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M F Kahn

Publications and source records attributed to M F Kahn.

At least 145 records · Page 8Linked to original sources
PubMed1991

[Massive osteolysis of the metacarpal bones. Apropos of a case of an osteolytic form of psoriatic rheumatism].

The authors report a case of massive osteolysis of all of the metacarpal bones of the right hand in a 26 year old man. The disease commenced 9 years previously with painful symptoms associated with inflammation and the initial X-rays showed periosteal reaction of the 2nd and 3rd metacarpals. Massive osteolysis of all of the metacarpal bones, including the 1st metacarpal, developed progressively over a period of one year, although no signs of osteolysis were observed in the carpal bones or phalanges. A surgical operation, performed to realign the ring and little fingers, revealed a 4 mm thick periosteal sheath explaining the maintenance of a certain degree of stability of the metacarpals despite the massive osteolysis. Histological examination eliminated any neoplastic or infectious aetiology and confirmed the inflammatory origin with vascular and lymphocytic proliferation. The development of palmo-plantar psoriasis several months after the onset of the painful symptoms suggested the diagnosis of psoriatic rheumatism. This is a rare site with an unusual clinical course with massive osteolysis of all of the metacarpal bones, but it appears to be the most likely hypothesis. The clinical course was stabilised by non-steroidal anti-inflammatory agents but there was no bony reconstruction.

Adult↗
PubMed1991

Parvovirus B19 infection can induce histiocytic necrotizing lymphadenitis (Kikuchi's disease) associated with systemic lupus erythematosus.

We report three cases of systemic lupus erythematosus (SLE) associated with necrotizing histiocytic lymphadenitis (Kikuchi's disease) and immunologically proven human parvovirus B19 infection. Simultaneous occurrence of SLE and Kikuchi's disease was a characteristic of the three cases. Kikuchi's disease is an uncommon disease that usually affects young women and is characterized by painless unilateral cervical lymph-node enlargement. T-cell regions of affected lymph nodes are exclusively involved with patchy paracortical necrosis surrounded by a polymorphous cell population of histiocytes and macrophages. However, lymphadenopathy in patients with SLE may be histologically indistinguishable from Kikuchi's necrotizing lymphadenitis. The cause of Kikuchi's disease remains uncertain, although infectious agents have been proposed. A positive IgM-specific anti-human parvovirus B19 antibody test in our three cases suggests that B19 can induce a necrotizing histiocytic lymphadenitis and possibly a clinical SLE flare. High-dose (1 mg/kg/day) and medium-dose (0.5 mg/kg/day) oral prednisone was an effective treatment for constitutional and visceral symptoms of Kikuchi's and SLE diseases.

Adolescent↗
PubMed1991

[3 cases of Kituchi's lymphadenitis in systemic lupus erythematosus. Role of the parvovirus B19].

Florid necrotizing lymphadenitis, characterized by segmental infarction and lymphoid hyperplasia, is an uncommon feature of systemic lupus erythematosus (SLE). Kikuchi's disease is a well-defined clinicopathological entity, with a strong preference for the cervical lymph nodes of young women. The etiology of histiocytic necrotizing lymphadenitis (HNL) remains unknown, although viral agents have been proposed. HNL may reflect a self-limited SLE-like autoimmune disease but full-blown SLE associated with this condition has not, to the best of our knowledge, been reported. Thus, ours is the first description of the coexistence of SLE and HNL in 3 patients with immunologically proven parvovirus B19 infections. SLE and HNL were diagnosed simultaneously in 2 patients, but was retrospective in the third, in whom anti-tuberculous therapy was ineffective. Patients 1 and 2 were treated with prednisone (1 mg/kg/d) and responded rapidly. These data suggest that both HNL and SLE flares can be caused by parvovirus B19 infection.

Adult↗
PubMed1991

[Vasculitis and neoplasms. 14 cases].

