[Pruritus induced by cimetidine].
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Biomedical subjects
Publications and source records attributed to J Taillandier.
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Glomerular lesions were studied in 41 patients with hepatic cirrhosis (32 cases) or steatosis (9 cases) by optical microscopy (38 cases) and immunofluorescence (22 cases) examinations of biopsy samples. The most frequently observed lesion on optical microscopy was a glomerulosclerosis (16 cases), arteriolar lesions being present in 15 cases, two-thirds of which had associated glomerular lesions. Immunofluorescence revealed the presence of immunoglobulin deposits in 17 cases, these possessing two main characteristics: the prevalence of IgA (14 cases), alone or in association with other immunoglobulins; and the predilection for the mesangium alone, or in association with parietal deposits. The glomerular nephropathy in the cirrhotic patients was completely latent in 3 out of 4 cases, renal signs, when they existed, being of mild intensity. Renal lesion can occur in the absence of severe hepatopathy, particularly in the presence of steatosis. IgA deposits in the mesangium, a fundamental feature of hepatic glomerulopathy, can be related to the presence of IgA deposits in the liver sinusoids, suggesting the development of IgA deposits in several organs during these affections. Their pathogenesis is still obscure but two hypotheses have been suggested: an immune disease with deposits of circulating immune complexes in the kidney; a non-immune disease, IgA deposits being a secondary and not a primary feature.
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The staging of pelvic cancers using imaging techniques is not very precise, even with the most recent methods. However, optimal treatment depends on the results of this staging. In our experiment, we carried out a pelvioscopy prior to any curative treatment on all our patients who had had pelvic cancer for at least three years. Seventy-eight pelvioscopies were performed with 48 patients, entailing minimum morbidity and no mortality. For 23 patients, the lymph nodes were metastasized even though the C.T. were considered normal. With this simple method, staging of pelvic cancers can be improved and this extensive, unnecessary surgery can be avoided in many cases.
The authors collected observations concerning 11 newly histologically proved cases of a combination of Paget's disease and carcinoma metastatic to bone on the same bone from members of the French Rheumatology Society. The most frequent locations can be specified from their analysis and an analysis of 26 detailed cases from the literature, i.e. pelvis, femur, rachis, tibia, humerus, and the cancers most frequently involved--prostate, bronchi, kidney, breast and intestine. The most usual histological appearance is osteolytic, except in the case of prostatic carcinoma. The metastasis reveals the presence of cancer in 2 cases out of 3, whereas Paget's disease is most often already diagnosed. A histological examination is necessary because of the risk of non recognition of such metastases or of confusion with sarcomatous degeneration. It does not appear to be exceptional to find Paget's disease in combination with a metastasis on the same bone. Although six of the cases concern metastases only located at sites of Paget's disease, an analysis of all the cases does not seem to indicate that Paget bone is more exposed to metastases than normal bone, since both diseases in fact locate preferentially at the same sites on the skeleton.
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A 46-year-old man presented signs of secondary syphilis, including a skin eruption, multiple adenopathies, and alopecia. The diagnosis was confirmed by positive serological and Nelson's tests. Inflammatory arthritic signs developed in a few joints two weeks after the onset of the skin eruption, affecting mainly the left wrist, right sternoclavicular joint, lumbar spine, and right shoulder and hip joints, which were painful and stiff. Tests for a rheumatic origin, especially urethral smears and HLA B27 antigen, were negative. The articular manifestations disappeared completely after 8 to 10 days of penicillin. Rheumatic disorders from secondary syphilis affect one or several of the large joints, and quite frequently the sternoclavicular joints, the clinical, radiological, and biological characteristics showing no particular features. Diagnosis is based on the exclusion of other causes for the rheumatic disorder, total rapid regression after penicillin alone, and the simultaneous appearance of the affections.
Myasthenia gravis characterized by physical examination, electrophysiologic abnormalities, ephedronium test, without thymoma, associated in a 47 year-old-man, with mycosis fungoides. Myasthenia gravis began two years after the onset of mycosis fungoides, and the patient died of infection four years after the development of the cutaneous lymphoma. At autopsy, there was no visceral involvement. Myasthenia gravis and lymphoma rarely coexist; the occurrence of myasthenia gravis shortly after the onset of mycosis fungoides suggests that the two disorders may be linked by immunological abnormalities.
We describe 4 cases of hepatic hypertrophic osteoarthropathy treated successfully by liver transplantation. Hepatic hypertrophic osteoarthropathy is a rare and disabling condition associated with severe liver diseases. It responds poorly to conservative management, and liver transplantation is the only radical treatment option.