Biomedical subjects
Publications and source records attributed to J R Harle.
Neuroleptic malignant syndrome (NMS) associated with metoclopramide is rare. NMS probably results from neuroleptic-induced dopamine receptor blockade. We describe a case and have found only seven reports of metoclopramide-induced NMS in the literature.
We report a 65-year-old patient who presented a rapid eruption of keratoses on sun-exposed areas and an explosive transformation into several squamous-cell carcinomas, occurring during the accelerated phase of a chronic granulocytic leukemia. Clinical findings resembled those usually described in xeroderma pigmentosum. The role of immunosuppression, chemotherapy and possible genetic predisposition is discussed.
Coexistence of IgA deficiency with sarcoidosis has been reported occasionally. Enteropathy occurs exceptionally in this association. We report the case of a 45 year-old woman experiencing disseminated sarcoidosis which involved mediastinum, chest, lymph nodes, liver, bone marrow, and skin. Immunoglobulin deficiency involving essentially IgA was found 15 years later. Digestive investigations showed gastroduodenal specific localizations associated with lymphoid nodular hyperplasia without villi atrophy.
The authors report a case of chronic dissection of the aorta discovered during the evaluation of disseminated intravascular coagulation. The first signs of bleeding occurred 4 years after the initial aortic trauma at the time of unclamping of the aorta during an aorto-coronary bypass. This case was characterised by the severity of coagulation abnormalities, the severe thrombocytopenia and that of platelet aggregation events.
After angiography, a 17 year-old male patient presented a pseudo appendicular syndrome. After two poorly contributive surgical explorations, CT and MR Imaging showed atresia of the infra-renal vena cava, with pelvic thrombophlebitis extending to the gonadal and lumbar collateral circulation.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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A 51 year-old woman presented with sudden loss of vision secondary to serous neuroretinal detachments of both maculas. Fluorescein angiography revealed multiple hyperfluorescent pin-point dots in the early phases. The areas of fluorescein hyperfluorescence became more diffuse as dye leaked into the subretinal space. The diagnostic of acute monoblastic leukemia was made. Following treatment, her vision improved. Fundus examination at that time showed resolution of the bilateral serous retinal detachment. She died one month after the onset of visual complaints and autopsy was refused. There have been 14 previous reports of acute leukemia with serous retinal detachment. In most cases, retinal detachment occurred as the presenting sign or during relapse of the systemic disease. It was often bilateral and located in the posterior pole. Histopathologic studies showed leukemic infiltration of the choroid with areas of degeneration and proliferation of the retinal pigment epithelium. Angiographic findings are similar to what is observed in choroidal ischemia. The relationships with macular serous retinal detachment and choriocapillaris occlusion are discussed.
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The authors report a case of hepatic tuberculosis on a pre-existing Hodgkin disease with hepatic localisations. They point out how echographic and CT imaging are non specific in this disease and so insist on the diagnostic interest of puncture-biopsy under guidance of the hepatic nodules.
The authors describe the case of a 67 year-old woman bearing a malignant lymphoma displaying two different histological patterns: a Lennert's lymphoma pattern in a cervical lymph node and a diffuse centroblastic lymphoma pattern in an axillary node. Immunophenotyping on frozen and paraffin sections showed a predominant positivity of T-cell markers in the cervical node, while the axillary lymphadenopathy exhibited a major positivity of B-cell markers and a restricted expression of the lambda light chain. However, genotyping provided the evidence of a single neoplastic B-cell clone proliferating in both cervical and axillary nodes. These findings suggest that histological pattern of Lennert's lymphoma is devoid of absolute specificity. Thus, genotypic analysis is a useful tool for the diagnosis of so-called "lymphoepithelioid lymphomas".
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