Publications by authors named "Khalil El-Karoui"

Article Synopsis
  • Microangiopathies thrombotiques (MAT) encompass a diverse group of disorders marked by hemolytic anemia, thrombocytopenia, and microvascular obstruction, often leading to organ damage, particularly in the kidneys and brain, as seen in hemolytic-uremic syndrome (HUS). *
  • A key focus is on atypical HUS (aHUS), which involves dysregulation of the alternative complement pathway, with many specifics of its pathology and treatment in unique contexts (like pregnancy and kidney transplants) still poorly understood.*
  • Recent advancements in diagnosis and treatment for aHUS in specific situations are highlighted, alongside the current and future challenges in managing these conditions effectively.*
View Article and Find Full Text PDF

During the pandemic period, health care systems were substantially reorganized for managing COVID-19 cases. Corresponding consequences on persons with chronic diseases remain insufficiently documented. This observational cohort study investigated the direct and indirect impact of the pandemic period on the survival of kidney transplant recipients (KTR).

View Article and Find Full Text PDF

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease. While biallelic variants affecting IFT140 are responsible for Mainzer-Saldino syndrome (characterized by severe ciliopathy causing skeletal abnormalities, kidney disease, and cysts), monoallelic loss-of-function (LoF) variants have been recently reported as an important cause of ADPKD beyond PKD1/2 genes. Herein, we report 6 non-family-related cases of monoallelic IFT140 LoF variants, identified from 1,340 exomes sequenced for nephrological indications in our local database.

View Article and Find Full Text PDF
Article Synopsis
  • * Effective treatment requires personalized care, with a focus on supportive measures, including sodium-glucose transporter 2 inhibitors and sparsentan, especially for patients with chronic kidney damage.
  • * While glucocorticoids are useful for high-risk patients, their benefits diminish after stopping, and newer therapies like targeted-release budesonide and anti-B-cell strategies show promise for directly addressing the disease's underlying mechanisms.
View Article and Find Full Text PDF

Background: Hereditary transthyretin (ATTRv) p.Val142Ile (V122I) mutation is the most common inherited cause of cardiac amyloidosis and little is known about the phenotype and outcome of the rare homozygotic genotype. This study aimed to compare phenotypic characteristics and outcomes between heterozygous and homozygous patients with ATTRv V122I amyloidosis.

View Article and Find Full Text PDF

The causal protein of amyloid light-chain (AL) amyloidosis is a monoclonal immunoglobulin free light chain (mFLC), which must be quantified in the serum for patient diagnosis and monitoring. Several manufacturers commercialize immunoassays that quantify total kappa (κ) and lambda (λ) FLC, but results can differ greatly between these tests. Here, we compared a recently developed enzyme-linked immunosorbent assay (ELISA) (Sebia) with N-Latex immunonephelometry (Siemens) in 96 patients diagnosed with AL amyloidosis (histologically confirmed) and 48 non-AL patients sent to our referral center for suspicion of cardiac amyloidosis.

View Article and Find Full Text PDF
Article Synopsis
  • The study examined renal function in 232 adult patients with hereditary transthyretin (ATTRv) amyloidosis at a French center, revealing a significant prevalence of chronic kidney disease (CKD) in this group.
  • Older age and a history of hypertension were linked to a higher likelihood of CKD, while better heart function as indicated by left ventricular strain was associated with a lower prevalence.
  • Over 24 months, patients showed a significant decline in estimated glomerular filtration rate (eGFR), with rates of decline varying based on age and specific genetic variants, suggesting ongoing kidney issues among those with ATTRv amyloidosis.
View Article and Find Full Text PDF

Importance: Older patients are underrepresented in studies of rituximab for the treatment of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Little is known about outcomes and adverse events associated with the use of rituximab therapy among patients 75 years and older with ANCA-associated vasculitis.

Objective: To examine outcomes and adverse events associated with the use of rituximab therapy in patients 75 years and older with ANCA-associated vasculitis, specifically granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA).

