[Visceral leishmaniasis of tussive form with presence of circulating anticoagulants: 2 cases in non-immunosuppressed patients].
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Biomedical subjects
Publications and source records attributed to J J Morand.
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A 65-year-old female was admitted with leg edema by retroperitoneal fibrosis and tricuspid valve incompetence by fibrosis, cutaneous fibrosis, moderate flushing over the upper body without diarrhea. It revealed an ileal carcinoid tumor with hepatic metastases. Octreotide (Sandostatine), tumor excision and interferon alpha 2b treatment led to a regression of flushing and edema, a reduction of fibrosis and a stabilization of the metastatic carcinoid, with normal serotonin levels.
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INTRODUCTION: Panniculitis is a common manifestation of lupus, but is rarely the first manifestation in systemic lupus erythematosus. We report a case associated with fasciitis. CASE REPORT: A 67-year-old man was hospitalized for fever, pleuropericarditis, subcutaneous diffuse infiltration of the two thighs and the abdomen due to panniculitis and lupic fasciitis. Antiphospholipid antibody test was positive. There was non antiphospholipid syndrome. COMMENTS: Panniculitis can occur simultaneously or a few months or years before systemic lupus erythematosus. An association with fasciitis should be entertained whenever the cutaneous involvement is extensive and firm. In such a situation, deep biopsies are indicated. Observations of further cases will help identify the role of general steroid therapy in fasciitis-panniculitis and systemic lupus erythematosus.
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INTRODUCTION: Capillary leak syndrome is a specific entity among syndromes with capillary hyperpermeability. Endothelial cell activation is related to the higt level of adhesion molecules (sICAM-1, sVCAM-&, sCD62E) possibly due to several cytokines (IL-2, TNF ...). CASE REPORT: An 84-year-old woman was hospitalized for erythroderma. Ofujui papuloerythroderma was diagnosed and edema was attributed to capillary leak. A kinetic study of several cytokines and adhesion molecules sCD62E, sVCAM-1 and sICAM-1 was done. Outcome was favorable with corticopuvatherapy. DISCUSSION: The capillary leak syndrome reported here is simlar to that described in other erythrodermas with or without lymphoma. The keratinocyte would be activated by the CD4 T lymphocyte via the gamma-interferon mediator. The T cell secretes cytokines (interleukin-1, tumor necrosis factor ...) which activates the endothelium and increases vascular permeability. The level of adhesion molecules and changes observed during the episode of edema demonstrated the endothelial activation.
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A study of HIV infection among secondary school students was conducted in Djibouti in February 1990 during a national hepatitis survey. Serology was negative for HIV and syphilis among 294 students (ages 14 to 20 years) in spite of a dramatic increase of HIV seropositivity (as high as 41%), and a high level of syphilis positive serology (up to 46%) among adult high-risk groups such as street prostitutes. Results of a face-to-face interview of these pupils indicated that 64% had a basic knowledge of AIDS. As expected, a much better knowledge of AIDS was found among those who recently received AIDS education. However, 80% of secondary school teenagers did not consider themselves at risk for acquiring HIV. Transmission of HIV among school-children would be possible through sexual activity (22% stated to be sexually active) or parenteral therapy (75% had received at least one intramuscular injection), and not likely through blood transfusion or intravenous drug abuse. Results, close to those of a similar study in Zimbabwe, suggest that AIDS education programme should be given to all secondary school pupils and include public health lectures on syphilis, tuberculosis, and HIV infection.
The author presents a list of the audio-visual productions about Tropical Medicine, as well as of their main characteristics. He thinks that the audio-visual educational productions are often dissociated from their promotion; therefore, he invites the future creator to forward his work to the Audio-Visual Health Committee.