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Biomedical subjects

B Duquesnoy

Publications and source records attributed to B Duquesnoy.

At least 163 records · Page 9Linked to original sources

Immune complexes in ankylosing spondylitis and controls.

Slight elevations in circulating immune complexes (CIC) were found in 10 ankylosing spondylitis patients when compared to healthy subjects, whilst higher levels of CIC and other complement products were found in patients with Reiter's syndrome and reactive arthritis. It is suggested that complement studies should be carried out at different stages of the disease; firstly during episodes of infection and secondly during the stage of chronic inflammatory disease.

Antigen-Antibody Complex↗

[The reactive arthritis syndrome. Rheumatological limits].

The term reactive arthritis (RA) refers to an inflammatory joint disease in the absence of bacteria in the joint, but which is caused by a distant extra-articular infection. They occur as a result of a variety of infections, which are essentially genital or gastro-intestinal in subjects with a particular genetic predisposition characterized by the presence of the HLA-B27 antigen or one of the CREG group of antigens (B7 - B27 - BW22 - BW42). The most complete clinical expression of reactive arthritis is the Fiessinger-Leroy-Reiter syndrome. Apart from the reactive arthritis with a generally accepted aetiology such as those following infections of the genital tract (Chlamydia trachomatis, Ureaplasma urealyticum or of the gastrointestinal tract: Yersinia enterocolitica and pseudotuberculosis, Shigella flexneri, Salmonella minor, Campylobacter jejuni), the authors discuss the possibility of including, in a broader definition of RA, post-streptococcal arthritis and cases of arthritis following gonococcal, meningococcal and Brucella infections. RA does not always have a favourable clinical course. It is not exceptional to see a picture of recurrences with progression towards chronic inflammatory rheumatism.

Arthritis↗

[Treatment of algodystrophies].

The first part of the article is a general review of the various drug treatments available for algodystrophy : purely symptomatic, analgesic treatment, vaso-active drugs, calcitonin. The major advance over the last few years has been the use of beta-blockers and calcitonin but, to date, only one double blind trial has been published. This study demonstrated the value of calcitonin after one month of treatment. The authors undertook a retrospective study of 651 cases and a prospective study of 91 cases and based their work on the evaluation of various treatments prescribed separately examining each therapeutic sequence rather than each individual case. Three treatments stood out by their frequent use : griseofulvin, calcitonin and beta-blockers. Each of these drugs was effective in more than 60 p. cent of cases. It is impossible, in such a study, to formulate a hierarchy of the various treatments. Only controlled studies will be able to establish their order of effectiveness. The results vary somewhat according to the site of the algodystrophy. The best therapeutic response is obtained in lesions involving the hip leading to a very favourable prognosis.

Adrenergic beta-Antagonists↗

[Rheumatoid polyarthritis and extensive necrotizing vasculitis. Apropos of 2 cases].

The author reports two cases of severe rheumatoid arthritis (RA) where the manifestations of necrosis vasculitis consisted of extensive and bullous gangrene of the lower limbs. In one case, the laboratory picture was that of major complement consumption (CH50 unmeasureable, marked fall in various compounds including C3 and C4) with very high levels of circulating immune complexes. An attempt at treatment by plasmapheresis, immunodepressants and corticosteroids led to moderate stabilisation of the vasculitis (regression of purpura) but remained incapable of resolving the local problem of gangrene. The severity of the lesion led to amputation of both legs. In the other case, there as a fall in CH50 with the presence of circulating immune complexes. Similar treatment led to stabilization of the lesions but final amputation could not be avoided to deal with the residue. Interruption of treatment was followed by an inflammatory exacerbation which was satisfactorily dealt with by further sessions of plasmapheresis. The authors discuss the value of such immunodepressant therapy in severe RA in the light of these cases.

Adrenal Cortex Hormones↗

[Results more than five years after osmic acid synoviorthesis of the rheumatoid knee].

Osmic acid synoviorthesis is an adjuvant form of local treatment for rheumatoid arthritis, the value of which has been demonstrated by a large number of studies over some 30 years. However, it is widely considered that the stability of the results of this type of synoviorthesis is less satisfactory than that obtained with isotope synoviorthesis and that osmic acid may damage the articular cartilage. The authors analyzed the results of a retrospective study of 90 rheumatoid knees treated by this method with a follow-up of more than 5 years (mean period 9 years). With such a follow-up, a satisfactory clinical result was seen in 44.5 p. cent of cases and radiological evaluation of the knees treated showed no worsening in initial signs in an identical percentage of cases. Best results were obtained in joints where there was little radiological damage and in cases of inflammatory or only moderately progressive arthritis, good results may also be hoped for in more severe or advanced cases. The good overall quality of the results obtained with a mean follow-up of 9 years would be in favour of the value of osmic acid synoviorthesis in the local treatment of rheumatoid arthritis.

Arthritis, Rheumatoid↗

Failure to find C1q-binding material and anti-IgG antibodies in ankylosing spondylitis.

C1q-binding immune complexes (C1C), anti-IgG antibodies (anti-IgG Ab), and complement levels were investigated in the serum of 37 patients with ankylosing spondylitis (AS). In all these studies the mean levels observed in patients with AS were similar to those in 31 normal subjects. Moreover, no significative difference in either CIC or anti-IgG Ab levels was observed when the patients were classified in different clinical forms according to the localisation (peripheral and central) or to the gravity (mild and severe) of the AS. In a parallel study increased CIC and anti-IgG Ab levels were found in most of the 81 patients with seropositive or seronegative rheumatoid arthritis.

Antibodies, Anti-Idiotypic↗

[Quantitative bone scintigraphy in the study of the sacroiliac joint in chronic inflammatory rheumatism].

Scintillation counting of the sacro-iliac bones using technetium pyrophosphate or diphosphate is a simple examination without danger. The uptake opposite each sacro-iliac bone is assessed by reference to that of the lumbar spine visible on the film. A study of a control group of 81 subjects permits one to determine the existence of variations in relation to age: the fixation is high in subjects under the age of 20 years and reduced in adults aged over 50 years. The 44 controls from 20 to 50 years, permit one to retain as reference value, the ratio 1.14 for the right sarco-iliac bone and 1.11 for the left sarco-iliac bone with a confidence interval of 0.13. There was noted a significantly high uptake during arthritis. Whether this was the axial form (40 cases) or the peripheral from (7 cases) and during Reiter's syndrome (15 cases). This hyperfixation was more frequent and more important when the sacro-iliac involvements (whether accompanied or not by radiological signs) were the cause of inflammatory pain. Increased uptake was also noted during other forms of chronic inflammatory rheumatism: rheumatoid arthritis (10 cases). Chronic inflammatory rheumatism (unclassifiable) 20 cases. It thus seems that one may retain in many cases the existence of sacro-iliac inflammatory changes without the latter being necessarily accompanied by clinical or radiological signs. The discovery of hyperfixation of the sacro-iliacs during chronic inflammatory rheumatism is further evidence in favour of the diagnosis of sacro-iliac arthritis but should be interpretated in the light of the general context.

Adolescent↗