A nephrotic syndrome of tropical origin: case report and short review of the aetiology.

We present a case of nephrotic syndrome in a 38-year-old man of Ivorian origin. In the search of the cause of his illness an infection with Plasmodium malariae (P. malariae) was diagnosed by serology and by microscopy of a Giemsa thin blood smear which revealed rare gametocytes of P. malariae. Proteinuria significantly diminished within three months after antimalarial treatment. Antibodies against Schistosoma were detected as well. Examination of kidney biopsy revealed a discrete mesangioproliferative glomerulonephritis. This case highlights that a thorough history-taking may be essential and that infectious diseases should be included in the differential diagnostic thinking process when a nephrotic syndrome is diagnosed.

[Hemolytic uremic syndrome and thrombotic thrombocytopenic purpura]. / Syndrome hémolytique urémique et purpura thrombotique thrombocytopénique.

Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are thrombotic microangiopathies (TMA). Both familial and sporadic forms exist: anaemia, thrombopaenia, renal failure and neurologic disorders are common clinical features. The differential diagnosis depends on plasma levels of von Willebrand factor-cleaving protease: there is a deficiency of this protease in patients with TTP whereas its rate is normal in HUS. We remind pathophysiology, etiologies and treatment of these TMA.

[Shoshin beriberi: myth or reality?]. / Le Shoshin béribéri: mythe ou réalité?

Shoshin is a fulminating form of cardiac beriberi developing in a few hours in a young alcoholic. Without specific treatment it evulers, toward death by cardiogenic shock and metabolic acidosis. Treatment by thiamine and alkalinisation permits a spectacular and fast recovery.

Paleodemography: expectancy and false hope.

From parent populations (N = 50,000) stochastically generated, representing different levels of correlation (r) between the age at death and a hypothetical biological indicator (r = 0.8-0.98), reference samples and target demographic samples are randomly drawn. Two iterative techniques, proportional fitting procedure and Bayesian, are used to estimate from the reference samples the age distribution of the targets. Due to the random fluctuations of the pattern of aging, both in the reference and target samples, these techniques converge only in expectation toward the true value of a distribution, but not in practice for any particular realization. Nevertheless, these techniques allow the estimation of the average of an age distribution, even if its shape is unknown. Under the hypothesis that the target sample is drawn from a stationary population, this average represents the life expectancy at 20 years (plus 20 years). Using this mean age at death for the adults and the juvenility index at death (D5-14/D20-omega), a new set of paleodemographic estimators were derived from 40 archaic life tables. For a hypothesized stable population, they give the life expectancy at birth and at 20 years, and the probability of death at 1 and 5 years.