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Biomedical subjects

M F Kahn

Publications and source records attributed to M F Kahn.

At least 253 records · Page 14Linked to original sources

[Twenty-three cases of gonococcal arthritis (author's transl)].

Twenty-three cases of gonococcal arthritis involving 10 men and 13 women aged from 18-81 years (mean, 32 years) are reported. Seven of the men had developed urethritis 3 to 21 days previously. Seven of the women had no signs or symptoms of genital infection. Twelve patients presented with polyarticular lesions and 7 with monoarticular lesions heralded by migratory arthralgias. The joints most commonly affected were the knees, fingers, wrists and ankles. Ten patients had tenosynovitis of the flexor muscles of fingers, and 10 exhibited a skin rash suggestive of the condition. Haemocultures were positive for N.gonorrhoeae in 4 out of 12 patients. The organism was isolated from synovial fluid in 7/11 cases and from urethral and vaginal secretions in 9/20 cases. All patients were cured rapidly and without sequelae with penicillin or ampicillin.

Adolescent↗

[T-lymphocyte subpopulations in chronic inflammatory rheumatism].

Monoclonal antibodies to a series of human lymphocytes subpopulations antigens (OKT) specific of the peripheral T cells (OKT3), of the inducer population (OKT4) of the suppressor cytotoxic population (OKT 5, OKT8), and anti-Ia (OKI1) were used to study blood lymphocytes from 50 patients with active or inactive rheumatoid arthritis (RA) and from 23 patients with ankylosing spondylitis (AS). In RA patients, there is a significant decrease of the total T cell population (T3 +) with higher percentages of helper (T4 +) T cells than in controls. In active forms of the disease, there also is a decrease in the suppressor cytotoxic (T5 + and T8 +) subset with a significant increase of the immunoregulating ratios T4 +/T5 + or T4 +/T8 +. Elevated levels of Ia + lymphocytes are found in all RA patients. Corticosteroid treatment seems to erase these abnormalities. On the contrary in AS patients, no significant modification of the T cell populations was evidenced.

Antibodies, Monoclonal↗

[Soluble SS-A, SS-B and RNP antinuclear antigen antibodies in 66 cases of pure or associated forms of Gougerot-Sjögren syndrome].

In a prospective study, 66 patients fulfilling the criteria of Sjögren's syndrome were evaluated from the standpoint of the presence of soluble SS-A, SS-B and RNP specific nuclear antigen antibodies. There were 25 cases of pure Sjögren's syndrome and 41 cases of this syndrome associated with a connective tissue disease. Anti SS-A antibodies were found in 10 per cent of cases and anti SS-B in 21 per cent, without there being any significant difference in prevalence between pure and associated forms of Sjögren's syndrome. Three patients simultaneously showed anti SS-A and anti SS-B antibodies, four had only anti SS-A and eleven anti SS-B. Amongst the forms associated with a connective tissue disease all of the latter were represented with an equivalent prevalence. 18 per cent of the patients had anti-RNP with a majority of associated forms of Sjögren's syndrome. In this population of 66 patients with Sjögren's syndrome, no clinical manifestation appeared to be correlated with the presence of anti SS-A and SS-B antibodies. Amongst the laboratory features, only cryoglobulins were significantly more frequent.

Adult↗

[Evolutive aspects of Sharp's mixed connective tissue disease. 23 cases (author's transl)].

Among 23 patients with Sharp's disease, 14 initially had only polyarthritis, Raynaud's syndrome and anti-ribonucleoprotein antibodies. During a mean 5.6 years (range: 1-7 years) follow-up these 14 patients, 2 cases of pericarditis, 1 case of trigeminal neuralgia, 2 cases of nephropathy and 1 case of pulmonary arterial hypertension were observed. The 9 remaining patients had symptoms of multiple collagen disease. They were followed up for a mean of 4.3 years (range: 3-7 years) and 3 developed pericarditis. We discuss the prognostic significance of anti-DNA antibodies (7 cases) and low serum complement (3 cases) which, when combined, seem to be associated with severe visceral lesions.

Antibodies, Antinuclear↗

[Incidence of previous engagement in sports among patients with symptomatic arthrosis. Controlled study].

The authors investigated sports-related precedents in two groups of male subjects, aged 40 years and over, of French nationality. One group had consulted for a degenerative, chronic rheumatic disorder, and the control group showed no signs of this type of disorder. Care was taken to verify that the two groups did not differ in terms of profession, means of commuting from home to work, and non-sporting leisure physical activities. The authors observed that the subjects of the first group (chronic degenerative rheumatic disease) more frequently engaged in a sports activity, and in a significant manner, than did the control subjects. A separate study of the certain kinds of sports and the various arthritic localisations also revealed significant correlations. Although this involved a retrospective enquiry, the authors feel that the results provide arguments in favor of the pathogenic role of sports activity, with regard to peripheral joints and the spine. However, this role of sports is probably only partial and irregular. The risks of sports activity must be put in perspective and balanced with the various advantages afforded by the practice of sports.

