Recherche

Appointments that are neither attended nor cancelled are a major cause of delays in our hospitals. If you are unable to keep your appointment, please let us know as soon as possible.  Any appointment that is missed and not cancelled at least 48 hours before the scheduled time will incur a fee:30 euros for a consultation or a standard scintigraphy scan100 euros for an MRI, an X-ray, a CT scan or a PET-CT scan€200 for a procedureThere are several ways to cancel an appointment:Through the MyHUB app, if you originally booked your appointment via the appUsing the cancellation forms available on our websiteOr by calling 02 555 55 55 and following the menu options until you reach the relevant department. 

Appointments that are neither attended nor cancelled are a major cause of delays in our hospitals. If you are unable to keep your appointment, please let us know as soon as possible. Any appointment that is missed and not cancelled at least 48 hours before the scheduled time will incur a fee: 30€ for a consultation or a standard scintigraphy scan100€ for an MRI, an X-ray, a CT scan or a PET-CT scan200€ for a procedure There are several ways to cancel an appointment: Through the MyHUB app, if you originally booked your appointment via the appUsing the cancellation forms available on our websiteOr by calling 02 555 55 55 and following the menu options until you reach the relevant department.  You can cancel your appointment up tu 48 hours before with no fees incurred

What is eosinophilic oesophagitis? Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease of the esophagus that affects children and young adults and manifests as difficulty swallowing (dysphagia), chest pain, and sometimes food becoming lodged in the esophagus. In children, esophagitis often manifests as vomiting, abdominal/chest pain, and refusal to eat. Patients often adapt their diet, avoid certain foods (bread, meat, rice), and eat more slowly. Chronic inflammation makes the esophagus stiffer, which can lead to narrowing (strictures). Therefore, to prevent this progression, long-term follow-up and maintenance treatment are indicated. First consultation Gastroenterology consultation, recording of symptoms, recording of any allergies and atopic diseases, and assessment of nutritional status. Diagnosis The diagnosis of EoE is based on the triad of symptoms of oesophageal dysfunction (particularly dysphagia), eosinophilic infiltration on oesophageal biopsies, and exclusion of other causes of oesophageal eosinophilia.Investigations Gastroscopy (OGD) with biopsies: Essential examination that may reveal rings, furrows, a trachealised appearance, white exudates (microabscesses), or a fragile mucosa. At least 6 oesophageal biopsies (proximal and distal) are essential.Histology: Confirmation of the presence of at least 15 eosinophils per high-power field.Full blood count (FBC): To look for blood eosinophilia, which is often moderate. Allergy assessment: Not indicated as a first-line investigation in adult patients; skin tests (prick tests) or specific IgE measurements, often targeting milk, wheat, eggs or soya, are sometimes performed, although their sensitivity is limited.Barium oesophagram (TOGD or OED X-ray): Performed in cases of significant stenosis (narrowing) to map the lesions before endoscopic dilatation. Treatments Treatment of EoE aims to reduce inflammation, relieve symptoms (dysphagia) and prevent fibrosis. First-line treatment is based on proton pump inhibitors (PPIs), topical corticosteroids (swallowed), or elimination diets, often continued long term. PPIs: Often the first step in reducing inflammation, although their exact mechanism in EoE is not strictly related to reflux (intrinsic anti-inflammatory effect). Topical/local corticosteroids: Orodispersible budesonide is highly effective in treating inflammation and relieving symptoms; it is reimbursed in Belgium in cases of resistance to PPIs.Elimination diets: Removal of the most frequently implicated allergenic foods (milk, wheat, soya, eggs, tree nuts, fish and shellfish), ideally under dietary supervision. These diets are difficult to follow in adults and affect quality of life. For these reasons, an elimination diet excluding one or two allergens (milk, or milk and wheat) may be offered as first-line treatment.Biological therapies: New biological medicines targeting inflammation, such as dupilumab, are used when treatment with PPIs and budesonide fails. Dupilumab is reimbursed in Belgium for this indication.Oesophageal dilatation: Performed endoscopically in cases of significant narrowing (stricture) of the oesophagus. Follow-up Eosinophilic oesophagitis is a chronic disease requiring long-term medical follow-up to prevent complications, particularly fibrosis or strictures. Follow-up, supervised by a gastroenterologist, combines symptom assessment, endoscopies with biopsies, and management of treatments (PPIs, corticosteroids, biologic medication, diet).Regular medical follow-up: An annual consultation, or even one every two years, is recommended to assess treatment adherence and symptoms.Endoscopic monitoring: This is necessary because symptoms alone are not sufficient to assess disease activity. A follow-up endoscopy is necessary if treatment is modified (dose reduction or discontinuation of a medication) to confirm histological remission (a decrease in the number of eosinophils to < 15 per field).Maintenance treatments: prescribed to prevent recurrences. Most patients relapse when treatment is stopped, underscoring the importance of chronic management. Multidisciplinary approach: Follow-up often involves an allergist and a dietitian, particularly if an elimination diet is undertaken (milk, wheat, etc.).Monitoring for complications: Repeated endoscopies make it possible to monitor the development of strictures (narrowing of the oesophagus).  Transition to adulthood The transition of patients treated and followed in paediatrics takes place during a gastroenterology consultation, in order to provide the necessary follow-up in adulthood. Our specialists Associated department

