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Biomedical subjects

E Vidal

Publications and source records attributed to E Vidal.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Anticardiolipin antibodies and Horton disease].

A prospective study, including 86 patients with giant cell arteritis proven by temporal artery biopsies, was performed to determine the prevalence of anticardiolipin antibodies, the antibody isotype, the relationship of antibodies to ischemic involvement and their evolution during corticosteroid treatment. Controls were obtained from 50 subjects without vasculitis or autoimmune disorders. Before treatment, 50% of patients' sera contained anti-cardiolipin antibodies (vs 8% in controls, p < 0.0001). These antibodies were IgG-ACL in 36% of patients and IgM-ACL in 17% of patients (vs respectively, 4% and 2% in controls). No significant association was observed between the incidence of ischemic ocular complications and the levels of anti-cardiolipin antibodies. During corticosteroid treatment, the level of anti-cardiolipin antibodies, mostly IgG class, decreased to become negative in 2 months. An increase of these antibodies was observed with the occurrence of relapses in four patients, after the end of corticosteroid therapy. The significance of IgG and IgM antibodies is different in giant cell arteritis. IgG antibodies may be markers of the course of this vasculitis.

Adrenal Cortex Hormones↗
PubMed1994

[Systemic signs of primary Gougerot-Sjögren syndrome. 48 cases].

Forty-eight patients with primary Sjögren syndrome are documented together with the results of their baseline investigations. The majority of patients were female (44 out of 48) and mean age was 63.2 years. Common clinical features included 20 parenchymal lung disease, among which 4 had interstitial pulmonary fibrosis and 2 lymphocytic interstitial pneumonitis, 12 neurologic manifestations, 16 Raynaud's phenomenon, 12 arthritis, and 3 gastrointestinal involvement. Haematological features occurred in 15 patients and another autoimmune disease was encountered in 13 cases. These extraglandular manifestations were the dominating reasons for hospital referral in 43.5% of cases, the sicca syndrome were most often only mentioned by the patients after special questioning which explain considerable delay before the diagnosis.

Adult↗
PubMed1994

[Clinical course of Horton disease. Apropos of 42 cured patients].

We report a prospective study of 42 patients with biopsy-proven giant cell arteritis (CGA) who recovered for more than one year (mean follow up of 71 months since withdrawal of steroid treatment). It was used the same regimen of prednisone and well closely monitored along the whole treatment. In 22 patients, dapsone was given concomitantly with prednisone. Mean duration of steroid therapy was 23.1 months (range: 6-57 months); it was significantly decreased with treatment by dapsone (12 months and 12 days). Age, sex, initial clinical and biological (acute phase reactants) findings did not provide useful information for predicting steroid treatment needed for recovery. Thirty-six relapses were observed in 22 patients (60%) during treatment or after its withdrawal. Incidence of relapses declined during steroid treatment and relapses were (only) observed over first 6 months after steroid withdrawal. Three amaurosis fugax occurred at the beginning of treatment and an axillar bilateral stenosis was also observed. Forty-eight side effects of corticosteroids were recorded in 26 patients (63%): myopathy (n = 12), bone complications (n = 11), metabolic complications (n = 9). Twelve patients (63%) had experienced side effects of dapsone. This study emphasized the difficulty in treating CGA. Close monitoring is required. A steroid regimen is recommended.

Aged↗
PubMed1993

[Isolated inflammatory syndrome: think of benign tumors of the liver].

The authors report seven cases of benign tumors of the liver revealed by elevated acute phase reactants. They show that these elevated acute phase reactants are not linked with a particular histological diagnosis, the presence of tumor necrosis and that they disappear with the chirurgical cure of the tumor.

Acute-Phase Proteins↗
PubMed1993

[Autoimmune thyroid diseases and Horton disease].

In a retrospective study of 115 patients with giant cell arteritis, 5 clinically patent autoimmune diseases were recorded; including 2 patients (1.8%) with Grave's disease and 1 with hypothyroidism. Among these patients, 46 had systematic assays of blood thyroid hormones and 39 were systematically investigated for anti-thyroid antibodies (ATAb):3 (6.5%) had biological hypothyroidism and 4 (10.3%) had ATAb. These findings were not significantly different from those of a control group of 39 age and sex matched patients.

