Search PubMed⌕ Search

Biomedical subjects

B Duquesnoy

Publications and source records attributed to B Duquesnoy.

At least 145 records · Page 8Linked to original sources

[Histomorphometric data in 5 cases of pseudohypoparathyroidism: discussion on bone sensitivity to parathyroid hormone].

We studied 5 patients (aged 8 to 18) presenting chronic calcipenia with hyperphosphatemia and an increase in C terminal-specific immunoreactive parathyroid hormone. Systematic radiography of the hands revealed 2 cases with signs of subperiosteal resorption characteristic of hyperparathyroidism and 2 cases of cortical fibrillation. These cases were monitored by measuring phosphate levels in the urine after injection of parathyroid hormone (Ellsworth-Howard test), by determining urinary elimination of cyclic AMP after injection of parathyroid hormone (Chase-Aurbach test) and by assaying cyclic AMP levels in the plasma after intravenous administration of parathyroid hormone (Tomlinson-Hendy test). These 3 measurements revealed no changes upon injection of parathyroid hormone, even after administration of vitamin D, thus suggesting renal resistance to parathyroid hormone. The absence of cyclic AMP secretion is suggestive of perturbation of the membrane receptor. Histomorphometric study of the bones showed an increase in resorption and osteoid areas and in the relative osteoid volume without modification of osteoid thickness, which is very suggestive of an effect of parathyroid hormone on the bone. Pseudohypoparathyroidism was, then, characterized by renal resistance to parathyroid hormone and an effect of the latter on bone cells.

Adolescent↗

[Bone involvement in hypothyroidism in adults. Apropos of 20 patients].

Although bone changes in hyperthyroidism are well known, they have been much less studied in hypothyroidism and we set out to establish whether they did occur in the latter condition. We present the results of a prospective study of 20 adult patients, with acquired primary hypothyroidism. No changes in urinary or blood calcium or phosphorus metabolism were observed and serum parathormone, 25-hydro, 125-dihydro and 24-25-dihydroxycholecalciferol concentrations were normal. Histological examination of iliac crest bone biopsy after double labelling with tetracycline showed normal bone trabeculation volume, surface of resorption and rates of calcification. However, the relative osteoid volume was increased and there was a much higher osteoid thickness index. These observations may be explained by a global decrease in the activation and activity of the multicellular units of bone remodeling due to the general slowing of cellular metabolism encountered in that condition.

Adult↗

[Sensitivity of bone to parathyroid hormone in type I pseudohypoparathyroidism. 6 cases].

The sensitivity of bone to parathormone in pseudoparathyroidism is not well known. Six patients with Type I pseudohypoparathyroidism (4 with Albright's osteodystrophy) had increased alkaline phosphatase levels (5 patients) and radiological signs of periosteal resorption in the hand in one case. All patients had histological signs of increased surfaces of resorption and periosteocytic lacunae, increased osteoid surfaces and relative osteoid volume with no change of the index of osteoid thickness. These changes are identical to those observed in hyperparathyroidism which leads on to the discussion of the role of the increased parathormone secretion induced by the lack of calcium on the remodeling of bone. Our six cases show that there is no bone resistance to parathormone. The diversity of bone changes in hyperparathyroidism, similar to that of primary hyperparathyroidism, is without doubt dependent on the degree of renal insensitivity to PTH through the inactivation of vitamin D.

Adolescent↗

[Current aspects of the osteoarticular pathology of hemodialysis patients. Results and discussion of a rheumatological survey].

In a prospective study, 80 patients undergoing long-term hemodialysis, 30% more than ten years, were evaluated for joint function and radiographic abnormalities; 58 patients (72%) had clinical symptoms; non-specific arthralgia was the most frequent; 15 patients had inflammatory pain (shoulders 9, hands 3) and diminution of finger mobility (10). Radiological examinations showed 40 abnormal findings in 23 patients (28%): erosive arthropathies of fingers (4), and multiple geodes of the carpus (8), of the humeral head (7) or of the hip (9). We also detected spondylolisthesis (4), erosive arthropathy of cervical (6) or lumbar (2) spine. Pathological study of synovial biopsies was performed in 16 cases. Amyloidosis was found in 4 samples taken routinely. In 2 other cases the biopsy was done on the basis of lesions seen on x-rays: we found amyloidosis in the synovial membrane in both patients and in the bone in one. In 8 patients we found C3 deposits positive in immunofluorescence. These results underline the role of amyloidosis in the mechanism of some arthropathies in long-term hemodialysis patients.

Adult↗

Cervical neurological complications of rheumatoid arthritis. Surgical treatment techniques and indications.

A critical study of 11 cases with neurological complications resulting from damage to the cervical spine during rheumatoid arthritis prompts the authors to reconsider their therapeutic strategy. After recalling the various neurological complications and their mechanisms, they propose an extension of the range of indications for surgical treatment. The limits of this extension are defined according to neurological and radiological criteria and the risks inherent in each method.

Adult↗

[Lateral radiculography in the vertical position for the diagnosis of narrow lumbar canal].

