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Biomedical subjects

M Dougados

Publications and source records attributed to M Dougados.

At least 325 records · Page 18Linked to original sources
PubMed1982

Influence of oral contraceptive therapy on the activity of systemic lupus erythematosus.

Since harmful effects of estrogens in murine lupus are well established, we studied the influence of oral contraceptive therapy on systemic lupus erythematosus activity in 26 female patients with lupus nephropathy. Combined preparations containing either 50 micrograms (14 patients) or 30 micrograms (7 patients) of ethinyl-estradiol were used in 21 courses in 20 patients. Initial manifestations or exacerbations of systemic lupus activity appeared within 3 months of beginning hormonal therapy in 9 patients, an overall incidence of lupus flare-up of 43%; there was major renal involvement in 4 patients. Conversely, evidence of lupus exacerbation did not develop in any of 11 patients who received pure progestogen oral contraceptive therapy with either continuous low-dose norsteroids (6 patients) or discontinuous progestogens at normal dosage (5 patients). These patients were followed for 5--30 months. Our data indicated that oral contraceptive therapy that used estrogens, even at low doses, often induced exacerbation of systemic lupus erythematosus activity. Pure progestogens, which were effective and devoid of such unfavorable effects, may be preferred in these patients.

Adolescent↗
PubMed1982

[Destructive arthritis and Behçet's syndrome].

The arthritis of Behçet's syndrome is not usually responsible for articular destructions, so that the presence of destructive lesions makes the diagnosis of Behçet's syndrome doubtful. Here is presented the observation of a 29 years old man (his illness beginning at twelve), with a typical Behçet's syndrome, who developed a destructive arthritis. Arthritic and systemic flares showed a parallel evolution. Destructive lesions involved wrists, hands, feet and elbows. The search for another cause of destructive arthritis (mainly juvenile rheumatoid arthritis and ankylosing spondylitis) was negative. The occurrence of destructive arthropathies in Behçet's syndrome has been exceptionally reported.

Adolescent↗
PubMed1981

[Solitary intracranial plasmacytoma : report of a case and review of the literature (author's transl)].

The authors report the case of a 71 year old woman affected by a solitary intracranial plasmacytoma. Computed tomography statement and monoclonal gammapathy found in the serum and in the cerebrospinal fluid permitted the diagnosis. Brain tumor and gammapathy improved after radiotherapy. A review of the 17 cases reported in the available literature showed some characteristics of these tumors : epidemiology, localization, evolution.

Aged↗
PubMed1980

[Circulating anticoagulants with antiprothrombinase activity in systemic lupus erythematosus (author's transl)].

Circulating anticoagulants with antiprothrombinase activity were detected in 14 out of 49 patients (i.e. 29%) presenting with severe forms of systemic lupus erythematosus (SLE) predominantly renal (29) or extrarenal (20). Nine of these 14 patients had thrombopenia and 8 had a falsely positive Wassermann test. The anticoagulants were more frequently encountered in patients with severe extrarenal manifestations (9/20 cases) than in patients with severe proliferative renal lesions (5/29 cases). They were found in 5 out of 10 patients with arterial and/or venous thrombosis. Anticoagulant levels paralleled the course of the disease during treatment. No haemorrhage was observed in 14 percutaneous renal biopsies performed on 11 patients free from outer coagulopathies. This suggests that the presence of antiprothrombinase anticoagulants in the blood of patients without thrombopenia or other coagulation disorders is compatible with surgery or biopsy of the kidney.

Blood Coagulation↗
PubMed1980

[Treatment of severe systemic lupus erythematosus. Long-term results in 55 patients (author's transl)].

