[Moschcowitz' disease. Clinical and anatomo-pathologic study of a case].
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Biomedical subjects
Publications and source records attributed to J Arlet.
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The authors report 2 cases of Paget's disease associated with phosphate diabetes. The hypothesis of the secretion of a phosphaturic substance by Paget's bone cells is discussed.
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From literature data and their own experience, the authors comment hematological complications, related to the use of D-penicillamine, mainly in theumatoïd arthritis. Hypereosinophilia is more common than thrombopenia, but, both complications are usually benign. Anemia alone is very rare. Leukopenia appears in 6% of treated patients, but pancytopenia is rare. Leukopenia and pancytopenia are the most severe complications, even fatal in some cases. The safest dose of D-penicillamine seems to be between 600 and 900 mg per day, provided that, however, regular hematological controls may be achieved.
The remission of rheumatoid arthritis is a generally accepted concept, although few studies have been performed in this area. The authors report 32 cases of rheumatoid arthritis in remission in a population of 300 patients (10.7%). These cases of rheumatoid arthritis did not present any distinctive signs in comparison with the other patients. The remission was obtained an average of 6.5 years after the onset of the disease and has lasted, to date, for an average of 2.55 years. 30 of the 32 patients were still in remission at the last consultation. The criteria of remission proposed by the ARA are confirmed by these cases. The authors raise the question of the influence of basic treatment on the incidence of remission.
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