[Hypertrophic osteoarthropathy, liver disease and hypogonadism].
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Biomedical subjects
Publications and source records attributed to P Arlet.
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Some imperfectly known clinical aspects of polychondritis chronica atrophicans (relapsing polychondritis), as extracted from a series of 12 cases, are presented. The osteoarticular lesions are sometimes unusual, involving the temporomandibular or cervical articulations, and the renal lesions may be severe. Pericarditis seems to be more frequent than usually mentioned in the literature. Pulmonary complications are not always those which are classically associated with lesions of the tracheo-bronchial cartilages. Haematological manifestations are not uncommon and must be taken into account when evaluating the prognosis of the disease.
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Two patients presenting ocular complications of hyperviscosity syndrome in Waldenström's macroglobulinemia have been treated by plasmapheresis after inefficiency of immunosuppressive therapy. Plasma exchange seems an useful treatment as shown by clinic and angiographic improvement. In each case improvement of retinopathy was correlated with decrease of serum IgM level and blood viscosity measured by isotopic method. Fluorescein angiography, easily repeated, seems a very good method for following hyperviscosity syndrome in Waldenström's macroglobulinemia.
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Over a 3 years period, PTH, 25 OHD, calcium and phosphate levels were measured in all patients admitted to a department of Internal Medicine with abnormal phospho-calcic metabolism or bone disease. The diagnostic value of iPTH was analysed, especially in cases of hyper- and hypocalcaemia. In hypercalcaemia, the iPTH did not differentiate between the two main differential diagnoses: hyperparathyroidism and cancer. In patients with a negative calcium balance, the iPTH level is often raised and many help towards diagnosis. However, it should first of all orientate the clinician towards the detection of renal failure which is a common cause of this condition.
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