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1.
Rev Med Interne ; 39(12): 950-954, 2018 Dec.
Article in French | MEDLINE | ID: mdl-29914710

ABSTRACT

INTRODUCTION: Bisalbuminemias consist in rare qualitative modifications of several aspects in the albumin pattern. Bisalbuminemias, most of which are not pathological, can be observed using capillary electrophoresis. CASE REPORTS: We report a case of hereditary bisalbuminemia diagnosed by chance while exploring chronic unexplained hypereosinophilia in a 42-year-old patient. The patient's normal lipid profile, the lack of an antibiotic treatment or pancreatic pathology, and the persistence of the bisalbuminemia after one month, suggested a diagnosis of genetic bisalbuminemia. In light of other such cases, we review the main causes of bisalbuminemia, both genetic and acquired. CONCLUSION: The diagnosis of genetic bisalbuminemia is made by first eliminating the usual acquired etiologies: analytical or drug interference, acute pancreatitis and binding of immunoglobulins. Then, after having checked the lipemic index, reviewed the patient's medical history, comorbidities, and treatments, repeating the electrophoresis will help identify the cause of the bisalbuminemia.


Subject(s)
Albumins/analysis , Anti-Bacterial Agents/therapeutic use , Artifacts , Blood Protein Electrophoresis , Hematologic Diseases/diagnosis , Serum Albumin/analysis , Adult , Albumins/metabolism , Diagnosis, Differential , Drug Interactions , Female , Hematologic Diseases/blood , Humans , Pancreatitis/blood , Pancreatitis/drug therapy
2.
Rev Pneumol Clin ; 66(5): 295-301, 2010 Oct.
Article in French | MEDLINE | ID: mdl-21087724

ABSTRACT

The pleuropulmonary manifestations of necrotising vasculitis are frequent and polymorphic. If the existence of extrapulmonary signs and the presence of neutrophil polynuclear anticytoplasmic antibodies are helpful for the diagnosis of a bout of vasculitis, the existence of pleuropulmonary symptoms can also make for discussion of infections or iatrogenic effects induced by immunosuppressive treatments.


Subject(s)
Lung Diseases/diagnosis , Pleural Diseases/diagnosis , Systemic Vasculitis/diagnosis , Antibodies, Antineutrophil Cytoplasmic/analysis , Churg-Strauss Syndrome/diagnosis , Granulomatosis with Polyangiitis/diagnosis , Humans , Microscopic Polyangiitis/diagnosis
3.
Acta Haematol ; 123(2): 110-6, 2010.
Article in English | MEDLINE | ID: mdl-20051682

ABSTRACT

Hairy cell leukemia (HCL) is a rare, chronic, B-cell, lymphoproliferative disorder. Treatment has been revolutionized by the advent of interferon (IFN)-alpha and purine analogs (PA). First-line therapy with PA yields complete response rates of 75-100%, with many long-lasting remissions. In the event of profound neutropenia and/or infectious complications, a short sequence of IFN-alpha may precede PA treatment. Because of the excellent results achieved with PA therapy, the potential role of rituximab (an anti-CD20 monoclonal antibody that is highly effective against most B-cell lymphomas) in HCL has yet to be elucidated. Six HCL cases treated with rituximab are reported herein with a view to elucidating the potential role of the drug in HCL. The indications essentially consist of relapsing or refractory disease, avoiding the cumulative toxicity of PA, consolidation therapy in order to eradicate minimal residual disease, and first-line therapy for patients with contraindications to PA and IFN-alpha.


