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Biomedical subjects

O Bletry

Publications and source records attributed to O Bletry.

At least 37 records · Page 2Linked to original sources
PubMed1994

Pregnancy and its outcome in systemic lupus erythematosus.

In a multi-centre prospective study of systemic lupus erythematosus and pregnancy in France, 117 cases were identified from 1987 to 1992. We report significant morbidity and mortality for mother and fetus from an analysis of 103 cases. Pregnancy outcome was as follows: 28 full-term births, 48 premature births, 18 fetal losses (13 early and two late spontaneous abortions, three stillbirths), five therapeutic abortions and four elective abortions (for unwanted pregnancy). Four preterm neonates died. Lupus was active at pregnancy onset in 28 patients. Of 75 patients with inactive lupus at conception, 27 relapsed during pregnancy, and seven postpartum. Two patients with nephrotic syndrome treated with high-dose corticosteroids died from opportunistic infections. Fetal loss correlated with a history of proteinuria and absence of anti-SSA antibodies. Prematurity was related to a history of fetal loss, active lupus at pregnancy onset, hypertension and > or = 20 mg/day prednisone during pregnancy. Intrauterine growth retardation correlated with pregnancy of short duration, low serum C3 or C4, hypertension, and absence of SSA antibodies. Three of 22 newborns whose mothers had anti-SSA antibodies developed neonatal lupus: two with cutaneous involvement and one with complete atrioventricular block.

Abortion, Therapeutic↗
PubMed1994

Intravenous gamma globulin as first line therapy in polymyositis and dermatomyositis: an open study in 11 adult patients.

OBJECTIVE: Polymyositis (PM) and dermatomyositis (DM) are inflammatory muscle diseases of presumed autoimmune origin. Many possible interventions are available to treat these patients: corticosteroids, immunosuppressive drugs, plasmapheresis, and total body irradiation. But these therapies are not always effective and may be responsible for certain serious side effects. Polyvalent intravenous immunoglobulin (IVIG) has been tried with success in inflammatory myopathies after failure of traditional treatment. An attempt was made to evaluate the efficacy of IVIG as first line therapy in patients with PM or DM. METHODS: Eleven Caucasian patients [6 women, 5 men, mean age 55.6 (SD 10.1) years], with active recent inflammatory myopathy, were treated by high doses of IVIG as first choice. The average duration of inflammatory myopathy before IVIG was 9.6 months (SD 10.2 months, with a range of 1 month to 3 years). Five patients had PM and 6 had DM. None had myositis associated with connective tissue disease. Two patients had a history of malignant disease: 1 lymphoma and 1 breast tumor with relapse of the malignancy during the study. One patient had a probable lung carcinoma and in another patient, ovarian carcinoma was diagnosed a few months after the onset of IVIG. We used preparations of polyvalent human i.v. gamma globulins with intact IgG. All patients received 1 g/kg daily for 2 days each month. The mean course of treatment was 4 months. RESULTS: Clinical assessment, evaluated by proximal muscle power and biochemical tests, was carried out before each treatment period. Significant clinical improvement was noted in only 3 of the 11 patients (one with acute coxsackie virus B infection, and one with possible drug induced myopathy). Mean muscle power estimated for the 11 patients before and after IVIG therapy was not significantly improved. Eight patients showed significant biochemical improvement (more than 50%). Mean CK levels for the 11 patients showed a statistically significant decrease during IVIG therapy (p < 0.01). Minor IVIG side effects were noted in one patient. CONCLUSION: IVIG therapy seems effective rarely as first therapy in patients with inflammatory myopathy but may be considered especially in viral or drug induced myopathy. IVIG therapy as the first treatment may also be tried in patients with contraindication for steroids, and in mild myopathy, especially in the elderly, to avoid steroid induced side effects.

Adult↗
PubMed1993

Hepatitis C virus and essential mixed cryoglobulinaemia.

Clinical and laboratory evidence of liver involvement are frequently found in essential mixed cryoglobulinaemia (EMC). We looked for evidence of hepatitis C virus (HCV) infection in 37 patients with EMC. Anti-HCV antibodies (Ab) were found in 16/37 (43%) patients with EMC using the ELISA 2 test and the RIBA 2 test. The 16 anti-HCV-Ab positive patients (group 1) were compared to the 21 anti-HCV-Ab negative patients (group 2). Group 1 patients had more frequent cutaneous involvement (P = 0.02), clinical, biological and histologic hepatic involvement (P < 0.01), higher serum cryoglobulin and lower CH50 levels (P < 0.001). Serum hepatitis B virus markers were infrequent in both groups and no patient from either group had detectable serum HBV DNA. These preliminary results suggest that HCV may be another cause of mixed cryoglobulinaemia.

