75004 Paris, France
| | - Jean-Baptiste Arnoux
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France
| | | | - Anais Brassier
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France
| | - Florence Habarou
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France; Metabolomics Unit, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Valérie Barbier
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France
| | - Coraline Grisel
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France
| | - Marie-Thérèse Abi-Warde
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France
| | - Nathalie Boddaert
- Department of Pediatric Radiology, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, PRES Sorbonne Paris Cité, INSERM U1000, Institut Imagine, Paris, France
| | - Alice Kuster
- Pediatric Critical Care Unit, Femme-Enfants-Adolescents Hospital, Nantes University, Nantes, France
| | - Aude Servais
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France; Department of Nephrology, Transplantation, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Anna Kaminska
- Neurophysiology Unit, AP-HP, Necker Enfants Malades Hospital, Paris, France
| | - Carole Hennequin
- Biochemistry, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Laurent Dupic
- Pediatric Critical Care Unit, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Fabrice Lesage
- Pediatric Critical Care Unit, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Guy Touati
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France
| | - Vassili Valayannopoulos
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France
| | - Bernadette Chadefaux-Vekemans
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France; Metabolomics Unit, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Mehdi Oualha
- Pediatric Critical Care Unit, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Monika Eisermann
- Neurophysiology Unit, AP-HP, Necker Enfants Malades Hospital, Paris, France
| | - Chris Ottolenghi
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France; Metabolomics Unit, Necker Enfants Malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Pascale de Lonlay
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, APHP, Imagine Institute, Paris Descartes University, Paris, France
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Dao M, Hummel A, Boyer O, Charbit M, Joly D, Dessaix K, Salomon R, Knebelmann B, Servais A. P0238LONG-TERM OUTCOME OF CHILDHOOD IDIOPATHIC NEPHROTIC SYNDROME. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0238] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Little is known about the long-term outcome of childhood idiopathic nephrotic syndrome (INS), in particular long-term complications, rate of relapses, frequency of prolonged steroid (S) and immunosuppressive treatment (IS). The choice of immunosuppressive drug remains discussed. Our aim was to study the long-term outcome in adulthood of patients with INS diagnosed during childhood.
Method
In this monocentric retrospective study, we included all adult patients (>18 years) admitted in our nephrology department between 2013 and 2019 with INS diagnosed during childhood. Patients who reached ESRD during childhood were excluded. Data regarding the outcome in adulthood were obtained through clinical database and medical charts.
Results
Eighty-two patients (M/F = 2/1) were included. Sixty-height patients had steroid-sensitive nephrotic syndrome (SSNS), including 52 with steroid-dependant nephrotic syndrome (SDNS). The other 14 patients had steroid-resistant nephrotic syndrome (SRNS). The median age at diagnosis was 3.9 years (1.2-16.5). The median number of relapses during childhood was 12 (0-52), 0.9/patient/year. 89% of patients received IS therapy in addition to S during childhood: median number of successive therapeutic lines was 3 (0-10) per child.
Median follow-up during adulthood was 4.6 (0.1-25) years. 67% of patients experienced at least one relapse during adulthood, with a median number of relapses of 0.53 (0-3.7)/patient/year. Risk of relapse during adulthood was significantly associated with the total number of relapses during childhood (p=0.015) and with the number of relapses per year during childhood (p=0.007). 45% of patients received IS in addition to S during adulthood, mainly mycophenolate mofetil (23/82), calcineurin inhibitors (21/82) and rituximab (12/82). High blood pressure was observed in 22% of patients.
At last follow-up, median eGFR was 90 (64-117) mL/min/1.73m in SSNS patients, 86 (57-126) mL/min/1.73m in SDNS patients and 70 (23-113) mL/min/1.73m in SRNS patients. Only 4/82 patients presented with eGFR lower than 60 mL/min/1.73m. Among them, 3 had SRNS. Only 1 thrombo-embolic event and 3 severe infections were reported.
Bone densitometry was performed in 26 adult patients and osteopenia was found in 19 of them (73%).
Conclusion
The incidence of relapses in adulthood was relatively high in our study. However bias related to inclusion criteria could play a role. Whereas renal function remained normal in most patients, high blood pressure and osteopenia were frequent but major complications were rarely reported.
