[Prophylactic and therapeutic use of a low molecular weight heparin fraction, CY 216]. / Utilisation prophylactique et thérapeutique d'une fraction d'héparine de bas poids moléculaire: CY 216.

The aim of our work was to study in a population of high risk patients with hemorrhagic and or thrombotic disease, the preventive or therapeutic effect of a low molecular weight heparin fraction, CY 216 (Choay, France), particularly in surgery. CY 216 was given to 9 patients for the treatment of a thrombosis (pulmonary embolism, acute ischemia, deep venous thrombosis) and to 40 patients in prevention of thrombosis. In this second group, 28 had a high thromboembolic risk such as valvular prosthesis, cardiac arrythmia, coronary artery bypass, etc. For all the patients, CY 216 was injected sub-cutaneously twice or three times a day at the mean dose of 1.5 mg/kg/d, equivalent to 300 U anti-Xa Choay/24 h, and always injected 24 hours before surgery. The biological tests used were: blood cells count, platelet count, prothrombin time, activated partial thromboplastin time, heparinemia levels by two technics: anti-factor-Xa activity and anti-factor IIa activity. None thrombotic complication was observed in the 40 patients prophylactically treated and a constant improvement of thrombosis was noted for the 9 patients with thrombo-embolic disease. In 3 patients, bleeding complications were observed: for 2 patients, all the coagulation tests were normal and anti-Xa activities were less than 0.55 U/ml; in one patient, the bleeding time was prolonged (15 minutes Ivy Incision) and returned to normal when the CY 216 was stopped. Concerning the biology, there was no modification except for anti-Xa activity which mean was 0.30 U/ml (01-07). However, this test is unable to predict either thrombotic or hemorrhagic events.

[Extramembranous glomerulopathy in chronic B lymphoid leukemia. 5 years' follow-up]. / Glomérulopathie extra-membraneuse au cours d'une leucémie lymphoïde chronique B. Recul de 5 ans.

A nephrotic syndrome due to membranous nephropathy and B chronic lymphocytic leukemia were simultaneously discovered in a 52 year old patient. Proteinuria was significantly reduced with chlorambucil therapy and nephrotic syndrome disappeared. Treatment withdrawal for 5 months resulted in a significant lowering of serum albumin level, while blood lymphocyte count increased. These observations indicate a probable causal relationship between the lymphoproliferative disease and the onset of the glomerulopathy which is supported by the efficacy of the chemotherapy on the evolution of the nephrotic syndrome.

[Hypophosphatasia in an adult, with late clinical manifestations (author's transl)]. / Hypophosphatasie de l'adulte à manifestations cliniques tardives.

A case of hypophosphatasia with osteomalacia and subtrochanteric pseudo-fractures is described in a 53 years old woman. Bone biopsy showed an excess of osteoid. Alkaline phosphatase activities in sera were low. There was no excretion in the urine of abnormal quantities of phosphoetanolamine. But alkaline phosphatase activities were low in bone and intestine. Two sons were affected by biological hypophosphatasia without clinical features. These data support the diagnosis of minimal hypophosphatasia in an adult.

[Bone marrow biopsy in the diagnosis of hematopoietic tuberculosis]. / Intérêt de la biopsie médullaire pour le diagnostic de la tuberculose hématopoïétique

The authors report 6 cases of tuberculosis of the bone marrow, in which the diagnosis was made by biopsy. Three of these cases, included peripheral blood abnormalities, such as pancytopenia, whereas in the three other, nothing special was found on routine blood examination. All the patients, except one who died from intercurrent infection, became cured thanks to anti-tuberculosis treatment. Marrow biopsy thus permits early diagnosis, miliary tuberculosis, even when usual radiological and bacteriological investigations are negative.