[Two cases of polyarteritis nodosa with a good prognosis?]. / Deux périartérites noueuses de bon pronostic?

INTRODUCTION: Polyarteritis nodosa is a systemic necrotizing vasculitis that may become serious, even with no usual poor prognosis factors. EXEGESIS: We report two cases of polyarteritis nodosa with negative histology, starting only with an extensive necrosis of the extremities. The treatment, associating corticosteroids and, secondarily, immunosuppressors, did not prevent a bilateral half-leg amputation for the two patients. In the first case the disease stabilized, but in the second one, it worsened, leading to death within 2 years. CONCLUSION: This clinical aspect of the disease is unusual and should be identified because of its bad prognosis. It might benefit from a treatment from the outset associating corticosteroids and immunosuppressors, even with no usual bad prognosis factors.

[Peri-aortic fibrosis: unusual case of jaundice]. / La fibrose péri-aortique: une cause rare d'ictère.

Periaortic fibrosis is defined as the development of aortic perianeuvrysmal fibrosis either resulting from a focal inflammatory reaction or a self-perpetuating process. Compression of neighboring organs is a possible complication. Bile duct obstruction is exceptional.

[Cardiac amyloidosis: a restrictive cardiopathy with no single prognosis]. / L'amylose cardiaque: une cardiopathie restrictive au pronostic non univoque.

Cardiac amyloidosis is expressed as a restrictive myocardiopathy. Echocardiography suggests the diagnosis. There is a great difference between the prognosis of senile cardiac amyloidosis and "AL" amyloidosis. We illustrate this point with two case reports.

[Infectious endocarditis on permanent endocavitary stimulation leads: apropos of 2 cases]. / Endocardites infectieuses sur sondes de stimulation endocavitaire permanentes: à propos de deux cas.

BACKGROUND: Permanent endocavitary pacemaker lead infectious endocarditis is rare. Two new cases are reported. CASE REPORTS: The first case appeared in a 63-year-old white woman with a permanent endocavitary pacemaker for 3 years. It was caused by Streptococcus bovis, unique to this pathology. The second case was caused by Streptococcus epidermidis in a diabetic 72-year-old woman. In these two cases, the clues to the diagnosis were hemocultures and transesophageal echocardiography. CONCLUSION: These two cases emphasize the importance of transesophageal echocardiography (TEE) for diagnosis and for driving treatment. Treatment is based on appropriate antibiotics and pacemaker removal. In the second, case, the material was surgically removed under cardiopulmonary bypass because of the size of the infection.

[Acquired factor VIII inhibitor and chronic lymphoid leukemia: apropos of a case]. / Inhibiteur acquis du facteur VIII et leucémie lymphoïde chronique: à propos d'un cas.

The emergence of an autoantibody directed against factor VIII or "acquired haemophilia" is unusual. Half the time it occurs in a context of disease disrupting immunity. Chronic lymphoid leukemia seems to be an exceptional association but could not be fortuitous.