[Prolonged fever and schizocytosis disclosing myxoma of the left atrium].
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Female↗
Biomedical subjects
C Vermeulen
Publications and source records attributed to C Vermeulen.
[Cushing's syndrome: a diagnostic strategy].
Biologic and radiologic investigations in the diagnosis of Cushing syndrome are evaluated. A two-step diagnostic procedure is propounded. The combination of absence of overnight suppression of plasma cortisol by dexamethasone and elevation of urinary free cortisol and midnight plasma cortisol levels establishes the diagnosis of Cushing syndrome in most patients. The next step is to determine the precise cause of Cushing syndrome by baseline plasma ACTH assays, the high-dose dexamethasone test and the visualization of the adrenals by iodocholesterol scintigraphy and/or computed tomography.
17-Hydroxycorticosteroids↗
[Retroperitoneal seminoma without testicular lesion. A case report and review of the literature].
The case of a 54-year-old man with a retroperitoneal seminoma and normal testes is reported. Diagnosis was established late, when the tumor had become large and inoperable and produced symptoms of subocclusion. Onset of gynecomastia, an uncommon occurrence, had been recorded two years earlier and should have given rise to suspicion. The tumor was a histologically unmixed seminoma with very significant beta-HCG secretion. A chemotherapy-radiotherapy combination produced dramatic improvement. From data from a review of the literature, pathogenesis, diagnosis and management of this uncommon type of seminoma are discussed.
Chorionic Gonadotropin↗
Evidence for adrenal and/or ovarian dysfunction as a possible etiology of idiopathic hirsutism.
Thirty-one cases of idiopathic hirsutism, characterized biochemically in the basal state by increased levels of urinary 3 alpha-androstane-5 alpha, 17 beta-diol and normal levels of the main androgens, were studied. In order to determine a possible etiologic heterogeneity of idiopathic hirsutism, pituitary gonadotropin responses to synthetic luteinizing-releasing hormone (LRH) and adrenal steroid responses to adrenocorticotropic hormone (ACTH) stimulation were evaluated and the results were compared to those in six normal women. On the basis of the results obtained in each hirsute patient after LRH and ACTH tests, two groups were identified. The majority, 23 of 31 hirsute patients (group I), had results similar to those in the control group. In the other eight patients (group II), biologic abnormalities were disclosed and suggested a partial adrenal 11 beta-hydroxylase defect in two patients, an incomplete form of adrenal 3 beta-ol deficiency in one patient, an adrenal hyperreactivity without evident cause in two patients, and polycystic ovary syndrome in association with an adrenal hyperreactivity in three patients. As a group, the eight patients showed ACTH-stimulated increments in testosterone, delta 4-androstenedione, dehydroepiandrosterone, and 17-ketosteroids that were significantly greater (p less than 0.01) than the mean responses in the control group. The conclusion is that some women who previously were designated as having "idiopathic" hirsutism had an adrenal and/or ovarian component to their hyperandrogenism which could be shown only by appropriate dynamic tests.
17-Ketosteroids↗
[Hyperparathyroidism following cervical irradiation. A case and review of the literature].
A case of hyperparathyroidism in a fifty-four-year-old man, who had had cervical irradiation eighteen years earlier, is reported. Review of the medical literature reveals that the first such case was described in 1975 and that approximately 20.5% of all patients with hyperparathyroidism have had irradiation to the head and/or neck (126 cases were found in the literature). In most instances, patients had irradiation before age twenty. The mean time-interval between irradiation and diagnosis of hyperparathyroidism is 37.5 years. Radiation dose was always above 200 rads. Histologic examination found 71.7% adenomas, 25% hyperplasias, and 3.3% borderline lesions. Antecedent irradiation to the neck should be considered an additional clue to the diagnosis of hyperparathyroidism.
Head↗
[Pathological hyperprolactinemia II. course and diagnostic and therapeutic problems].