Adult↗

[Comparison of severity and native anti-DNA antibody levels in systemic lupus erythematosus. Serodiscordant lupus].

The authors studied the clinicobiological correlations between the severity of systemic lupus erythematosus (SLE) and native anti-DNA antibody levels in 176 patients suffering from this disease. Certain patients were studied at different stages of their disease. This correlation was very close in one out of two cases and relative in one case out of four. In one-fourth of these patients, a significant and persistent discordance existed, and these patients were therefore studied apart. Certain SLE which have been suppressed over long periods of time continue to have elevated anti-DNA levels which are occasionally associated with lowered levels of complement. This has been previously reported in the literature. All decisions to modify corticosteroid treatment based only on biological data is therefore questionable. In contrast, in certain cases of SLE where the evolution of the disease is relatively severe, no anti-DNA or antinuclear antibodies are present. These "seronegative" SLE cases are proof that the "specific" biology of this disease may be erroneous for diagnosis as well as for prognosis. The authors review the possible or known causes for the absence of these antibodies in SLE. They believe that native anti-DNA levels are only of relative value in SLE and feel that these values must be examined with respect to clinical and other biological data in order to treat and survey patients affected with this disease.

Antibodies, Antinuclear↗

[Diffuse gingival plasmocytoma: a rare location of extra-osseous solitary plasmocytomas (author's transl)].

A 51-year-old man presented with isolated diffuse gingival hypertrophy, the diagnosis of a plasmocytoma being suspected after pathological and immunohistological examinations of a gingival biopsy (light chain lambda plasmocytes). The isolated nature of this diffuse gingival plasmocytoma was confirmed by biological tests and radiological investigations. The evolution of solitary plasmocytomas is variable, and while certain of these lesions remain isolated even after many years, other plasmocytomas, apparently local, are associated with myelomas which either become evident or may sometimes develop. The extremely rare nature of diffuse gingival locations of extra-osseous solitary plasmocytomas is confirmed by a review of the published literature. Studying histological sections by immunofluorescence enables the polyclonal or monoclonal nature of the plasmocytes to be established, this distinction being an important element in the prognosis.

Fluorescent Antibody Technique↗

[Aseptic arthritis with positive serology for Yersinia pseudotuberculosis. Apropos of 6 new cases].

Six personal observations of aseptic acute arthritis with positive serology for yersinia pseudotuberculosis (YPT) have been related, the specific serodiagnosis was clearly positive (greater than 1/500) for all the patients and the rate variations of repeated examinations were constantly observed. These cases have been compared with 14 sporadic observations of the existing studies where such reactive arthritis were referred to a recent YPT infection, this confrontation leads us to specify the characteristics of this inflammatory rheumatism : starting by a prearthritic phase with variable combination of fever, diarrhea, abdominal pains, erythema nodosum, usually polyarticular affection (90%) mostly of the knees (89%), ankle-joints, wrists and elbows, marked inflammatory clinical and biological signs but without X. Rays abnormalities. The course which seems hastened by anti-inflammatory medication ends up several weeks or months later without recurrences or secondary diseases by a recovery. The presence of HLA B27 antigen in 50% out of the 10 tested cases enables us to discover the intervention of a predisposing genetic factor. A semiologic and nosologic comparison is established with polyarthritis of YEC infection. The discussion concerning the 18 observations where only serology based diagnosis exists, turns mainly on the reality of sporadic YPT rheumatism. If it is not yet possible to assert with certitude the authenticity of such YPT reactive arthritis there is several arguments in support of that, particularly the existence of post-septicemia aseptic polyarthritis and the existence of similar joint-affection during the far-east scarlatiniform fever which is a special form of YPT infection.

Adult↗

[Gonococcal arthritis].

Gonococcal arthritis, a rare complication of gonorrhoea, more frequent in women, causes polyarthritis in 75% of cases or monoarthritis. An erythematous skin rash or acute pustular rash (40%), recent signs of genital infection (75% of cases in man, less than 50% in women) suggest the diagnosis. The gonococcal nature of the arthritis is confirmed by isolation of the germ in the joint fluid, the blood and the skin biopsies. In about half the cases, these bacteriological investigations are negative, but the diagnosis remains very probable if the germ is isolated from one or other of the primary foci of the infection: ureter, cervix, vagina, rectum and even pharynx. The rapidly favourable course under antibiotic treatment with penicillin or ampicillin confirms the diagnosis. The pathogenesis of arthritis is a direct toxic action of the gonococcus on the synovial membrane and the periarticular structures. The role of circulating immune complexes recently demonstrated in gonococcemia is probably not relevant.

Arthritis, Infectious↗