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Biomedical subjects

J F Viallard

Publications and source records attributed to J F Viallard.

At least 37 records · Page 2Linked to original sources
PubMed2000

Severe pancytopenia triggered by recombinant hepatitis B vaccine.

We describe the case of a teenager who developed fever, arthritis, cutaneous vasculitis and severe pancytopenia 3 weeks after the third vaccination boost with a recombinant hepatitis B vaccine. Bone marrow examination showed paucity of late myeloid elements and, subsequently, maturation arrest. Interferon-gamma (IFN-gamma) production by peripheral blood mononuclear cells from the patient was dramatically increased. An underlying immune predisposition (HLA-DR3) may have indirectly enabled the vaccine to trigger a hepatitis B virus-specific cytotoxic T-lymphocyte response. It is therefore possible that the pancytopenia was induced by a dysregulation of the CD8+ T-cell compartment via increased IFN-gamma production.

Adolescent↗
PubMed2000

Unusual manifestations of type II cryoglobulinaemia associated with Waldenström's macroglobulinaemia.

Cryoglobulinaemia in association with Waldenström's macroglobulinaemia is relatively common, ranging from 8% to 18% of cases; however, < 5% have symptoms or complications. We describe a patient with a history of cutaneous, peritoneal, and fallopian tube vasculitis related to type II cryoglobulinaemia associated with Waldenström's macroglobulinaemia. Cytotoxic treatment was initiated (cyclophosphamide, vincristine, and prednisone) and had a good initial response. However, after the third course of chemotherapy, the patient presented with septic shock and died. Even though cryoglobulinaemia is a model of systemic vasculitis, peritoneal and fallopian tube vasculitis associated with type II cryoglobulinemia has not been described previously.

Cryoglobulinemia↗
PubMed2000

Hepatitis C virus infection with and without cryoglobulinemia as a case of Churg-Strauss syndrome.

Chronic hepatitis C virus (HCV) infection may be associated with numerous immune disorders, with vasculitis including polyarteritis nodosa, or with both. Cryoglobulinemia, which is often present, can also be expressed by vasculitis. We describe 2 cases of Churg-Strauss syndrome (CSS) in patients with HCV infection. We found no previous case of CSS accompanying HCV infection in the literature. The current patients were women aged 40 and 66 years. In both cases, a clinical and laboratory pattern suggesting CSS was found before the HCV infection was discovered. One patient had cryoglobulinemia. One patient was successfully treated with interferon (IFN). The other was treated for 18 months with IFN and corticosteroids. Second-line therapy consisting of IFN with ribavirin was successful. The emergence of HCV infection may have led to an induced form of CSS. The relationship among HCV, cryoglobulinemia, and CSS is not clear, but may be similar to that existing between polyarteritis nodosa and hepatitis B virus. These observations suggest that IFN-alpha therapy may be effective against CSS in HCV infected patients with or without cryoglobulinemia.

Adrenal Cortex Hormones↗
PubMed1999

Flow cytometry study of human cyclin B1 and cyclin E expression in leukemic cell lines: cell cycle kinetics and cell localization.

Experiments by flow cytometry (FCM) after nuclei isolation have never been done to investigate cyclins. We have conducted different experiments by FCM using whole cells and isolated nuclei to study the immunolocalization and kinetic patterns of cyclin B1 and cyclin E in various leukemic cell lines. During asynchronous growth, all whole cells had a scheduled, cell cycle phase-restricted expression of cyclin B1. By using a washless immunostaining of unfixed nuclei, cyclin B1 was detected in all cell cycle phases, including G1, although to a lesser extent than in G2/M, suggesting that in whole cells the cyclin B1 epitope is masked and accessible only in isolated nuclei. When the cells were synchronized at the G1/S boundary by thymidine or in the G1 phase by sodium n-butyrate, an identical accumulation of cyclin B1 was observed. As for cyclin E, its expression was higher with thymidine treatment than with sodium n-butyrate, particularly in nuclei. The elevated cyclin B1 level in the cells arrested at the G1/S boundary may reflect the increased half-life of this protein stabilized as the result of cyclin E overexpression. However, our FCM data also support the notion that accumulation of human cyclin B1 in leukemic cell lines begins during the G1 phase of the cell cycle, probably in the nucleus. The detection of cyclin B1 by Western blot in cells sorted in the G1 phase of the cell cycle confirms this finding. It is possible, therefore, that tumor transformation or leukemic phenotype may invariably be associated with altered cyclin B1 expression.