Aged↗
PubMed1993

[Multiple autoimmune syndrome].

Report a case of multiple auto-immune syndrome with auto-immune thyroiditis, Sjögren's syndrome, primary biliary cirrhosis. Moreover the patient suffered from neuropsychiatric symptoms and anti-cardiolipid antibodies were significantly elevated.

Aged↗
PubMed1993

[Periarteritis nodosa and parvovirus B19 infection].

The authors report a case of polyarteritis nodosa which coincide with serological conversion to parvovirus B19. After review of the literature, they recall the role of this virus in human pathology and also the role of different infectious agents in the PAN pathogenesis.

Aged↗
PubMed1993

Breast cancer with systemic manifestations mimicking Still's disease.

We describe a case whose clinical features strongly suggested Still's disease, which led to the discovery of breast cancer. Our patient's symptoms consisting of fever, joint inflammation, pleuritis, and pericarditis, were initially resistant to high doses of steroids, and disappeared only after the cancer was removed, despite rapid tapering and cessation of steroid therapy. A paraneoplastic phenomenon seems probable.

Breast Neoplasms↗
PubMed1993

[Immunohistochemical study of lesions of temporal arteritis in Horton's disease].

Fourteen monoclonal antibodies were used to immunohistochemically label 22 temporal artery biopsy specimens taken from patients with temporal arteritis before treatment (n = 10), after 1.3 days of corticotherapy (n = 6) and after 12-30 days of steroids (n = 6). Histological sections from untreated patients revealed an inflammatory infiltrate comprised of approximately equal proportions of macrophages and T lymphocytes; the majority of the latter belonged to the CD4+ subset (the CD4+/CD8+ ratio varied from 2/1 to 4/1, depending upon the biopsy). These cells expressed high levels of HLA DR and low levels of interleukin-2 (IL2) receptors. A few B lymphocytes and plasmocytes were seen, mainly in the adventitia. Antigen-presenting cells (APC) were always found in the damaged media and natural killer cells (few in number) were sometimes present. Some macrophages were positively immunolabeled for IL6. A short, 1-to-3-day course of corticosteroids did not appreciably modify the lesions: cells remained highly activated, APC were seen in half the biopsies and IL6 immunolabeling persisted. The findings were essentially the same in treated but poorly controlled patients. Biopsies from 2 patients in clinical and biological remission revealed the persistence of an active immunological process. These observations indicate that the immunological process is poorly controlled by corticosteroid therapy.

Aged↗
PubMed1993

[Renal hypertrophy studied by techniques of nuclear medicine in post-nephrectomy patients].

Study of group of 61 patients, nephrectomized as a result of various diseases and who before and three months after surgery underwent blood pressure, effective renal plasma flow (EPFF) and unilateral renal function determinations in order to verify the compensating ability of the remaining kidney. Effective renal plasma flow was determined by a single injection and removal of six serial blood samples with 125-I-Hippuran. Unilateral renal function was determined from the relative uptake of 99mTc-DMSA 24 hours after injection. The patients were divided into four groups according to their overall and unilateral renal function as well as the presence or absence of hypertension. Patients with normal EPFF and symmetrical renal function showed a significantly increase in the function of the remaining kidney after surgery (p < 0.001). Patients with normal or slightly reduced EPFF (< 10%) and highly asymmetrical unilateral function as well as those with decreased EPFF (> 10%) and symmetrical or asymmetrical unilateral renal function did not increased the function of the remaining kidney after nephrectomy, and hypertensive patients whose blood pressure returned to normal values after nephrectomy had a decreased function of the remaining kidney after surgery (< 0.001). It is concluded that it is possible to predict the functional behaviour of the remaining kidney after nephrectomy, and that the compensating ability will basically depend on the previously existing (overall and unilateral) renal function as well as the presence or absence of hypertension.

Blood Flow Velocity↗
PubMed1992

The effects of cardioversion and defibrillation on left ventricular systolic function.

