ABSTRACT
Harada's disease is a uveo-meningitis syndrome characterized by meningo-encephalic manifestations preceded by bilateral posterior uveal lesions. The etiology of Harada's disease is still unclear but it probably involves an auto-immune reaction to melanocytes. This mechanism would account for the high incidence of Harada's disease in dark-skinned patients. This report describes a case of Harada's disease that occurred in a 28-year-old woman from North Africa. Ophthalmologic manifestations were typical with regard to clinical features and course involving bilateral papillary edema followed by exsudative detachment of the retina and diffuse cicatricial epitheliopathy of the posterior poles. However neurologic signs were mild, the main finding being atypical headache, and this particularity delayed diagnosis. Limited cerebral involvement that did not coincide with ocular lesions explains the fact that a thorough search for posterior uveal involvement with the aforesaid features was necessary. Although it occurs mainly in dark-skinned Asians, Harada's disease deserves the attention of physicians practicing in tropical areas.
Subject(s)
Uveomeningoencephalitic Syndrome/diagnosis , Adult , Female , HumansABSTRACT
The authors have made a systematic study by PRICK-test and RAST, sometimes followed by a rhino-manometric provocation, of the frequency of sensitization to the two moulds Alternaria and Cladosporium in 200 "all comers" children in a paediatric consultation. The frequency was low, only 10% for those consulting in the groups of asthma, rhinitis, pollinosis, repeated respiratory infections and syndromes of obstructed expiration taken together, and 13% for allergic asthma only. This sensitivity is rarely isolated, but is most often accompanied, or complicated by, other pneumoallergens, such as dust, mites, pollens and sometimes cockroaches. It imposes certain particular clinical traits on asthma (summer asthma or recurring asthma) and in others appears to be strongly influenced by the habitat. The skin tests seem to be very weak and RAST insufficient to be sure of real sensitization. Diagnosis, always difficult, is probably best done by a provocation test (preferably rhino-manometry) and this jumps over the bundle of clinical and biological arguments, as well as being, at least in our country, the most useful mimic of atmospheric moulds. The authors insist on the importance of the interrogation which should be concerned with the chronological and environmental circumstances and all respiratory infections that are suspected of having an allergic factor.
Subject(s)
Alternaria/immunology , Cladosporium/immunology , Mitosporic Fungi/immunology , Respiratory Hypersensitivity/etiology , Adolescent , Allergens/immunology , Animals , Asthma/etiology , Child , Child, Preschool , Cross-Sectional Studies , France/epidemiology , Humans , Infant , Intradermal Tests , Radioallergosorbent Test , Respiratory Hypersensitivity/diagnosis , Respiratory Hypersensitivity/epidemiology , Rhinitis/etiologyABSTRACT
From a case in a 13 and half year old girl, the cardiospasm diagnostic basis are pointed out. Though infrequent this disease can occur in children and infants. During initial stage, the dynamic radiographic signs are difficult to recognize. In a more advanced stage, radiographic signs are clear. Radiographic examinations are also necessary in evaluation of surgical results, mainly in looking for post-operative gastroesophageal regurgitation.
Subject(s)
Esophageal Achalasia/diagnostic imaging , Adolescent , Esophageal Achalasia/diagnosis , Esophageal Achalasia/etiology , Female , Gastroesophageal Reflux/diagnostic imaging , Humans , Postoperative Period , RadiographyABSTRACT
Among 998 children with recurrent respiratory diseases 26 children with selective IgA deficiency were found. Three groups were considered according to IgA level in serum: group I with IgA under 0.05 g per litre; group II with IgA between 0.05 and 0.3 g per litre; group III with IgA above 0.3 and under 1 g per litre. Non specific immunity was studied in these patients including immunoglobulin levels, alpha-1-antitrypsin (A.A.T.) phenotypes, phagocytosis of staphylococcus aureus by PMN, lysozyme level, complement system. Cellular immunity was evaluated by IDR tests and rosette forming cells (RE). Only non specific immune systems were disturbed in some patients and appeared as aggravating factors in IgA deficient patients. We found: Abnormal phenotypes of ATT in 11 cases; deficiencies of engulfment in 6 cases, of bactericidal activities of PMN in 7 cases out of 16 studied; decrease of lysozyme level in 4 cases out of 17 studied; increase of IgE level in 9 cases with atopic symptoms in 7 patients. In our experience the chief aggravating factor in IgA deficient patients is abnormal phenotype of AAT.
