[Diagnostic problems posed by a case of bird breeder's lung].
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Biomedical subjects
Publications and source records attributed to A Barois.
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3 cases of hypercalcemia are reported, among 14 tetraplegic patients with porphyria. The calciuria, the estimations of parathormone, calcitonin and the isotopic calcium balance studies, suggested in the two most serious cases, hypercalcemia due to immobilisation. The main factor seems to be the duration of the immobilisation. The predisposing role of renal failure and catecholamines is discussed.
A 6p+ chromosome was observed in a dysmorphic and mentally retarded child. The mother was found to be carrier of an insertion: ins(6;2) (p22;q24;q34). The patient was therefore trisomic for 2q24 leads to 2q34. The same insertion was found in his brother in the balanced state. A comparison of this observation and four other cases from the literature allows a description of the symptoms characteristic of trisomy 2q24 leads to 2q34 : mid-face hypoplasia, carp-shaped mouth, neurological disorders, severe mental retardation.
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Estimation of serum folate was carried out in 74 patients with various neurological disorders. Levels less than normal were detected in 63 of them, with mainly peripheral neuritis, cerebellar syndromes and/or psychological disorders. The role of certain etiological factors was demonstrated, e.g. alcoholism, malnutrition, diarrhea, anti-epileptic treatment. Links between these neurological disorders and the folate deficiency remain to be demonstrated. In at least 8 cases, treatment with folic acid seems to have had a favourable influence on the course of these disorders.
In this research involving 172 cases of acute primary polyradiculoneuritis, the authors draw attention to the frequency and seriousness of the autonomic disorders, notably circulatory disorders (arterial hypertension, bradycardia), water retention, disorders in glucose metabolism. They have found a close correlation between the development of arterial hypertension and levels of VMA and the cathecholamines and between the appearance of hyperglycaemia and the level of urinary 17 OH. Free water clearance is often negative and becomes positive as the paralytic syndrome improves. The biological picture is identical with that brought about by inappropriate secretion of HAD. From the therapeutic point of view, caution is advised in using certain procedures and in prescribing certain drugs.
The authors report a case of myelopathy associated with macrotic anemia. The prior inefficacy of treatment with B1, B6 and B12 vitamins, in spite of a normal Schilling test, suggested the possibility of folate deficiency, the concentration of which was found very low in the serum (1.5 mg/ml). The addition of folic acid to the vitamins already administered without success, was followed by rapid recovery of the anemia and a frank neurological improvement maintained after 10 months follow-up. The rare similar cases observed in the world literature are analysed here. The other neurological manifestations, due to folate deficiency, the etiological circumstances and the methods of diagnosis are recalled.
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