Résumé
Antiphospholipid syndrome has received considerable attention due to its association with a number of serious clinical disorders including arterial and venous throboembolism, acute ischemic encephalopathy, and recurrent pregnancy loss. Thrombotic episodes are well recognized complication of Crohn's disease. Hypercoagulable state of the disease may be responsible for such thrombotic events. The association of IBD and autoimmune condition is also well recognized, even poorly understood. There may be a possible association between antiphospholipid syndrome and hypercoagulable state in Crohn's disease. Few reports on Crohn's diseases associated with antiphospholipid syndrome were documented. We experienced a 31-year-old female patient who was admitted for cerebral infaction and diagnosed of antiphospholipid syndrome with Crohn's disease.
Sujets)
Adulte , Femelle , Humains , Grossesse , Syndrome des anticorps antiphospholipides , Encéphalopathie ischémique , Maladie de CrohnRésumé
Nodular fasciitis is rare and benign fibroblastic proliferative disease which tends to be confused microscopically with spindle cell sarcoma. It is a distinctive lesion and a very important one because of its ability to simulate a malignant process. Histopathologically, nodular fasciitis can be grouped into three subtypes based on their relation with the fascia: subcutaneous, fascial, intramuscular. We report a case of nodular fasciitis misdiagnosed as Baker's cyst in a patient with rheumatoid arthritis.
Sujets)
Humains , Polyarthrite rhumatoïde , Fascia , Fasciite , Fibroblastes , Kyste poplité , SarcomesRésumé
Parkinson's disease is a chronic, progressive disorder characterized by progressive muscular rigidity, pill-rolling tremor, stooping posture, shuffling gait, and akinesia. Hand deformities associated with Parkinson's disease were first described in 1864 by Ordenstein. The hand deformity of Parkinsons disease consists of metacarpophalangeal joint flexion and interphalangeal joint extension. In clinical practice, the problem is often overlooked or misdiagnosed as rheumatoid arthritis. We experienced 2 cases of pseudorheumatoid hand deformities secondary to Parkinsons disease, and report these cases with a review of the literatures.
Sujets)
Polyarthrite rhumatoïde , Troubles neurologiques de la marche , Anomalies morphologiques de la main , Main , Articulations , Articulation métacarpophalangienne , Raideur musculaire , Maladie de Parkinson , Posture , TremblementRésumé
Amyloidosis is a disease that characterized by accumulation of an amorphous, proteinaceous materials in the various tissues and organs, but its origin is unknown. Recent clinical study showed that incidence of amyloidosis in rheumatoid arthritis was near 10% to 21%. Secondary amyloidosis is caused by accumulation of serum amyloid. A which is doing the acute phase behavior faster than C reactive protein. Symptoms of amyloidosis are various according to the involved organ. Gastrointestinal symptoms are obstruction, ulcer, malabsorption, and bleeding. Diarrhea is very intractable with the conventional antidiarrheal agent, the mechanism of that is infiltration of amyloid material in the intestinal myenteric plexus, sympathetic nerve and ganglion. We report a case of 65 years old woman with rheumatoid arthritis presented with abdominal pain, intractable diarrhea which was not controlled by antidiarrheal agents. Duration of arthritis is only 2 years. Immunohistochemical stain showed AA type which meant secondary form. We treated with Octreotide analogue and total parenteral nutrition for chronic diarrhea.
Sujets)
Sujet âgé , Femelle , Humains , Douleur abdominale , Amyloïde , Amyloïdose , Antidiarrhéiques , Arthrite , Polyarthrite rhumatoïde , Protéine C-réactive , Diarrhée , Pseudokystes mucoïdes juxta-articulaires , Hémorragie , Incidence , Plexus myentérique , Octréotide , Nutrition parentérale totale , UlcèreRésumé
The antisynthetase syndrome is characterized by inflammatory myositis associated with intersititial lung disease (ILD), polyarthritis, mechanic's hand, and Raynaud's phenomenon, and usually with fever. The patients with these conditions have autoantibodies to aminoacy1-tRNA synthetases (histidy1-, threony1-, alany1-, isoleucy1-, and glycy1-tRNA synthetase) ; the most common is anti-histidy1-tRNA sythetase (anti Jo-1), present in 20% of myositis patients in Western countries. However, the mechanisms of production of autoantibodies to aminoacy1-tRNA synthetases are not understood. Several hypotheses about the relationship of anti-aminoacy1-tRNA synthetases with inflammatory myositis have been reported. The poor prognostic outcome for the antisynthetase patients are related to ILD. We experienced two cases of antisynthetase syndrome which have characterized by the clinical manifestations, and report these cases with a review of the literatures.
