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P Godeau

Publications and source records attributed to P Godeau.

At least 181 records · Page 10Linked to original sources
PubMed1993

[Long-term prognosis of arterial lesions of Behçet's disease].

We analyzed the charts of 25 patients with arterial lesion in Behçet's disease with mean follow-up 76 months. We conclude that prognosis is poor. Corticosteroids and surgery if possible is needed, anti-aggregant or anticoagulants and prosthetic rather than venous graft are suitable. This therapy does not exclude the risk of relapse. Immunosuppressive drugs in addition to corticosteroids seem to be more efficient than corticosteroids alone but the therapeutic modalities need to be define.

Adult↗
PubMed1993

[Acquired corticotropin insufficiency in adults. 2 new cases].

We report two new cases of isolated corticotropin deficiency, associated with TSH deficiency in one of the two patient. The diagnostic was made difficult because the symptoms were mainly psychiatric. Low plasmatic cortisol and ACTH level were found, with low T3, T4 and TSH in the second patient. The TSH did not respond to the stimulation by TRH. The cerebral tomodensitometry and magnetic resonance imaging focused on the sella turcica were normal, eliminated a tumor and showed an empty sella turcica. The patients have to be followed-up because an isolated deficiency may further complete to panhypopituitarism.

Adrenocorticotropic Hormone↗
PubMed1993

[Malacoplakia. Apropos of a case of retroperitoneal site].

Malacoplakia is a granulomatous inflammatory disease caused by a disorder of macrophage bactericidal function. The disease, histologically characterized by the presence of Michaelis-Gutmann bodies, has a preference for the urogenital tract and less frequently affects the gastrointestinal tract and the retroperitoneal region. We report the unusual case of a male patient who presented with retroperitoneal pseudotumoral malacoplakia associated with vesical malacoplakia. The main pathophysiological, diagnostic and therapeutic aspects of this rare disease are described.

Adult↗
PubMed1993

[What criteria for the diagnosis of antiphospholipid syndrome?].

The "historical" definition of the antiphospholipid syndrome is the most widely used: history of at least one venous and/or arterial thrombosis and/or two miscarriages, and positive tests for lupus anticoagulant and/or anticardiolipin antibodies, on two occasions more than 8 weeks apart. More recently, a Mexican group proposed another definition taking into account the number of clinical manifestations and the titer of anticardiolipin antibodies to categorize patients as definite, probable or doubtful antiphospholipid syndrome. The respective merits and limitations of both definitions are discussed.

Antiphospholipid Syndrome↗
PubMed1993

[Sarcoidosis in a cicatrix: apropos of 5 cases].

The authors report 5 cases of sarcoidosis developed on scars. Sarcoidosis may be isolated (1 case); it may precede (1 case) or accompany systemic sarcoidosis, or occur during a relapse (3 cases). Dermatologists who observe cicatricial changes always suspect sarcoidosis. It is therefore important that physicians should examine the scars of their patients with suspected sarcoidosis, since biopsy of these scars is easily performed, confirms the diagnosis and avoids more invasive explorations.

Adult↗
PubMed1993

[Endothelin: the vasoconstrictor of the 1990's?].

Endothelin is a recently isolated 21 amino acid peptide with vasoconstrictor activity. It seems to be part of the "hormonal" production by the vascular endothelium and might play a key role in the regulation of vasomotricity. The principal property of endothelin is that it induces an intense and prolonged arterial and venous contraction. Endothelin is secreted by endothelial cells under the influence of various stimuli (thrombin, adrenaline, shearing stress, hypoxia, etc.), then binds to specific membrane receptors thereby increasing the intracellular free calcium concentration. Endothelin has many other vascular and extravascular properties: it has positive inotropic and chronotropic effects, increases renal vascular resistances and reduces the glomerular filtration rate, contracts bronchial and gastrointestinal smooth muscle, induces proliferation of the vascular smooth muscle cells as well as that of fibroblasts and glomerular mesangial cells. Compared with experimental data in animals, human data are still scantly. Plasma endothelin concentration rises in acute renal failure and in chronic renal failure treated by dialysis, diabetes mellitus, essential arterial hypertension, pre-eclampsia and asthma. The development of specific antagonists and endothelin in synthesis inhibitors should soon enable us to specify the modes of regulation of endothelin production before considering applications to therapy.

Animals↗
PubMed1993

[Relapsing polychondritis and mesenteric panniculitis: apropos of 2 cases].

