[Benzylthiouracil induced anca associated glomerulonephritis in patients with graves 'disease]

Background: Renal complications in Graves' disease are rare and may be related either to the disease itself or secondary to antithyroid drugs

Aim: We report 6 cases of renal damage in patients with Graves' disease treated with Benzylthiouracil collected over a period of 14 years

Methods: There were 6 women with a mean age of 37.86 +/- 14.25 years. All patients developed renal vasculitis associated with ANCA. The signs were dominated by renal proteinuria and renal failure associated with hematuria in all cases. The lung involvement was the most common extrarenal manifestation occurred in 4 patients [alveolar hemorrhage in 2 cases, lymphocytic alveolitis in 1 case and pleurisy in 1 case]. The benzylthiouracil was discontinued in 3 patients still under treatment. Corticosteroid therapy was used alone or in combination with cyclophosphamide in all cases. Plasmapheresis sessions were made during the alveolar hemorrhage. A complete remission was obtained in one case and incomplete remission in 2 cases. The other 3 patients required chronic hemodialysis. One patient died of sepsis

Conclusion: The possibility of renal impairment in antithyroid drugs treated Graves' disease requires monitoring to detect urinary abnormalities in order to early initiate therapy and improve patient's outcome

[Calciphilaxis in chronic renal failure: 3 cases]

Calciphylaxis is a small vessel disease responsible for vascular calcification and skin necrosis. It occurs in association with chronic renal failure and has a poor prognosis. Report new cases. We report 3 cases of calciphylaxis occurred in patients with chronic renal failure secondary to interstitial nephritis in 1 case, diabetic nephropathy in 1 case and thrombotic microangiopathy in 1 case. They were 2 females a 1 man aged of 44.3 years meanly. Hyperphosphoremia and hyperparathyroidism were the essential risk factors. All patients died by sepsis. This course was precipitating by corticotherapy in 2 cases. Early recognition and treatment of risk factors is mandatory to reduce mortality in uremic patients with calciphylaxis

[Vascular trombosis of renal graft: 9 cases]

Allograft renal thrombosis can occur in 1 to 6% of cases. Many predisposing factors has been identified especially alteration of coagulation. We analyzed in this study frequency and predisposing factors of renal graft thrombosis. We report a retrospective study including 319 renal transplant recipients. Nine patients [2, 8%] presented veinous graft thrombosis in 5 cases and arterial thombosis in 4 cases. There were 6 men and 3 women aged of 30, 6 years meanly [10-56] which developed the thrombosis 6 days [1-48] after the transplantation. All patients were detransplanted after 16, 2 days and 1 patient died. Thrombosis constitute an important cause of graft loss. A perfect surgical technic and prophylactic treatment in high risk patients are necessary to reduce this complication