Subject(s)
Antibodies, Monoclonal/therapeutic use , Leukemia, Hairy Cell/drug therapy , Adult , Aged , Aged, 80 and over , Antibodies, Monoclonal, Murine-Derived , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Cladribine/therapeutic use , Fatal Outcome , Female , Humans , Interferon-alpha/therapeutic use , Male , Middle Aged , Pentostatin/therapeutic use , Rituximab , Treatment Outcome
6.
Rev Med Interne ; 30(4): 365-8, 2009 Apr.
Article in French | MEDLINE | ID: mdl-18585825

ABSTRACT

We report a 69-year-old man admitted in intensive care unit for aseptic meningoencephalitis. Initially, suspicion of an infectious etiology led to introduce an anti-infectious treatment. Behçet's disease was diagnosed during hospitalization incited to screen for noninfectious etiologies. A high dose steroid therapy was rapidly effective. The diagnosis of neuro-Behçet's disease was entertained.


Subject(s)
Behcet Syndrome/diagnosis , Meningoencephalitis/drug therapy , Adrenal Cortex Hormones/therapeutic use , Aged , Behcet Syndrome/drug therapy , Behcet Syndrome/pathology , Brain/pathology , Humans , Magnetic Resonance Imaging , Male , Treatment Outcome
7.
World J Gastroenterol ; 14(1): 158-9, 2008 Jan 07.
Article in English | MEDLINE | ID: mdl-18176983

ABSTRACT

Acute liver failure (ALF) is relatively frequent during heat stroke (HS). This risk must be emphasized, because its incidence is higher than is usually thought. In a recent study by Weigand et al, two cases were reported in which liver failure was the leading symptom. We have confirmed their conclusion in a study of 25 cases of HS with ALF, compared with 25 other cases without ALF. Moreover, we observed that hypophosphatemia on admission could predict occurrence of ALF during HS. As for clinical and other biological parameters, phosphatemia should be monitored for at least 3 d in all cases of HS, even when it is thought to be mild.


Subject(s)
Heat Stroke/complications , Liver Failure, Acute/etiology , Adult , Heat Stroke/epidemiology , Humans , Liver Failure, Acute/epidemiology , Male , Risk Factors
8.
Ann Chir Plast Esthet ; 52(5): 528-30, 2007 Oct.
Article in French | MEDLINE | ID: mdl-17719711

ABSTRACT

Mediatisation of a scientific event could be neither controlled, nor verifiable. The experience which has been lived through the first worldwide allotransplantation of composite tissues of the face confirms that the actors of a surgical innovation are not the owners. Because there is neither confidentiality nor possible patent. Curiously the scientific world, providing with a sharing ethic, which rightly privileges the free spreading of knowledge in the way that most people could benefit of it. Obviously it is made without denied controversy, for truth as purpose. This scientific word that way joins the media one, with a specific ethic of the duty of information, but also interested in mercantile preoccupations quick to cultivate controversy not to enlighten this truth but to better sell pictures or papers. Than the author should only sustain this instrumentation which could certainly flatter him, and from which he could used, but in reality that paralysed him a little to go on in serenity with his shadow worker way.


Subject(s)
Facial Transplantation/ethics , Tissue Donors , Humans
9.
Rev Med Interne ; 28(9): 594-602, 2007 Sep.
Article in French | MEDLINE | ID: mdl-17624636

ABSTRACT

SCOPE: Clinical implications associated with polymorphisms in drug-metabolizing genes involved in the chemotherapy of colorectal cancers (5-flurorouracil, oxaliplatin and irinotecan) are reviewed. CURRENT SITUATION AND SALIENT POINTS: Treatments of colorectal cancers have been greatly improved last years but patients respond differently to identical medication. Genetic polymorphisms are one of the major causes of these individual responses to drugs associated with sometimes severe adverse effects. Pharmacogenetics is based on all polymorphisms that determine genetic human diversity associated with variable response to anticancer drugs. PERSPECTIVES: Morbidity and mortality related to toxicity or inefficacy of these drugs could be reduced by analyzing the pharmacogenetic profile of patients before treatment. Results should be integrated in protocols for monitoring and assessment the dosage of drugs.


