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Biomedical subjects

L Auquier

Publications and source records attributed to L Auquier.

At least 19 recordsLinked to original sources
PubMed1990

[Polymyalgia rheumatica and temporal arteritis. Observations on prognosis and treatment].

1. There is still controversy about polymyalgia rheumatica (PMR) and temporal arteritis (TA), either expressions of a single disease or two different conditions with overlapping. Nearly 50% of TA present with a PMR syndrome and 5% of PMR have a positive temporal artery biopsy. 2. Biopsy is useful for diagnostic purposes but does not seem to have any prognostic value in the management of PMR and TA. 3. The best symptomatic treatment is represented by prednisone. Prednisone has to be continued over a large period of time creating adverse effects in elderly people unless minimal doses are used. 4. TA visual or neurological complications are often observed in the first weeks of the disease thus leading many authors to recommend high doses (0.5 mg to 1 mg/kg/day) to patients with TA and even with PMR. To us starting high doses are to be used in severe clinical conditions of TA, particularly those presenting visual symptoms (nevertheless lower doses may be successful as well). Concerning other patients with TA and with PMR a starting dose of 10 to 30 mg depending on the clinical picture then a follow up dosage of 10 and even less, is suggested.

Biopsy↗
PubMed1985

[Acute polyarthritis associated with Sweet's syndrome].

A 43-year old man presents with acute febrile neutrophilic dermatosis (Sweet's syndrome) associated with acute seronegative polyarthritis. Although no definite diagnosis of viral infection could be made, the patient had raised serum antibodies against cytomegalovirus (1/1280; 1/2560). Histological examination showed typical lesions of Sweet's syndrome as well as the presence of extra- and intracellular unidentified particles in histiocytes.

Adult↗
PubMed1985

[A case of congenital insensitivity to pain with destructive arthropathies of the limbs and spine. Discussion on nosology and physiopathology of the disease].

A seventeen year old boy presented with destructive arthropathy of the lower limbs and discovertebral spaces. Past history yielded recurrent episodes of indolent fractures and progressive knee and ankle deterioration. The patient denied any pain sensation in the past and at examination. Other neurological tests were normal. Beta-endorphin level was elevated in the CSF. Response to the cold pressor test was modified after injection of Naloxone. The nosology and physiopathology of congenital insensitivity to pain are discussed.

Adolescent↗
PubMed1984

[Systematic research on enthesopathies in chronic rheumatism. Results and pathological significance. Relation to erosive spondylitis and other tendinous or synovial lesions].

A routine investigation for rheumatic tendon lesions was conducted in 47 patients with an inflammatory spondylo-arthropathy and in 30 patients with rheumatoid arthritis. The incidence of tendon lesions (calcaneal and extra-calcaneal) differed very significantly (p less than 0.001) between the two groups (58.3% of patients with inflammatory spondylo-arthropathy had at least one tendon lesion, 6.6% of patients with rheumatoid arthritis). These results and data from the literature suggest that rheumatic tendon lesions are a characteristic feature of spondylo-arthropathy in the same way as sacro-iliitis, the absence of subcutaneous nodules, the absence of rheumatoid factor and the high incidence of histocompatibility antigen HLA B27. Together with this diagnostic value, there is also a histopathological value: inflammatory and ossifying tendinitis contrasts with the destructive synovitis of rheumatoid arthritis and can be considered to be a "sign" of inflammatory spondylo-arthropathy. Tendinitis and juxta-articular bone lesions in the limbs, so-called "peripheral" lesions, are similar to the vertebral lesions around the intervertebral disk and the posterior interapophyseal joints found in inflammatory spondylo-arthropathy. These lesions seem to be a common pathological feature, at least in part, with the polyarthropathies of childhood.

Adolescent↗
PubMed1984

[Enthesopathy in inflammatory spondyloarthropathy. Incidence, clinical, radiological and anatomical descriptions. Current status of the question. Apropos of 37 cases].

Based on a series of 37 personal patients and data from the literature, a number of characteristics of enthesopathies can be observed in the course of inflammatory spondyloarthropathies. Our series is based on 20 cases of ankylosing spondylitis (ASP), 8 cases of Fiessinger-Leroy-Reiter syndrome, 8 cases of psoriatic rheumatism (Pso Rh) and one combined form (psoriasis + Reiter + ASP). As well as the frequent involvement of the calcaneus (29 patients), we found more unusual extra-calcaneal localisations in 23 patients. The clinical symptomatology consisted of pain on activity and on weight-bearing at the sites of insertion of the tendons, which were sometimes swollen. The disease was occasionally very incapacitating. The radiological signs consist of lesions of erosion (initially) and reconstruction (subsequently). The histological signs consist of zones of osseous reorganisation and osteo-tendinous inflammatory infiltration. The mechanism of these enthesopathic lesions is still unclear. Our observations are similar to those reported in the literature, which are essentially paediatric studies. Enthesopathy appears to be a diagnostic and lesional element in common with inflammatory spondyloarthropathies (which include ASP, Reiter's Pso Rh, enteropathic rheumatisms and Behçet's disease) and, at least partially, with juvenile rheumatisms. In the latter case, the precocity of the tendinoperiosteal signs seems to be a very important element in the orientation of the diagnosis at the pre-spondylitic stage.