Out of 55 patients with severe systemic lupus erythematosus (SLE) retrospectively studied from 1962 to 1979, 32 had diffuse proliderative glomerulonephritis and 23 had one or several extrarenal and/or haematological manifestations of the disease. All received corticosteroids in high dosage (0,8 to 1,5 up period was 48 months from the beginning of treatment. The actuarial survival rates for the whole groupe after 1,5 and 10 years were 92,4%, 83,4% and 77,2% respectively. Eight patients died: 5 of SLE and 3 of iatrogenic complications. Four are kept alive by maintenance haemodialysis. At the end of the study period, SLE was quiescent in 37 patients, including 14 who had discontinued corticosteroids for 5 to 72 months. The five-year survival rates were very similar in patients with renal and extrarenal involvement (86,4% and 81,6% respectively). In the latter group myocardial insufficiency, thrombopenia and thromboembolic complications were the main factors of morbidity and mortality. Corticosteroids were administered alone to 25 patients and in combination with cyclophosphamide to the remaining 30. Cyclophosphamide was given initially in 13 cases or subsequently on account of intolerance (7 cases) or resistance (10 cases) to steroids. Similar results were obtained with these two therapeutic regimens, but it must be noted that cyclophosphamide was mainly used in the more severe forms of SLE.

Adrenal Cortex Hormones↗
PubMed1980

[Thromboembolic manifestations in systemic lupus erythematosus (author's transl)].

Among 60 patients (56 females, 4 males) with severe forms of SLE, 13 developed thromboembolic arterial and/or venous manifestations, an overall incidence of 21.6 percent. Thrombophlebitis episodes, mainly affecting lower limbs, occurred in 8 patients, usually an initial or early manifestation of active lupus disease; thrombophlebitis was recurrent in two, and pulmonary embolism was proved in two patients. Arterial occlusion developed in 7 patients, early in the course of active SLE and mainly affecting peripheral arteries in 4, later and affecting coronary arteries in three. In two patients, both arterial and venous manifestations occurred simultaneously or successively. A circulating anticoagulant with antiprothrombinase activity was present in 8 (61 percent) of the 13 patients with thromboembolic manifestations, as compared to only 21 percent of those without such manifestations, a highly significant (p less than 0.001) difference.

Arteries↗
PubMed1980

[Anticoagulants with antithrombinase activity in systemic lupus erythematosus (author's transl)].

An anticoagulant with antithrombinase activity was looked for in 49 patients with systemic lupus erythematosus and found to be present in 14 of them. The latter were suffering from severe and progressive lupus, specially with arterial involvement. The presence of an isolated antithrombinase does not contraindicate a renal biopsy provided the platelet count and other coagulation factors are normal.

Blood Coagulation↗
PubMed1976

[Current aspects of the Fiessinger-Leroy-Reiter syndrome seen at the initial stage in a military setting].

The authors report a series of 40 recent personal cases of the Fiessinger-Leroy-Reiter syndrome seen at the initial stage in military personnel, in which post-diarrhoeal forms were combined with post-urethritis forms. They emphasize the special features of the articular lesions which alone orient the diagnosis towards this syndrome which is confirmed by the evolution and the paraclinical examinations. They also emphasize the value for diagnosis of the disease of testing for HLA B27 and also its importance with regard to the prognosis, but they show that this antigen is sometimes absent particularly subjected to numerous hostile factors related to poor hygienic conditions. The authors conclude that the presence of the HLA B27 antigen must not lead to a refusal to recognize the relation of this disease to service in patients who have been subjected to the hostile factors that have a role in the genesis of the Fiessinger-Leroy-Reiter syndrome, as this is frequent in military personnel.

Adult↗
PubMedDate not supplied

Spread of clonal T-cell expansions in rheumatoid arthritis patients.

