Papers by Joëlle Nortier
Revue Médicale de Bruxelles, 2015
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Nephrology Dialysis Transplantation, May 1, 2015
PLOS ONE, Aug 5, 2013
Background: Patients with end-stage renal disease (ESRD) and latently infected with Mycobacterium... more Background: Patients with end-stage renal disease (ESRD) and latently infected with Mycobacterium tuberculosis (LTBI) are at higher risk to develop tuberculosis (TB) than healthy subjects. Interferon-gamma release assays (IGRAs) were reported to be more sensitive than tuberculin skin tests for the detection of infected individuals in dialysis patients. Methods: On 143 dialysis patients prospectively enrolled, we compared the results from the QuantiFERONH-TB Gold assay (QFT), to those of an IGRA in response to in vitro stimulation of circulating mononuclear cells with the mycobacterial latency antigen Heparin-Binding Haemagglutinin purified from Mycobacterium bovis BCG (native HBHA, nHBHA). Results: Seven patients had a past history of active TB and 1 had an undetermined result with both IGRAs. Among the other 135 patients, 94 had concordant results with the QFT and nHBHA-IGRA, 40.0% being negative and therefore not latently infected, and 29.6% being positive and thus LTBI. Discrepant results between these tests were found for 36 patients positive only with the nHBHA-IGRA and 5 only with the QFT. The nHBHA-IGRA is more sensitive than the QFT for the detection of LTBI dialysis patients, and follow-up of the patients will allow us to define the clinical significance of discrepant results between the nHBHA-IGRA and the QFT.
Seminars in Nephrology, May 1, 2019
Revue Médicale de Bruxelles, Jun 1, 2015
Introduction: Nephrolithiasis is a frequent disease observed in 1 to 20 % of the general populati... more Introduction: Nephrolithiasis is a frequent disease observed in 1 to 20 % of the general population. This disease predominates in male patients (2:1) and is characterized by a high rate of recurrences (about 50 %). Case report: We report the case of a 45-year old male patient who experienced during about ten years recurrent bilateral renal colic episodes due to brushite lithiasis. These stones were treated with multiple extracorporeal shock wave lithotripsy sessions. A pyeloureteral junction syndrome predisposing to bulky stones formation has been put in evidence and required a pyeloplasty. After more than ten years of disease activity, a biochemical screening diagnosed primary hyperparathyroidism (PHPT). Radiological assessment identified a parathyroid gland adenoma. Successful surgical removal of this lesion was followed by resolution of the symptomatic kidney stones formation. Discussion: PHPT is associated with kidney stones in about 20 % of the patients. Hypercalciuria is the main risk factor of stones formation but other predisposing factors are also probably involved. Patients carrying a polymorphism located in the coding sequence of the calcium-sensing receptor gene or in the regulatory region of this gene seem to experience an increased occurrence of urinary lithiasis. Conclusion: The present case stresses the impor tance of a metabolic assessment in all patients with recurrent nephrolithiasis, especially in case of bilateral episodes.
Kidney International, Apr 1, 2014
To the Editor: We acknowledge Zhang et al. for their outstanding review of the new magnetic reson... more To the Editor: We acknowledge Zhang et al. for their outstanding review of the new magnetic resonance imaging (MRI) methods in nephrology. The authors have described the application of MRI techniques for renal functional imaging in various clinical settings very thoroughly. In prolongation to this excellent review, we would like to share our experience with diffusion-weighted (DW) MRI in assessing renal morphological alterations in two recent cases of immunoglobulin (Ig)G4-related disease. The first was a 65-year-old man who presented with chronic kidney disease. Kidney biopsy showed IgG4-related tubulointerstitial
Journal of The American Society of Nephrology, 2010
American Society of Nephrology, 43rd Annual Meeting (Denver, USA, 2010)info:eu-repo/semantics/pub... more American Society of Nephrology, 43rd Annual Meeting (Denver, USA, 2010)info:eu-repo/semantics/publishe
Nephrologie & Therapeutique, Oct 1, 2009
ButDescription de l'evolution clinique des infections a Leishmania apres transplantation rena... more ButDescription de l'evolution clinique des infections a Leishmania apres transplantation renale. Discussion de la contribution des techniques de biologie moleculaire dans le diagnostic des leishmanioses.Patients et MethodesRevue des dossiers medicaux de deux patients italiens transplantes renaux avec episodes recurrents de leishmaniose.ResultatsLe premier patient (homme, 49 ans) a presente deux episodes de leishmaniose viscerale (LV) 10 et 15 annees apres la transplantation, traites avec succes par injections intramusculaires d'antimoniate de meglumine. Six ans plus tard, il a recidive une lesion ulceree de la langue traitee par injections intra-lesionnelles du meme antiparasitaire. Le second patient (homme, 54 ans) a presente quatre episodes successifs de LV, le premier etant survenu 17 ans apres la transplantation. Chez ce patient, la presentation classique de la maladie etait associee a une vasculite cryoglobulinemique au niveau des membres inferieurs. Tous les episodes ont ete traites avec succes par un cycle complet d'amphotericine B liposomale, associee a une reduction de l'immunosuppression. Chaque traitement etait suivi par une remission clinique complete et une disparition de la cryoglobulinemie de type II. L'ADN parasitaire a ete detecte dans le sang du patient lors des recidives. L'analyse du polymorphisme de longueur des fragments de restriction (RFLP) de l'ADN parasitaire a confirme le meme genotype de Leishmania infantum lors des episodes successifs.DiscussionL'immunosuppression medicamenteuse expose les patients transplantes renaux, vivant en region endemique, a un risque accru de leishmaniose recidivante. Ceci est une presentation analogue aux recidives frequentes de leishmaniose observees chez les patients infectes par le VIH. Les multiples episodes infectieux presentes par nos deux patients suggerent la persistance d'amastigotes au sein des macrophages et la reactivation d'une infection latente. Les resultats de l'analyse RFLP de l'ADN de Leishmania realisee chez notre second patient sont en faveur de cette hypothese.ConclusionLes patients transplantes renaux immunocompromis presentent un risque eleve de leishmaniose recidivante. Les techniques modernes de biologie moleculaire sont des outils importants pour le diagnostic et le suivi du traitement de ces patients. Des etudes cliniques futures devront determiner l'interet de traitements plus intensifs ou d'une prophylaxie secondaire de longue duree pour diminuer le risque de recidives.
