We report the first case of probable protein-losing enteropathy revealing a cytomegalovirus/Yersinia enterolytica infection at the onset of a chronic lymphocytic leukaemia. Severe hypoprotidaemia, digestive tract yersiniosis, ulcerative and microgranulomatous enteritis with a large number of cytomegalic inclusions in mucosal cells, and incipient lymphoid proliferation were the most characteristic findings.

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[Relationships between rhizomelic pseudo-polyarthritis and mitochondrial myopathy. 24 cases].

OBJECTIVES: Diagnosis of polymyalgia rheumatica requires the elimination of other inflammatory diseases due to the lack of a specific diagnostic criteria. Since results of muscle biopsy have been considered non-specific, we evaluated the full spectrum of histological, histochemical and biochemical data observed in 24 patients with suspected polymyalgia rheumatica. METHODS: From January 1989, the diagnosis of polymyalgia rheumatica was suspected in 24 patients (4 males, 20 females; mean age 67.8 years, range 50-88) hospitalized in our unit for inflammatory joint and muscle pain with a current duration of 6-30 months. Muscle biopsies were obtained in each case. RESULTS: Based on the histological, histo-enzymatic, ultrastructural and biochemical analyses, 19 patients fulfilled the criteria defining mitochondrial myopathies. After favourable outcome (reduced pain, involution of biochemical inflammatory syndrome) following prednisone therapy (0.5 mg/kg/day) a second muscle biopsy revealed identical abnormalities. CONCLUSION: These muscular diseases have been described mainly as hereditary encephalo-myopathies, but in our series the mitochondrial myopathy may have preceded the polymyalgia rheumatica or been acquired, aggravating the inflammatory process. Muscle biopsy might act as a referee for diagnosis.

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[Abortion in a woman with hyperimmunoglobulin D syndrome].

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Abortion, Induced↗