Cytomegalovirus pneumonia in a patient with rheumatoid arthritis treated with low dose methotrexate and prednisone.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to M Bisson.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
PURPOSE: To determine whether Epstein-Barr virus (EBV) could be involved in the pathogenesis of Sjögren's syndrome (SS). PATIENTS AND METHODS: In situ hybridization using the BamH1-W fragment of EBV DNA was performed using labial salivary gland biopsy specimens from 14 patients with SS (eight with primary SS and six with secondary SS) and 39 control subjects. Furthermore, labial salivary gland biopsy specimens from 12 patients with SS (seven with primary SS and five with secondary SS) and 24 control subjects were submitted to the polymerase chain reaction to detect EBV DNA. RESULTS: In situ hybridization detected EBV DNA in epithelial cells of labial salivary gland biopsy specimens from four of eight (50%) patients with primary SS, zero of six patients with secondary SS, and three of 39 (8%) control subjects. The difference between patients with primary SS and control subjects was statistically significant (p less than 0.02). The polymerase chain reaction detected EBV DNA in six of seven (86%) patients with primary SS, three of five (60%) patients with secondary SS, and seven of 24 (29%) control subjects. The difference between patients with primary SS and control subjects was statistically significant (p less than 0.01). CONCLUSION: Both newly developed techniques showed that the presence of EBV DNA was significantly increased in patients with primary SS in comparison with control subjects. In all the positive SS patients who underwent in situ hybridization, epithelial cells of the labial salivary gland were the target of EBV infection. Our results suggest that this virus may play a role in the pathogenesis of SS. We cannot yet determine whether EBV is directly responsible for the destruction of the gland, or if its presence is a secondary event following gland injury.
Three aspects of the action of oxygenated free radicals were studied in 10 controls and 20 patients with rheumatoid arthritis, 11 not treated and 9 treated with D-penicillamine. Free radical production was evaluated in whole blood, malondialdehyde was measured in plasma, the concentration of antiradicular enzymes (copper and manganese superoxide dismutase, catalase and glutathion peroxydase) in hemolysate, platelets and plasma and copper superoxide dismutase activity in a chloroform erythrocyte extract. Only patients treated with D-penicillamine showed a significant decrease in the concentration of platelet anti-radicular enzymes and plasma manganese superoxide dismutase. The involvement of oxygenated free radicals in the pathophysiology of rheumatoid arthritis and in the mechanism of action of D-penicillamine in this pathology is discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Thirty-five bone marrow biopsies were performed in 9 patients with plasmacytic/plasmablastic myeloma stage IIIA of the Durie and Salmon classification. The cytologic and/or histologic transformation observed in the serial bone marrow biopsy specimens of 3 patients reflected an aggravation of the disease, and was expressed as an increase of bone marrow plasmablasts associated with a gradual decrease or even disappearance of the plasmacytic component. Beyond 50% of bone marrow plasmablasts, the plasmablastic myeloma represented a more aggressive phase in the course of the disease. In 2 patients this transformation was manifested by the development of extramedullary lesions. The possibility of chemotherapy influencing the progression of the plasmablastic clone by destroying the initial plasmacytic clone cannot be ruled out. These results are not devoid of therapeutic implications. They also emphasize the need for serial bone marrow biopsies for better detection of transformation into a less favorable cytologic and/or histologic type of myeloma.
Explore the source record for details and available documents.
Iliopsoas bursitis is the classical manifestation of synovial cysts of the hip. We report the first observation of a new localization of these cysts: the sheath of rectus femoris muscle. The patient presented with a hip osteoarthritis and an important mass of the front of the thigh. Computed tomography was useful in establishing the diagnosis and hip arthrography confirmed the communication between the joint and the rectus femoris sheath.
Monoclonal immunoglobulins present a normal structure and have an antibody activity. This activity may be directed against exo-antigens especially bacterial, but more frequently against auto-antigens. It may then be symptomatic and therefore explain unusual clinical or biological manifestations in the course of monoclonal dysglobulinemias; but, most of the time, the monoclonal auto-antibody activity is asymptomatic and polyspecific, as it is only the monoclonal expression of polyclonal natural auto-antibodies. A comprehensive review of the various antibody activities of monoclonal immunoglobulins is presented. With the presence, in large quantities, of monoclonal immunoglobulins and their antibody activity, the links between dysglobulinemia and autoimmune disease are discussed as well as the pathogenic role of auto-antibodies.
The effect of bone marrow plasma cell morphology at diagnosis on survival time was evaluated in 66 patients with multiple myeloma. According to the morphologic classification multiple myeloma was categorized as plasmacytic, plasmacytic/plasmablastic, or plasmablastic. The plasmablastic myeloma had an estimated median survival of 9 months compared with 42 months for plasmacytic/plasmablastic myeloma. Median survival of plasmacytic myeloma has not yet been attained. Plasma cell morphology at diagnosis is an important predictor of survival duration in patients with multiple myeloma. These parameters provide information required for decisions on treatment modalities.
The degree of medullary infiltration by plasmocytes has a prognostic value which completes the clinical classifications proposed in multiple myeloma. Beyond a 50 p. cent medullary infiltration, the mean survival of the patients is significantly shorter (p less than 0.02) than survival of patients presenting less than 50 p. cent medullary infiltration. The degree of medullary infiltration is unrelated to the stage of Durie and Salmon classification, but is correlated to the degree of differentiation of the plasmocytes.
The authors present a study of superoxide dismutase, catalase and glutathione peroxidase in hemolysis product, platelets and serum of 23 patients with rheumatoid polyarthritis and 11 healthy subjects. The nature of the treatment enables to divide the 23 patients into 3 groups: group I (8 cases): no treatment; Group II (7 cases): steroid therapy alone; group III (8 cases): basic treatment associated (3 cases) or not (5 cases) to steroid therapy. Statistical analysis shows no significant difference, whatever the environment and the treatment contemplated. The significance of these results is discussed and compared with literature data concerning only enzymatic activities and not the blood levels as in the present study.