Cerebral toxoplasmosis in acquired immuno deficiency syndrome. A comparative assisted tomographic and neuropathological study of a case.

Authors report a case of fatal CNS toxoplasmosis in a young homosexual man suffering from Kaposi angio-sarcoma. This paper is principally concerned with CT scan and neuropathological correlations.

[Acquired immunodeficiency syndrome, Kaposi's disease and cerebral toxoplasmosis in a young man. Review of the literature apropos of a case]. / Syndrome d'immunodéficience acquise, maladie de Kaposi et toxoplasmose cérébrale chez un homme jeune. Revue de la littérature à propos d'un cas.

We report a new case of acquired immune-deficiency syndrome (AIDS) in a 43 year-old white homosexual man, characterized by the association of disseminated cutaneo-mucous Kaposi's sarcoma and cerebral toxoplasmosis. This man had Kaposi's sarcoma for about 10 years but evolution became quickly extensive in July 1981. Chlorambucil was prescribed at that time and was the cause of a pancytopenia. Death occurred in July 1982 due to a cerebral mass identified as toxoplasmosis on a left temporal biopsy. This observation is typical of AIDS, a new syndrome which suddenly developed in the last 2 years in the United States in homosexual men, Haitians and hemophiliacs, and is characterized by disseminated Kaposi's sarcoma and/or opportunistic infections, with a very high mortality rate. Severe toxoplasmosis of CNS has been reported in AIDS and appears to result from defects in cellular immunity which permit recrudescence of latent infection. Cerebral biopsy is necessary for the diagnosis of cerebral toxoplasmosis as seroconversion occurs infrequently in immuno-suppressed hosts. AIDS appeared in Western Europe in 1982. Most of the cases were reported in France, Denmark, Belgium and Great Britain. These cases differ from reported cases in the USA: fewer drug or poppers users, fewer homosexual men, an important number of people having lived or travelled in the Kaposi's endemic area (Mediterranean basin and Central Africa). The immunological profile of patients presenting AIDS in Europe doesn't seem to differ from the american profile: serious cellular immunodeficiency and marked increase in the suppressor/cytotoxic cell population. As in the United States, one may suspect, among several hypotheses, that it is caused by one or several transmissible agents now present in France. The nature of these agents, transmissible by sexual contacts and blood, is not yet known: the role of the CMV is now less probable and most of the studies look for the role of other factors such as the HTLV.

[Iatrogenic arthritis after intestinal by-pass as a treatment for obesity (author's transl)]. / Les polyarthralgies en rapport avec les dérivations intestinales.

The authors report three observations of patients having suffered from arthralgias as an aftermath of intestinal by-pass for treatment of refractory obesity. They remind the main troubles cropping up after such surgical treatment and refer to the data already existing in the literature dealing with articular manifestations. They think this pathology is in keeping with arthritis already reported in inflammatory colitis and they suggest a similar pathogeny.