[Concentric demyelinating leukoencephalitis of the Baló type with symptomatology and clinical evolution of multiple sclerosis; (anatomoclinical case)].
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Biomedical subjects
Publications and source records attributed to M Serban.
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Forty patients with rheumatoid arthritis (RA) selected according to the ARA criteria, in whom the onset of disease had appeared after the age of 65 years, were studied comparatively with a control group of 40 RA patients in whom the disease had occurred before this age. Every patient was subjected to a complex clinical and biologic investigation. The characteristics of the two groups are presented. The onset of disease in old age was frequently acute (65% of the cases as compared with 45% in the control group). The difference between the two groups was statistically significant from this viewpoint (p less than 0.001). Presence at onset of certain general manifestations associated with loss of weight, risomelic involvement and association of Horton disease were found in 50% of the old agers as compared with 12.5% in the control group. The radiologic aspect was similar in both groups. Positive rheumatoid factor in 64% of the cases, as well as the homogeneous or speckled antinuclear factor were likewise comparable with the data in the younger group. From the evolutive point of view RA with onset in old age showed good response to therapy. Chrysotherapy was effective in 80% of the patients in the old age group and in less than 50% of the controls.
Urinary excretion of albumin was determined in 133 clinically healthy subjects and 236 patients suffering from diabetes mellitus (150 cases), collagen diseases (45 cases), or arterial hypertension (41 cases) in whom there was no clinical or laboratory evidence of renal involvement. Urine albumin was measured by an improved single-radial-immunodiffusion technique and results were expressed as urine albumin to creatinine concentration ratio (mg/g). The geometric mean values in the patients were about 2 to 2.5 times higher than in controls. When considered on an individual basis, at least 40 per cent of the patients had values above the 99th-percentile value for controls. The results suggest that quantitative determination of urinary albumin may be useful for detecting early structural functional alterations of the glomerular filter.
Serum and urinary lysozyme were assessed in 138 patients with malignant hemopathies, of whom 71 with acute leukemias. Serum lysozyme values were found increased in acute myelocytic or monocytic leukemias and normal in lymphocytic leukemias and lymphomas. Serum lysozyme estimation is of value in the diagnosis of acute leukemias which cannot be differentiated by morphologic, cytochemical and cytoenzymatic methods. Renal insufficiency associated with malignant hemopathies is in itself a cause of rise of both the serum and urinary lysozyme values.
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The Melkersson-Rosenthal syndrome consists of the following signs: recurrent oedema of the lips and intermittent facial oedema with recidivant aspect; recidivant peripheral facial paresis; scrotal tongue. The cases of a 14-years-old girl is presented. She has two elements of the above signs (recurrent oedema of the lips with facial oedema and scrotal tongue), and additionally ocular affectation: keratitis and bilateral blepharitis. This associations, which has not been found in the literature, is emphasized.
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A survey was conducted on 711 patients, adults and children. The results indicated the high incidence of cytomegalovirus infection among population and confirmed the virus transmission through blood transfusion. The existence of congenital infection in newborn seems to be confirmed. Some prevention measures are suggested.
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Comparative studies aiming at the detection of certain tubular protein elements by means of Ouchterlony's immunodiffusion, in parallel with lysozyme and guanase assays, were carried out in the unconcentrated urines of 746 subjects, of whom 655 apparently healthy inhabitants (mostly children) from a region with endemic nephropathy (EN) and from Bucharest, as well as 91 adults with EN or various other diseases with renal involvement. The presence of light chains, of lysozymuria exceeding 2 microgram/ml, of beta2 microglobulin and of guanase in the urines of children and adults from the endemic area was significantly more frequent than in the control groups. These immunochemical changes are hence considered as valuable criteria for the detection of EN prior to the uremic stage. They should be looked for, first and foremost, in the young relatives of patients with this disease. In the stage of nitrogen retention the diagnostic value of these tests is reduced, since the same changes can also be found in the urines of patients suffering from other diseases with renal involvement, which show nitrogen retention as well.