Natural growth of prolactinomas unrelated to pregnancy of certain drugs is slow. Mixed adenomas should be systematically looked for since acromegaly or Cushing syndrome may be cured by bromoergocriptine (brc) alone. Management of prolactinomas now rests mainly on bromoergocriptine. Surgery may still be indicated in encapsulated voluminous adenomas, in growing tumors that do not respond to large doses of brc, and in exacerbations during pregnancy which are not rapidly controlled by brc. When hyperprolactinemia does not respond to brc the patient should be investigated for a premenopausal state of a suprasellar lesion.
Adenoma↗
[Pathologic hyperprolactinemia. I. Positive diagnosis and etiology].
Hyperprolactinemia is common and mainly encountered in premenopausal women. The most prevalent causes are drugs (estrogens, neuroleptics), hypothalamic and pituitary disorders (functional abnormalities, intrasellar adenomas, suprasellar lesions) and hypothyroidism. Although the typical picture is the amenorrhea-galactorrhea syndrome, hyperprolactinemia may be revealed by many other features, including obesity, hirsutism and sterility. When plain roentgenograms show a normal sella, neither dynamic tests nor polytommography can lead to unequivocal diagnosis of a tumor. Computerized tomography scanning is now the most reliable investigation in patients with hyperprolactinemia resulting from an obvious or suspected tumor.
Adenoma↗
[Localized bullous pemphigoid induced by thermal burn].
BACKGROUND: Induced bullous pemphigoid is known to be triggered by drugs and some physical agents. Six cases of bullous pemphigoid induced by thermal burns have been reported since 1991. CASE REPORT: We observed a bullous eruption around thermal burns of the left leg in a 89 year-old woman. Bullous pemphigoid was diagnosed by histological and immunohistochemical findings with a sub-epidermal blister and linear IgG and C3 deposition at the dermal-epidermal junction. Indirect immunofluorescence was negative. The eruption rapidly resolved with topical steroids. DISCUSSION: We describe a bullous pemphigoid induced by a thermal burn. This case is original because the eruption was localized only around the site of the burn and healed with topical steroids. In the literature, there are 6 other cases reported but only one localized. We discuss the hypothesis of asymptomatic bullous pemphigoid exacerbated by presentation of bullous pemphigoid antigen by thermal burns or self immunization against antigens altered by burns.
Aged↗
[Vibratory angioedema].
BACKGROUND: Vibratory angioedema is a rare form of physical urticaria. This entity can be an hereditary autosomal dominant disorder or an acquired sporadic disease. Immediate and delayed forms have been reported. CASE-REPORT: A 34-year-old woman was referred to us for a vibratory angioedema induced by mountain biking. Despite her handicap, she could provoke a clinical tolerance with disappearance of pruritus but not of erythema and edema if she continued her physical effort. Diagnosis was confirmed with a vibratory stimulus using a Vortex for 5 minutes. The realization of a controlled vibratory stimuli among 20 volunteers induced a positive response in 7 cases (35 p. 100). DISCUSSION: These results raise the problem of the specificity of the test but also point out the possible physiological response of the body to intense vibratory stimulations.
Adult↗
[Insulin allergy (author's transl)].
Severe allergies to insulin are uncommon. In most cases, allergy is merely a mild and transient reaction at the site of injection. Immediate reactions (generalized or localized) originate in an overproduction of specific IgE anti-insulin antibodies. Local delayed reactions are mainly due to substances other than insulin (adventitious contaminants, foreign proteins, zinc) and fit Gell and Coombs' description of type IV allergic reactions. Diathesis and the history of previous discontinued insulin therapy are important to consider. Management differs according to the severity of allergic reactions. Methods range from simple observation to desensitization. Monocomponent pork insulin is useful in a number of cases. Human synthetic insulin may possibly be responsible for allergies similar to those which occur with monocomponent insulin.
Drug Hypersensitivity↗