On the day of your consultation please go to one of the registration terminals in the central hall 20 minutes before your appointment.  Documents to bring with you Your identity documents Any document attesting to your rights to receive care (“BIM”, “réquisitoire” to cover medical expenses.) The results of or prescription for any examinations if applicable Documents to bring with you

What is it? Primary immunodeficiencies are rare diseases, most often of genetic origin, in which part of the immune system does not function properly from birth. They affect both children and adults and may sometimes only become apparent later in life. They most commonly manifest as infections that recur frequently, last a long time or respond poorly to treatment; some are associated with autoimmune or inflammatory manifestations. Recognising these signs enables an appropriate diagnosis and management. In the event of unusual and recurrent infections, a specialist consultation, following referral by your general practitioner, is recommended. Assessment and diagnosis Our Immunodeficiency Treatment Unit brings together internist-immunologists, paediatricians, biologists, pulmonologists, gastroenterologists and infectious disease specialists around the patient. The process begins with an immunological assessment: measurement of antibodies (immunoglobulins IgG, IgA and IgM), evaluation of the response to vaccines, analysis of immune cells and, when useful, genetic testing. This assessment enables an accurate diagnosis and identification of the type of deficiency. Care is personalised: prevention and rapid treatment of infections, appropriate vaccinations and, for many antibody deficiencies, replacement therapy with immunoglobulins administered in hospital (intravenously) or at home (subcutaneously). Regular follow-up aims to detect and treat any complications (autoimmune, pulmonary or digestive) and to adapt treatment over time. This coordinated, multidisciplinary approach, from childhood through adulthood, improves quality of life and reduces the risk of complications. Advice On a daily basis, simple measures help limit infections: keeping vaccinations up to date, good hand hygiene, regular dental care and prompt treatment of infections. Most episodes can be managed on an outpatient basis. However, you should seek medical advice without delay, or even go to the Emergency Department on the advice of our available specialist doctors, in the event of a high and persistent fever, breathing difficulties, a sudden deterioration in your general condition, neck stiffness or signs of a severe infection. If in doubt, contact your healthcare team: it is better to make one call too many. Specific care pathway 1. First signs and referral — Recurrent, persistent or poorly responsive ENT, bronchial or pulmonary infections may suggest an immunodeficiency. The general practitioner or paediatrician then refers the patient to a specialist consultation.2. Assessment and diagnosis — A blood test measures antibodies (IgG, IgA and IgM) and the response to vaccines; analysis of immune cells and, sometimes, genetic testing complete the assessment. These tests confirm the diagnosis and determine its type, such as common variable immunodeficiency (CVID), the most common form in adults.3. Starting treatment — When an antibody deficiency is confirmed, replacement therapy with immunoglobulins is generally offered, either by intravenous infusion in hospital or subcutaneously at home. This is combined with prompt treatment of infections and appropriate vaccinations.4. Long-term follow-up — Regular consultations are used to monitor treatment effectiveness, adjust doses and detect any autoimmune, pulmonary or digestive complications. Follow-up is coordinated between the various specialists.5. Daily life and support — Therapeutic education, support from patient associations and, for children, planning the transition to the adult team help patients live as well as possible with the condition. Useful documents File trajet.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficits_immunitaires_secondaires.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_entites_frontieres.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficits_immunitaires_combines.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficits_immunitaires_combines_severes.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficits_du_complement.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficit_selectif_iga.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficit_immunitaire_commun_variable.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficit_en_anticorps_specifiques.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_defauts_phagocytaires.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_defauts_de_commutation_de_classe.pdf Transition to adulthood Many primary immunodeficiencies diagnosed in childhood require lifelong follow-up. To ensure a seamless transition, the move from paediatrics to adult medicine is prepared in advance, progressively and with support. The young patient meets the adult care team, gains a better understanding of their condition and treatment, and becomes more independent. Paediatricians and adult physicians share medical information so that the transition takes place smoothly, without any loss of information or interruption in care. Focus / Research Our team participates in international research on inborn errors of immunity. The work of Jean-Christophe Goffard, conducted in collaboration with major academic networks, has notably helped explain why some people develop severe forms of viral infection: it has demonstrated the role of autoantibodies directed against type I interferons—key molecules in antiviral defence—and of underlying immune deficiencies, for example in severe COVID-19. This research improves the diagnosis of immunodeficiencies and paves the way for more personalised care. Our Specialists Associated department

