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Biomedical subjects

D Valeyre

Publications and source records attributed to D Valeyre.

At least 145 records · Page 8Linked to original sources
PubMed1983

[Etiology and precipitating factors of necrotizing angiitis with respiratory manifestations. 5 case reports].

Five cases of periarteritis nodosa or Churg and Strauss angeitis are reported. They all had one feature in common, their onset after desensitivity procedures, an injection of gammaglobulin or vaccination. These factors were found either at the onset or before a relapse of the disease. None of the patients had HBS antigen, which supports the hypothesis of a multiple antigenic etiology of periarteritis nodosa, some of which may cause respiratory symptoms, especially asthmatic attacks. The authors emphasise the importance of prohibiting desensitivity procedures and vaccinations in patients with severe asthma.

Adult↗
PubMed1983

[Pulmonary diffusion of gentamicin administered by the direct intravenous route].

Gentamicin diffusion in pulmonary parenchyma was studied in 10 adult patients with normal renal functions before undergoing thoracic surgery. This aminoside was given in a one time dose of 120 mg directly and by way of IV route in 10 min time; blood samples from peripheral and pulmonary sources were drawn at regular intervals between the 10 min period and the 8th hr; parenchymal samples were collected 1 and 2 hrs after drug administration. After separation of residual blood by centrifugation at high speed, the tissues are grinded and homogenized. The assay was performed with an immunological method using a fluorescent polarized detection system. Tissue levels were low in all the patients (0.5 to 2.75 micrograms/g of fresh tissue) and this in spite of the high level of blood collected throughout the administration protocol. As a rule, the relation between tissue/blood is lower than those discussed in literature concerning bronchial secretion. Beside this, the concentrations are similar in peripheral and pulmonary blood collected. Practical conclusions are drawn for therapeutic purpose.

Gentamicins↗
PubMed1983

[Chronic obstructive bronchopneumopathies as manifestations of a Gougerot-Sjögren syndrome. Apropos of 2 cases].

The authors report two cases of Sjögren's syndrome presenting as chronic obstructive bronchopulmonary disease. They stress the need to consider the possibility of Sjögren's syndrome when confronted with chronic obstructive lung disease in a woman in her fifties, without history of bronchopulmonary disease or smoking, unexposed to occupational dust and without ENT infection or gastro-oesophageal reflux.

Aged↗
PubMed1983

[Bird fancier's lung and Crohn disease. Apropos of a case].

The case of pigeon breeders' disease reported here is peculiar not only because of the large number of birds with which the patient was in contact, but also because the disease developed in a patient presenting with both pulmonary tuberculosis and Crohn's disease. Moreover, 18 months after eviction of the birds and beginning of corticosteroid therapy, the number of lymphocytes in fluid from broncho-alveolar lavage remained high.

Alveolitis, Extrinsic Allergic↗
PubMed1982

[Malignant lymphomas and sarcoidosis (author's transl)].

Five cases of sarcoidosis associated with malignant lymphoma are reported. In one patient, sarcoidosis was diagnosed several years after the onset of Hodgkin's disease. Of the remaining 4 patients, three developed nodular mixed lymphoma and one immunoblastic lymphoma (complicating angioimmunoblastic lymphadenopathy with dysproteinaemia) 3 months to 12 years after sarcoidosis were diagnosed. Such cases are extremely rare. They may be due to coincidence, but Danish epidemiological data suggest a relationship between the two diseases. Overstepping of humoral immunity in sarcoidosis may induce the emergence of a clone of formerly quiescent neoplastic B-cells.

Adolescent↗
PubMed1982

Pulmonary sarcoidosis with an alveolar radiographic pattern.

Thirty-three cases of sarcoidosis (4.4% of 746 patients) showed an alveolar radiological pattern. A study of pulmonary function was carried out in 25 patients and compared with that of 46 patients with the interstitial radiological type of sarcoidosis. Twenty-two cases have been followed up from one to six years after the initial examination. The radiographic lesions were most often bilateral and included nodules greater than 15 mm with ill-defined margins or diffuse, infiltrative, non-retractile opacities with fluffy margins. Bilateral mediastinal lymph nodes were present in 27 patients. In 20 patients an associated reticulation was found on radiography. In four patients an open lung biopsy was done. The granulomatous nodules were identical to those found in other forms of sarcoidosis, although they were more confluent in the affected areas. Clinical and functional findings did not differ from those in the more common forms of sarcoidosis. Alveolar sarcoidosis has a sudden course. The alveolar radiological patterns always disappeared, with or without steroid treatment, while reticular patterns persisted in four patients. Rapid radiological changes were observed. Some functional abnormalities persisted in cases that were followed. It is concluded that alveolar sarcoidosis is a distinct acute form of sarcoidosis.

Adolescent↗
PubMed1981

[A 5 consecutive day combination of CIS platinum and bleomycin in squamous cell bronchial carcinoma (author's transl)].

Twenty patients with inoperable squamous cell carcinoma of the lung (14 previously untreated and 6 previously treated) received a combination of bleomycin and cis-platinum for 6 consecutive days every 3 or 4 weeks. Pulmonary toxicity was minimal with only one case of reversible bleomycin-induced acute interstitial pneumopathy. The response rate was 65 p.cent. Thirteen patients had an objective response, including 5 apparently complete regressions. All responders were previously untreated patients. The results are discussed in the light of pharmacokinetic and cell kinetic data, and lead to a proposal for a non-conventional combined approach in squamous cell carcinoma of the lung, hitherto relatively unresponsive to chemotherapy.

