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Biomedical subjects

A Ryckewaert

Publications and source records attributed to A Ryckewaert.

At least 73 records · Page 4Linked to original sources
PubMed1982

[Rheumatoid arthritis and HLA system. A search for correlations between histocompatibility antigens and characteristic features of the disease].

Possible correlations between the HLA antigens A, B, C and DR and the clinical and biological features of rheumatoid arthritis were investigated in 74 patients with positive serology. The DR 4 antigen was present in 46 of these patients (62%), being apparently more frequent in those whose disease had begun before the age of 35 (p less than 0.05). DR 4 was also more common in pure rheumatoid arthritis than in forms associated with Gougerot-Sjogren's syndrome (p less than 0.05). No correlation could be found between the HLA phenotype and the other parameters studied, i.e. sex, corticosteroid therapy. Steinbrocker's radiological stages, plasma levels of rheumatoid factor and gammaglobulins and presence of antinuclear antibodies.

Adult↗
PubMed1982

[Mechanisms and prognosis of neutropenia in Felty's syndrome. 27 cases (author's transl)].

Twenty patients with Felty's syndrome were investigated. Isotopic studies of polymorphonuclear neutrophils, bone marrow biopsies and autoradiographies, and cultures of granulous stem cells showed that neutropenia resulted from three mechanisms acting simultaneously: hypermargination of the neutrophils predominantly in the spleen, decreased production of granulocytes in the bone marrow, and peripheral hyperdestruction of the neutrophils. Anti-granulocyte antibodies were detected in 3/12 patients. Other factors present in the serum of 2/4 patients seem capable of inhibiting the growth of granulocytic stem cells. Secondary bacterial infection (77%) may explain the severity of the prognosis: 13 out of 27 patients died 4 years on average after neutropenia was diagnosed.

Agranulocytosis↗
PubMed1982

[Twenty-three cases of gonococcal arthritis (author's transl)].

Twenty-three cases of gonococcal arthritis involving 10 men and 13 women aged from 18-81 years (mean, 32 years) are reported. Seven of the men had developed urethritis 3 to 21 days previously. Seven of the women had no signs or symptoms of genital infection. Twelve patients presented with polyarticular lesions and 7 with monoarticular lesions heralded by migratory arthralgias. The joints most commonly affected were the knees, fingers, wrists and ankles. Ten patients had tenosynovitis of the flexor muscles of fingers, and 10 exhibited a skin rash suggestive of the condition. Haemocultures were positive for N.gonorrhoeae in 4 out of 12 patients. The organism was isolated from synovial fluid in 7/11 cases and from urethral and vaginal secretions in 9/20 cases. All patients were cured rapidly and without sequelae with penicillin or ampicillin.

Adolescent↗
PubMed1982

[Rheumatoid arthritis with antinuclear factor. A prospective study of 50 cases (author's transl)].

The clinical and laboratory features of rheumatoid arthritis (RA) with antinuclear factor (ANF) were prospectively analyzed in 50 patients and compared with those of another series of 50 patients of similar age, sex and duration of disease, but without ANF. The severity of articular lesions was about the same in both series, but systemic symptoms and Gougerot-Sjögren syndrome occurred more frequently in patients with ANF. Gold compounds and D-penicillamine appeared to be well tolerated by all patients. RA patients with ANF had more strongly positive responses to latex and Waaler-Rose tests. Farr's radioimmunoassay was sometimes positive (11/49), but as a rule, the degree of positivity was inferior to 50%.

Adult↗
PubMed1982

Nonosteomalacic osteopathy associated with chronic hypophosphatemia.

We studied bone histomorphometry in 19 patients with chronic hypophosphatemia related to an idiopathic renal phosphate wasting and without histological osteomalacia. Nine patients had renal lithiasis (group 1), three had radiological osteoporosis (group 2), and seven had lumbar pain (group 3). In the whole group of 19 patients, serum phosphate levels were low (24.9 +/- 2.1 mg/l), calcium in blood was normal, calcium in urine was increased, and iPTH was low. Histomorphometric data showed decreased osteoblastic surfaces with normal resorption surfaces, normal osteoid volume and calcification front. There was no correlation between serum phosphate level and histomorphometric parameters. There was no statistical difference between the data of the 3 groups of hypophosphatemic patients. We concluded that chronic hypophosphatemia in the adult doses not always lead to osteomalacia but to an unusual osteopathy characterized by an osteopenia due to an isolated decrease in bone formation. The respective importance of phosphate deficiency and of decreased iPTH level in the pathogenesis of this osteopathy is uncertain.

Adult↗
PubMed1982

HLA system and side effects of gold salts and D-penicillamine treatment of rheumatoid arthritis.