Adult↗
PubMed1993

[4 new cases of neuromyositis, one of them associated with HTLV-I infection].

Neuromyositis is a very rare type of polymyositis where, beside the usual muscular manifestations, there are signs of peripheral neuropathy which can be found at clinical, electromyographic and/or pathological examination. We have seen between 1983 and 1990 four cases of neuromyositis. The neurological disorder was an axonopathy in two cases which is usual in neuromyositis; in the other two cases, there was a polyradiculoneuritis which seems to be very rare in this syndrome. In the four patients the disease was particularly severe and unresponsive to treatment. One of our patients had HTLV-I infection diagnosed by polymerase chain reaction amplification and in situ hybridization, while the serological test was negative. To our knowledge only three cases of HTLV-I associated neuromyositis have been reported in the literature.

Adult↗
PubMed1993

Dermatomyositis and ovarian cancer: a report of 7 cases and literature review.

The relationship between malignancy and inflammatory myopathies is now statistically well established. However, the link between polymyositis (PM) or dermatomyositis (DM) and ovarian cancer (OC) has never been clearly emphasized. OC is the 6th most frequent malignancy, occurring in about 1% of the general female population. We describe 7 cases of DM associated with OC (proven in 6 patients, and very probable in a 7th), in a series of 140 adult inflammatory myopathies followed in our institution [84 PM and 56 DM (including 45 female)]. Twenty-four patients had associated malignancy (12 PM and 12 DM). Without considering the probable case, OC occurred in 13.3% (6/45) of the total female DM population, a much higher rate than the 1% observed in the general female population; and in 21.4% (6/28) of females aged over 40 with DM. In women over 40 with DM, ovarian cancer has a major position among associated internal malignancies, and has to be adequately looked for by physicians.

Adult↗
PubMed1992

[Multiple cholesterol embolism mimicking periarteritis nodosa].

Ten men aged 56 to 84 were hospitalized with a diagnosis of periarteritis nodosa, whereas they had multiple cholesterol embolism. The diagnosis was corrected post mortem in the first 3 patients and subsequently in live patients. The particularly misleading clinical manifestations were neurological (polyneuritis in 5 cases, mononeuritis in 1, central nervous system disorders in 3), pulmonary (alveolar haemorrhage in 2 cases, respiratory failure of unknown mechanism in 4) and pericardial (2 cases). Five patients had eosinophilia (more than 500 eosinophils/mm3). The elements that led to the correct diagnosis were the presence of vascular risk factors in all 10 patients (but hyperlipidaemia in only one), severe complications of the atheromatous disease in all cases, a precipitating or aggravating factor in 8 patients (anticoagulant therapy in 7, arteriography in 6) and the finding of purple or necrotic toes (6 cases). Histological (5 cases) and/or ophthalmological (2 cases) evidence was obtained in only 6 patients. Seven patients died 1 to 3 years after the onset of the disorders. Studies on low-density lipoprotein metabolism are in progress to determine the mechanism of clinical manifestations unexplainable by embolism.

Aged↗
PubMed1992

[Peripheral calcific embolism after percutaneous mitral valvuloplasty].

The authors report a case of calcific embolization after percutaneous mitral valvuloplasty. The nature of the embolism was confirmed by anatomopathological examination after popliteal embolectomy. This complication would appear to be extremely rare but represents an additional risk in patients with calcific mitral stenosis.

Adult↗
PubMed1992

[Temporal arteritis in young subjects. A trial of nosological classification apropos of 6 cases].

Six young-adult patients (19- to 32-years-old) are described: 3 men with temporally localized systemic vasculitis (thromboangiitis obliterans 2, Churg-Strauss angiitis 1) and 3 patients (2 men, 1 woman) with isolated temporal arteritis. Temporal arteritis in subjects under 40 years of age consists of either a temporal localization of systemic vasculitis (thromboangiitis obliterans or Buerger's disease, Churg-Strauss angiitis or polyarteritis nodosa) or a distinct entity of which only 12 biopsy-proven cases have been reported to date. The latter is differentiated from temporal (giant cell) arteritis of the older patient by a higher incidence in men, and the absence or rarity of general symptoms, ocular complications and an accelerated erythrocyte sedimentation rate. Two types of temporal arteritides in young adults seem to be distinguishable: an asymptomatic form with an isolated temporal nodule and a more symptomatic one. In some cases, temporal arteritis in young adults corresponds to a unique entity "juvenile temporal arteritis", which seems to be different from Takayasu's arteritis, localized forms of polyarteritis nodosa and Kimura's disease. Although its treatment remains difficult to define, therapy of the symptomatic form could include steroids, whereas the asymptomatic one seems to require only simple monitoring.

