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Biomedical subjects

M De Vos

Publications and source records attributed to M De Vos.

At least 109 records · Page 6Linked to original sources
PubMed1987

Repeat ileocolonoscopy in reactive arthritis.

Ileocolonoscopy on patients with HLA-B27 related disease, reactive arthritis and ankylosing spondylitis (AS) with peripheral arthritis, revealed the presence of inflammatory lesions in biopsy specimens from the ileum in 71 and 60% of the cases, respectively. A 2nd ileocolonoscopy was performed on 14 patients, 4 to 22 months after the first. In 6 of the 7 patients in articular clinical remission, the inflammatory gut lesions had disappeared. The gut biopsies of the 7 patients with active joint disease continued to show inflammatory lesions. One of these patients underwent a 3rd ileocolonoscopy after having gone into clinical remission, possibly secondary to treatment with sulfasalazine; the histology was completely normal. The strong relationship between clinical articular inflammation and gut inflammation seems to support the hypothesis that in B27 related diseases, repetitive exogenous triggering causing transgression of oral tolerance by increased gut permeability, provokes and maintains the joint inflammation.

Adolescent↗
PubMed1987

Late onset pauciarticular juvenile chronic arthritis: relation to gut inflammation.

Ileocolonoscopy with biopsy of the ileum, ileocecal valve and cecum was performed on 32 patients (22 males, 10 females) with juvenile chronic arthritis (JCA) with pauciarticular onset. Mean age at onset of disease was 12 years. Ankylosing spondylitis (AS) was diagnosed in 13 patients; the other 19 cases were classified as reactive arthritis with recurrent or persistent pauciarticular synovitis. Twenty-two patients (68%) were HLA-B27 positive; 8 patients (25%) carried the HLA-Bw62 antigen. Ileocolonoscopy was performed 6 months to 32 years after the initial manifestation of the disease (mean : 9 years). Fourteen patients had macroscopic lesions of the ileum and ileocecal valve although only 8 of these had a history of intestinal complaints. Twenty-six patients (81%) presented histological signs of gut inflammation. Most of the gut abnormalities were classified as active chronic or Crohn-like lesions (19/26). Only 7 patients had acute or bacterial enteritis-like lesions. Acute lesions were seen in only one patient with AS. All but 2 patients with sacroiliitis, in whom signs of gut inflammation were found, had active chronic lesions. All the 8 HLA-Bw62 positive patients had histological evidence of gut inflammation. Only chronic or Crohn-like lesions were found. In the majority of patients with JCA with pauciarticular onset, gut inflammation was found on ileum biopsy. Some of their lesions are related to Crohn's disease, and the presence of the HLA-Bw62 antigen could predispose to the arthritis seen in these cases.

Arthritis↗
PubMed1987

HLA antigens in seronegative spondylarthropathies. Reactive arthritis and arthritis in ankylosing spondylitis: relation to gut inflammation.

The prevalence of HLA-A, B, C and DR antigens was determined and compared in 94 patients with reactive arthritis, 54 patients with ankylosing spondylitis (AS), 37 patients with inflammatory bowel disease (IBD) and in 1,010 apparently normal blood donors. The 185 patients all underwent ileocolonoscopy with biopsy of ileum, ileocecal valve and cecum. HLA-B27 was found elevated in the groups with reactive arthritis (48%, chi 2 = 82, p less than 0.0005) and the AS groups (78%, chi 2 = 157, p less than 0.0005), compared to healthy controls. HLA-Bw62 was significantly raised in the patients with reactive arthritis (34%, chi 2 = 73, p less than 0.0005) (particularly the HLA-B27 negatives (48%, chi 2 = 90, p less than 0.0005) and in the HLA-B27 negative patients with AS (25%, chi 2 = 5.5, p less than 0.02). This did not apply to the other patients with AS (4.7% NS). HLA-Bw62 could be associated with a specific clinical picture of asymmetrical pauciarticular arthritis, accompanied by enthesopathies and sacroiliitis classified as idiopathic reactive arthritis, especially when the disease is of enterogenic origin. The frequency of HLA-Bw62 was very high in patients with reactive arthritis and in patients with AS with active chronic (n = 39, 23%, chi 2 = 13, p less than 0.0005) and Crohn-like lesions (n = 14, 50%, chi 2 = 35, p less than 0.0005) on gut biopsy, normal in patients with acute lesions (n = 35, 11%, NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Familial aggregation in seronegative spondyloarthritis of enterogenic origin. A family study.