What are interstitial pneumonias? Diffuse interstitial pneumonias are a group of relatively rare lung diseases. They are disorders of the lung parenchyma (that is, of the lung itself) with a varying degree of inflammation and fibrosis resulting in a sometimes severe respiratory insufficiency.  The principal pathologies covered by this term are •    Idiopathic pulmonary fibrosis •    Sarcoidosis •    Non-specific interstitial pneumonia •    Cryptogenic organising pneumonia •    Lung disorders secondary to autoimmune diseases (connective tissue disease and vasculitis)  •    Hypersensitivity pneumonitis (farmer‘s lung, bird fancier’s lung •    Some pneumonias of occupational origin (exposure to asbestos or to mineral or metal dust) or drug induced Idiopathic pulmonary fibrosis (IPF) Idiopathic pulmonary fibrosis (IPF) is the most common disease of this group, together with sarcoidosis. The annual incidence is estimated at 10 new cases for 100,000 persons per year and this figure seems to be rising. In IPF the lung is progressively destroyed and replaced by scar tissue. This results in an irreversible and progressive respiratory insufficiency.  Causes and risk factors Its etiology is unknown but smoking, pollution, exposure to certain viruses and the presence of gastroesophageal reflux are risk factors. There are also family forms in which gene mutations have been clearly identified.  IPF affects more men than women and is generally diagnosed at around the age of 60.  Diagnosis and treatment These diseases are rare and therefore demand particular expertise. The diagnosis is complex and requires a multidisciplinary discussion.  In the case of idiopathic pulmonary fibrosis there are two possible treatments: with Esbriet or Ofev. These do not cure the diseases but do make it possible to slow its progress.  If the patient shows no contraindications a lung transplant must be envisaged. In this particular case we work closely together with the lung transplant team. Multidisciplinary meetings are held regularly to discuss complex cases and we have a clinical research unit that permits access to an advanced research programme in this field and patients are invited to participate in international trials to test new treatments.  The Erasmus Hospital is a member of the European experts network in the field of diffuse interstitial pneumonia (ERN lung). We are active in the field of clinical research by providing the opportunity to participate in research protocols and clinical trials.  Finally, we support and participate actively in activities organised by patients’ associations, in particular the   Association Belge Francophone contre la Fibrose Pulmonaire (ABFFP). Useful documents Informations destinées aux patient(e)s Brochure : thérapie par Esbriet (pirfénidone) Brochure : Fibrose Pulmonaire Idiopathique (FPI) Brochure : traitement de votre Fibrose Pulmonaire Idiopathique (FPI) avec OFEV® File information_patient_pid_hub_v3.pdf File 1.2.d_interventions.pdf Requests for opinion Téléchargez le document de demande d'avis de la part du médecin traitant ou spécialiste à destination de la Clinique des pneumopathies interstitielles diffuses. Demande d'avis Multidisciplinary team Découvrez l'équipe multidisciplinaire de la Clinique de Pneumopathies interstitielles et diffuses. Organisation chart Our specialists

Care pathways, patient testimonials and health information: find all the videos on the H.U.B’s YouTube channel! Image Care pathways, testimonials, research, training and health information: find all H.U.B videos in one place! Brussels University Hospital offers a wide range of audiovisual content on YouTube (@hopitaluniversitairebruxelles). Content to help you better understand health, the hospital and its areas of expertise The channel offers several types of content: Care pathways and testimonials: discover patients’ experiences and the care provided by our teams. Hospital life and professions: meet the professionals who make the hospital come alive every day. Research and innovation: learn about the scientific projects and medical advances to which our teams contribute. Training and seminars: find content intended for healthcare professionals. Health information: access reliable explanations about diseases, their diagnosis, prevention and treatment. HOP'Voices: listen to podcast episodes and discover the topics that inspire our teams. One shared channel, improved access to health information By bringing this content together, H.U.B aims to make it easier for its various audiences to discover and share: healthcare professionals, patients, relatives and the general public. Subscribe to the channel now (@hopitaluniversitairebruxelles) and share the videos you find interesting and useful for yourself or your loved ones. Every share can help make health information accessible to everyone. Discover the H.U.B channel on YouTube!

