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Resume Introduction De nombreuses complications cutanees ont ete decrites chez les malades traites par ciclosporine. Parmi elles, les atteintes du follicule pilo-sebace sont particulierement frequentes. La ciclosporine peut en effet declencher une hypertrichose, une keratose pilaire, une acne ou des folliculites. Elle peut plus rarement provoquer une hyperplasie sebacee. Nous en decrivons un cas exceptionnel. Observation Un homme âge de 27 ans, greffe renal depuis 1993, a consulte en fevrier 2003 pour une eruption papuleuse du visage survenue au cours d’un traitement par ciclosporine et prednisone. Les lesions confluaient sur presque toute la surface des joues, du front et sur les regions temporales. L’examen histologique a confirme le diagnostic d’hyperplasie sebacee. Un traitement par isotretinoine a ete debute ; une amelioration etait perceptible des le premier mois de traitement. Discussion Des hyperplasies sebacees ont ete decrites chez environ 10 p. 100 des malades traites par ciclosporine, mais uniquement chez des hommes âges de 40 ans en moyenne. Il s’agissait le plus souvent d’une augmentation de la taille des glandes sebacees, les formes profuses restant exceptionnelles. Notre cas est remarquable en raison du jeune âge du malade, de la survenue rapide, mais tardive par rapport a l’introduction de la ciclosporine, et de la profusion des lesions.

HLA class I typing performed in parallel by molecular biology and serology has revealed cases where an HLA class I allele was identified whereas the corresponding antigen was not detected on the cell surface. In the present report, we describe four members of a family in whom an HLA-A1 allele identified at the molecular level was typed as A "blank" by lymphocytotoxicity. This serologically blank antigen was undetectable by isoelectric focusing (IEF). Sequencing of the HLA-A*01 allele from the promoter region to the eighth exonic region revealed insertion of a "C" nucleotide at the beginning of the fourth exon as compared to the common HLA-A*0101 allele. This mutation causes a frame shift, giving rise to an early stop codon in the fourth exon.

Besides hepatocytes, representing the main replication site of hepatitis C virus, peripheral blood mononuclear cells also represent a crucial target for viral infection. Hepatitis C virus compartmentalization (i.e., non-random distribution) of viral variants between plasma and peripheral blood mononuclear cells, more frequently observed in liver transplant patients compared to non-transplanted patients, makes liver transplantation an interesting model for the analysis of hepatitis C leukotropism. This article aims to present, firstly, in clinical and biological features arguing favour of hepatitis C virus infection leukotropism and, secondly, to review current knowledge about compartmentalization between plasma and peripheral blood mononuclear cells, especially in the liver transplantation setting.

Many cutaneous complications have been reported in patients treated with cyclosporine. Alterations of the pilosebaceous follicle are particularly frequent. Hypertrichosis, follicular keratosis, acne and folliculitis are very common. Nevertheless, the occurrence of sebaceous hyperplasia is exceptional.A 27 year-old man consulted in February 2003 for a papulous eruption of the face. He was treated by cyclosporine and prednisone since his renal transplantation in 1993. The lesions flowed together on the cheeks, forehead and temples. The histological analysis confirmed the diagnosis of sebaceous hyperplasia. There was a perceptible improvement of the cutaneous state after one month of isotretinoin treatment.Sebaceous hyperplasia appears in about 10 p. 100 of patients treated with cyclosporine. This side effect occurs only in men of a mean age of 40 years. An increase in sebaceous gland size is often described, but profuse forms are uncommon. Our case report is exceptional because of the young age of the patient, and the occurrence of diffuse sebaceous hyperplasia that appeared a long time after the introduction of cyclosporine.

To study the course of pregnancy after renal transplantation and to assess the impact of the pregnancy on the renal graft.[corrected] Retrospective study of 20 pregnancies from 16 renal transplant recipients between January 1987 and December 1998. Mean patient age was 30.3 +/- 4 years. Mean time between transplantation and the onset of pregnancy was 56.4 +/- 34.8 months.The main maternal complications were hypertensive disorders (7 cases) of which 3 preeclampsia. The mean gestational age at delivery was 36 +/- 3.1 weeks. Ten patients delivered prematurely of which 9 were induced prematurity. Nine cesarean sections were carried out either for obstetrical reasons or for causes not directly related to the transplantation. The mean neonatal weight was 2386 +/- 644 g with five small for gestational age. We did not observe any acute rejection. The follow up revealed six cases of chronic rejection. None of them seemed directly related to the pregnancy.The course of pregnancy after renal transplantation is generally uncomplicated without increased risk of graft lose. However, a stable renal function and an interval of two years or more after the transplantation are requested before allowing a pregnancy. Hypertension, diabetes mellitus or impaired renal function (creatininemia150 mumol/l) are contraindications for pregnancy.