ABSTRACT
INTRODUCTION: Chronic lymphoid leukemia (CLL) is a hematological malignant disease, associated with a clonal B cell proliferation. The incidence is 4400 new cases per year in France. The prevalence increases with age with a median age at diagnostic of 65 years. Renal involvement is rare and estimated at 1.2% of patients with CLL. Renal pathological diagnoses associated with CLL are variable and are not always related to the hematological disease. We report here on cases of patients with CLL who underwent a renal biopsy over the past 16 years in Marseille. METHODS: All cases of renal biopsies performed in patients with CLL between2000 and 2016 in Marseille were included. Pathological analysis was performed by the same experimented pathologist. Data were collected at the time of biopsy and after treatment. RESULTS: Ten patients were included in this study. The reason for renal biopsy was acute kidney injury or the onset of nephrotic syndrome. We report on 4 cases of membranous nephropathy, 1 minimal change disease, 1 cryglobulinemia-related membrano-proliferative glomerulonephritis, 1 light chain amyloidosis, 1 fibrillary glomerulonephritis, 1 interstitial monoclonal infiltration and one case of non-specific tubular lesions. Only one patient was treated before the biopsy, 7 patients received a specific hematological treatment of CLL because of its renal involvement. Renal and hematological responses were variable. CONCLUSION: Renal involvement of CLL is rare and is not mentioned in the Binet classification. Yet, it can be severe, with acute kidney injury or nephrotic syndrome, and can lead to the initiation of a specific treatment. The most frequent presentation this series was secondary MN, which differs from previous series.
Subject(s)
Kidney Diseases/etiology , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , Aged , Aged, 80 and over , Amyloidosis/diagnosis , Amyloidosis/etiology , Female , France , Glomerulonephritis/diagnosis , Glomerulonephritis/etiology , Glomerulonephritis, Membranous/diagnosis , Glomerulonephritis, Membranous/etiology , Humans , Kidney/pathology , Kidney Diseases/diagnosis , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Leukemic Infiltration/diagnosis , Leukemic Infiltration/etiology , Male , Middle Aged , Nephrosis, Lipoid/diagnosis , Nephrosis, Lipoid/etiology , Nephrotic Syndrome/diagnosis , Nephrotic Syndrome/etiology , Paraneoplastic Syndromes/diagnosis , Paraneoplastic Syndromes/etiology , Retrospective StudiesSubject(s)
Calciphylaxis/drug therapy , Renal Dialysis/adverse effects , Thiosulfates/therapeutic use , Aged , Aged, 80 and over , Calciphylaxis/etiology , Calciphylaxis/therapy , Combined Modality Therapy , Diabetes Mellitus, Type 2/complications , Diabetic Foot/drug therapy , Diabetic Foot/etiology , Diabetic Foot/surgery , Female , Humans , Leg Ulcer/drug therapy , Leg Ulcer/etiology , Leg Ulcer/surgery , Male , Middle Aged , Recurrence , Skin TransplantationABSTRACT
INTRODUCTION: Using iodine povidone in internal way may be responsible of severe adverse effects, sometimes causing death of the patients. EXEGESE: A 36th years old woman, with a secondary sterility has benefitted of an uterine opacification by iodine povidone before a laparotomy and a salpingotomy. In post surgery she presented an anuric acute renal failure and a severe anaemia which have needed a transfusion. Outcome was favourable with a recuperation of diuresis and a full normalization of the renal function. CONCLUSION: The authors recommend to respect the indications of iodine povidone.
Subject(s)
Acute Kidney Injury/chemically induced , Anti-Infective Agents, Local/adverse effects , Povidone-Iodine/adverse effects , Adult , Anti-Infective Agents, Local/administration & dosage , Fallopian Tubes/surgery , Female , Humans , Laparotomy , Povidone-Iodine/administration & dosageABSTRACT
Septicaemia concerning Lactobacillus jensenii is exceptional. This bacteria commensal of the normal human flora is known for its low pathogenicity. We report here the observation of a woman, 50 years old, who was admitted in our service for an obstructive acute renal failure and who has presented a septicaemia due to L. jensenii, with a favourable issue by use of antibiotics (amoxicillin-clavulanic acid). This observation permits to report the clinical and bacteriological characteristics of L. jensenii. The importance of the immunodepressed status (diabetes mellitus, chronic renal failure) and use of the endoureteral acts is mentioned.
