Anti-glomerular basement membrane disease, ulcerative colitis, and primary sclerosing cholangitis: link or co-incidence?

International audienceUlcerative colitis, primary sclerosing cholangitis, and anti-glomerular basement membrane disease (anti-GBM) are three rare immune diseases with incompletely under-stood pathogenic mechanisms. We describe here the case of a 29-year-old man with ulcer-ative colitis and primary sclerosing cholang -itis who, eight years later, developed anti-GBM disease with destruction of all glomeruli leading to end-stage kidney disease. Association of these three immune diseases in the same patient has never been described. Because HLA-mediated susceptibility cannot be incriminated completely in our case, we hypothesize that environmental factors or previous immunosuppressive treatment used might be the link

Renal biopsies after 70 years of age: a retrospective longitudinal study from 2000 to 2007 on 150 patients in Western France.

International audienceThe elderly are more often referred to nephrologists and questions about indications for renal biopsy are increasing. The vascular lesions that appear with aging make the diagnosis of additional nephropathy more difficult. The purpose of our study is to investigate the characteristics of renal biopsies in the elderly in order to evaluate the indications and their use in guiding specific therapeutic interventions. Patients over 70 years who underwent a renal biopsy between 2000 and 2007 in Rennes University Hospital were retrospectively analyzed for biopsy complications, clinical features, diagnosis, therapy and its complications, evolution and mortality. Among the 150 renal-biopsied patients, 60% had a glomerulopathy and 30% had nephrotic syndrome. Biopsy complications occurred in 3.3%. 64% of nephrotic patients received immunosuppressive treatment and 62% of them developed drug-associated complications. In the treated group, there was more remission and survival at day 1000 was improved. Renal biopsy may be indicated in the elderly, because it often gives a therapeutically useful diagnosis and complications are rare if contra-indications are respected. Kidney biopsy revealed histological diagnoses that were not usually suspected by the clinical presentation. In addition, immunosuppressive therapy did not alter the mortality rate, but did increase survival at 3 years

and primary sclerosing cholangitis: link or co-incidence?

Anti-glomerular basement membrane disease, ulcerative colitis

L'art préhistorique, une archéologie

Depuis la découverte de la grotte Chauvet, en 1994, les études en art préhistorique ont bénéficié d’un renouvellement profond des connaissances, des outils, mais aussi des approches méthodologiques. Après les découvertes vient la reconnaissance de l’ancienneté de cet art. L’art pariétal s’étudie, à partir des années 1970-1980, dans son contexte archéologique. Les datations, les fouilles éloignent la grotte de l’image de sanctuaire à laquelle elle restait alors le plus souvent associée. Des fonctions sociales plus complexes émergent et nourrissent aussi de nouvelles problématiques. Des territoires graphiques inédits apparaissent et modifient sensiblement la cartographie « pariétale » de l’Europe. Au Brésil, en Australie, les découvertes participent à l’internationalisation des recherches, débouchant sur une dynamique commune, comme le souci d’appréhender les sites dans leur globalité, à la croisée de questionnements autant archéologiques qu’environnementaux, mais aussi conservatoires, qui génèrent de nouvelles approches. La multidisciplinarité fait donc son entrée sur ce terrain. Si l’émerveillement et la fascination restent les mêmes en découvrant Armintxe en 2016 que 150 ans auparavant sous le plafond d’Altamira, les approches scientifiques ont en revanche considérablement évolué pour ancrer fermement l’étude des productions graphiques dans l’archéologie préhistorique