[C-reactive protein in inflammatory articular diseases: comparison of concentrations in blood and synovial fluid]. / La proteine C-reactive dans les affections inflammatoires articulaires: comparison des dosages sanguin et synovial.

We evaluated the diagnostic value of measuring C-Reactive Protein (CRP) in blood and in synovial fluid for the detection of inflammatory articular diseases in 154 patients. High concentrations of CRP in blood were found in microcrystalin arthritis, polymyalgia rheumatica and Horton's disease. Our results show a good correlation between CRP and erythrocyte sedimentation rate for ankylosing spondylitis (p less than 0.01), systemic lupus erythematosus (p less than 0.01), rheumatoid arthritis (p less than 0.05), polymyalgia rheumatica and Horton's disease (p less than 0.05). The CRP measurement in blood did not separate seropositive versus seronegative rheumatoid arthritis, systemic lupus erythematosus versus rheumatoid arthritis and treated versus non-treated rheumatoid arthritis. There was a good correlation between CRP concentration in blood and in synovial fluid but the concentration was lower in synovial fluid than in blood (p less than 0.01). Then, the CRP measurement in synovial fluid does not have a higher diagnostic value than in blood.

[A new case of Urbach-Wiethe disease. Electron-microscopy study]. / Un nouveau cas de maladie d'Urbach Wiethe. Etude en microscopie électronique.

A new case of Urbach Wiethe disease is reported. The diagnosis of this disorder, despite the existence of typical histological connective tissue deposits, was recognized late. The authors review the morphological characteristics of the disease, emphasizing that atypical clinical presentations may occur which underline the importance of the histological examination.

[Prolonged fever and latent tuberculous foci]. / Fièvres prolongées et foyers tuberculeux latents.

Two cases of prolonged fever are reported. In the first case a tuberculous abscess of the liver was considered after an ultrasonic examination of the periphery of an hepatic calcification discovered many years ago; a right hepatectomy confirmed the diagnosis. The second patient was treated twenty years ago for a tuberculous exsudative peritonitis. The pelvic examination showed a myoma. A computed body tomogram disclosed a picture of pyometritis. This was confirmed by laparotomy showing tuberculous salpingitis and pyometritis by praevia myoma.

[Diagnosis of prolonged eosinophilic pneumopathies]. / Diagnostic des pneumopathies prolongées à éosinophiles.

Prolonged pulmonary eosinophilia are defined by the association of a pneumonia and a blood eosinophilia persisting for over a month. They cover a wide range of disorders : prolonged Loeffler's syndrome, Carrington's chronic eosinophilia pneumonia, allergic bronchopulmonary aspergillosis, necrotizing vasculitis as Churg and Strauss allergic granulomatosis and angeitis and polyarteritis nodosa, and the hypereosinophilic syndrome. All these conditions may form a continuum centered by the poorly defined chronic eosinophilic pneumonia. This entity may result from a non treated Loeffler's syndrome or may progress to the severe necrotizing vasculitis or hypereosinophilic syndrome.

[Benign pseudo-tumoral lymphoid hyperplasia with massive Destombes-Rosai-Dorfman histiocytosis]. / Hyperplasie lymphoïde bénigne pseudo-tumorale avec histiocytose massive de Destombes-Rosai et Dorfman.

The authors report one case of sinus histiocytosis with massive lymphadenopathy which occurred in a 70 years old woman. They remind the main features of this pseudolymphomatous benign disorder with three key microscopic findings : massive sinus histiocytosis, lymphophagocytosis, proliferation of mature plasma cells. There is no effective therapy and nothing definite about the etiology.

[The urinary elimination of cobalt 57 in iron-deficiency anemia and in iron-overload states]. / L'élimination urinaire du 57cobalt dans les anémies hyposidérémiques et les états de surcharge en fer.

The authors used the 57 Co urinary excretion test to assess the intestinal absorption of iron in anemia associated with hypoferrinemia and in iron overload states. Among the anemia associated with hypoferrinemia, a high elimination of 57 Co had been found in all patients (15) with post-haemorrhagic iron deficiency anemia. Conversely, this elimination was very low in all 10 patients with anemia due to chronic inflammatory diseases. Moreover the test detected few iron deficiency anemia due to a decreased intestinal absorption of iron. In the iron overload states, the test had been performed in 2 subgroups of patients : chronic anemic patients with transfusional iron overload and hemochromatosis without anemia. In the transfusional iron overload group, 19 patients with thalassemia major who are routinely transfused have a moderate decrease of the 57 Co excretion. This finding probably reflects a continuing intestinal absorption of iron. On the other hand, 6 patients with acquired idiopathic sideroblastic anemia have a very low excretion. In the non anemic hemochromatosis, a high urinary level of 57 Co was present in 5 patients with idiopathic hemochromatosis when it was lower and variable in 6 patients with alcoholic siderosis. Using Wilcoxon, Mann and Whitney's non parametric test, there is a significant difference between the results of both groups. So, in idiopathic hemochromatosis, the high urinary level of 57 Co reflects an inappropriately high absorption of iron in spite of the iron overload and the test may be of value in detecting asymptomatic carriers of the disease.

[Glucagonoma without diabetes: a case report (author's transl)]. / Glucagonome sand diabète: une observation.

A further case of glucagonoma is reported, unusual features being the prolonged duration of cutaneous manifestations (12 years), and the absence of diabetes. Possible explanations for this anomaly: compensatory insulin or somatostatin secretion, production of a non functional glucagon, or low levels of circulating glucagon, are envisaged but without a formal response.