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Biomedical subjects

J M Brun

Publications and source records attributed to J M Brun.

66 records · Page 4Linked to original sources
PubMed1978

[Auto-immune juvenile polyendocrinopathy (author's transl)].

The observation on a young girl of a chronic mucocutaneous candidiasis associated with a pernicious anemia and a primary defect of parathyroid, adrenal and gonadal functions has brought us to a general review on non tumoral, multiple endocrinopathies in children. The analysis of the 47 observations of literature including the symptomatic triad, moniliasis, hypoparathyroidism and adrenal insufficiency, correlated with 107 other cases including only an incomplete triad but other well systematized associations, brings us to enlarge the fame of Whitaker's syndrom, to the more generalized one of auto immune juvenile poly-endocrinopathies. It seems to us that this new entity can be individualized: --by clinical features, linked to the age of occurence, to the predilection for the female sex, the specific chronology of the symptoms (moniliasis, hypoparathyroidism, primary hypothyroidism, adrenal and gonadal insufficiencies, Hashimoto thyroiditis, chronic diarrhoea, alopecia, pernicious anemia, "idiopathic" liver disease). --by genetic findings : compatible with an autosomic recessive transmission. --by the antaomo pathological aspect of the destroyed endocrine glandes on which the lymphocyte infiltration rises. --and by the etiopathogenic mechanism which is certainly linked to a defect of cell mediated immunity. Moreover, these different features seem to differentiate this juvenile syndrom from the polyendocrinopathies of the adult.

Adolescent↗
PubMedDate not supplied

[Association of Basedow's disease and autoimmune thrombopenic purpura. No effect of hyperthyroidism on antiplatelet autoimmunity].

The association between Graves' disease and autoimmune thrombocytopenic purpura is rare and yet more frequent than would be expected from a mere coincidence. The existence of an immunological disorder common to Graves' disease and autoimmune thrombocytopenic purpura and/or a direct responsibility of hyperthyroidism in the genesis of immunological disturbances resulting in autoimmune thrombocytopenic purpura are hypotheses put forward to try and explain why these two pathologies are associated. We report two cases in which the antiplatelet autoimmunity developed independently of the thyroid functional disorder, making it unlikely that hyperthyroidism played a direct role in the occurrence of the immunological disorders responsible for the autoimmune thrombocytopenic purpura. The physiopathology responsible for the Graves' disease-autoimmune thrombocytopenic purpura association remains imperfectly known. The existence of an immunological pathogenetic mechanism underlying both diseases seems to be likely; it probably acts through an antigenic determinant that is common to thyroid cells and platelets.

Adult↗
PubMedDate not supplied

Influence of obesity and hypertriglyceridaemia on the low HDL2-cholesterol level and on its relationship with prevalence of atherosclerosis in type 2 diabetes.

High density lipoprotein subfraction 2 (HDL1)-cholesterol level is usually decreased in Type 2 (non-insulin-dependent) diabetes. A study was carried out in 251 Type 2 diabetic patients (106 males [M], 145 females [F]) and in 120 non diabetic controls in order to determine the influence of hypertriglyceridaemia and obesity on the HDL2-cholesterol level and to analyse the relationship between HDL2-cholesterol level and atherosclerosis (coronary heart disease, peripheral atherosclerosis or cerebral vascular disease), in Type 2 diabetes. Influence of hypertriglyceridaemia and obesity on HDL2-cholesterol level was studied by comparing the mean values of HDL2-cholesterol between diabetics and controls, after controlling for hypertriglyceridaemia and obesity, and by a multiple linear regression test. A stepwise logistic regression was performed to analyse the association between the prevalence of atherosclerosis and several variables: age, duration of diabetes, hypertension, cigarette smoking, body mass index, mean glycaemia, total cholesterol, triglyceride, HDL-cholesterol, HDL2-cholesterol and HDL3-cholesterol levels. In both men and women, when both of the factors (hypertriglyceridaemia and obesity) were present of when only one was, HDL2-cholesterol level was significantly lower in the diabetic population, compared with controls. But when obesity and hypertriglyceridaemia were absent, HDL2-cholesterol level, in the diabetic population, was not significantly different from controls (M: 17.9 +/- 13.3 vs 20.5 +/- 13.8 mg/dl: NS; F: 30.1 +/- 21.5 vs 27.6 +/- 14.2 mg/dl: NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Endocrine abnormalities in HIV infections].

The finding of endocrine gland lesions at pathological examination in AIDS and reports of several cases of endocrine disease in patients with this syndrome have prompted us to study endocrine functions in 63 patients (51 men, 12 women) with HIV-1 infection. According to the Center for Disease Control (CDC) classification system, 13 of these patients were stage CDC II, 27 stage CDC III and 23 stage CDC IV. We explored the adrenocortical function (ACTH, immediate tetracosactrin test) and the thyroid function (free T3 and T4 levels, TRH on TSH test) in all 63 patients. The hypothalamic-pituitary-gonadal axis (testosterone levels, LHRH test) and prolactin secretion (THR test) were explored in the 51 men. The results obtained showed early peripheral testicular insufficiency at stage CDC II and early pituitary gland abnormalities with hypersecretion of ACTH and prolactin also at stage CDC II. On the other hand, adrenocortical and pituitary abnormalities were not frequently found. The physiopathology of the endocrine abnormalities observed in HIV-1-infected patients remains unclear, but one may suspect that it involves interleukin-1 since this protein factor has recently been shown to stimulate the corticotropin-releasing hormone secretion and to act directly on the glycoprotein capsule of the virus (gp 120) whose structure is similar to that of some neurohormones.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

[Trouble of liver function in polymyalgia rheumatica (author's transl)].

The possible existence of liver function disease such as cholestasis during temporal arteritis or polymyalgia rheumatica has been recently discovered. Two cases are reported of cholestasis without jaundice during polymyalgia rheumatica. The altérations most frequently observed are the elevation of the alcalin phosphatases, 5' nucleotidases, gamma G.T. and the retention of BSP. The syndrome disappears by treatment as well as the rheumatologic disease. It seems to be interesting to diagnose polymyalgia rheumatica through this trouble of liver funcion.

Cholestasis, Intrahepatic↗
PubMedDate not supplied

[Prognostic evolution of Graves' disease. Surgical treatment (author's transl)].

We report 80 cases of Graves' disease with goiter and homogeneous scintiscan. All the patients underwent surgery after treatment of hyperthyroidism by ATD then by iodine : bilateral subtotal lobectomy was performed in 89 % of cases. The patients have been followed up for 1 to 10 years after surgery, the actuarial rate of euthyroidism is stable at 77 % from the 3rd to the 10th year on. In the same way, 16 % of hypothyroidism and 9 % of recurrent hyperthyroidism do not change from respectively the first and the third year to the tenth after surgery. No correlation has been found between their appearance and the various clinical and biological parameters which has been studied.

Adult↗