Among 67 patients with rheumatoid arthritis treated with gold salts (aurothiopropanol sulphonate) a significant correlation (p less than 10(-2)) was noted between gold toxic reactions, whatever their type, and the HLA antigens A1, B8, Cw7, and DR3. Forty-two patients were genotyped, and a correlation was observed between gold side effects and the haplotype A1 Cw7 B8 DR3 (p less than 10(-2), RR = 8.0). In addition 3 out of 4 cases of renal intolerance to D-penicillamine were observed in patients possessing the Cw7 B8 DR3 haplotype.

Adult↗
PubMed1982

[Osteoarticular diseases from J.M. Charcot to the present time].

In foreign countries Charcot's main contribution in the field is known as Charcot's joint. A special paper is devoted to this topic by Dr Hubault in this issue of the Revue. It is perhaps less widely known that Charcot's thesis was devoted to rheumatoid arthritis and that he wrote also interesting observations on gout. Pierre Marie gave many famous contributions to bones and joints diseases. In 1886 he described acromegaly. In 1890 he described hypertrophic pulmonary osteoarthropathy which he correctly linked with lung diseases although some of the cases he had collected in the literature were instances of pachydermo-periostosis. In 1900 he gave a brilliant description of achondroplasia in 2 of his patients: Anatole and Claudius. On the 11th of February 1898 he reported 2 patients which were the basis of a historical description of ankylosing spondylitis, on which papers by Strümpell and von Bechterew had appeared in 1884 and 1893. The subsequent works at the Clinique des Maladies du Système Nerveux de la Salpêtrière on sciatica and herniated disks are related in Professor de Seze's paper in this issue of the Revue.

Achondroplasia↗
PubMed1982

[Soluble SS-A, SS-B and RNP antinuclear antigen antibodies in 66 cases of pure or associated forms of Gougerot-Sjögren syndrome].

In a prospective study, 66 patients fulfilling the criteria of Sjögren's syndrome were evaluated from the standpoint of the presence of soluble SS-A, SS-B and RNP specific nuclear antigen antibodies. There were 25 cases of pure Sjögren's syndrome and 41 cases of this syndrome associated with a connective tissue disease. Anti SS-A antibodies were found in 10 per cent of cases and anti SS-B in 21 per cent, without there being any significant difference in prevalence between pure and associated forms of Sjögren's syndrome. Three patients simultaneously showed anti SS-A and anti SS-B antibodies, four had only anti SS-A and eleven anti SS-B. Amongst the forms associated with a connective tissue disease all of the latter were represented with an equivalent prevalence. 18 per cent of the patients had anti-RNP with a majority of associated forms of Sjögren's syndrome. In this population of 66 patients with Sjögren's syndrome, no clinical manifestation appeared to be correlated with the presence of anti SS-A and SS-B antibodies. Amongst the laboratory features, only cryoglobulins were significantly more frequent.

Adult↗
PubMed1982

[Unclassifiable inflammatory rheumatism with HLA B27].

The authors report on 25 patients carrying the HLA B27 histocompatibility antigen and suffering from un-classifiable inflammatory rheumatism. The group included 12 men and 13 women. At the time of the initial observation, the inflammatory rheumatism was localised particularly in the lower limbs, knees, ankles and heels, in 14 of the cases; 7 of the cases revealed chronic polyarthritis, with a largely symmetrical involvement of the joints in the fingers. At the end of the observation period, which lasted 38 months, on average (from 6 months to 1 1/2 years), the series included 3 cases of sero-negative polyarthritis, with symmetrical involvement of the fingers and bony erosions which can probably be classified with cases of rheumatoid polyarthritis (HLA B27 being a coincidence), 2 certain and 3 possible cases of ankylosing spondylarthritis. For several years following the onset of the disease, the majority of the other patient continued to suffer rheumatism of the lower limbs in exacerbations and often accompanied by talalgia.

Adolescent↗
PubMed1981

[Evolutive aspects of Sharp's mixed connective tissue disease. 23 cases (author's transl)].

Among 23 patients with Sharp's disease, 14 initially had only polyarthritis, Raynaud's syndrome and anti-ribonucleoprotein antibodies. During a mean 5.6 years (range: 1-7 years) follow-up these 14 patients, 2 cases of pericarditis, 1 case of trigeminal neuralgia, 2 cases of nephropathy and 1 case of pulmonary arterial hypertension were observed. The 9 remaining patients had symptoms of multiple collagen disease. They were followed up for a mean of 4.3 years (range: 3-7 years) and 3 developed pericarditis. We discuss the prognostic significance of anti-DNA antibodies (7 cases) and low serum complement (3 cases) which, when combined, seem to be associated with severe visceral lesions.

Antibodies, Antinuclear↗
PubMed1981

Action of vitamin D metabolites on PTH secretion in man.