Subject(s)
Antineoplastic Agents/therapeutic use , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/genetics , Pharmacogenetics/methods , Acetylcholinesterase/genetics , Antineoplastic Agents/adverse effects , Butyrylcholinesterase/genetics , Camptothecin/adverse effects , Camptothecin/analogs & derivatives , Colorectal Neoplasms/enzymology , Dihydrouracil Dehydrogenase (NADP)/genetics , Humans , Irinotecan , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Organoplatinum Compounds/adverse effects , Oxaliplatin , Polymorphism, Genetic
10.
Rev Med Interne ; 28(6): 424-5, 2007 Jun.
Article in French | MEDLINE | ID: mdl-17320248

ABSTRACT

INTRODUCTION: Prostatic localization of actinomycosis is unusual. CASE REPORT: We report the case of a 59 years-old diabetic man, hospitalised for a prostatic actinomycosis spontaneously fistulised in the rectum. Two species of Actinomyces were found in blood culture and in pus of the fistula. DISCUSSION: Therapeutic management including surgical treatment of the fistula and a specific antibiotherapy led to cure the prostatic infection due to Actinomyces.


Subject(s)
Actinomycosis/diagnosis , Diabetes Complications/microbiology , Prostatic Diseases/microbiology , Humans , Male , Middle Aged , Prostatic Diseases/diagnosis
11.
Rev Med Interne ; 27(6): 497-8, 2006 Jun.
Article in French | MEDLINE | ID: mdl-16546304

ABSTRACT

INTRODUCTION: In long-term survivors of testicular cancer, a greater risk of developing cardiovascular disease is reported. On the other hand, acute vascular event during chemotherapy is uncommon. CASE REPORT: We report on a case of acute myocardial infarction in a young man receiving chemotherapy (BEP) for testicular cancer. DISCUSSION: We suggest a causal association between chemotherapy and early myocardial infarction. The physiopathological mechanisms are discussed here.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Myocardial Infarction/chemically induced , Testicular Neoplasms/drug therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Bleomycin/administration & dosage , Cisplatin/administration & dosage , Echocardiography , Electrocardiography , Etoposide/administration & dosage , Humans , Male , Myocardial Infarction/diagnosis , Myocardial Infarction/physiopathology
12.
Metab Syndr Relat Disord ; 4(3): 185-95, 2006.
Article in English | MEDLINE | ID: mdl-18370737

ABSTRACT

The aim of this study was to ascertain if hyperhomocysteinemia is associated with the metabolic syndrome. The metabolic syndrome is a cluster of cardiovascular risk factors. Hyperhomocysteinemia is an obvious independent risk factor for atheroma, and thrombosis morbidity and mortality. EPIMIL is a prospective epidemiological survey, which began with a crosssectional study of cardiovascular risk factors in a French male population, followed by monitoring for 10 years. Initial data collection, blood pressure measurement, ECG, and blood samples have been performed. For the metabolic syndrome, we used the criteria of the Third Report of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP ATP III) on detection, evaluation, and treatment of high blood cholesterol in adults. Out of 2045 men aged 20-58 years (37.7 +/- 8.7 years), 185 (9%) have metabolic syndrome (at least three criteria), 587 (29%) have a plasma homocysteine level of >/=12 micromol/L, and 202 (10%) have a level of >/=15 micromol/L. Mean homocysteinemia is 10.97 +/- 5.01 micromol/L for the whole population and does not differ significantly with (11.4 +/- 6 micromol/L) or without (10.9 +/- 5 micromol/L) the metabolic syndrome, as does its value distribution. Nor does it correlate with the Body Mass Index (BMI), waist and hip measurements, or blood glucose, HbA1c, insulin resistance, and cardiovascular risk markers (CRPus, microalbuminuria). It weakly correlates with systolic and diastolic blood pressure, creatinine clearance, tobacco use, cholesterolemia, triglycerides, and free fatty acids, but not with HDL and LDL fractions, or lipoprotein(a) (Lp(a)). It contributes slightly to the 10-year vascular risk according to the Framingham equations or Score system. In this male population, homocysteinemia and the prevalence of hyperhomocysteinemia do not differ with or without the metabolic syndrome. Plasma homocysteine level does not correlate with its main criteria. Hyperhomocysteinemia is not associated with the metabolic syndrome; nevertheless, it should be monitored in high-risk cardiovascular patients.