What is a complication of haemodialysis? Haemodialysis is an essential treatment for patients with severe or end-stage kidney failure. Despite advances in dialysis techniques, it may be associated with acute or chronic complications, sometimes severe, which may require specialised care.These complications may be related to the dialysis session, vascular access, anticoagulant treatments, cardiovascular and metabolic disorders, or prolonged exposure to haemodialysis.Some complications are common, while others are rare and complex. Their diagnosis can be difficult in patients with multiple comorbidities and may sometimes require the involvement of several specialties. What are the main complications? Complications may occur during or after a dialysis session, or develop gradually over the course of follow-up.They include in particular:Hypotension and other haemodynamic complications during dialysis;Fluid, electrolyte and acid–base disorders;Cardiovascular complications;Reactions related to the dialyser or extracorporeal circuit;Haemorrhagic or thrombotic complications;Infections related to catheters or vascular access;Thrombosis, stenosis, aneurysms or other complications of arteriovenous fistulas;Mineral and bone disorders and vascular or valvular calcifications;Anaemia and malnutrition;Complications related to prolonged exposure to dialysis, particularly β2-microglobulin-related amyloidosis.Some of these complications may lead to repeated hospitalisations, loss of vascular access, a reduced quality of life or, in the most severe cases, be life-threatening. When should you seek medical advice? Specialist assessment is necessary, in particular, in the event of:Repeated or poorly tolerated hypotension during dialysis;Repeated difficulties in carrying out dialysis sessions;Prolonged or unusual bleeding after dialysis;Malfunction or thrombosis of a fistula or catheter;Signs of infection of the vascular access;Swelling, pain or changes in the appearance of the fistula;Cardiovascular or neurological disorders occurring during or after sessions;Persistent metabolic disorders despite treatment adjustment;Unexplained joint or bone pain in patients who have been on dialysis for a long time;Any unusual or difficult-to-explain complication. How is the diagnosis established? Diagnosis is based on a comprehensive clinical and laboratory assessment tailored to each situation.Depending on the suspected complication, investigations may include:Specialised clinical and laboratory assessment;Analysis of dialysis session parameters;Assessment of vascular access;Doppler ultrasound or specialised imaging;Cardiovascular examinations;Microbiological tests if an infection is suspected;Assessment of mineral, bone and nutritional parameters;Specialised investigations in the event of a rare or atypical complication.The aim is to rapidly identify the cause of the complication in order to initiate appropriate treatment and, whenever possible, prevent its recurrence. Our care at H.U.B. The management of complex haemodialysis complications at H.U.B. is based on close collaboration between the nephrology teams and the various specialties involved.Nephrological expertiseNephrologists assess and treat dialysis-related complications and adapt renal replacement therapy to each patient’s individual characteristics.Particular attention is paid to preventing complications and preserving vascular access in order to maintain the quality and continuity of haemodialysis treatment.Multidisciplinary careDepending on the clinical situation, care may involve:Nephrology;Vascular surgery;Interventional radiology;Cardiology;Infectious diseases;Anaesthesia;Intensive care;Nutrition;Internal medicine;Renal transplantation.This organisation enables rapid management of complications and facilitates access to specialised diagnostic and therapeutic techniques.Particular expertise in vascular accessVascular access is an essential component of haemodialysis treatment. Its preservation is therefore a priority.H.U.B. has established close collaboration between nephrologists, vascular surgeons and interventional radiologists, enabling the diagnosis and management of thromboses, stenoses, infections and other complications affecting arteriovenous fistulas and catheters.This approach aims to preserve vascular access and limit the need for catheters or the creation of new access sites.Paediatric–adult collaboration and transitionHaemodialysis complications also affect children and adolescents requiring renal replacement therapy.Within H.U.B., the paediatric nephrology teams at the Queen Fabiola Children’s University Hospital (HUDERF) and the adult nephrology team at Erasme Hospital collaborate to ensure continuity of care.Particular attention is paid to the transition from paediatric to adult care. This gradual transition ensures continuity of follow-up, the transfer of medical information and the young patient’s progressive development of autonomy.Research and innovation at H.U.B.H.U.B. contributes to advancing knowledge in the field of chronic kidney disease, dialysis and its complications.This activity helps improve the prevention, diagnosis and management of haemodialysis complications and, where relevant, enables patients to access clinical research projects or collaborations with specialised centres. Why choose H.U.B.? Specialist expertise in nephrology and renal replacement therapy;Management of common, rare and complex complications of haemodialysis;Close collaboration between nephrology, vascular surgery and interventional radiology;Access to specialised technical facilities;Multidisciplinary management of complex situations;Collaboration between paediatric and adult nephrology;Organisation of the transition of patients from paediatric to adult care;Collaboration with the renal transplantation centre;Opportunities to participate in research projects and expert networks. Our specialists Associated department