A family study of 2 probands, suffering from seronegative spondyloarthritis with ileocolonoscopic evidence of chronic inflammation of the ileum, is presented. On the father's side 2 brothers carry the HLA-Bw62 antigen. One developed typical Crohn's disease, the other showed chronic inflammatory signs of the ileum on biopsy. These lesions have frequently been demonstrated in reactive arthritis and ankylosing spondylitis (AS) with peripheral arthritis, in the absence of gastrointestinal symptoms. On the mother's side there were no clinical or histological signs of ileum inflammation, or spondyloarthritic features, although the mother carries the HLA-B27 antigen. The 4 children are all HLA-Bw62 and B27 positive, but only 2 of them have developed seronegative spondyloarthritis associated with histological evidence of chronic ileum inflammation. The familial aggregation of the seronegative spondyloarthritides is demonstrated. The lesions found on ileal biopsy in reactive synovitis and AS with peripheral arthritis may be related to Crohn's disease.

Adolescent↗
PubMed1985

HLA-B27 related arthritis and bowel inflammation. Part 2. Ileocolonoscopy and bowel histology in patients with HLA-B27 related arthritis.

Ileocolonoscopy and microscopic examination of ileum biopsies were performed on 35 patients with reactive arthritis, with asymmetrical pauciarticular arthritis and enthesopathies. Ileocolonoscopy was also performed on 26 patients with ankylosing spondylitis (AS) and on 19 control patients with rheumatoid arthritis, juvenile chronic arthritis, systemic lupus erythematosus and psoriatic arthritis. In the reactive group, ileocolonoscopy showed macroscopic inflammation in 16 cases and abnormal microscopic examination in all but 2 cases, even in patients without gastrointestinal disorders. In the 2 patients with sexually acquired disease, the gut was normal. In the AS group, inflammation was observed in the B27 negative and positive patients with peripheral joint involvement. Occasionally, ileal signs were seen in the HLA-B27 positive patients without peripheral joint involvement. None of the controls showed signs of gut inflammation. Ilecolonoscopy may be of value in detecting subclinical forms of bowel inflammation.

Adolescent↗
PubMed1984

Macroscopic and histological changes of the ileum HLA-B27 related diseases: therapeutic consequences.

Ileocolonoscopy and microscopic examination of ileum biopsies have been performed on patients with reactive synovitis, ankylosing spondylitis (AS) and on a control group. Histological signs of gut inflammation were present in practically all patients with reactive synovitis, with the exception of the patients with sexually-acquired disease. In the AS group, inflammation of the ileum was observed in the HLA-B27 negative patients and in AS B27 positive patients with peripheral joint involvement. Occasionally, changes of the ileum were seen in the B27 positive AS patients without peripheral joint involvement. Signs of gut inflammation were absent in all controls. These data suggest that chronic inflammation of the ileum could be implicated in the pathogenesis of some cases of reactive synovitis and even in the peripheral joint involvement frequently seen in ankylosing spondylitis. In the second part of the study, sulfasalazine (Salazopyrin) was administered to 15 HLA-B27 positive patients with reactive synovitis, who had failed to respond to non-steroidal anti-inflammatory drugs. In 11 of the 15 patients, a clinical and biological remission occurred 3 to 11 months after the start of sulfasalazine treatment. The frequency of spontaneous remissions in reactive synovitis calls for confirmation of these encouraging results in double-blind controlled studies.

Adolescent↗
PubMed1976

Hospital treatment and diagnosis of Mycoplasma pneumoniae pneumonia.

A study was started in 1972 in order to determine the true etiology of patients who presented with obscure pulmonary infiltrates. Patients who were included in this study had sera drawn on two occasions. Complete testing was performed for the various viruses and also for Mycoplasma pneumoniae antibodies. The study continued through 1975 and a total of 159 patients were included. Of these 159 patients, 28 had positive complement fixation tests for M. pneumoniae antibodies. The clinical profile and treatment course is outlined and discussed.

Adolescent↗
PubMedDate not supplied

Jejunal arteriovenous malformation, diagnosed by angiography and treated by embolization and catheter-guided surgery: case report and review of literature.

A case of chronic gastrointestinal hemorrhage caused by a small jejunal arteriovenous malformation (AVM) is reported. Treatment by endovascular embolization was temporarily successful. Subsequently, the patient underwent laparoscopic resection, guided by intraoperative catheter localization with methylene blue. Histopathology confirmed a true AVM. Eighteen months after treatment, the patient is free of symptoms. Literature of jejunal AVMs is reviewed.

Aged↗