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Biomedical subjects

L Guillevin

Publications and source records attributed to L Guillevin.

At least 361 records · Page 20Linked to original sources
PubMed1986

[Malignant arterial hypertension in periarteritis nodosa. Incidence, clinicobiologic parameters and prognosis based on a series of 165 cases].

The authors studied clinical and biological data occurring in 165 patients observed during 23 years and afflicted with polyarteritis nodosa. Hypertension was present in 52 patients (31.5%) and seven of them suffered from malignant hypertension (4%). Mean age of patients (6 male, 1 female), with malignant hypertension was 38 +/- years old. Mean follow up was 49 +/- 28 months including 26 +/- 21 months after discontinuation of treatment of polyarteritis nodosa. Malignant hypertension occurred during the first year of evolution of polyarteritis nodosa. Renal insufficiency was present in 5 of 7 patients. Proteinuria was greater than 1 gr/d in 4 cases. Renal arteriography was performed in 6 patients and showed in every case renal ischemia and microaneurysms in five. In 4 patients measurements of plasma renin activity and of aldosterone were obtained. A stimulation of those hormones was demonstrated. Some symptoms of polyarteritis nodosa were present with a high incidence in case of malignant hypertension: digestive signs (6/7), orchitis (3/6). HBs antigen was present in 6 cases and hepatitis in 5. Captopril was effective in every case, alone or associated with other treatments. Follow up of hypertension went from 8 months to 4 years. At present time 6 patients are alive and one is lost of follow up. A treatment is necessary in 6 of 7 patients. Creatininemia is greater than 300 micromol/l in 4 patients. A successful kidney transplantation was performed in one case. Our study shows a close relation between malignant hypertension observed in polyarteritis nodosa, vascular nephropathy, digestive and urologic signs. Hepatitis B virus could be responsible of those manifestations.

Adult↗
PubMed1986

[Treatment of systemic scleroderma with ketanserin. Randomized, double-blind 6-months study of 27 cases].

Twenty-seven patients with systemic scleroderma and Raynaud's phenomenon underwent a randomised double blind therapeutic trial: monotherapy with Ketanserine (80 mg/day for 6 months) against Placebo. The secondary effects were comparable in both groups as were the withdrawals from the trial for aggravation of Raynaud's phenomenon (one in each group). No significant difference was observed between the two groups as regards the evolution of the Raynaud's phenomenon or skin changes. Dysphagia was improved in the Ketanserine group (p less than 0.05) but not in the Placebo group. Some patients in the Ketanserine group experienced an improvement in the Raynaud's phenomenon at the end of the trial period; there were no improvements in the Placebo group. Three haemorrheological parameters (total blood viscosity, plasma viscosity and thixotropism) were abnormal at the beginning of the trial and did not improve by the end in the Ketanserine group. The K infinity coefficient of Quemada's law was normal at the start of the trial and increased after treatment (p less than 0.05).

Clinical Trials as Topic↗
PubMed1986

[Blood hypereosinophilia syndrome with cardiac involvement and extramembranous glomerulopathy].

The case of a 71 year old woman with an idiopathic hypereosinophilic syndrome is reported. Bidimensional ultrasonography was in favor of endomyocardial involvement. This case was original as nephrotic syndrome developed, due to membranous glomerulopathy which was complicated with renal vein thrombosis. Both eosinophilia and nephrotic syndrome greatly improved with corticosteroid treatment. Nonetheless, the patient died suddenly after 2 years, and this demise is in keeping with the overall poor prognosis of idiopathic eosinophilic syndrome.

Aged↗
PubMed1985

[Treatment of systemic scleroderma with factor XIII in 86 patients, with long-term follow-up].

Eighty-six patients with progressive systemic sclerosis were given coagulation factor XIII intravenously in different dosage regimens. The mean duration of treatment was 19 +/- 18 months and patients were followed up for 22.9 +/- 18.8 months. Improvement or stabilization of the lesions was obtained in 44/86 patients and exclusively concerned skin lesions; there was no improvement in visceral lesions. The drug was well tolerated in short-and long-term treatment. It is concluded that factor XIII demonstrated lasting effectiveness in one-half of the patients treated.

Adult↗
PubMed1985

[Unexplained prolonged fever and inflammatory syndromes. Diagnostic value of abdominal X-ray computed tomography. Randomized prospective study of 36 cases].