Adult↗
PubMed1992

Inappropriate secretion of antidiuretic hormone (SIADH) in a patient with systemic lupus erythematosus (SLE): a case report.

The Syndrome of Inappropriate Secretion of Antidiuretic Hormone (ADH) or SIADH has been reported in a great variety of diseases and disorders of the central nervous system. However, to our knowledge only three cases [Kaplan et al., Decaux et al. 1981, Agus et al. 1983] of SIADH associated with systemic lupus erythematosus (SLE) have been described in the literature. We report here a new case of SIADH in association with SLE.

Adult↗
PubMed1992

[Raynaud's phenomenon and blood viscosity].

Raynaud's phenomenon is mainly linked with cold provoked vasomotor perturbations, but also with rheological alterations since blood viscosity is enhanced by lowering temperature. Several methods are available for studying distal vascularization: peri-ungual capillaroscopy, digital plethysmography and laser-Doppler. Digital arteriography must be reserved to serious ischemia regarding the general anesthesia needed to avoid spasm. All these methods explore especially the vessel wall. Conservely, blood viscosity which has been developed for 25 years investigates the content of the vessel. Since 1965, numerous hemorheological studies pointed out the rheological disorders, especially those concerning plasma and blood viscosity. The most usual viscometry abnormalities revealed erythrocyte hyperaggregation, red cell hypodeformability, blood and plasmatic hyperviscosity. In a comparative study, 46 patients with Raynaud's phenomenon were studied: we performed peri-ungual capillaroscopy, plethysmography and viscosity measurements. The results demonstrated a link between capillaroscopy and thixotropy. Both investigations are never normal at the same time in connectivites and never abnormal at the same time in Raynaud's disease (primary Raynaud's phenomenon). In conclusion hemorheological studies showed nearly normal rheological parameters in Raynaud's disease, but abnormal rheological parameters in secondary Raynaud's phenomenon.

Adult↗
PubMed1991

Elevated serum levels of soluble interleukin-2 receptor: a marker of disease activity in the hypereosinophilic syndrome.

We report here the presence of very high serum levels of the soluble interleukin-2 receptor (sIL-2R) in patients with blood hypereosinophilia with or without detectable markers of malignancy or signs of visceral involvement. The highest sIL-2R levels were observed in 16 eosinophilic patients with T-cell lymphoma (3,440 to 79,500 U/mL). Elevated levels of sIL-2R were also present (1,330 to 22,500 U/mL) in sera from 38 patients with the hypereosinophilic syndrome (HES) without detectable T-cell lymphoma. In this group of patients, the highest levels were noted in the patients with the malignant form of HES. Significantly lower levels were measured in sera of patients with hypereosinophilia associated with parasitic diseases, allergic disorders, or other miscellaneous diseases. Elevated serum sIL-2R levels were not closely paralleled by changes in the number of CD25-positive peripheral blood mononuclear cells as assessed by flow cytometric analysis. However, expression of IL-2R messenger RNA was detected in blood mononuclear cells collected from HES patients. In eight eosinophilic patients with T-cell lymphoma, the serum sIL-2R levels were significantly correlated with the eosinophil counts, and with the total number of blood hypodense eosinophils. alpha-Interferon (alpha-IFN) therapy resulted in both a dramatic clinical improvement and a rapid decrease in sIL-2R levels and blood hypereosinophilia. Similar beneficial effects of alpha-IFN were noted in patients with malignant HES who lacked a detectable T-cell lymphoma. Our data indicate that HES is associated with elevated serum IL-2R levels. The highest levels were observed in the most severe forms of HES with hematologic markers of malignancy or evident visceral involvement. Serum levels of sIL-2R might represent a useful indicator for the management of HES patients. In addition, the respective changes of sIL-2R and blood eosinophilia might reflect distinct processes of mononuclear cell activation affecting the eosinophil lineage.

Adult↗