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Biomedical subjects

M Longy-Boursier

Publications and source records attributed to M Longy-Boursier.

At least 55 records · Page 3Linked to original sources

[Oxidative stress and malaria. Apropos of 24 cases of Plasmodium falciparum malaria].

Oxidative stress has been suggested to be implicated in malaria. But it is not clear whether its major role is to kill intraerythrocytic parasites or to cause damage to host tissues. We have studied it in 24 European subjects hospitalized in Saint-André hospital, Bordeaux, France for Plasmodium falciparum access returning from a tropical trip, and in a group control of 16 subjects. Malondialdehyde, one of the oxidative stress markers is significantly increased in patients compared to the control group (m = 5.24 vs 2.14 mol/l). At the same time, it is observed a significative decrease in antioxidant factors, vitamin A and vitamin E. We found no relationship of the severity of malaria to the importance of the oxidative stress, and the question whether the oxidative stress attack host tissues or kill parasites remains entire. These observations should be completed by larger studies, particularly to improve malaria treatments available nowadays.

Adolescent↗

Concurrent herpes simplex type 1 necrotizing encephalitis, cytomegalovirus ventriculoencephalitis and cerebral lymphoma in an AIDS patient.

Unlike cytomegalovirus (CMV) ventriculoencephalitis, herpes simplex virus type 1 necrotizing encephalitis has only rarely been observed in AIDS patients. A 40-year-old bisexual man was followed for an HIV1 infection from 1987 onwards. In June 1993 he was referred for sudden confusion, left hemiparesia and fever. The blood contained less than 10 CD4 lymphocytes/mm3. The patient remained comatose and febrile, and died 4 weeks later. In coronal sections of the brain there was necrosis of the internal parts of the left temporal lobe, necrosis of certain areas of the ventricular walls and a small tumor at the top of the right frontal lobe, which proved to be a polymorphic high-grade lymphoma. CMV ventriculoencephalitis lesions were prominent in the ventricular walls of the occipital lobes and there was a strong nuclear signal for CMV using in situ hybridization. Herpes simplex virus type 1 was shown in the nuclei and cytoplasm of certain neurons and astrocytes in the borders of the necrotized temporal lobe areas by immunohistochemistry, in situ hybridization and electron microscopy, whereas in situ hybridization and immunohistochemistry for CMV were negative in such areas. Necrotizing type 1 encephalitis must not be overlooked in immunodeficient patients.

Acquired Immunodeficiency Syndrome↗

[A rare cause of paroxysmal eosinophilia: eosinophilic gastroenteritis].

The authors report the case of a 16 year-old boy admitted for the seventh acute occurrence in 18 months of abdominal pain associated with hypereosinophilia. Each episode was identical in nature and receded spontaneously after 5 or 6 days. Biopsy of a fiber colonoscopically obtained specimen of small intestine was performed. The diagnosis of eosinophilic gastroenteritis was based upon an infiltration of the digestive mucosa by eosinophils, the absence of elements in favor of other types of digestive-tract disease (parasitic, allergic, hematologic, or inflammatory), and the absence or other illness outside the digestive system. However, the incidental discovery of a distal dilation of both of the patients ureters during one such episode, that disappeared with the other symptoms, raises the possibility of a bladder location as well, and thus of a hypereosinophilic syndrome. Corticoids were administered then tapered down. A relapse occurred 2 months later. Currently, he is taking 20 mg of a corticoid every other day and has presented no manifestations over the last 9 months.

Adolescent↗

[Sweet syndrome and Yersinia enterocolitica infection. 2 cases].

Sweet's syndrome is an acute febrile neutrophilic dermatosis. Although it frequently appears as an idiopathic disorder, it may occur in association, often as presenting sign, with malignancy or more rarely with infections. We report two cases of Sweet's syndrome preceded by digestive infection due to Yersinia enterocolitica, affirmed by significant rises in serum antibody titers. Other nongastrointestinal manifestations of such infections are known, predominantly arthritis and erythema nodosum. Sweet's syndrome is a rare complication of these infections. Treatment with systemic steroids, usually effective, can be replaced by antibiotics with apparently favorable results. The search of an infectious origin should be systematic in cases of Sweet's syndrome that appear to be idiopathic.