Adult↗
PubMed1983

[Enthesopathies in ankylosing spondylitis and seronegative inflammatory rheumatism. 28 cases].

A few demonstrative cases of severe and disabling enthesopathy in patients with ankylosing spondylitis (AS) and related syndromes, psoriatic arthritis (PA) or Reiter's disease (RD) have prompted the authors to investigate the incidence of enthesopathy in such patients. A retrospective clinical and radiological study was conducted in 48 patients (mean age: 34.8 years) 27 of whom had AS, 9 RD and 12 PA. The overall incidence of enthesopathy was 58.3%. Beside the classical calcaneal lesions (50%), extracalcaneal manifestations of the disease involving the knees and shoulders were found in 39% of the patients. The HLA B27 antigen was detected in 87% of patients with enthesopathy, while 82% had clinical inflammation of the spine. The mean duration of clinical symptoms due to enthesopathy was 2-6 weeks in 36% and 6 months to 1 year in 45%. One striking feature of enthesopathy in this series was the lack of response to steroidal and non-steroidal anti-inflammatory drugs contrasting with the response of the associated arthritis. Since enthesopathies appear to be of diagnostic significance in the group of arthropathies of the spine, their incidence in other articular diseases should be the object of systematic comparative evaluations. A diffuse exacerbation of enthesopathy may constitute the initial manifestation of seronegative HLA B27 positive arthropathy, which is not without therapeutic implications.

Female↗
PubMed1983

[Comparative changes in sedimentation rate, haptoglobin and orosomucoid during the development of rhizomelic pseudopolyarthritis and temporal arteritis. Attempted definition of the biological parameters for monitoring these diseases].

In pseudo-polyarthritis of the extremities as well as in temporal arteritis we have noted a very marked correlation between sedimentation rate (ESR) and inflammatory proteins at the beginning of the disease. By contrast there is a dissociation during the course of the illness and sometimes at the time of onset in those rare forms with a normal ESR. It was therefore concluded that the ESR was not sufficiently accurate as an index of surveillance in such diseases. Study of inflammation proteins is in rare circumstances of diagnostic value at the time of onset of the disorder, in forms with a normal ESR. Comparative study of their variations with that in ESR would appear to provide an accurate factor in surveillance during the course for peripheral pseudo-polyarthritis and temporal arteritis. At that time, even though a return to a satisfactory clinical state and a normal ESR may be accompanied by a persistent increase in such proteins, it is not felt to be desirable to attempt to obtain their normalization. Finally, it would appear that their return to normal at the end of the course of the disease provides a reliable test of cure.

Adrenal Cortex Hormones↗
PubMed1983

Decrease of the OKT8 positive T cell subset in polymyalgia rheumatica. Lack of correlation with disease activity.

Peripheral T cell populations were investigated in 35 patients suffering from polymyalgia rheumatica. The total number of T cells was low compared with those of a control group of similar age (P less than 10(-3). This decrease was demonstrated by using both classic E-rosette and monoclonal antibody techniques (OKT3, and OKT4 + OKT8) and was shown to be secondary to a selective T8 defect (P less than 10(-9). There was no correlation between the decrease in T8 (a cytotoxic suppressor T cell subset) and steroid therapy, disease activity, and temporal arteritis, nor between this decrease and the T gamma percentage and the presence of circulating immune complexes (CIC). The T gamma cell percentage was low in the patient group (P less than 10(-5) and correlated with the presence of detectable CIC (P less than 0.05). In contrast to the T8 and T gamma defects, concanavalin A-stimulated cells from 5 selected patients were found capable of suppressing in vitro anti-trinitrophenyl response. This suppression was found in both autologous and allogeneic experiments. From these data one can assume that an immune anomaly (T8 defect) could be the origin of CIC and the disease occurrence.

Aged↗
PubMed1983

[Results of a new controlled survey of the spine of tractor operators].

In order to appreciate the consequence of tractor driving on the incidence of low back pain 72 tractorists (mean age: 35,1 +/- 6,3; mean first year driving (18,6 +/- 4,8), mean duration of driving (15,2 +/- 4,7) were compared to 62 non tractor driving farm workers (mean age: 36,5 +/- 6,5). Subjects were studied during a systematic yearly examination at the regional office for medical prevention. They were not informed of the purpose of the study. All subjects were submitted to a 45 items questionnaire made by one rheumatologist and to a standard physical examination of the dorsal and lumbar spine by another rheumatologist. No X-rays examination were performed during this enquiry. Results were as follows: non specific lowback pain was a frequent complaint in both groups, but was found significantly more frequent in non tractorists (p less than 0,01). Discrimination of non specific low back pain by duration of pain episodes (greater than or equal to 3 months) gave of lower frequency of the symptom which was found similar in both groups. Non tractorists complained more frequently of lumbago and sciatica (p less than 0,05). Identical abnormal physical examination were found in tractorists and non tractorists. Professional consequence were infrequent and not different between tractorists and non tractorists. No correlation were found between results of questionnaire, physical examination and mean duration of tractor driving.

Adolescent↗