[Oesophageal motility abnormalities in systemic sclerosis: frequency and predictive factors]

Esophageal involvement is frequent during systemic sclerosis. It consists on esophageal motor abnormalities. Esophageal manometry is the gold standard for the diagnosis. To determine the frequency and the type of the esophageal motor abnormalities among patients presenting a systemic sclerosis; and to look for factors associated with a greater risk of theses disorders. A retrospective study relating to all the esophageal manometries carried out among patients presenting a systemic sclerosis was undertaken. During a 12 years period, 128 cases were studied. Esophageal motor abnormalities were found among 97 patients [76%]. Specific esophageal involvement was found among 52 patients [42%], and non specific motor abnormalities among 31 patients [24%]. The only associated factor with a specific esophageal involvement is occurrence of dysphagia. Esophageal motor abnormalities are frequent in patients with systemic sclerosis. They can be specific and nonspecific. Esophageal manometry should be systematically performed among these patients, even in the absence of dysphagia

Association d'un lupus erythemateux systemique et d'une dermatomyosite

Systemic lupus erythematosus [SLE] associated with dermatopolymyositis [OM]. This association is rare. Diagnosis may be difficult because of their common clinical findings. We report here a case. A 22-year-old man was admitted for arthritis with fever, diffuse myalgia and periorbital skin heliotrope rash. Electromyogram and muscular biopsy were suggestive of DM. The patient was treated with oral prednisone. Two months and a half later, he was admitted for impure nephrotic syndrome in relation with diffuse proliferative glomerulonephritis. Antibodies against native double- stranded- DNA were positive, and normal skin biopsy showed immune complex deposit on dermo-epidermic junction, suggestive of SLE. The patient was treated with high doses of prednisone and 6 monthly intravenous pulses of cyclophosphamide. Skin lesions and nephrotic syndrome improved. Presently, the patient remains asymptomatic. While being of different pathogenesis, SLE and DM may coexist in the same patient