[Acute renal failure in the course of occupational lead intoxication. Chelation therapy responsability (author's transl)]. / Insuffisance rénale aiguë au cours d'un saturnisme professionnel. Responsabilité du traitement chélateur.

In a patient with occupational plumbism and a normal kidney function, EDTA therapy (1 g/24 h) resulted in a massive lead excretion (15 000 microgram/24 h) together with acute renal failure. A direct nephrotoxic effect of EDTA was excluded: after renal function returned to normal, EDTA could be subsequently readministered at progressively increasing doses (250 mg to 1 g/24 h) without any renal dysfunction. These findings strongly suggest a close relationship between the burden of lead mobilized by EDTA and the acute renal failure. This case can be classified as acute lead nephropathy of which only a few instances have been reported in the literature. The interest of monitoring lead excretion during chelation therapy is particularly emphasized.

[Goodpasture's syndrome. A new case]. / Syndrome de Goodpasture. Une nouvelle observation

The authors report a new observation of Goodpasture's syndrome in a 21 years old patient. Diagnosis was made by renal biopsy after discovering, by immunofluorescence techniques, linear deposits of IgG and C3 on the renal basal lamina. Anti-basal lamina antibodies of the plasma were not found. In spite of therapy by steroids, a rapid worsening of renal functions accompanied a nephrotic syndrome. Supplementing hemodialysis helped patients to survive without recurrence of hemoptysis. Heparinotherapy prescribed on the creation of an arteriovenous fistula seemed to have brought a temporary improvement of the renal function.