Adult↗

[Epidemiological, clinical, biological and developmental aspects of leptospirosis: apropos of 30 cases in Aquitaine].

We have studied retrospectively 30 cases of leptospirosis observed in Aquitaine (South West France) from 1980 till 1992. This review was made in three internal and a nephrology department in Bordeaux hospital. Most cases occurred by indirect contact with infected animals or by occupational exposures. Onset was brutal with fever often associated with painful syndrome and sometimes conjunctival suffusion. Jaundice (70%), acute renal failure (67%), meningitis (50%) and hemorrhagic signs (50%) were among the major visceral manifestations. Diagnosis was always confirmed by micro-agglutination test. Leptospira ictero-hemorrhage was the predominant serogroup found. The outcome was favorable in 22 patients; reversible complications were seen in six cases (five acute renal failure with hemodialysis myocarditis and pulmonary edema in two hemodialysed patients, polyradiculoneuritis). Two patients died (acute respiratory failure and meningo-encephalitis with diffuse hemorrhagic syndrome). The characteristic of our series is the high frequency of hepatorenal syndrome due to the importance of our nephrologist recruitment. Furthermore our study confirm the vital prognostic characters of the pulmonary, renal, hemorrhagic and neurologic complications. No absolute relationship was found between the clinical and laboratory findings and the serotype of leptospira. Penicillin remains the treatment of choice and should be started as soon as possible the avoid the life threatening visceral complications.

Adolescent↗

[Joint manifestations and parvovorus B19 infections: 8 cases].

Human Parvovirus B19 (PB19) may cause joint manifestations. We report eight cases of polyarthritis associated with PB19 IgM: six cases of acute polyarthritis spontaneously resolving within a few days, and two other cases suggesting that PB19 should be responsible for accutisation of chronic disease (lupus with Kikuchi's disease and HLA B27 related arthritis).

Adult↗

[A rare etiology of spinal cord compression: Gaucher disease].

Gaucher's disease is a sphingolipidosis transmitted as an autosomal trait. Bone lesions are frequent in type 1 of the disease (i.e. the adult type without neurological manifestation). We report the case of a 70-year old woman suffering from spinal lesions with vertebral collapse and spinal cord compression. Our diagnosis was based on the finding in bone samples of Gaucher cells looking like large macrophages, and on the enzymatic assay of glucocerebrosidase. New treatments, such as replacement of the deficient enzyme by placental glucocerebrosidase, are currently being evaluated.

Aged↗

[Ventricular arrhythmia and halofantrine intake. Probable deleterious effect. Apropos of 3 cases].

Incidence and malignant forms of imported Plasmodium falciparum malaria are increasing, and chemoprevention is more and more replaced by stand-by treatment and radical cure in preventing access on return from malaria areas. Halofantrine is recommended for this radical cure: it's an habitually well-tolerated amino-alcohol with very few side-effects. We report three cases of long QT-interval due to halofantine: three different young women coming back from Africa took halofantrine (500 mg (2 tablets) six hourly for three doses on the first and the seventh day) and all presented with syncopal episodes. Serum electrolyte concentrations and echocardiograms were normal. In one case only, a diagnosis of Plasmodium falciparum malaria was made, without severe manifestations, and in the two other cases, treatment was a radical cure. In two cases, several bursts of torsades de pointes ventricular tachycardia due to halofantrine were proven and electrophysiological cardiac tests concluded that they had a congenital long QT-interval/Romano-Ward syndrome). So far halofantrine cardiac toxicity was unknown with single dose of 24 mg/kg/d. This phenomenon can be very severe in case of preexisting cardiopathy. In spite of the rarity on the congenital Romano-Ward syndrome, systematic electrocardiogram is necessary before giving halofantrine.

Adult↗