A. Kheder

Renal transplantation in Tunisia — a three-year experience

Until June 1986 renal transplants for Tunisian patients were performed in Europe (2), but since then, a renal transplantation program has started at the Charles Nicolle University Hospital in Tunis. The responsibility for transplantation is shared between nephrologists, urologists and immunologists.

AB0634 Brown tumors in hemodialysis: study of 12 tunisian patients

Background Brown tumors are unusual but serious complications of renal osteodystrophy. This unusual complication of secondary hyperparathyroidism (HPT) is more commonly seen with increased longevity of hemodialysis patients and can be found in any bone Objectives We retrospectively studied 12 patients presenting with chronic renal failure and brown tumor related to secondary hyperparathyroidism Methods The purpose of this study is to analyze clinical, biologic and radiologic characteristics of brown tumors in our patients Results Eleven patients were on chronic hemodialysis and 1 case was chronic renal failure. The median duration between renal failure and end stage renal failure was 36 months (range: 12-190 months) and the median duration in dialysis for 11 cases: 92 months (range: 72-252 months). The bone pain was noted in all cases (100%), pathological fracture in one case (8%) and a palpable bone tumor in 10 cases (83%). Elevated serum calcium (> 2.35 mmol/L) was noted in four cases (33%), elevated serum Phosphate (> 1.78 mmol/L) in ten cases (80%), elevated serum alkaline phosphate (> 290 UI/L) in all cases and intact PTH was > 300 pg/mL in all cases with a serum median rate at 1475 pg/mL (range: 682-3687 pg/L). Subtotal parathyroidectomy was performed in all cases with a resultant decrease in size of brown tumors. Conclusions Phosphate binders and vitamin D are useful preventive measures of secondary HPT and brown tumors. Radiological bone evaluation is need to diagnosis asymptomatic brown tumors. Parathyroidectomy remains the first choice treatment leads often in a decrease of size of brown tumors. Remaining tumor mass may need sometimes local surgical removal after parathyroidectomy. Disclosure of Interest None Declared

AB0459 Rheumatologic manifestations of behçet’s disease: 250 cases

Background Behçet’sdisease (BD) is a chronic relapsing multisystem inflammatory disorder that is manifest in oro-genital ulcerations, characteristic skin lesions, intraocular inflammation and, less commonly, vascular, gastrointestinal, and neurologic manifestationsJoint manifestations are common in Behçet’sdisease, Their unusual forms deserve to be known Objectives To define the epidemiology and the clinical features of Behçet’sdisease giving special attention to unusual forms. Methods Retrospective review of 250 cases with joint manifestations identified among 330 cases of Behçet’sdisease seen over a 20-year period. All the patients met International Study Group for Behçet’sdisease criteria. Radiographs of all joints with arthritis were obtained. Starting ten years ago, a radiograph of the sacroiliac joint was taken routinely Results Joint manifestations were present in 75% and were inaugural in 30% of cases. Inflammatory arthralgias were the most common manifestation and observed in 81%, interesting mainly the large lower limb joints. Arthritis was less common: oligoarthritis (35%), monoarthritis (25%) and polyarthritis (15%). Sacroiliitis was observed in 7% of patients. Unusual forms like destruction polyarthritis, popliteal cyst, myositis were rare. Joint involvement is common in BD and could be the first manifestation of the disease. Most of the patients present with inflammatory arthralgias of the large lower limb joints. Disease course is usually favorable, spontaneously or with treatment. However, in our study population, skeletal manifestations were responsible for significant disability Conclusions Joint manifestations are common in Behçet’sdisease and could be the first manifestation of the disease. Their unusual forms deserve to be known since they can raise diagnostic problems when they are inaugural. Most of the patients present with inflammatory arthralgiasof the large lower limb joints. Disease course is usually favorable, spontaneously or with treatment. However, in our study population, skeletal manifestations were responsible for significant disability Disclosure of Interest None Declared

P001 - Variations de l’insulinémie au cours des troubles de la tolérance glucidique

Résultats : L’âge moyen des patients du groupe C (50,8 ans) est nettement supérieur à ceux des groupes A et B (37,3 et 35,7 ans). Le BMI des patients du groupe B est de 36,6 vs 27,08 et 27,24 pour les groupes A et C. L’insulinémie basale et après HGPO est plus élevée dans le groupe B (31,7 et 153,1 mui/l) que dans les groupes A et C. Une différence significative est retrouvée entre groupe A et B concernant d’autres paramètres tel que : PAS, PAD, taux de triglycérides et uricémie. Ces résultats confirment le rôle clé de l’obésité dans l’apparition de l’insulino-résistance et des troubles métaboliques. Une prévention primordiale basée sur un mode de vie sain constitue un élément essentiel pour faire régresser la prévalence du syndrome métabolique et éviter la dégradation de l’insulinosécrétion.