Case reports in nephrology, 2014
Mycobacterium fortuitum is a ubiquitous, rapidly growing nontuberculous mycobacterium (NTM). It i... more Mycobacterium fortuitum is a ubiquitous, rapidly growing nontuberculous mycobacterium (NTM). It is the most commonly reported NTM in peritoneal dialysis (PD) associated peritonitis. We report a case of a 52-year-old man on PD, who developed refractory polymicrobial peritonitis necessitating PD catheter removal and shift to hemodialysis. Thereafter, M. fortuitum was identified in the PD catheter culture and in successive cultures of initial peritoneal effluent and patient was treated with amikacin and ciprofloxacin for six months with a good and sustained clinical response. Months after completion of the course of antibiotics, the patient successfully returned to PD. To our knowledge, this is the first reported case of M. fortuitum peritonitis in the field of polymicrobial PD peritonitis. It demonstrates the diagnostic yield of pursuing further investigations in cases of refractory PD peritonitis. In a systematic review of the literature, only 20 reports of M. fortuitum PD peritonitis were identified. Similar to our case, a delay in microbiological diagnosis was frequently noted and the Tenckhoff catheter was commonly removed. However, the type and duration of antibiotic therapy varied widely making the optimal treatment unclear.
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Nephrologie & Therapeutique, 2006
8ème réunion commune de la Société de néphrologie et de la Société francophone de dialyse (Lille,... more 8ème réunion commune de la Société de néphrologie et de la Société francophone de dialyse (Lille, 3-6 octobre 2006)info:eu-repo/semantics/publishe
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Ndt Plus, May 3, 2012
A 65-year-old man presented with a progressive increase in plasma creatinine (PCr). Two years bef... more A 65-year-old man presented with a progressive increase in plasma creatinine (PCr). Two years before, diffusion-weighted magnetic resonance imaging had revealed a relapse of immunoglobulin G4 (IgG4)-related autoimmune pancreatitis (AIP) associated with sclerosing cholangitis. Bilateral hypointense renal cortical nodules were also described. Kidney biopsy showed patchy disappearance of tubules, sparse interstitial fibrosis and IgG41 plasma cells (>30 per high power field) leading to the diagnosis of IgG4-related tubulointerstitial nephritis (TIN). Despite methylprednisolone, PCr and serum IgG4 levels remained elevated. Starting azathioprine (AZA) normalized IgG4 levels, which elicited corticosteroid withdrawal after 17 months. One year later, renal function remains stable. Our clinical observation underlines the importance of biological and radiological long-term follow-up of patients with previous AIP in order to early detect IgG4-related renal involvement. Corticosteroids are the first choice, but in the case of adverse effects or partial remission, AZA could be a useful and safe alternative therapy.
Clinical Nephrology
Acute granulomatous tubulointerstitial nephritis (GTIN) is a rare finding in renal biopsy. Differ... more Acute granulomatous tubulointerstitial nephritis (GTIN) is a rare finding in renal biopsy. Differential diagnosis is facilitated when GTIN is associated with granulomatous bilateral anterior uveitis (GBAU). Nevertheless, differentiation between a rare form of granulomatous tubulointerstitial nephritis and uveitis syndrome (TINU) and sarcoidosis can be challenging. We report a case of biopsy-proven GTIN with concomitant GBAU, leading to a dead-end diagnosis. We discuss workup and propose a diagnostic algorithm based on a literature review. We also report a successful treatment of ophthalmologic and renal relapse using mycophenolate mofetil.
Kidney International Reports
Background: Arteriovenous fistula delay or absence of maturation is a common problem in hemodialy... more Background: Arteriovenous fistula delay or absence of maturation is a common problem in hemodialysis. The prevalence of antiphospholipid antibody is higher among hemodialysis patients compared to the general population and is inconsistently associated with arteriovenous fistula thrombosis or stenosis. However, the effect of antiphospholipid antibodies on delayed or absence of maturation of the arteriovenous fistula has never been studied. Methods: We retrospectively identified 103 hemodialyzed patients with arteriovenous fistula whether used or not. We collected the clinical and biological data potentially involved in arteriovenous fistula maturation and investigated the association between antiphospholipid antibody positivity and arteriovenous fistula maturation failure according to KDOQI guidelines. Results: In our cohort, the prevalence of arteriovenous fistula maturation failure was of 45.8%. The prevalence of antiphospholipid syndrome was of 7.8 %, whereas only 10.7% of patient...
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Papers by Joëlle Nortier