What is Pulmonary Arterial Hypertension (PAH)? Pulmonary arterial hypertension (PAH) is a rare and serious disease that affects the blood vessels in the lungs. These vessels become too narrow or stiff, which increases the pressure in the pulmonary arteries. As a result, the right side of the heart has to work much harder to pump blood, which can weaken it over time. If left untreated, PAH can lead to right heart failure. There is another rare form called chronic thromboembolic pulmonary hypertension (CTEPH), which is caused by blood clots in the pulmonary arteries (pulmonary embolism) and can present in a similar way to PAH. How to recognize pulmonary arterial hypertension? Symptoms may appear gradually. It is important to pay attention to them:Shortness of breath, even with moderate effort (climbing stairs, walking)Unusual, persistent fatiguePalpitations (rapid or irregular heartbeat)Chest painDizziness or faintingSwelling of the legs or ankles (edema)These symptoms are not specific to PAH, but if they persist, consult your doctor. Be aware: swollen legs and fainting (syncope) during exertion are very serious signs that require prompt medical attention. Who is at risk for pulmonary arterial hypertension (PAH)? PAH can affect people of all ages, from early childhood to the elderly. Certain medical conditions predispose individuals to PAH and require annual screening by cardiac ultrasound—this is the case for autoimmune diseases (such as systemic sclerosis) and hereditary forms.Patients with congenital heart diseaseAutoimmune diseases (e.g., scleroderma, lupus)People living with HIVAssociated with certain drugs or toxic substances (e.g., amphetamine derivatives, Mediator®)Causes and risk factorsIdiopathic: no known causeGenetic: hereditary formAssociated with other diseases (e.g., heart defects, liver cirrhosis, autoimmune diseases)Related to certain medications or toxic substances (e.g., Mediator®, amphetamines, and some chemotherapy drugs)Pulmonary arterial hypertension in BelgiumThis is a rare disease: about 15 to 50 cases per million inhabitants. This likely represents several hundred patients, but many remain undiagnosed. Early diagnosis is essential to improve quality of life and longevity. What kind of medical care is needed for PAH? How is Pulmonary Arterial Hypertension diagnosed?Pulmonary function tests: You breathe into a device that measures your lung capacity. This helps rule out other respiratory diseases.Electrocardiogram (ECG)Echocardiography: A simple, painless test that assesses heart function and detects elevated pressure in the pulmonary arteries.Right heart catheterization: This is the key test to confirm PAH. A small tube is inserted into a vein to directly measure blood pressure in the pulmonary arteries. The test is done under local anesthesia, is quick, and generally well tolerated.Chest CT scan or cardiac MRI: These provide detailed images of the heart and lungs and can detect abnormalities such as clots or malformations.Exercise testBlood testsWhat treatments are available?At homeOral medicationsVasodilators and antiproliferative agents: to widen the pulmonary vessels and alter their structureDiuretics: to reduce swelling and relieve the heart’s workloadOxygen therapy: If oxygen levels in the blood are too low, oxygen can be provided at home via a mask or nasal cannula.H.U.B also offers advanced outpatient therapiesContinuous infusions: Some treatments are administered continuously via a pump connected to a small catheter placed under the skin or into a central vein. These require specialized care.Targeted injectable therapies: Specific medications are injected regularly to relax the pulmonary arteries and improve blood flow.Cardiopulmonary rehabilitation: Supervised sessions of light physical activity to improve breathing during exertion, boost endurance, and manage stress and fatigue.Follow-up care may also include physiotherapists, nurses, psychologists, or dietitians, depending on the patient's needs.Specialized follow-up is essentialPulmonary Hypertension requires multidisciplinary care in a specialized center. At the Brussels University Hospital (H.U.B), the Pulmonary Hypertension & Heart Failure Clinic brings together:Expert cardiologists and pulmonologistsSpecialized nursesPhysiotherapists, dietitians, psychologistsSurgeons, geneticists, and radiologistsA personalized and coordinated care approachIn summary:PAH is a rare, serious but treatable diseaseSymptoms are often misleading: shortness of breath, fatigue…Early diagnosis helps improve quality of lifeEffective treatments exist, most of which can be done at homeH.U.B is a reference center for this condition  Need specialized advice or tailored follow-up? Would you like information for yourself or one of your loved ones?Contact the Pulmonary Hypertension and Heart Failure Clinic at H.U.BBy phone at +32 (0)2 555 59 53 or by email at SecMed [dot] Cardio [dot] erasme [at] hubruxelles [dot] be (SecMed[dot]Cardio[dot]erasme[at]hubruxelles[dot]be) Coordination with your primary care physician is possible.