Adult↗
PubMed1981

[Legionnaires disease : 3 cases from the northern suburbs of Paris (author's transl)].

During the summer of 1980, 3 sporadic cases of Legionnaires disease (ML) were recognized in the northern suburbs of Paris. The clinical picture was characterized by an extensive pneumonia, high fever with repeated rigors (3 cases), a confusional state (2 cases), and transitory watery diarrhea (3 cases). Blood cultures, evidence of bacterial antigens in blood or urine, and serology notably for chlamydia and mycoplasma pneumoniae were all negative. The diagnosis of ML (serotype I) was confirmed by serology using indirect immunofluorescence against Legionella pneumophila (LP) with an antigen prepared by Taylor. In one patient treated early with erythromycin (4 g/day), there was a quick and favorable response. Two other patients died, and in their case erythromycin therapy was started late. At necropsy, the lesions were solely thoracic, and were characterized by an alveolitis with many macrophages, and intense leukocytosis, and rich in fibrin; in one case, extensive fibrosis was noted; in the other, LP was diagnosed by direct and indirect immunofluorescence on a lung specimen. In the pneumology department of Hôpital Avicenne, two other patients with acute pneumonias and similar clinical and radiological pictures had elevated titres to LP (1/64), but they did not rise or fall. The diagnosis of ML is probably nevertheless, particularly as the serology was negative for both Mycoplasma pneumoniae and the Chlamydias. Two of the three cases presented were among seventeen acute febrile pneumonias admitted to the pneumology department of Hôpital Avicenne between the 1st of July and the 1st of October 1980, showing the relative frequency of this infection.

Aged↗
PubMed1981

[Thyroid disorders during sarcoidosis (author's transl)].

A clinical, scintigraphic and hormonal study of the thyroid was performed in 50 patients with intrathoracic sarcoidosis. The patients were divided into two groups: T - : n = 32, no thyroid abnormality; T +, 18 cases, with thyroid disorders (9 moderate diffuse goitres, 2 thyroid nodules, 7 nodular goitres). All had normal T4, T3 and TSH levels, except one patient with Graves's disease. Scarce sarcoid granulomas were found in 3 out of 4 patients who underwent thyroidectomy. Dissemination, activity, type of sarcoid thoracic involvement were not different in the two groups. In contrast, T + group had higher seric IgG levels than T - group (p less than 0,05). The association of sarcoidosis and goitre is not fortuitous but thyroid enlargement and sarcoid diffusion do not seem interrelated. Auto-immune thyroiditis seems unlikely in our cases, according to the low frequency of thyroid auto-antibodies. We discuss the possible role of seric immunoglobulins in the constitution of thyroid hypertrophy with or without hyperthyroidism in sarcoidosis.

Adult↗
PubMedDate not supplied

Sarcoidosis activity: correlation of HRCT findings with those of 67Ga scanning, bronchoalveolar lavage, and serum angiotensin-converting enzyme assay.

PURPOSE: The objective of this study was to correlate the findings of sarcoidosis on high resolution CT (HRCT) with indexes of disease activity as measured with 67Ga scan, bronchoalveolar lavage (BAL), and serum angiotensin-converting enzyme (SACE) assay. METHOD: Twenty-nine patients with proven sarcoidosis underwent HRCT scan, 67Ga scan, BAL, and SACE assay within a 1 month period. The extent of parenchymal involvement by nodules, consolidation, ground-glass attenuation, and linear opacities was quantified to the nearest 10% of surface area affected on the CT examination. Whole-lung gallium uptake was quantified and the percentage of BAL-recovered lymphocytes (BAL-%LC) and SACE levels obtained by chart review. CT scores of disease extent were correlated with measured indexes of activity using the Spearman rank correlation coefficient. RESULTS: The mean extent of nodules, consolidation, ground-glass attenuation, and linear opacities on HRCT images was 15.1 +/- 16.6, 1.6 +/- 4.0, 17.5 +/- 25.4, and 7.6 +/- 9.6%, respectively. The extent of nodules and consolidation correlated with the intensity of lung gallium uptake (r = 0.46, p < 0.02), BAL-%LC (r = 0.50, p < 0.01), and SACE levels (r = 0.38, p < 0.05). No significant correlation was found between extent of ground-glass attenuation or linear opacities with any indexes of disease activity. CONCLUSION: On HRCT scan, nodules and consolidation in sarcoidosis reflect disease activity as measured by 67Ga scan, BAL, and SACE assay.

Adult↗
PubMedDate not supplied

[Obstructive jaundice caused by granulomatous stenosis of the extrahepatic bile ducts in sarcoidosis].

A 37-year-old black West Indian woman with sarcoidosis developed obstructive jaundice due to stenosis involving the entire length of the common hepatic bile duct associated with stenosis of the cystic duct. Neither gallstones nor extrahepatic biliary tract lymph node involvement were found. Stenosis was ascribed to biliary involvement of sarcoidosis because of the presence of noncaseating granulomas in the cystic duct and the gallbladder neck. There was no hepatic involvement. Cholecystectomy and left hepaticojejunostomy were performed. Postoperative recovery was unremarkable. Jaundice disappeared and liver tests returned to normal values. This case report underlines the importance of verifying the patency of the extrahepatic biliary tract before severe cholestasis can be ascribed to intrahepatic involvement of sarcoidosis.

Adult↗