A randomized study was carried out in 36 patients to determine the diagnostic value of abdominal computerized tomography (CT) in protracted fever of obscure origin and/or unexplained inflammatory syndromes. There were no clinical or biological signs pointing to a diagnosis, and 55% of the patients had already been unsuccessfully explored in other hospital departments. CT was performed initially in group I patients and after some of 56 predetermined conventional examinations (including 20 considered "invasive") carried out in a definite order in group II patients. An early diagnosis could be made within 2 months in 17 patients (47%): 7 in group E and 10 in group II. The underlying disease was diagnosed in 4 cases in group I and 1 case in group II (where 4 other cases could have been diagnosed, had CT been performed earlier); the difference was not significant. Nor was there any difference between the two groups in the number of examinations performed, the cost of investigation and the duration of stay in hospital. However, a number of reasons are in favour of early CT examination in protracted fever: the so-called "invasive" explorations were uncomplicated in group I and complicated in 2 patients of group II; following randomization, a diagnosis was made by CT within less than 3 days in the 4 patients of group I, and there were neither false-positive nor false-negative results of CT. If CT had been performed early in all patients, 9 diagnoses would have been made, representing 25% of the cases or 1/2 of early diagnoses. Abdominal CT proved unable to establish the 10 late diagnoses (i.e. after a mean delay of 18 months).

Adult↗
PubMed1985

[Behçet's disease: a vascular function study by the venostasis test and DDAVP infusion].

Recurrent thromboembolic accidents are frequent complications of Behçet's disease. Ten patients were investigated, 5 of them during an acute exacerbation of the disease. Abnormal responses to the venostasis test and to DDAVP (i.v.) were demonstrated in acute cases. Factor VIII activities after DDAVP were increased in all 10 patients, which suggests that the response of the vascular endothelium to the stimulus was normal and that a fibrinolytic system inhibitor may be present in the plasma of some patients.

Adolescent↗
PubMed1985

[Current aspects of the Vogt-Koyanagi-Harada syndrome. Apropos of 9 cases].

We have studied 9 cases of the Vogt Koyanagi Harada (VKH) syndrome as defined by the criteria of the American Uveitis Society; all these cases presented evidence of past or present exudative retinal detachment (RD). In 2 cases the RD was shallow and limited to the posterior pole, in 3 cases encephalo-meningeal symptoms were absent, in 2 cases skin and hair symptoms were absent. In all, 5 cases in this series presented as an incomplete, dissociated form of the disease. However the clinical cause of the disease in these "formes frustes" was not simpler or quieter than in the complete forms; incomplete response or drug dependence were encountered with steroid therapy, and immunosuppressive drugs were used in 3 cases. It is to be noted that in one case an extensive RD involving the posterior pole occurred bilaterally: this RD did not respond to maximal steroid and immunosuppressive therapy and reattachment was obtained only after vitrectomy. In another case bilateral optic disc neovascularization was observed in association with severe papillitis despite heavy steroid therapy. A cure was obtained with immunosuppressive drugs.

Adolescent↗
PubMed1985

[Periarteritis nodosa: clinical and therapeutic study of 126 patients followed-up during 23 years].

A hundred and twenty-six patients with systemic polyarteritis nodosa (PN) were studied over a 23 year period. The clinical symptoms and paraclinical data of PN are reviewed, and the results obtained by the different therapeutic approaches used during this period are presented: steroids alone and then associated with immunosuppressors and, in the most recent cases, associated with plasma exchange. The actuarial survival of patients in this retrospective and unrandomised series was comparable whether steroids were used alone or with immunosuppressors. The different therapeutic approaches in PAN are discussed especially with respect to the role of immunosuppressor therapy and plasma exchange.

Adrenal Cortex Hormones↗
PubMed1985

[Digestive manifestations of periarteritis nodosa in a series of 120 cases].

In a series of 120 patients with periarteritis nodosa (PAN), 50 had gastrointestinal manifestations; 34 had transient abdominal pain which regressed spontaneously or in response to corticosteroid therapy and required no further investigation. Thirty one more serious episodes occurred in the remaining 26 patients. Eight of these were in fact the initial signs of PAN and 13 required laparotomy. There were 20 episodes of abdominal pain (peritonitis: 9, pancreatitis: 4, acute cholecystitis: 2, duodenal ulcer: 3, intestinal infarction: 1, unexplained pain without diagnosis at laparotomy: 1) and 11 of gastrointestinal hemorrhage (melaena or hematemesis: 4; hematochezia: 5). Clinical and biological features of patients with and without gastrointestinal manifestation were not significantly different except for cardiac involvement which was significantly more frequent (p less than 0.05) in the second group. Corrected survival rates were significantly lower (p less than 0.05) in patients with gastrointestinal manifestations. These results show that, in patients with PAN, digestive manifestations, particularly perforations, carried a poor prognosis. Nevertheless exploratory laparotomy and surgery unrelated to PAN (eg appendicectomy) were well tolerated.

Abdomen↗