The purpose of this research was to evaluate the left ventricular systolic function behavior after cardioversion and defibrillation. The study included 18 adult patients who had direct current cardioversion or defibrillation performed for conversion of spontaneous or induced arrhythmias. All patients were submitted to a careful medical evaluation and an M-mode echocardiogram before cardioversion or defibrillation. The clinical and echocardiographic evaluations were repeated immediately after, and 6 and 12 h following the countershock. Six hours after cardioversion or defibrillation a statistically significant (p = .04) decrease in contractility (circumferential fiber shortening and ejection fraction) was observed without significant changes in preload (end diastolic volume), heart rate or afterload (end systolic stress and diastolic arterial pressure). Within 12 h, the left ventricular systolic dysfunction disappeared. The impairment of systolic function was independent of the amount of energy used, the type of arrhythmia, the rhythm after cardioversion or defibrillation and the etiologic cardiac diagnoses. There was a significant (p = .03) direct, negative and linear correlation between left ventricular systolic indices (ejection fraction and circumferential fiber shortening) before the countershock and the amount of decrease in systolic function after the countershock. In spite of the fact that most patients had a low ejection fraction, none of them presented clinical signs of heart failure. Defibrillation and cardioversion produce a transient decrease in cardiac contractility which is independent of the amount of energy used and does not produce clinical signs of heart failure.

Arrhythmias, Cardiac↗
PubMed1992

Diagnosis of brain death: superiority of perfusion studies with 99Tcm-HMPAO over conventional radionuclide cerebral angiography.

The use of technetium-99m hexamethyl-propyleneamine oxime (99Tcm-HMPAO) in the diagnosis of brain death has been evaluated in 41 studies of 37 patients with severe brain injury, who were under the effect of drugs or when other diagnostic methods were equivocal. HMPAO studies were compared with conventional radionuclide angiography performed simultaneously by intravenous administration of HMPAO as a bolus. The ages of patients ranged from 4 months to 75 years. Dynamic flow images and 5-min static uptake images were acquired following bolus injection of 555 Mbq of 99Tcm-HMPAO. All patients showing no brain uptake were confirmed as brain-dead by standard clinical criteria, with no contradictory cases in the static study. In addition, all patients who were not brain-dead showed HMPAO uptake at least in the brainstem. Dynamic flow images were equivocal in five patients, four of whom had no uptake on static images and clinically confirmed brain death. In addition, two other cases showed "mismatched" dynamic and static images: in one case no perfusion was observed on flow images but uptake restricted to the posterior fossa was seen on static images; the other case showed perfusion on the dynamic study and static imaging revealed hemispheric uptake with no posterior fossa uptake. Static perfusion 99Tcm-HMPAO studies offer advantages over conventional brain scintigraphy, better results being due to adequate assessment of posterior fossa activity and avoiding equivocal studies.

Adolescent↗
PubMed1992

[Anti-cardiolipin antibodies in Horton's disease].

A prospective study on 11 patients with temporal artery biopsy-proven arteritis examined the frequency and significance of anti-cardiolipin antibodies. Antibody levels in 7 patients were higher than 20 units but were not correlated with an inflammatory syndrome, as assessed by measurement of 4 inflammatory proteins (fibrinogen, C-reactive protein, orosomucoid and haptoglobin). These 7 patients were treated with steroids and their antibody levels returned to the normal range after 4 to 16 weeks of therapy, later than the inflammatory proteins. Two patients had slight increases of their anti-cardiolipin antibody levels, but no signs of clinical relapse or increases of inflammatory proteins were observed. In this study, no correlation was found between the presence of anti-cardiolipin antibodies and the occurrence of ischemic complications in 6 of the 11 patients.

Aged↗
PubMed1992

Concurrent temporal arteritis and Churg-Strauss syndrome.

We describe the case of a 41-year-old man who presented with clinical and histopathologic evidence of temporal artery lesions associated with the Churg-Strauss syndrome. Pathological examination of the temporal artery showed panarteritis without giant cell formation or fibrinoid necrosis. We review the world literature concerning the vasculitides with features that overlap giant cell arteritis (GCA) and polyarteritis nodosa (PAN) and classify into 2 sub-groups PAN with unusual temporal artery localization and GCA with variably disseminated arterial injuries. These cases emphasize the fact that not all arteritis involving the temporal arteries is GCA. Only 3 cases with temporal artery involvement and concurrent Churg-Strauss syndrome have been published.

Adult↗