Despite a large number of studies identifying expanded T-cell clones among infiltrating lymphocytes, little is known about their distribution in patients suffering from rheumatoid arthritis. To evaluate the clonality of alpha/beta T-cell populations in arthritic locations and PBL, we determined the CDR3 size lengths of TCR beta-chain transcripts using BV (Vbeta), BC (Cbeta), BJ (Jbeta), and clonotype-specific primers. Transcripts from PBL of healthy donors show gaussian profiles of approximately eight CDR3 size peaks in most BV subfamilies. Dominant peaks standing out above the normal background identify expansions of one or several T-cell clones within a given BV subfamily. The analysis of six patients suffering from rheumatoid arthritis showed clonal expansions in all samples including PBL. Synovial tissue infiltrates revealed less complex repertoires with a greater number of expanded clones than PBL. Expanded clones varied from one patient to another; no recurrences were observed. Most interestingly, identical clones were identified bilaterally in arthritic knee joints and PBL from the same patient. Our data show that given T-cell clones are not only locally expanded but can also be found in the periphery, and strongly suggest that many similar clones spread throughout the bodies of patients.

Adult↗
PubMedDate not supplied

Biologic, histologic and densitometric effects of oral risedronate on bone in patients with multiple myeloma.

Recent studies have shown that treatment with bisphosphonates could be effective against the myelomatous skeletal deterioration. However, the mechanisms of action of these drugs in multiple myeloma (MM) have been poorly studied. In the present study, 11 patients with MM and bone lesions were treated orally with 30 mg/day of risedronate for 6 months, and monitored for 6 additional months. Mean serum calcium decreased from day 4, with a concomitant increase in circulating levels of PTH (1-84) and 1,25-(OH)2D. These parameters reached their nadir on day 7 and returned to baseline value during the treatment period. Markers of bone resorption, pyridinoline and deoxypyridinoline decreased from day 7; they were at 50% and 78% of their basal value at the end of treatment and follow-up periods, respectively. A significant reduction of estimates of bone formation (serum alkaline phosphatase and osteoclacin) appeared at month 3 and persisted for the remainder of the 9-month period. Histomorphometric analysis showed a significant reduction of activation frequency, number of osteoclasts and erosion depth. Bone turnover was high at baseline, and normal after treatment, without mineralisation defects. Mean wall thickness was not different before and after treatment. Spinal bone mineral density measured by dual energy X-ray absorptiometry increased (5.3%) at the end of treatment. We conclude that oral risedronate in multiple myeloma induces a noticeable and rapid inhibition of bone resorption.

Absorptiometry, Photon↗
PubMedDate not supplied

The role of anti-inflammatory drugs in the treatment of osteoarthritis: a European viewpoint.

Despite the fact that there is no scope for an inflammatory process in a strict definition of osteoarthritis (OA), inflammation nevertheless seems to be of great relevance in understanding not only the occurrence of the disease but also its propensity and/or persistence. Longitudinal epidemiologic studies suggest that inflammation--defined by the presence of synovitis within the joint cavity--is a potent predisposing factor for cartilage breakdown. Nonsteroidal anti-inflammatory drugs (NSAIDs) have demonstrated their beneficial short term, rapid-acting effect. However, two questions remain: the choice of NSAIDs versus analysis as first line therapy for symptomatic treatment in OA, and the long-term structural effect of such therapy.

Acetaminophen↗
PubMedDate not supplied

NSAIDs in ankylosing spondylitis.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) effects in Ankylosing Spondylitis (AS) are only suspensive but because of their rapid efficacy on inflammatory symptoms they are the first-line treatment in AS. Short term efficacy of NSAIDs in AS is observed for most patients but the correlation of NSAID intake with the long term prognosis and its potential influence on the structural progression of the disease is still unknown. Therefore, and due to the gastrointestinal side effects of these drugs, daily practice is mostly in favour of discontinuous intake of NSAIDs, following the clinical relapses. However, the recent introduction of specific Cox-2 inhibitors, with a lower risk of severe gastrointestinal adverse events, may modify this attitude. Moreover, some patients are inadequately relieved of pain and inflammation by NSAIDs. The number of NSAIDs to be tested and for each NSAID, the optimal dosage that must be used before categorizing a patient as "refractory to NSAID therapy" have to be clarified. The recent determination of response and remission criteria for NSAIDs therapy is the first step towards well-defined guidelines for short-term and long-term management of NSAIDs in AS.

Anti-Inflammatory Agents, Non-Steroidal↗