Results obtained in 66 cases emphasize the value of lateral imaging to increase sensibility of radiculography in the diagnosis of narrow lumbar canal. In all cases, in fact, the anteroposterior diameter of the opacified canal diminished in the standing position in proportions varying from 20 to 50%, and furthermore, in 20% of patients diagnosis was only possible from this image. Narrowing of the canal was considered as being present in patients with an anteroposterior canal diameter in the standing position that was less than 11 mm in corrected values. This image appears therefore to be an essential one, particularly as clinical symptomatology of narrow lumbar canal is very often atypical (62% of cases). Moreover, contrary to widespread opinions, computed tomography is sometimes less sensitive than radiculography in this type of disorder.

Humans↗

[Bone effects of hypothyroidism in adults. Apropos of 20 cases].

In contrast to the complications of hyperthyroidism, the bone lesions associated with hypothyroidism have not been extensively studied. A prospective study was conducted in 20 adults with protothyroid acquired hypothyroidism did not reveal any abnormalities in the parameters of phospho-calcium metabolism or the concentrations of PTH and the metabolites of vitamin D. The histomorphometric study of bone revealed hyperosteoidosis reflected by a considerable increase in the index of thickness of the osteoid, essentially affecting the relative osteoid volume. The surfaces of resorption and the bony trabecular volume were within normal limits and the rate of calcification was slightly decreased. The modifications of the histomorphometric investigation can be interpreted as a consequence of the slowing down of the basal osseous activity (BMR) due to thyroid hormone deprivation.

Adult↗

Circulating immune complexes and complement in rheumatoid arthritis.

Rheumatoid arthritis is characterized immunologically by the detection of rheumatoid factor (RF) and circulating immune complexes (CIC). The pathogenesis role played by these CIC has been discussed a long time. A part of this theoretical question, it could be of interest to know if these technics could help the clinician in the diagnosis or in the follow up of the patients with RA.

Antigen-Antibody Complex↗

[Phospho-calcium metabolism and bone histomorphometry in chronic alcoholism. Apropos of 25 cases].

Twenty five subjects, chronic alcoholics for more than five years, without any past history or clinical signs of portal hypertension or oedemato-ictero-ascitic decompensation, were examined by laboratory tests reflecting phosphoro-calcium metabolism and by transiliac bone biopsy with histomorphometric examination of nondecalcified bone. The subjects were fairly homogeneous in terms of liver function and liver disease, when present, was only minimal. The phosphoro-calcium parameters were generally normal, but hypomagnesaemia was observed. On the other hand, the histomorphometric study often revealed marked alterations: hyperosteoidosis: raised index of osteoid thickness (IOT) in 15 of the 25 cases, increase in the relative osteoid volume (ROV) in 12 cases and increase in the osteoid area (OA) in 8 cases. The bony trabecular volume (BTV) was only mildly reduced (13 out of 24) and there was increased resorption, reflected by an increase in the area of resorption (AR) seen in 15 cases, associated with a moderate increase in the area of periosteocytic lacunae (APOL). The essential changes consist of hyperosteoidosis with morphological osteomalacia in 60% of cases and reduction of the trabecular volume in 54%. Comparison of the different parameters reveals the following histomorphometric profile: BTV; AR; ROV; OA; IOT; APOL. Thus, histological bone changes occur in chronic alcholics before the appearance of signs of liver failure. These quantitatively minor changes are suggestive deficiency type bone.

Adult↗

[5-year treatment of rheumatoid polyarthritis with D-penicillamine].

A series of thirty patients with rheumatoid arthritis in whom D-penicillamine therapy was initiated more than five years ago was analyzed. Results were satisfactory in nine patients: two (6.6%) are still taking D-penicillamine and seven (23%) have experienced stabilization of their disease. In nine patients (28%) therapy was discontinued before the end of the third year because of adverse side-effects; no harmful side-effects were recorded after the third year. In ten patients (33%) D-penicillamine was discontinued because of ineffectiveness, either during the first year because of non-responsiveness (3 patients) or after the first two years because of escape phenomenon (7 patients). The authors compare their series to those previously reported in the medical literature. They believe that D-penicillamine should be given in progressive and moderate doses (averaging 600 mg per day). The mean duration of therapy with D-penicillamine was 27 months, lower than that recorded with chrysotherapy or anti-malarials; in 30% of patients, D-penicillamine was discontinued because of adverse side-effects. These findings show that, though D-penicillamine may be useful, it should be considered only after chrysotherapy.

Arthritis, Rheumatoid↗

[A new case of rheumatoid nodulitis].

A new case of rhumatoid nodulitis is reported in à 28 year old man presenting with rapidly regressive arthralgia, numerous rhumatoid nodules and metatarsal lesions without signs of associated arthritis. The biochemical profile was non-specific; serology was weakly positive for rhumatoid factor; there was no obvious immunological disorder (no circulating immune complexes, total complement and its various fractions within normal limits). The clinical findings, treatment and classification of this condition are discussed with reference to six other published cases with a similar clinical and paraclinical features.

Adult↗