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Minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases

BACKGROUND: Human immunodeficiency virus (HIV) is associated with diverse glomerular diseases. Characteristics of minimal change nephrotic syndrome (MCNS) in this setting have been little studied, and the specific features of this uncommon association remain to be determined. METHODS: We conduct a r...

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Autores principales: ARRESTIER, Romain, SATIE, Anne-Pascale, ZHANG, Shao-yu, PLAISIER, Emmanuelle, ISNARD-BAGNIS, Corinne, GATAULT, Philippe, RAIMBOURG, Quentin, BUOB, David, VOCILA, Flavia, HENG, Anne-Elisabeth, FRANCOIS, Helene, MOKTEFI, Anissa, CANAUD, Guillaume, MATIGNON, Marie, DEJUCQ-RAINSFORD, Nathalie, BROCHERIOU, Isabelle, SAHALI, Dil, AUDARD, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247501/
https://www.ncbi.nlm.nih.gov/pubmed/30458703
http://dx.doi.org/10.1186/s12882-018-1132-x
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author ARRESTIER, Romain
SATIE, Anne-Pascale
ZHANG, Shao-yu
PLAISIER, Emmanuelle
ISNARD-BAGNIS, Corinne
GATAULT, Philippe
RAIMBOURG, Quentin
BUOB, David
VOCILA, Flavia
HENG, Anne-Elisabeth
FRANCOIS, Helene
MOKTEFI, Anissa
CANAUD, Guillaume
MATIGNON, Marie
DEJUCQ-RAINSFORD, Nathalie
BROCHERIOU, Isabelle
SAHALI, Dil
AUDARD, Vincent
author_facet ARRESTIER, Romain
SATIE, Anne-Pascale
ZHANG, Shao-yu
PLAISIER, Emmanuelle
ISNARD-BAGNIS, Corinne
GATAULT, Philippe
RAIMBOURG, Quentin
BUOB, David
VOCILA, Flavia
HENG, Anne-Elisabeth
FRANCOIS, Helene
MOKTEFI, Anissa
CANAUD, Guillaume
MATIGNON, Marie
DEJUCQ-RAINSFORD, Nathalie
BROCHERIOU, Isabelle
SAHALI, Dil
AUDARD, Vincent
author_sort ARRESTIER, Romain
collection PubMed
description BACKGROUND: Human immunodeficiency virus (HIV) is associated with diverse glomerular diseases. Characteristics of minimal change nephrotic syndrome (MCNS) in this setting have been little studied, and the specific features of this uncommon association remain to be determined. METHODS: We conduct a retrospective study. Clinical, biological and pathological characteristics of patients with MCNS and HIV infection were assessed. We evaluated HIV infection by in situ hybridization and CMIP expression by immunochemistry on kidney biopsies and compared it to HIV-associated nephropathy (HIVAN) and idiopathic MCNS. RESULTS: Eight patients were identifies. In all but one of these cases, MCNS occurred after HIV diagnosis (mean of 9.5 years). Acute kidney injury was detected in three cases. Mean CD4(+) lymphocyte count was 733/mm(3) and three patients had a detectable HIV viral load. In situ hybridization for HIV-1 RNA detection yielded a positive signal in a few tubular cells in the renal parenchyma in two of four patients with HIV infection associated with MCNS. Podocytes of these patients presented strong positive immunostaining for CMIP (4/4). Three patients suffered steroid-dependent nephrotic syndrome, and another two patients had at least one relapse. Rituximab treatment was initiated in four cases. After a median follow-up of 20 months, all patients were in remission (complete in 5 cases). CONCLUSIONS: In patients with MCNS occurring in a context of HIV infection, podocyte injury seems to be associated with CMIP induction rather than renal HIV infection but further studies are needed to determine the molecular link between these two conditions.
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spelling pubmed-62475012018-11-26 Minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases ARRESTIER, Romain SATIE, Anne-Pascale ZHANG, Shao-yu PLAISIER, Emmanuelle ISNARD-BAGNIS, Corinne GATAULT, Philippe RAIMBOURG, Quentin BUOB, David VOCILA, Flavia HENG, Anne-Elisabeth FRANCOIS, Helene MOKTEFI, Anissa CANAUD, Guillaume MATIGNON, Marie DEJUCQ-RAINSFORD, Nathalie BROCHERIOU, Isabelle SAHALI, Dil AUDARD, Vincent BMC Nephrol Research Article BACKGROUND: Human immunodeficiency virus (HIV) is associated with diverse glomerular diseases. Characteristics of minimal change nephrotic syndrome (MCNS) in this setting have been little studied, and the specific features of this uncommon association remain to be determined. METHODS: We conduct a retrospective study. Clinical, biological and pathological characteristics of patients with MCNS and HIV infection were assessed. We evaluated HIV infection by in situ hybridization and CMIP expression by immunochemistry on kidney biopsies and compared it to HIV-associated nephropathy (HIVAN) and idiopathic MCNS. RESULTS: Eight patients were identifies. In all but one of these cases, MCNS occurred after HIV diagnosis (mean of 9.5 years). Acute kidney injury was detected in three cases. Mean CD4(+) lymphocyte count was 733/mm(3) and three patients had a detectable HIV viral load. In situ hybridization for HIV-1 RNA detection yielded a positive signal in a few tubular cells in the renal parenchyma in two of four patients with HIV infection associated with MCNS. Podocytes of these patients presented strong positive immunostaining for CMIP (4/4). Three patients suffered steroid-dependent nephrotic syndrome, and another two patients had at least one relapse. Rituximab treatment was initiated in four cases. After a median follow-up of 20 months, all patients were in remission (complete in 5 cases). CONCLUSIONS: In patients with MCNS occurring in a context of HIV infection, podocyte injury seems to be associated with CMIP induction rather than renal HIV infection but further studies are needed to determine the molecular link between these two conditions. BioMed Central 2018-11-20 /pmc/articles/PMC6247501/ /pubmed/30458703 http://dx.doi.org/10.1186/s12882-018-1132-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
ARRESTIER, Romain
SATIE, Anne-Pascale
ZHANG, Shao-yu
PLAISIER, Emmanuelle
ISNARD-BAGNIS, Corinne
GATAULT, Philippe
RAIMBOURG, Quentin
BUOB, David
VOCILA, Flavia
HENG, Anne-Elisabeth
FRANCOIS, Helene
MOKTEFI, Anissa
CANAUD, Guillaume
MATIGNON, Marie
DEJUCQ-RAINSFORD, Nathalie
BROCHERIOU, Isabelle
SAHALI, Dil
AUDARD, Vincent
Minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases
title Minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases
title_full Minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases
title_fullStr Minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases
title_full_unstemmed Minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases
title_short Minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases
title_sort minimal change nephrotic syndrome in patients infected with human immunodeficiency virus: a retrospective study of 8 cases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247501/
https://www.ncbi.nlm.nih.gov/pubmed/30458703
http://dx.doi.org/10.1186/s12882-018-1132-x
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