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Affiliation(s)
- Myriam Dao
- Necker Enfants Malades, Adult nephrology, Paris, France
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
| | - Aurélie Hummel
- Necker Enfants Malades, Adult nephrology, Paris, France
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
| | - Olivia Boyer
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
- Necker Enfants Malades, Pediatric Nephrology, Paris, France
| | - Marina Charbit
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
- Necker Enfants Malades, Pediatric Nephrology, Paris, France
| | - Dominique Joly
- Necker Enfants Malades, Adult nephrology, Paris, France
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
| | - Kathleen Dessaix
- Necker Enfants Malades, Adult nephrology, Paris, France
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
| | - Rémi Salomon
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
- Necker Enfants Malades, Pediatric Nephrology, Paris, France
| | - Bertrand Knebelmann
- Necker Enfants Malades, Adult nephrology, Paris, France
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
| | - Aude Servais
- Necker Enfants Malades, Adult nephrology, Paris, France
- Centre de référence du Syndrome néphrotique idiopathique de l‘enfant et de l’adulte
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50
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Amoura A, Moktefi A, Halfon M, Karras A, Rafat C, Gibier JB, Gleeson PJ, Servais A, Argy N, Maillé P, Belenfant X, Gueutin V, Delpierre A, Tricot L, El Karoui K, Jourde-Chiche N, Houze S, Sahali D, Audard V. Malaria, Collapsing Glomerulopathy, and Focal and Segmental Glomerulosclerosis. Clin J Am Soc Nephrol 2020; 15:964-972. [PMID: 32444394 PMCID: PMC7341769 DOI: 10.2215/cjn.00590120] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/29/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Malaria, a potentially life-threatening disease, is the most prevalent endemic infectious disease worldwide. In the modern era, the spectrum of glomerular involvement observed in patients after malarial infections remains poorly described. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We therefore performed a retrospective multicenter study to assess the clinical, biologic, pathologic, and therapeutic characteristics of patients with glomerular disease demonstrated by kidney biopsy in France within 3 months of an acute malaria episode. RESULTS We identified 23 patients (12 men), all but 1 of African ancestry and including 10 patients with concomitant HIV infection. All of the imported cases were in French citizens living in France who had recently traveled back to France from an endemic area and developed malaria after their return to France. Eleven patients had to be admitted to an intensive care unit at presentation. Plasmodium falciparum was detected in 22 patients, and Plasmodium malariae was detected in 1 patient. Kidney biopsy was performed after the successful treatment of malaria, a mean of 24 days after initial presentation. At this time, all patients displayed AKI, requiring KRT in 12 patients. Nephrotic syndrome was diagnosed in 17 patients. Pathologic findings included FSGS in 21 patients and minimal change nephrotic syndrome in 2 patients. Among patients with FSGS, 18 had collapsing glomerulopathy (including 9 patients with HIV-associated nephropathy). In four patients, immunohistochemistry with an antibody targeting P. falciparum histidine-rich protein-2 demonstrated the presence of the malaria antigen in tubular cells but not in podocytes or parietal epithelial cells. An analysis of the apoL1 risk genotype showed that high-risk variants were present in all seven patients tested. After a mean follow-up of 23 months, eight patients required KRT (kidney transplantation in two patients), and mean eGFR for the other patients was 51 ml/min per 1.73 m2. CONCLUSIONS In patients of African ancestry, imported Plasmodium infection may be a new causal factor for secondary FSGS, particularly for collapsing glomerulopathy variants in an APOL1 high-risk variant background.
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Affiliation(s)
- Ariane Amoura
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Créteil, France.,Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Equipe 21, Créteil, France
| | - Anissa Moktefi
- Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Equipe 21, Créteil, France.,Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Département de Pathologie, Créteil, France
| | - Matthieu Halfon
- Assistance Publique des Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Service de Néphrologie, Paris, France
| | - Alexandre Karras
- Assistance Publique des Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Néphrologie, Paris, France.,Faculté de Médecine Paris-Descartes, Université de Paris, Paris, France
| | - Cédric Rafat
- Assistance Publique des Hôpitaux de Paris, Hôpital Universitaire Tenon, Urgences Néphrologiques et Transplantation Rénale, Paris, France
| | - Jean-Baptiste Gibier
- University of Lille, Centre Hospitalier Universitaire de Lille, Institut de Pathologie, Centre de Biologie Pathologie, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1172, Lille, France
| | - Patrick J Gleeson
- Institut National de la Santé et de la Recherche Médicale U1149, Immunoreceptors and Renal Immunopathology Laboratory, Université Diderot, Paris, France.,Royal College of Physicians of Ireland, Division of Nephrology, Dublin, Republic of Ireland
| | - Aude Servais
- Assistance Publique des Hôpitaux de Paris, Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Paris, France
| | - Nicolas Argy
- Assistance Publique des Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Laboratoire de Parasitologie-Mycologie Médicale, Centre National de Référence du Paludisme, Paris, France.,Institut pour la Recherche et le Développement, Université de Paris, Faculté de Pharmacie, Mère et enfant en milieu tropical Unité Mixte de Recherche 261, Paris, France
| | - Pascale Maillé
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Département de Pathologie, Créteil, France
| | - Xavier Belenfant
- Groupe Hospitalier Grand Paris Nord Est, Hôpital André Grégoire, Service de Néphrologie-Dialyse, Montreuil, France
| | - Victor Gueutin
- Association pour l'Utilisation du Rein Artificiel, Service de Néphrologie-Dialyse, Association pour l'Utilisation du Rein Artificiel Paris Plaisance, Paris, France
| | - Alexia Delpierre
- Hôpital Duchenne, Service de Néphrologie et Médecine Interne, Boulogne sur Mer, France
| | - Leila Tricot
- Hôpital Foch, Service de Néphrologie, Transplantation Rénale et Dialyse, Suresnes, France
| | - Khalil El Karoui
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Créteil, France.,Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Equipe 21, Créteil, France
| | - Noémie Jourde-Chiche
- Aix Marseille University, Institut National de la Santé et de la Recherche Médicale, Institut national de recherche pour l'agriculture, l'alimentation et l'environnement, Centre de recherche en CardioVasculaire et Nutrition, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire de la Conception, Centre de Néphrologie et Transplantation Rénale, Marseille, France
| | - Sandrine Houze
- Assistance Publique des Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Laboratoire de Parasitologie-Mycologie Médicale, Centre National de Référence du Paludisme, Paris, France.,Institut pour la Recherche et le Développement, Université de Paris, Faculté de Pharmacie, Mère et enfant en milieu tropical Unité Mixte de Recherche 261, Paris, France
| | - Dil Sahali
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Créteil, France.,Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Equipe 21, Créteil, France
| | - Vincent Audard
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Créteil, France .,Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Equipe 21, Créteil, France
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