Qu'est-ce qu'une maladie glomérulaire rare ? Les maladies glomérulaires sont des affections qui touchent les glomérules, les filtres microscopiques du rein chargés d'éliminer les déchets et l'excès d'eau de l'organisme. Lorsqu'ils sont endommagés, ils peuvent entraîner une perte de protéines dans les urines, la présence de sang dans les urines et une diminution progressive de la fonction rénale.Certaines de ces maladies sont rares et résultent d'anomalies génétiques, tandis que d'autres sont liées à un dérèglement du système immunitaire (maladies immunomédiées). Ces affections nécessitent une expertise spécialisée afin d'établir un diagnostic précis et de proposer un traitement adapté. Quels sont les symptômes ? Les manifestations varient selon la maladie et son stade d'évolution.Les signes les plus fréquents sont :Une protéinurie (présence excessive de protéines dans les urines) ;Une hématurie (présence de sang dans les urines) ;Des œdèmes, notamment au niveau des jambes ou du visage ;Une hypertension artérielle ;Une altération de la fonction rénale ;Une fatigue importante ;Dans certaines formes génétiques, des atteintes d'autres organes peuvent être associées.Certaines maladies peuvent évoluer silencieusement pendant plusieurs années avant d'être diagnostiquées. Comment établit-on le diagnostic ? Le diagnostic repose sur une évaluation approfondie réalisée par une équipe spécialisée.Les examens peuvent comprendre :Des analyses sanguines et urinaires ;Une évaluation complète de la fonction rénale ;Une biopsie rénale lorsque celle-ci est indiquée ;Des analyses immunologiques spécialisées ;Des examens génétiques visant à identifier une cause héréditaire ;Une évaluation des autres organes potentiellement concernés.L'identification précise de la maladie est essentielle pour adapter le traitement et déterminer le pronostic. Notre prise en charge au HUB Le HUB dispose d'une expertise reconnue dans le diagnostic et le suivi des maladies glomérulaires rares, qu'elles soient génétiques ou immunomédiées.Les patients bénéficient d'une prise en charge personnalisée intégrant les avancées diagnostiques et thérapeutiques les plus récentes.Expertise en maladies glomérulaires raresL'équipe de Néphrologie prend en charge l'ensemble des maladies glomérulaires rares, notamment :Les syndromes d'Alport et autres néphropathies héréditaires ;Les podocytopathies génétiques ;Les glomérulopathies liées aux anomalies du complément ;Les glomérulonéphrites à dépôts d'IgA ;Les glomérulonéphrites membranaires ;Les vascularites associées aux ANCA ;Le lupus érythémateux systémique avec atteinte rénale ;Les maladies glomérulaires associées à des maladies systémiques rares.Chaque dossier est discuté au sein d'une équipe spécialisée afin de définir la stratégie diagnostique et thérapeutique la plus appropriée. Une prise en charge multidisciplinaire La prise en charge des maladies glomérulaires rares nécessite souvent l'intervention de plusieurs spécialistes.Selon les besoins du patient, les équipes suivantes peuvent être impliquées :Néphrologie ;Génétique médicale ;Immunologie clinique ;Rhumatologie ;Médecine interne ;Anatomopathologie ;Ophtalmologie ;ORL ;Cardiologie ;Pédiatrie spécialisée.Cette collaboration permet une prise en charge globale tenant compte de toutes les dimensions de la maladie. Collaboration avec l'HUDERF De nombreuses maladies glomérulaires rares d'origine génétique se manifestent dès l'enfance ou l'adolescence. Le HUB collabore étroitement avec l'Hôpital Universitaire des Enfants Reine Fabiola (HUDERF) afin d'assurer un parcours de soins coordonné pour les jeunes patients atteints de maladies rénales rares.Un programme de transition pédiatrique-adulte est organisé afin d'accompagner progressivement les adolescents vers les soins adultes. Cette transition structurée permet d'assurer la continuité du suivi médical, le transfert des données cliniques et génétiques ainsi que l'acquisition de l'autonomie nécessaire à la gestion de leur maladie.Les équipes pédiatriques et adultes travaillent conjointement afin d'offrir une prise en charge cohérente et sécurisée tout au long de la vie du patient. Quels traitements sont disponibles ? Les traitements dépendent du type de maladie identifié.Ils peuvent comprendre :Des traitements visant à protéger la fonction rénale ;Des médicaments réduisant la protéinurie ;Des traitements immunosuppresseurs ;Des biothérapies ciblées ;Des traitements spécifiques de certaines maladies génétiques ;Une prise en charge des complications cardiovasculaires et métaboliques ;Une préparation à la transplantation rénale lorsque celle-ci devient nécessaire.L'objectif est de ralentir l'évolution de la maladie, préserver la fonction rénale et améliorer la qualité de vie. Recherche et innovation Le HUB participe activement à la recherche dans le domaine des maladies glomérulaires rares.Les équipes sont impliquées dans :Des registres nationaux et internationaux ;Des programmes de recherche translationnelle ;Le développement de nouveaux biomarqueurs diagnostiques ;Des études génétiques ;Des essais cliniques évaluant de nouveaux traitements ciblés.Cette activité permet aux patients d'accéder à une expertise de pointe et aux innovations thérapeutiques les plus récentes. Notre expertise Le HUB est un centre de référence pour les maladies rénales complexes et rares.Nos points forts :Expertise reconnue dans les maladies glomérulaires rares ;Accès à des analyses génétiques spécialisées ;Réunions multidisciplinaires dédiées ;Collaboration étroite avec les spécialistes des maladies systémiques et génétiques ;Parcours structuré de transition pédiatrique-adulte ;Participation active à la recherche clinique et translationnelle ;Approche personnalisée centrée sur le patient. Nos spécialistes Service associé