Blotting, Western↗
PubMed1999

[Acrodystrophic neuropathy of Bureau and Barrière].

INTRODUCTION: The acrodystrophic neuropathy described by Bureau and Barrière in the 1950s is a rare trophic complication of chronic, analgesic neuropathy due to alcohol abuse, which is at the origin of perforating ulcers of the foot, vasomotor disorders with dysautonomia, and leads to mutilating arthropathy of the lower limb. This neuroacropathy, also termed vagabonds' or vagrants' disease, usually occurs in subjects with a debilitated condition, chronic alcoholism, and unfavourable socioeconomic conditions. EXEGESIS: We report four cases of Bureau-Barrière disease which occurred in male subjects who were on average 55 years of age. The clinical presentation was close to that reported in the literature. Indeed, all four patients were alcoholic, nondiabetic and lived under conditions of precarious hygiene. Therapeutic management of the patients was difficult due to bad compliance with the treatment and persistence of alcohol abuse. Immobilization of the foot is considered to be the primary treatment. Local care including baths and bandages with hydrocolloids must be continued during several months, and associated with antibiotic therapy, administered by infusion when necessary. The outcome is often chronic, with poor prognosis. Given the limited therapeutic possibilities, acrodystrophic neuropathy is an invalidating disease with high morbidity. CONCLUSION: Bureau-Barrière disease is a rare, serious invalidating disease. The clinical symptomatology is usually based on the diagnostic triad: analgesia of the foot, perforating ulcers of the foot, and deforming and mutilating arthropathy of the lower limb. Treatment is often hampered due to poor compliance with local care and persistence of alcohol abuse.

Alcoholism↗
PubMed1999

[Non-Hodgkin's malignant lymphoma with parotid gland and ovarian localization].

INTRODUCTION: Parotidean and ovarian lymphoma often indicate the existence of non-Hodgkin's lymphoma, involving 1-5% and 0.2% of the cases, respectively. EXEGENESIS: The authors report the case of a 70-year-old woman who presented B cell lymphoma of the parotid gland revealed by a rapid increase in the parotid size. CT scan showed the existence of a tumor located in the left ovary, later confirmed by biopsy. The proposed diagnosis was diffuse B cell type lymphoma with double glandular localization. Adenopathy and bone marrow involvement were both lacking. CONCLUSION: Lymphoma with glandular localizations always require diagnosis confirmation via histological examination and immunophenotyping, and must be considered as the local sign of a general disease.

Aged↗
PubMed1999

[Group B streptococcal meningitis revealing an inner ear congenital malformation. A case report in an adult].

INTRODUCTION: Group B streptococcal meningitis is unusual in adults. It occurs in patients with a chronic disease. EXEGESIS: We report a case of group B streptococcal meningitis that occurred in a 32-year-old woman, uncovering inner ear congenital malformation associated with cerebrospinal fluid fistula. There was no recurrent episode of meningitis during a 2-year period following surgical correction of the malformation. CONCLUSION: Clinical signs suggesting cerebrospinal fluid fistula should be considered in any adult patient with severe group B streptococcal infection.

Adult↗
PubMed1999

Th1 (IL-2, interferon-gamma (IFN-gamma)) and Th2 (IL-10, IL-4) cytokine production by peripheral blood mononuclear cells (PBMC) from patients with systemic lupus erythematosus (SLE).

We investigated the production of IL-2, IFN-gamma, IL-10 and IL-4 by PBMC from 24 patients with SLE and 10 healthy individuals. Basal and mitogen-stimulated (lipopolysaccharide and phytohaemagglutinin (LPS + PHA)) cytokine production was determined in a whole blood assay (WBA). Supernatants were collected and assayed with specific ELISAs. Although the IL-2 and IFN-gamma contents did not differ significantly between patients and controls under both conditions, statistically significant correlations were found between each cytokine and disease activity (SLAM index) after stimulation (respectively, r = 0.501, P = 0.01 and r = 0.631, P = 0.001). PBMC IL-10 production was significantly higher for patients than controls (P = 0.05), but no correlation between IL-10 levels and the SLAM index was obtained. IL-4 production was not statistically different between SLE patients and controls. For stimulated WBAs, the IL-10/IL-2 and IL-10/IFN-gamma ratios were significantly correlated with disease severity (P = 0.02; P = 0.001, respectively). Overall, our data suggest that SLE is characterized by an elevated production of IL-10, reflecting the basal state of activation of the immune system. During exacerbation of SLE, IL-2 and IFN-gamma are synthesized in larger amounts and may cause the tissue damage observed.

Adolescent↗