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Biomedical subjects

J Barrier

Publications and source records attributed to J Barrier.

126 records · Page 7Linked to original sources
PubMedDate not supplied

[Polychimiotherapy and Waldenström's macroglobulinemia (author's transl)].

A 63-year-old man, with a Waldenström's disease discovered by cryoglobulinemia (ischemic lesions of fingers) was quickly aggravating (hyperviscosity syndrome) under treatment by chlorambucil in a dosage of 8 mg daily. We obtained a dramatic remission with combination of cyclophosphamide, vincristine, adriamycin and prednisone surrounding a total body irradiation. A new trial of polychimiotherapy (with lower dosage) for severe Waldenström's disease is actually on study.

Chlorambucil↗
PubMedDate not supplied

[Acute thrombocytopenic purpura associated with fenoprofene (author's transl)].

A 73-year-old woman, taking daily 3 to 4 tablets (900 to 1200 mg) of fenoprofene for 2 weeks, had a purpura related to an acute peripheric thrombocytopenia (platelet count of 24 000/mm3) with fast regression when we have stopped therapy. It is the second case of literature. This drug is also capable of causing acute agranulocytosis.

Aged↗
PubMedDate not supplied

[Waldenström's disease and periarteritis nodosa: fortuitous association? (author's transl)].

A 48-year-old-woman had simultaneously a peri-arteritis nodosa (PAN) and a Waldenström disease. PAN's symptoms were quickly regressive, neuropathy excepted (with slowness) under treatment by cyclophosphamide and prednisone. Hemopathy is now stabilized. Such a pathological association is exceptional (2 other cases in literature). Is it accidental? No cryoglobulinaemia or circulating immune-complexes or HBS antigen were found. Immunofluorescence study of arteriolar lesions in muscle showed a polyclonal fixation in inflammatory granuloma and monoclonal (IgM lambda) on endothelial side. Passive deposit is not excluded, because research of specific activity of IgM lambda (against fibrin or endothelial cells) was negative. Waldenström's disease has probably facilitated apparition of necrotizing angeitis but mechanism is not proved.

Female↗
PubMedDate not supplied

[Septicemia due to an unusual micro-organism: Actinobacillus actinomycetum comitans (author's transl)].

A new case of septicemia (without endocarditis) due to Actinobacillus actinomycetum comitans is described. The patient was a 59-year-old man with an intraventricular pacemaker. He was successfully treated by a combination of gentamicin and ampicillin. Human infections due to this demanding and slow-growing micro-organism, which is not related to actinomycosis, are only exceptionally reported. In 73% of the cases the endocarditis is subacute. The study of the literature demonstrates the prevalence of male patients and the usual absence of leukocytosis.

Actinobacillus↗
PubMedDate not supplied

Pancytopenia and severe cytopenia induced by low-dose methotrexate. Eight case-reports and a review of one hundred cases from the literature (with twenty-four deaths)

Severe adverse effects of low-dose methotrexate (less than 20 mg per week) are believed to be rare. We report eight cases of severe tricytopenia or pancytopenia seen in two medical departments of the same hospital in patients receiving low-dose methotrexate. Three patients had been under methotrexate for less than one month. Of the six patients with joint disease, five had rheumatoid arthritis and one psoriatic arthritis. A review of the literature found 92 previously reported cases of severe tricytopenia or pancytopenia induced by low-dose methotrexate. Of the total of 100 cases, 24 were fatal and 25 occurred within one month of treatment initiation. Potential risk factors were identifiable retrospectively in at least 50% of cases but were not all predictable or present at treatment initiation. In 30% of cases, no explanation for the hematologic complication was found, and in an additional 20% missing data precluded definite conclusions. The role of the risk factors incriminated in the literature is discussed. Although infrequent, cytopenia is a severe complication of methotrexate therapy that warrants a number of precautions, including periodic creatinine clearance and serum albumin determinations. Furthermore, the weekly dosing schedule should be printed on methotrexate boxes.

Adult↗