We have examined the effects of metabolites of vitamin D [25OHD3, 1,25(OH)2D3, 24,25(OH)2D3, and 25,26(OH)2D3] on serum calcium and iPTH in human deficient-D osteomalacia. The four metabolites decreased iPTH, but only for 1,25(OH)2D3 was a significant correlation between increase of serum calcium and decrease of iPTH observed. The 24,25(OH)2D3 and 25,26(OH)2D3 decreased iPTH despite a decrease of serum calcium at the beginning of treatment. The 25OHD decreased iPTH before increased serum calcium. These results could be interpreted as a direct effect of metabolites of vitamin D on PTH secretion. However, the conversion of other metabolites and the calcium concentration in parathyroid cells must be determined before this hypothesis can be accepted.

24,25-Dihydroxyvitamin D 3↗
PubMed1981

Bone histomorphometric reproducibility in normal patients.

To study bone histomorphometry reproducibility in normal subjects, we performed during orthopedic surgery bone biopsies in 16 postmenopausal women. Each woman had four bone biopsies, two at the usual site in the iliac crest, one on the left and one on the right side, and two other biopsies just behind the usual site, one at each side. We performed measurements of trabecular bone volume, relative osteoid volume, osteoid surfaces, osteoclastic resorption surfaces and calcification front. The average values of the 16 patients were compared, on the one hand, two by two, by a student test, and on the other hand, by a variance analysis. By these two methods the results showed no significant difference between the average values of the 16 patients at each location for any of the histomorphometric parameters studied. However, there was a location variation which was estimated by the intra-individual variation for a given patient. On the other hand, we calculated from the variance analysis the location variance for a group of 10 to 100 patients. In any case all the parameters had a location variation which was high for osteoclastic resorption surfaces and relative osteoid volume when expressed in % of the absolute value of these parameters. The variation of the trabecular bone volume was 0--46. 15% (95% confident limit interval) in a single patient and the hypothetical value of the location variation was 41.6% for a group of 10 patients and 13.0% for a group of 100 patients.

Aged↗
PubMed1981

Bone histomorphometry in hemodialysed patients.

We performed bone histomorphometry in thirty hemodialysed patients. Ten patients had a double iliac bone biopsy to estimate bone histomorphometry reproductibility. There was no difference between the mean results for each of the 10 patients at each site. However, there was an intra-individual variation which was small for the parameters of formation and particularly osteoid thickness and mineralizing rate and greater for resorption parameters. Mineralization rate appeared the most reliable and discriminant parameter. These 30 patients were separated in two groups according to their mineralizing rate (MR); patients with an MR greater than 0.3 mu/day were in group I and had severe hyperparathyroidism without major impairment of bone mineralization and high formation rate. They also had high serum alkaline phosphatases and high serum parathyroid levels measured with a COOH terminal antibody (iPTH). Patients with a low MR less than 0.3 mu/day (group II) had a severe mineralization defect with low formation rate, normal alkaline phosphatase and significantly lower levels of iPTH than in group I. This last type of histological bone lesion could not be due to aluminum intoxication since the level of serum aluminum was the same in the two groups. The mineralizing defect appeared to be inversely correlated with the percent of osteoid surfaces covered by osteoblast and with the iPTH level. These data suggest that during the course of renal osteodystrophy PTH stimulates not only bone resorption but also bone mineralization by increasing osteoblastic number.

Adolescent↗
PubMed1981

[Synovial vascularization and inflammation. II. Electron microscopy study of capillary permeability using immunoperoxidase].

The distribution of IgG and IgM into the normal and rheumatoid synovial membrane have been studied by the authors by means of immunoperoxidase electron-microscopy. Within the normal synovial while the IgG are diffusing out of the capillary the IgG are kept in the vascular lumen. Within the rheumatoid synovia IgG and IgM widely diffuse out of the microvasculature. This finding suggest that the rheumatoid inflammation is raising the permeability of synovial capillaries towards IgM molecules.

Arthritis, Rheumatoid↗
PubMed1981

[Gonococcal arthritis].

Gonococcal arthritis, a rare complication of gonorrhoea, more frequent in women, causes polyarthritis in 75% of cases or monoarthritis. An erythematous skin rash or acute pustular rash (40%), recent signs of genital infection (75% of cases in man, less than 50% in women) suggest the diagnosis. The gonococcal nature of the arthritis is confirmed by isolation of the germ in the joint fluid, the blood and the skin biopsies. In about half the cases, these bacteriological investigations are negative, but the diagnosis remains very probable if the germ is isolated from one or other of the primary foci of the infection: ureter, cervix, vagina, rectum and even pharynx. The rapidly favourable course under antibiotic treatment with penicillin or ampicillin confirms the diagnosis. The pathogenesis of arthritis is a direct toxic action of the gonococcus on the synovial membrane and the periarticular structures. The role of circulating immune complexes recently demonstrated in gonococcemia is probably not relevant.

Arthritis, Infectious↗