15.
Arch Pediatr ; 12(3): 288-90, 2005 Mar.
Article in French | MEDLINE | ID: mdl-15734126

ABSTRACT

Abdominal pain is uncommon in patient with Epstein-Barr infection and is usually attributed to an enlargement of the liver or spleen. We report on an 8-year-old girl with a pseudoperitonitis due to a mesenteric lymphadenitis associated with Epstein-Barr infection. Outcome was favourable without surgery. We review the different causes of abdominal pain occurring during Epstein-Barr infection.


Subject(s)
Abdominal Pain/etiology , Infectious Mononucleosis/complications , Mesenteric Lymphadenitis/complications , Mesenteric Lymphadenitis/etiology , Abdominal Pain/diagnostic imaging , Acute Disease , Antibodies, Viral/analysis , Child , Female , Follow-Up Studies , Herpesvirus 4, Human/immunology , Herpesvirus 4, Human/isolation & purification , Humans , Immunoglobulin M/analysis , Infectious Mononucleosis/diagnosis , Mesenteric Lymphadenitis/diagnosis , Mesenteric Lymphadenitis/diagnostic imaging , Radiography, Abdominal , Time Factors , Tomography, X-Ray Computed , Treatment Outcome
19.
Rev Med Interne ; 24(5): 282-7, 2003 May.
Article in French | MEDLINE | ID: mdl-12763173

ABSTRACT

PURPOSE: Prothrombin gene mutation G20210A (factor II) is, in frequency, the second genetic polymorphism involved in venous thrombosis. We report a retrospective studies on 38 patients issued from our medical department, all heterozygous for the factor II mutation and a literature review. METHODS: We have studied 38 patients, all heterozygous for the factor II mutation, selected through a population of 516 tested patients issued from our medical department from 1997 to 2002. The research was performed face with history of thrombotic or obstetrical events, angiopathy or familial screening. RESULTS: Twenty out of thirty-eight patients have at least one episode of venous thrombosis: superficial thromboses, deep thromboses and/or pulmonary embolism. One case of cerebral thrombophlebitis is observed. Venous thrombotic risk factors are associated in 12 cases (60%). Four out of thirty-eight patients have one episode of arterial thrombosis: cardiovascular, peripheral or cerebral. Arterial thrombotic risk factors are associated in all cases. Median age of the first venous thrombosis is earlier than the one of arterial thrombosis (39.11 versus 49.25 years). CONCLUSION: Our studies confirms the interest to search the prothrombin gene mutation when faced with a venous thrombotic event (deep vein thrombosis and/or pulmonary embolism) with or without acquired risk factors. Its involvement in thrombotic arterial disease is still a matter of debate. Data concerning its involvement in systemic diseases and angiopathies (thromboangeitis obliterans, Raynaud's phenomenon and migraine) are still needed. Mechanisms of thromboses could be an increase of prothrombin plasma level with high thrombin synthesis.


Subject(s)
Heterozygote , Mutation/genetics , Prothrombin/genetics , Pulmonary Embolism/genetics , Thrombosis/genetics , Adult , Aged , Arteries , Female , France/epidemiology , Genetic Carrier Screening , Genetic Testing/methods , Humans , Male , Middle Aged , Polymerase Chain Reaction , Polymorphism, Genetic/genetics , Prothrombin/metabolism , Pulmonary Embolism/blood , Pulmonary Embolism/epidemiology , Retrospective Studies , Risk Factors , Thrombosis/blood , Thrombosis/epidemiology , Veins
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