[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

[Renal involvement in the Behcet's disease]

Renal involvement in the Behcet's disease is rare. The clinical features vary from urinary sediment's abnormalities to ESRD. We propose to study the clinical, biological and histological data, the therapeutic management and the prognosis of patients. We report a retrospective study including 8 patients representing 1.23% of cases. The average age of the patient was of 37 +/- 12. 35 years with a clear male prevalence. Urinary signs were discovered fortuitously by the strips in the majority of the cases after an average of 18 months. It's about proteinuria and hematuria. Renal insufficiency and hypertension were rare. Pathological study highlighted 3 cases of amyloidosis, 2 cases of IgA nephropathy, 1 case of minimal change disease, 1 case of endo and extracapillary glomerulonephritis and 1 case of interstitial nephropathy. Patients having GN were treated by corticoids and immunosuppressive agents and those having an interstitial nephropathy were treated symptomatically with good evolution in the majority of the cases. Only one patient is dead, he had amyloidosis. Prognosis depended on the precocity of the diagnosis, the histological type and the treatment. The renal involvement during Behcet's disease is rare. Amyloidosis and Ig A nephropathy are the most frequent. Treatment is still controversial

[Peritoneal dialysis in elderly]

Peritoneal dialysis is used more and more as treatment of substitution of the end stage renal disease at the old subjects of more than 65 years and its effectiveness and its good tolerance were shown. To study the epidemiological and clinical profile of these patients, the indication and the advantages of PD, the various complications, the elements of prognostic and the survival of the patients and the technique. We made a retrospective study including a series of 13 old patients of more than 65 years and treaties by PD during the period extending from the 1983/2/11 to the 2005/12/31. They are 10 men and 3 women on average of 70 +/- 3, 1 year and representing 3, 62%of the totality of the patients. The diabetic and vascular nephropathies represent the first cause of ESRD. The PD was used of first intention at 53,84%of the patients whose majority suffers from a malnutrition due to advanced age, anorexia, psychological disorders, bad dental state and uraemia. The cardiovascular complications are frequent in this age bracket explaining heavy morbidity. The pulmonary and urinary infectious complications are also frequent. The more frequent peritonitis compared to the literature, are comparable between the 2 age brackets

Cardiovascular manifestations in ankylosing spondylitis. concerning 210 cases

To analyse and discuss cardiovascular manifestations of ankylosing spondylitis, evaluate the frequency and giving special attention to unusual forms. We retrospectively reviewed the medical records of 21 cases with cardiovascular manifestations among 210 cases of ankylosing spondylitis seen over a 25 years period who met the Amor criteria. Cardiovascular complications were found in 21 patients [10%]: 5 [2.40%] had aortic insufficiency, 2 [0.95%] had mitral insufficiency, 1 had mitral valve prolapse, 1 had pericarditis, 10 [4.7%] had atrioventricular block and 6 [2.8%] had bundle branch block. Takayashu's disease was diagnosed in one case. Cardiovascular involvement was common in patients longer disease duration. Peripheral arthriti as found in 33% and its prevalence did not differ in patients with or without cardiac involvement. Aortic insufficiency and conduction disturbances were the most common cause of cardiovascular involvement in ankylosing spondylitis. The funding of cardiovascular manifestations in 10% of our patients suggests that in this illness evidence of cardiac manifestations should be actively investigated in ankylosing spondylitis