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Biomedical subjects

P Chapoy

Publications and source records attributed to P Chapoy.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Enteropathogenic mechanisms involved in giardiasis in children (author's transl)].

23 patients with gastroenteritis and 9 with severe malabsorption syndrome related to giardiasis were investigated in a semi-prospective fashion as follows: (1) conjugated bile acid levels measured in duodenal aspirate (thin layer chromatography) in 6 patients with steatorrhea. (2) intraepithelial lymphocytes count (results expressed as the number of intraepithelial lymphocytes per 100 epithelial cells) in small intestinal biopsies from the 32 patients, 11 of which had immunoglobulin deficiency (9 IgA deficiency). The results indicate that there is no decrease in the percentage of conjugated bile acids (mean percentage 90%; normal = 80); a significantly increased percentage of intra-epithelial lymphocytes is documented in giardiasis (11.1% +/- 6.7), versus 2.3% +/- 0.5 in acute gastroenteritis (9 patients) and 6.3 +/- 0.5 in chronic diarrheas (6 patients) (p less than 0,001). This percentage, however, is significantly lower than in untreated coeliac sprue (23 patients) (12.17 +/- 11.6) (p less than 0,01). Conversely a high intraepithelial lymphocyte count does not correlate with the degree of intestinal villous atrophy (3 patients had severe and 6 partial villous atrophy) (r = 0.170). IgA deficiency should be suspected in patients with giardiasis presenting with intestinal villous atrophy (5 patients). Steatorrhea in our patients does not appear related to bile acid deconjugation. To explain enterotoxicity in giardiasis, more than a direct effect of the ventral disk of the parasite on intestinal mucosa, one should incriminate the host immune cell mediated response as shown by lymphocytic infiltration of the epithelium on small bowel biopsies.

Adolescent↗
PubMed1981

[Systemic carnitine deficiency: its place in Reye's syndrome (author's transl)].

A case of systemic carnitine deficiency in a 3-year-old child is reported. Clinical presentation included progressive cardiomyopathy and severe episodes of hypoglycaemia without ketosis, accompanied with hepatic encephalopathy. Each episode was initiated by upper respiratory infection and complicated by cardiac arrest. Oral carnitine (4 g/24 h) and low fat diet (20% of total calories) resulted in dramatic improvement of cardiac, hepatic and neuromuscular symptoms, while tissues remained depleted. Systemic carnitine deficiency should be suspected in patients with symptoms resembling Reye's syndrome.

Cardiomyopathies↗
PubMed1981

[Gluten enteropathy in children from south-eastern France (author's transl)].

Between 1969 and 1979, 123 cases of gluten-induced enteropathy were diagnosed in south-eastern France. The overall incidence of the disease was estimated at approximately one for 4 600 births. The mean age of the patients was 3.2 years. At the time of diagnosis, 71 children (57,7%) were less than 2 years old, and 52 children (42,3%) were above that age. There was a strong predominance of girls (60%) and North-Africans (48%). Children younger than 2 years presented with the usual malabsorption syndrome, whereas growth retardation, often isolated, was the main feature in older children. The relative increase observed since 1976 in the number of patients of the latter group despite a lower incidence of the disease was probably due to the withdrawal of infants' foods containing gluten. In 58 children followed up dietetic measures resulted in rapid clinical improvement, but healing of the mucosal lesions was much slower (19 months on average). In 28 patients who could be followed for longer periods, reintroducing gluten into the diet regularly led to histological relapse. These patients, however, had been selected for particular reasons. The true incidence of transient intolerance to gliadin is difficult to determine, since most subjects in perfect health refuse control biopsies.

Adolescent↗
PubMed1980

[Acute non-traumatic pancreatitis in childhood. Report of 9 cases (author's transl)].

The authors report 9 cases of acute non traumatic pancreatitis in children. The most common symptom in their patients is atypical abdominal pain often associated with vomiting (5 cases) and shock (4 cases). Among laboratory investigations: --High serum amylase level (average: 1 045 UI/l) is constant, associated with hypocalcemia and hyperglycemia in 3 patients. --Radiographic findings on plain film of the abdomen are diagnostic in 4 cases. --Abdominal ultrasound is the most reliable test and positive in the only patient on which performed. Among etiologies, drug induced pancreatitis is the most common (5 cases) due to combined Prednisone-L-Asparaginase (4 patients): --A duodenal ulcer and a case of choletithiasis are reported. --In 2 patients no determinant factors are found. A good response to parenteral nutrition, gastric suction and antisecretory agents is observed in 7 cases. 2 leukemic patients died shortly after the acute episode.

Acute Disease↗
PubMed1979

[Asymmetrical gonadal dysgenesis. Report of a case (author's transl)].

The authors report a case of asymmetrical gonadal dysgenesis related to 45XO-46XY mosaicism in a 16 year old girl. Delayed growth and puberty, Turner's dysmorphism without sexual ambiguity and skeletal abnormalities are the main clinical features suggesting the diagnosis. Exploratory laparotomy reveals infantil uterus, bilateral fallopian tubes and streak gonads. A right dysgenetic testis is identified on electron microscopic examination. Theories on pathogenesis of this unusual genetic defect are discussed.

Adolescent↗
PubMed1979

[Reye's syndrome. Report of two cases (author's transl)].

Two cases of Reye's syndrome aged 11 and 13 are reported, confirmed by hepatic biopsy. The favorable outcome observed in the second case seems to be more related with supportive therapy than exsanguinotransfusion and peritoneal dialysis. The physiopathology of this syndrome is not quite clear, but probably in relation with a diffuse mitochondrial insult. Early diagnosis and supportive therapy are important for a favorable outcome.

Child↗
PubMed1978

Common duct stones in infancy.

The term "bile ascites" is used when the bilirubin content of the ascitic fluid is higher than it is in the serum. Two cases of newborn infants with bile ascites associated with common duct stones are reported. Review of the literature reveals 11 additional cases of common duct stones that presented as bile ascites. The surgical treatment of bile ascites and common duct stones is described. In spite of the severity of the problem, the outcome is successful in most cases (83.3% survival in this review).

Ascites↗