[Hypothyroid myopathies. Clinical and histopathological aspects].
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Biomedical subjects
Publications and source records attributed to C Vital.
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The human immunodeficiency virus (HIV) may be responsible for several types of vasculitis: leucocytoclastic vasculitis, granulomatous angiitis, angiitis associated with lymphoproliferative syndromes or necrotizing vasculitis including periarteritis nodosa (PAN). We report a case of PAN in a 62-year old HIV1-positive woman. The patient had no co-occurrent hepatitis B virus infection and was negative for antinuclear antibodies. She presented with sicca syndrome, necrotic purpura, myalgias and polyneuropathy. Skin, muscle and nerve biopsies showed signs of necrotizing vasculitis. Multiple microaneurysms typical of PAN were present on branches of the abdominal aorta. The symptoms due to vasculitis regressed after treatment with corticosteroids in bolus injections and plasmapheresis. AZT was not given owing to intolerance. The literature on vasculitis associated with HIV infection is reviewed.
A variety of lesions of varying complexity were noted during pathological examinations of the brain in 30 cases of acute severe traumatic coma, of whom 27 survived for less than 10 days. "Diffuse brain damage" were present in all cases and contusions were frequently noted (83 p. 100). The lesions appear immediately after, and are directly related to the injury. Ischemic lesions were present in 66 p. 100 of cases and their mechanisms of production are various and interwoven. The frequency of respiratory difficulties associated with brain injuries is stressed. Two thirds of the cases with brain stem lesions (80 p. 100) were secondary to phenomena related to trans-tentorial herniation. Clinical examinations of these patients with acute severe coma demonstrates the difficulties encountered in assessing prognosis based on clinical findings within the first 48 hours.