Publications by authors named "Jean-Michel Rebibou"

Background: Carfilzomib, a new proteasome inhibitor indicated for patients with relapsed/refractory myeloma, has been associated with cases of thrombotic microangiopathy (CFZ-TMA). The role of variants in the complement alternative pathway and therapeutic potential of complement blockade with eculizumab remain to be determined.

Methods: We report 37 cases of CFZ-TMA recorded in the French reference center for TMA with their clinical characteristics, genetic analysis and outcome according to treatments.

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Background: The Banff Classification may not adequately address protocol transplant biopsies categorized as normal in patients experiencing unexplained graft function deterioration. This study seeks to employ convolutional neural networks to automate the segmentation of glomerular cells and capillaries and assess their correlation with transplant function.

Methods: A total of 215 patients were categorized into three groups.

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  • - Legionnaires' disease (LD) is a serious infection particularly affecting solid organ transplant recipients, though details about its impact on this group have not been well documented.
  • - A 10-year study in France identified 101 patients with LD among transplant recipients, finding that severe cases were linked to factors like negative urinary antigen tests and respiratory symptoms.
  • - Key imaging results showed significant lung involvement, and the study reported a 30-day mortality rate of 8% and a 12-month mortality rate of 20% among these patients.
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  • The study examines the prevalence and predictors of cerebral lesions in patients with immune thrombotic thrombocytopenic purpura (iTTP) and hemolytic uremic syndrome (HUS) during their acute phases.
  • One-third of the 73 patients analyzed showed acute ischemic lesions on MRI, and neurological symptoms were not significantly different between iTTP and HUS cases.
  • Key factors predicting these lesions included the presence of old infarcts, elevated blood pulse pressure, and a diagnosis of iTTP, indicating potential areas for enhanced treatment approaches.*
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Background: Interstitial inflammation and peritubular capillaritis are observed in many diseases on native and transplant kidney biopsies. A precise and automated evaluation of these histological criteria could help stratify patients' kidney prognoses and facilitate therapeutic management.

Methods: We used a convolutional neural network to evaluate those criteria on kidney biopsies.

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  • The study focuses on using a neural network to enhance the MEST-C classification method for diagnosing immunoglobulin A nephropathy (IgAN), which currently has variability in results between different pathologists.
  • A dataset of biopsies was divided into training, testing, and application groups to train the neural network and evaluate its accuracy compared to human assessments.
  • Results showed that the neural network could correctly classify over 73% of biopsy pixels and had substantial agreement with pathologists for most scores, highlighting its potential for reliable, automated analysis in clinical settings.
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Survivors of immune-mediated thrombotic thrombocytopenic purpura (iTTP) are exposed to clinical relapses when a disintegrin and metalloproteinase with thrombospondin type 1 repeats, member 13 (ADAMTS13) activity decreases during follow-up. Although preemptive rituximab usually improves ADAMTS13 activity in this context, 15% of patients experience refractoriness or intolerance to rituximab and require alternative strategies. Here, we addressed whether cyclosporine A (CSA) could improve ADAMTS13 activity and prevent clinical relapses in this context.

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Leukocyte immunoglobulin-like receptors (LILRs) are a family of inhibitory or stimulatory receptors expressed by immune cell types belonging to both myeloid and lymphoid lineage. Several members of the LILR family recognize major histocompatibility complex class I and thus play important roles in a range of clinical situations including pregnancy. Moreover, paired immunoglobulin-like receptors (PIRs), the murine orthologs of LILRs, are implicated in experimental transplant allorecognition by monocytes and contribute to the induction of donor-specific monocyte-memory.

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Background: Cancer-associated thrombotic microangiopathy (TMA) is a rare disease, with a poor prognosis. The classical treatment is urgent chemotherapy. Few data are available on the efficacy of plasma exchange (PE) and eculizumab in these patients.

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This study sought to identify risk factors for acute kidney injury (AKI) from pre-operative variables in a population of subjects aged over 65. Eligible patients were aged 65 years or over who underwent scheduled non-cardiac, non-ambulatory surgery. Patients with a diagnosis of AKI recorded in the hospital's databases were considered since cases, from which 300 patients with no diagnosis of AKI, were drawn at random as controls.

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Background And Objectives: The prognosis of patients undergoing kidney tumor resection or kidney donation is linked to many histologic criteria. These criteria notably include glomerular density, glomerular volume, vascular luminal stenosis, and severity of interstitial fibrosis/tubular atrophy. Automated measurements through a deep-learning approach could save time and provide more precise data.

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  • * A case study of a 69-year-old man with splenic marginal zone lymphoma and chronic kidney disease shows that after contracting COVID-19, his kidney function worsened, confirmed by elevated blood creatinine levels.
  • * A kidney biopsy revealed viral replication of SARS-CoV-2 in kidney cells, demonstrating a direct relationship between the viral infection and acute kidney injury in this patient.
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Introduction: Renal transplant recipients have a high peri-operative risk for cardiovascular events. The post-transplantation period also carries a risk of myocardial infarction (MI). Coronary artery disease (CAD) is a leading cause of death in these patients.

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In patients presenting with anti-glomerular basement membrane (GBM) disease with advanced isolated kidney involvement, the benefit of intensive therapy remains controversial due to adverse events, particularly infection. We aim to describe the burden of severe infections (SI) (requiring hospitalization or intravenous antibiotics) and identify predictive factors of SI in a large cohort of patients with anti-GBM disease. Among the 201 patients (median [IQR] age, 53 [30-71] years) included, 74 had pulmonary involvement and 127 isolated glomerulonephritis.

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Background: Rhabdomyolysis is a life-threatening disease that can lead to severe hyperkalemia, acute kidney injury (AKI) and hypovolemic shock. The predictive factors of AKI and acute to chronic kidney disease (CKD) transition remain poorly described.

Methods: This multicenter retrospective study enrolled 387 patients with severe rhabdomyolysis (CPK > 5000 U/L).

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Immune senescence is associated with age-related diseases (i.e. infectious disease, cardiovascular diseases and cancers).

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Few data are available concerning immune factors involved in the occurrence of new onset diabetes after transplantation (NODAT). Our objective was to determine an immune profile associated with the subsequent development of NODAT. The secondary objective was to build a predictive model of NODAT.

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Fusobacterium nucleatum is a common oral commensal bacterium capable of severe invasive infections. We report a case of a diffuse bilateral pneumopathy with F. nucleatum-positive blood culture successfully treated by common antibiotics in a patient receiving eculizumab for a drug-induced thrombotic microangiopathy (TMA).

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