Sujets)
Humains , Arthrite , Autoanticorps , Fièvre , Main , Ligases , Maladies pulmonaires , MyositeRésumé
Acute multifocal bacterial nephritis is a severe form of acute renal infection in which a heavy leukocytic infiltrate occurs throughout the kidney with intrarenal abscess formation. It is also early phase of renal corticomedullary abscess. It is imperative that a prompt acute diagnosis be made in most of these conditions, for these patients may be or may rapidly become septic and suddenly deteriorate if not treated appropriately and in a timely manner. Clinically, acute multifocal bacterial nephritis present as acute pyelonephritis and could be diagnosed by radiologic grounds including abdominal computerized tomography(CT) which demonstrates poorly defined wedge-shaped area of decreased contrast enhancement identical to those found in acute focal bacterial nephritis. This case was a women with high fever, pyuria and severe leukocytosis. It was diagnosed by abdominal computerized tomography which show multiple wedge-shaped area of decreased attenuation and by computerized tomography guide aspiration biopsy which demonstrates E. coli. We report one case of acute multifocal bacterial nephritis with the reviews of literatures which showed involvement of both kidneys
Sujets)
Femelle , Humains , Abcès , Ponction-biopsie à l'aiguille , Diagnostic , Fièvre , Rein , Hyperleucocytose , Néphrite , Pyélonéphrite , PyurieRésumé
Rhabdomyosarcoma is the most common sarcoma of children and adolescents. Rhabdomyosarcoma is a highly malignant soft tissue sarcoma that can arise in any site of the body containing striated muscle or its mesenchymal analogue. The common primary sites were head and neck including orbit, extremities, genitourinary tract, trunk, retroperitoneum, gastrointestinal tract, and thorax. There are basically three types of rhabdomyosarcoma: embryonal, alveolar, and pleomorphic; these categories may overlap histologically. Retroperitoneal rhabdomyosarcoma of embryonal type is rarely reported in an adult. Since we experienced a case of 25 X 20 X 12cm-sized retroperitoneal rhabdomyosarcoma of embryonal type, we report this with a review of literatures.
Sujets)
Adolescent , Adulte , Enfant , Humains , Membres , Tube digestif , Tête , Muscle strié , Cou , Orbite , Rhabdomyosarcome , Sarcomes , ThoraxRésumé
Early gastric cancer(EGC) is defined as carcinoma limited to the mucosa or submucosa, regardless of whether metastasis to lymph nodes have occurred, and the frequency of lymph node metastasis varies from 7 to 18%. The incidence of early gastric cancer has been increasing recently, probably with advance in the diagnostic procedure. Multiple gastric cancer, now cosidered to be a sort of multiple primary cancer by Moertels classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Multiple carcinoma was found in about 8.3% of 500 early gastric cancer cases at the National Cancer Center Hospital in Japan. In 77% of these, two lesions roexisted in the stomach. Coexistence of three lesions were found in 20% and more than four lesions in 3%. We report a case of multiple early gastric cancer of different histologic types in which two adenoma coexisted in the stomach.
Sujets)
Adénomes , Classification , Incidence , Japon , Noeuds lymphatiques , Muqueuse , Métastase tumorale , Estomac , Tumeurs de l'estomacRésumé
Early gastric cancer(EGC) is defined as carcinoma limited to the mucosa or submucosa, regardless of whether metastasis to lymph nodes have occurred, and the frequency of lymph node metastasis varies from 7 to 18%. The incidence of early gastric cancer has been increasing recently, probably with advance in the diagnostic procedure. Multiple gastric cancer, now cosidered to be a sort of multiple primary cancer by Moertels classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Multiple carcinoma was found in about 8.3% of 500 early gastric cancer cases at the National Cancer Center Hospital in Japan. In 77% of these, two lesions roexisted in the stomach. Coexistence of three lesions were found in 20% and more than four lesions in 3%. We report a case of multiple early gastric cancer of different histologic types in which two adenoma coexisted in the stomach.