ABSTRACT
The authors report two cases of Löfgren's syndrome, preceded by febrile polyarthritis with rise in antistreptolysin titer. The relationship between sarcoidosis and rheumatic fever is discussed. A review of the literature concerning Löfgren's syndrome with joint pain, permitted the authors to follow the course of present pathogenic concepts which haveled to the present opinion of the sarcoidosis nature of Löfgren's syndrome, when the latter is accompanied by erythema nodosum. The prolonged rise in antistreptolysin 0 titer which might suggest rheumatic fever, was not explained, but as the streptococcus was never found in throat swabs, it is probable that this was a non-specific phenomenon. However, certain authors believe that streptococcal infection, where it exists, may play a role, if not in the etiology of the sarcoidosis, at least in the Löfgren's syndrome which may lead to its discovery.
Subject(s)
Erythema Nodosum/etiology , Rheumatic Fever/complications , Sarcoidosis/complications , Adult , Antistreptolysin/analysis , Arthritis/etiology , Diagnosis, Differential , Female , Humans , Male , Pharynx/microbiology , Radiography , Sarcoidosis/diagnostic imaging , Streptococcal Infections/complications , Streptococcus/isolation & purification , Tuberculin TestSubject(s)
Asbestosis/epidemiology , Asbestosis/complications , Asbestosis/diagnostic imaging , Bronchial Neoplasms/etiology , Calcinosis , Disability Evaluation , Female , France , Humans , Male , Mesothelioma/etiology , Peritoneal Neoplasms/etiology , Pleura/pathology , Pleural Effusion/etiology , Pleural Neoplasms/etiology , Pleurisy/etiology , Pulmonary Fibrosis/etiology , Radiography , Respiratory Insufficiency/etiology , Retrospective Studies , Risk , Time FactorsSubject(s)
Pneumothorax/chemically induced , Prednisone/adverse effects , Administration, Oral , Adult , Empyema/chemically induced , Humans , Hydropneumothorax/chemically induced , Male , Middle Aged , Pleurisy/drug therapy , Pneumothorax/etiology , Prednisone/administration & dosage , Punctures/adverse effectsABSTRACT
Spontaneous pneumomediastinum is a relatively rare disease, the clinical signs of which may be misleading, and the physiopathology is still unknown. The authors report 7 cases collected over a period of 3 years and note the etiology, the clinical findings and the X-ray findings. The disease often affectsyoung sybjects, without any sex predominance. The initial symptom is thoracic pain and is often accompanied by dispnea. Subcutaneous emphysema only appears secondarily and may be mild. The association with pneumothorax is not rare. Among the etiological circumstances, pneumomediastinum often occurs after an effort or a respiratory infection with dyspnea. The diagnosis depends on the discovery of subcutaneous emphysema and on radiological signs in A.P. and lateral chest views. Treatment should be as conservative as possible in the usual benign forms. It should be limited to bed rest, analgesics and sedatives. In severe cases, supra-sternal drainage permits decompression of the mediastinum. The physiopathological mechanisms are discussed, but the usually accepted theory is rupture of an alveolus into the pulmonary interstitial tissue. The pressure gradient necessary for this rupture may be due to variations in alveolar or vascular pressure.