What is a complication after a kidney transplant? Kidney transplantation enables patients with end-stage kidney failure to regain kidney function and achieve a better quality of life. However, it requires long-term medical follow-up to preserve the function of the transplanted kidney and prevent or treat complications that may occur after transplantation.These complications may be related to the immune system, immunosuppressive treatments, infections, cardiovascular disease or the underlying kidney disease. Some complications may occur soon after transplantation, while others appear several years later.Specialised care makes it possible to detect abnormalities promptly, investigate their cause and adjust treatment in order to preserve the graft and the patient’s overall health. What are the main complications? Complications after kidney transplantation include, in particular:Acute or chronic rejection of the transplanted kidney;Infections, particularly opportunistic infections related to immunosuppression;Viral infections such as CMV or BK virus;Complications related to immunosuppressive medicines;Recurrence of the initial kidney disease in the graft;Cardiovascular and metabolic complications;High blood pressure, diabetes and lipid disorders;Haematological and bone complications;Cancers promoted by immunosuppression;Urological or surgical complications affecting the graft;Progressive deterioration of graft function, which may, in some cases, lead to transplant loss.The management of transplant patients therefore relies on a balance between sufficient immunosuppression to prevent rejection and limited immunosuppression to reduce the risk of infections, cancers and other complications. When should you consult a doctor? Specialist assessment is necessary, in particular in the event of:Increased creatinine levels or an unexplained decrease in graft function;New or increased proteinuria;Fever or signs of infection;Urinary symptoms or decreased urine output;Unexplained increase in blood pressure;Persistent digestive problems that may affect the absorption of medications;Adverse effects or suspected toxicity of immunosuppressive medications;Abnormal blood levels of anti-rejection medications;Detection of a viral infection such as CMV or BK virus;Appearance of a mass, skin lesion or other symptoms that may suggest a tumour-related complication.A change in the function of the transplanted kidney does not necessarily mean that rejection is occurring. Prompt investigation makes it possible to distinguish between the different possible causes and adjust the treatment. How is the diagnosis made? Diagnosis is based on regular monitoring and a specialised assessment of the graft function.Depending on the situation, the examinations may include:A blood test to assess kidney function;Testing for and quantification of proteinuria;Measurement of immunosuppressive drug levels;Testing for viral infections, particularly CMV and BK virus;An ultrasound scan of the graft and other imaging examinations;Testing for donor-specific antibodies (DSA);A biopsy of the transplanted kidney when necessary;Specialised microbiological, immunological or genetic tests, depending on the context.A graft biopsy can, in particular, help distinguish rejection from other causes of transplant dysfunction and guide treatment. Our care at H.U.B. The management of complications following kidney transplantation at H.U.B. is based on close collaboration between the nephrology and transplantation teams and the various specialties required for patient follow-up.Nephrology and transplantation expertiseNephrologists provide long-term follow-up for transplant patients, monitor graft function and adjust immunosuppressive treatment.In the event of graft dysfunction, a rapid assessment is carried out to investigate the various possible causes, including rejection, infection, drug toxicity, recurrence of the original kidney disease or a urological complication.Multidisciplinary careDepending on the clinical situation, various specialists may be involved:Nephrology;Kidney transplantation team;Urological surgery;Infectious diseases;Immunology;Anatomical pathology;Radiology;Cardiology;Endocrinology;Haematology;Oncology;Dermatology;Medical genetics.This multidisciplinary approach ensures comprehensive management of complications that may occur in transplant patients.Rejection of the transplanted kidneyRejection is an immune system reaction by the patient against the transplanted kidney. It may occur early or several years after transplantation.There are different mechanisms of rejection, and distinguishing between them is essential for selecting the appropriate treatment.Diagnosis is based on analysis of kidney function, testing for donor-specific antibodies, immunological assessment and, where indicated, a graft biopsy.Prompt management is essential to limit graft damage and preserve its function.Infections and complications related to immunosuppressionImmunosuppressive medicines reduce the immune response to prevent rejection, but they also increase the risk of infections.Specific monitoring is organised to detect certain viral infections, particularly CMV and BK virus, at an early stage. Early detection of BK virus replication makes it possible, in particular, to adjust immunosuppression and reduce the risk of graft involvement.Bacterial, viral, fungal or opportunistic infections may also require specialist management in collaboration with infectious disease specialists.Long-term complicationsFollow-up of transplant patients is not limited to monitoring the graft.Immunosuppression and chronic kidney disease may promote certain long-term complications, including cardiovascular diseases, metabolic disorders, bone complications and certain cancers.Preventive care is therefore put in place to reduce these risks and improve patient and graft survival.Recurrence of kidney disease in the graftSome kidney diseases may recur after transplantation and lead to a gradual decline in graft function.The risk of recurrence depends on the original kidney disease. Specific monitoring is organised for patients with a disease that may recur, allowing early diagnosis and appropriate management.Research and innovation at H.U.B.H.U.B. actively contributes to advancing knowledge in the field of kidney transplantation and its complications.The teams are involved in clinical and translational research projects focusing in particular on the mechanisms of rejection, the immune response, infections