Fourteen cases of vasculitis associated with a neoplasm are reported. The vasculitides were classified as: leukocytolytic vasculitis 7, periarteritis nodosa 4, purpura rheumatica 1, cutaneous granulomatous vasculitis 1, microvasculitis nervosa 1. The neoplasms were diagnosed as: 10 hemopathies (including 4 cases of refractory anemia) and 5 solid tumors (1 patient had 2 tumors). The cutaneous manifestations (purpura, papules, subcutaneous nodules, etc.) and fever were the most common, while joint and neurological involvement were the rarest. The evolution of the vasculitis was usually corticosensitive and independent of the underlying neoplasm. A review of the literature revealed that these vasculitides (primarily leukocytolytic) were frequently associated with dysplastic myelogenous syndromes and hairy cell leukemia, while bronchopulmonary and colonic neoplasms were the most common solid tumors. The mechanisms giving rise to these vasculitides are discussed.

Aged↗
PubMed1991

[Adult oligoarthritis with antinuclear factors. A new syndrome, relations with juvenile oligoarthritis].

We report an original form of chronic inflammatory arthritis in 14 young adults, mainly females: an oligoarthritis with antinuclear antibodies. A first group of 10 patients, 9 females and one male, over 17 year-old, mean age 25, presented with monoarthritis or oligoarthritis of the knees, and less frequently of the wrist or elbow. Arthritis was chronic, recurrent, not destructive nor incapacitating. Rheumatoid factor was absent, and the only biologic abnormality was positive ANA at a significant rate. No patient was typed for HLA DR5. No other clinical or biological symptom appeared during a mean follow-up period of 5.5 years (6 mo-30 yrs). The patients have been totally free of any ocular symptoms. The benignity of the disease and its good prognosis must be underlined. Another group of 4 adult women had a similar inflammatory disease, which started during childhood: the biological and clinical spectrum was found quite similar in both groups, except for uveitis which occurred only in the later. Most subsets of juvenile arthritis have counterpart in adulthood, except for the pauciarticular subset with AAN. The cases herein described could fill the gap, the only difference with the juvenile onset form being the absence of uveitis. Thus, even if our observations of oligoarthritis with ANA in young women are the equivalent of the pauciarticular form in young girls, ocular involvement remains specific of childhood.

Adolescent↗
PubMed1991

[Detection of anti-Ro(SS-A) by using immunoimprint. Comparison with double diffusion in agar. Apropos of a series of 63 primary Gougerot-Sjögren syndromes].

Among soluble anti-nuclear antigen auto-antibodies, anti-Ro(SS-A) were, for unknown reasons, difficult to detect by immunoimprint (II). The aim of this study was the development of a method of preparation of Ro(SS-A) antigen enabling greater sensitivity in the detection by II of the corresponding antibodies, then application of this method in a series of 63 cases of primary Sjögren's syndrome in order to study the clinical significance of anti-Ro(SS-A) antibodies. Ro(SS-A) antigen was prepared from human spleen and partially purified on DE-52 resin. The protein extract prepared reacted in II with reference anti-Ro(SS-A) and anti-La(SS-B) antibodies. The series of 63 cases of primary Sjögren's syndrome (57 F, 6M) included 50 of extraglandular primary Sjögren's syndrome and 13 of isolated glandular primary Sjögren's syndrome. Twenty two cases of primary Sjögren's syndrome had anti-Ro(SS-A) (35%). Twenty patients had anti-Ro(SS-A) by II (32%) and 17 by double diffusion in agar (27%) (p = NS). Among 7 discordant sera, 2 were not detected by II. The incidence of anti-Ro did not differ statistically between the extraglandular (40%) and glandular (15%) primary Sjögren's syndrome groups. Patients were divided into two groups according to whether they did (n = 22) or did not (n = 41) produce anti-Ro(SS-A).(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Antinuclear↗
PubMed1991

Sternoclavicular pustulotic osteitis (SAPHO). 20-year interval between skin and bone lesions.

In 2 cases of palmoplantar pustulosis, a 20-year interval was observed between the skin lesion and the bone involvement. In one case, the bone lesion came first. In the other a skin lesion was seen for 3 weeks without subsequent relapse. The 2 cases underline the multifaceted presentation of the condition for which we have coined the name synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome.

Adult↗