View Article and Find Full Text PDF

Background And Objectives: After two doses of mRNA vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), patients on dialysis show a defective humoral response, but a third dose could increase anti-SARS-CoV-2 spike IgG titers. Responses could be different in virus-naive and SARS-CoV-2-recovered patients on dialysis. However, characterization of memory B cell response after three doses is lacking.

View Article and Find Full Text PDF

Objective: There is currently no evidence of the possible benefit of plasma cell-targeting therapies (PCTT) in immunoglobulin A (IgA) monoclonal gammopathy (MG) associated with IgA vasculitis (IgAV). We report the outcome of different PCTT regimens in a cohort of MG-IgAV.

Methods: We used a French network to retrospectively describe the outcome of MG-IgAV patients treated with PCTT.

View Article and Find Full Text PDF

Background: The prevalence, prognostic role, and diagnostic value of blood pressure in immune-mediated thrombotic thrombocytopenic purpura (iTTP) and other thrombotic microangiopathies (TMAs) remain unclear.

Methods: Using a national cohort of iTTP ( = 368), Shigatoxin-induced hemolytic uremic syndrome ( = 86), atypical hemolytic uremic syndrome ( = 84), and hypertension-related thrombotic microangiopathy ( = 25), we sought to compare the cohort's blood pressure profile to assess its impact on prognosis and diagnostic performances.

Results: Patients with iTTP had lower blood pressure than patients with other TMAs, systolic (130 [interquartile range (IQR) 118-143] vs 161 [IQR 142-180] mmHg) and diastolic (76 [IQR 69-83] vs 92 [IQR 79-105] mmHg, both  < 0.

View Article and Find Full Text PDF
Article Synopsis
  • A retrospective study evaluated the safety of three JAK inhibitors (ruxolitinib, tofacitinib, baricitinib) using data from the WHO database, focusing on their associated adverse events.
  • The analysis found a significant link between these drugs and various adverse events, particularly infectious diseases, musculoskeletal issues, and certain cancers, with ruxolitinib showing a notable risk for viral, fungal, and mycobacterial infections.
  • Tofacitinib was specifically associated with gastrointestinal perforations, while no significant increase in major cardiovascular events was reported across the drugs studied.
View Article and Find Full Text PDF

The COVID-19 pandemic has profound adverse effects on the population on dialysis. Patients requiring dialysis are at an increased risk of SARS-CoV-2 infection and mortality, and many have experienced psychological distress as well as delayed or suboptimal care. COVID-19 survivors have prolonged viral shedding, but generally develop a robust and long-lasting humoral immune response that correlates with initial disease severity.

View Article and Find Full Text PDF

Background And Objectives: Dialysis patients have a high mortality risk after coronavirus disease 2019 (COVID-19) and an altered immunologic response to vaccines, but vaccine clinical effectiveness remains unknown in this population.

Design, Setting, Participants, & Measurements: Using Bayesian multivariable spatiotemporal models, we estimated the association between vaccine exposure and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) severe infections (with hospital admission) in dialysis patients from simultaneous incidence in the general population. For dialysis patients, cases were reported within the French end-stage kidney disease REIN registry from March 11, 2020, to April 29, 2021, and vaccine exposure (first dose) was reported in weekly national surveys since January 2021.

View Article and Find Full Text PDF

Background: Maintenance haemodialysis (MHD) patients have a high risk of initial mortality from coronavirus disease 2019 (COVID-19). However, long-term consequences of this disease in the MHD population are poorly described. We report the clinical presentation, outcome and long-term follow-up of MHD patients affected by COVID-19 in a multicentric cohort from the Paris, France area.

View Article and Find Full Text PDF

Background: Data from the PEXIVAS trial challenged the role of plasma exchange (PLEX) in ANCA-associated vasculitides (AAV). We aimed to describe kidney biopsy from patients with AAV treated with PLEX, evaluate whether histopathologic findings could predict kidney function, and identify which patients would most benefit from PLEX.

Methods: We performed a multicenter, retrospective study on 188 patients with AAV and AKI treated with PLEX and 237 not treated with PLEX.

View Article and Find Full Text PDF