after transplantation and complications related to immunosuppressive treatments.This work helps improve understanding of post-transplantation complications and develop new diagnostic and therapeutic strategies.Paediatric–adult collaboration and transitionKidney transplantation can be performed in children and adolescents. Follow-up must then take into account specific issues relating to growth, development, schooling and the gradual acquisition of independence.Within H.U.B., the paediatric nephrology teams at the Queen Fabiola Children’s University Hospital (HUDERF) and the adult nephrology team at Erasme Hospital collaborate to ensure continuity of care.A transition pathway is organised for adolescents and young adults to gradually prepare them for transfer to adult teams, while maintaining appropriate monitoring of the graft and immunosuppressive treatment.This organisation ensures continuity of care and limits interruptions in follow-up during a particularly important period in the life of a transplant patient. Why choose H.U.B.? Specialised expertise in renal transplantation and long-term follow-up of transplant recipients;Management of common, rare and complex complications;Access to multidisciplinary expertise;Close collaboration between nephrology, transplantation, surgery and other specialties;Access to specialised immunological, virological, radiological and histopathological examinations;Management of rejection and complex graft dysfunction;Expertise in managing infections and complications related to immunosuppression;Management of patients experiencing recurrence of their kidney disease in the graft;Close collaboration between paediatric and adult nephrology;Organisation of the paediatric-to-adult transition pathway;Participation in clinical and translational research projects. Our specialists Associated department

What is thrombotic microangiopathy? Thrombotic microangiopathies (TMAs) are a group of rare diseases characterised by the formation of small clots in very small blood vessels. These clots can lead to a reduced platelet count, destruction of red blood cells (haemolytic anaemia), and damage to various organs, particularly the kidneys, brain and heart. The main forms of TMA are thrombotic thrombocytopenic purpura (TTP) and atypical haemolytic uraemic syndrome (aHUS).TMAs constitute a diagnostic and therapeutic emergency. Rapid management can now considerably improve patients’ prognosis. When should TMA be suspected? Symptoms may appear suddenly and vary from person to person:Severe fatigue related to anaemia;Bruising or bleeding related to a drop in platelet count;Decreased kidney function;High blood pressure;Neurological disorders (headaches, confusion, visual disturbances, seizures);Abdominal pain or involvement of other organs. How is the diagnosis established? Diagnosis is based on a rapid assessment carried out by specialised teams.Tests generally include:A complete blood count;Tests for signs of haemolysis;Examination of a blood smear to look for schistocytes;Assessment of kidney function;Measurement of ADAMTS13 activity to identify TTP;Specialised analyses of the complement system when atypical haemolytic uraemic syndrome (aHUS) is suspected;Additional tests to identify an underlying cause. Our care at HUB The management of thrombotic microangiopathies at HUB is based on close collaboration between several specialties to ensure rapid diagnosis and treatment tailored to each patient.Nephrology expertiseAs the kidneys are frequently affected in thrombotic microangiopathies, patients receive a specialist assessment within the HUB Nephrology Department. Nephrologists provide diagnosis, monitor kidney function and, when necessary, implement specialised treatments such as dialysis or targeted treatments for complement-mediated forms.Multidisciplinary careDepending on the clinical situation, various specialists work together to care for the patient:Nephrology;Haematology;Internal medicine;Intensive care;Neurology;Cardiology;Medical genetics;Specialised laboratories.This multidisciplinary approach ensures comprehensive, personalised care. What treatments are available? Treatment depends on the type of thrombotic microangiopathy (TMA) identified.Depending on the situation, it may include:Plasma exchange;Immunomodulatory treatments;Treatments targeting the complement system;Management of an underlying cause (infection, autoimmune disease, medication, pregnancy, transplantation, etc.);Specialised renal care, including dialysis if necessary. Research and innovation at HUB HUB actively contributes to the advancement of knowledge in the field of rare kidney diseases and thrombotic microangiopathies.Where relevant, patients may benefit from access to clinical research protocols, specialised diagnostic analyses, and the expertise of national and international reference centres.This research activity helps improve diagnosis, understanding of disease mechanisms, and the development of new treatments. Why choose HUB? Recognised expertise in nephrology and complex kidney diseases;Specialised multidisciplinary collaboration;Access to specialised diagnostic tests;Management of emergency situations;Participation in expert networks and research projects;Personalised support for patients and their families. Collaboration with HUDERF Some thrombotic microangiopathies, particularly forms associated with genetic abnormalities of the complement system, may manifest during childhood. HUB works closely with the Queen Fabiola Children’s University Hospital (HUDERF) to ensure coordinated care for children and adolescents affected by these rare diseases.For patients receiving paediatric care, a transition programme is organised between the paediatric and adult teams. This gradual transition ensures continuity of care, the transfer of essential medical information and support for the young patient towards autonomous care in adulthood.Nephrologists, paediatricians, geneticists and other relevant specialists work closely together to ensure optimal follow-up throughout the care pathway, from childhood to adulthood. Our specialists Associated department