We report two cases of polychondritis associated with mesenteric panniculitis. Case 1. In February 1989, a woman born in 1949 presented with 40 degrees C fever accompanied by pain in the abdomen and pelvis. Eight days later, nodular skin lesions appeared on her lower limbs. The abdomen was swollen with gas and undepressible. An abdominal CT scan revealed partitioned peritoneal collections, and a guided needle aspiration produced a chylous fluid. Direct and indirect bacteriological examinations gave negative results. Histology showed intense inflammatory reaction with giant cells and lipophages, thereby confirming the presence of mesenteric panniculitis. Six months later, the development of chondritic lesions on the nose and the helix of the ear clinched the diagnosis of polychondritis. The patient was put on corticosteroid therapy for a few months, and in January this year (1993) she is durably asymptomatic. Case 2. In October 1977, a woman born in 1937 presented with polychondritis with prolonged fever, inflammatory syndrome and chondritic lesions of the nose, larynx and helix of the ear. In December 1978, she developed signs of abdominal obstruction. Laparotomy revealed infiltration by multiple nodular formations of the entire posterior line of attachment of the mesentery. Biopsies withdrew a puriform fluid. Histology showed a partly necrotic adipose tissue with giant cells and lipophages. High-dose corticosteroid therapy partially controlled the chondritic and abdominal manifestations. The occurrence of abdominal pain in patients with polychondritis may result from several disorders, such as iatrogenic complications, digestive tract vasculitis or ulcerative colitis, but also associated mesenteric panniculitis.

Abdomen, Acute↗
PubMed1993

Disseminated histoplasmosis with glomerulonephritis mimicking Wegener's granulomatosis.

Renal complications of disseminated histoplasmosis include chronic recurrent abcesses of the interstitium and urogenital tract. To our knowledge, glomerulonephritis has never been reported in histoplasmosis. We describe a case of proven histoplasmosis presenting with oral granulomatous ulceration and segmental glomerulonephritis that mimicked Wegener's granulomatosis (WG). All symptoms and renal parameters remitted under itraconazole treatment alone. In conclusion, glomerulonephritis may complicate the course of chronic disseminated histoplasmosis. Since it can masquerade as WG, systematic tissue staining for intracellular microorganisms should be done when WG is suspected.

Diagnosis, Differential↗
PubMed1993

MRI in 31 patients with Behçet's disease and neurological involvement: prospective study with clinical correlation.

Thirty one patients with Behçet's disease and neurological manifestations were prospectively studied with MRI. Cerebral venous thrombosis was diagnosed in 10 patients. MRI performed during the acute illness in eight patients showed an abnormally high signal on the T2 weighted sequences in the occluded sinus. MRI showed minor flow abnormalities suggestive of partial recanalisation of the sinus in two cases at a later clinical stage. MRI can be an alternative, non-invasive, investigation to intravenous cerebral angiography. In 13 patients with central nervous system involvement, MRI performed during the acute illness showed multiple hyperintense lesions on T2 weighted sequences. They were usually less than 5 mm, scattered and confluent, mainly in the white matter, distributed in the hemispheric white matter in nine cases, brainstem in eight, basal ganglia and thalamus in five, and cortex in two. MRI abnormalities were usually associated with appropriate clinical deficits, but were larger and more disseminated than expected.

Adolescent↗
PubMed1993

Antiphosphatidylethanolamine antibodies in systemic lupus erythematosus.

Antiphosphatidylethanolamine antibodies (aPEA) were investigated in a population of 78 systemic lupus erythematosus (SLE) patients, by means of an enzyme-linked immunosorbent assay method. These antibodies are specifically directed against phosphatidylethanolamine, one of the zwitterionic phospholipids present in cell membranes. Antiphosphatidylethanolamine antibodies were found in 13 patients (16.6%). They were generally associated with lupus anticoagulant (two patients), antiphospholipid antibodies directed against anionic phospholipids (six patients), or both (four patients). In only one case, aPEA were the sole detectable antiphospholipid antibodies. Thrombosis, recurrent fetal loss, valvular disease or neurological involvement was present in most (11 of 13) of the patients with aPEA. It seems valuable to carry on further searches for these antibodies in SLE, since patients with aPEA are at higher risk of thrombosis and/or recurrent fetal losses than are patients with antiphospholipid antibodies (anticardiolipin, anti-anionic phospholipid and/or lupus anticoagulant) other than aPEA. Moreover, since aPEA can be the sole detectable antiphospholipid antibodies, they should be investigated in SLE with thrombosis when neither lupus anticoagulant nor anticardiolipin antibodies can be demonstrated.

Adolescent↗
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↗
PubMed1993

[Treatment of hypereosinophilic syndromes of myeloproliferative expression with the combination of hydroxyurea and interferon alpha. Apropos of 7 cases].

Seven patients suffering from hypereosinophilic syndrome with clinical and/or hematological symptoms of a myeloproliferative syndrome were treated with a combination of hydroxyurea and interferon-alpha. To date, 6 of them have been followed for more than 1 year. In all cases, this therapy decreased circulating hypereosinophilia to under 1,500/mm3 and obtained normal eosinophil levels in 5 patients with a parallel regression of visceral complications. None of the patients experienced treatment-associated side effects, particularly hematological ones. Hypereosinophilic syndrome has a poor prognosis due, for the most part, to the development of visceral, cardiac and neurological complications, and, more secondarily, to the risk of progression towards acute leukemia. Conventional treatments, corticosteroids and hydroxyurea, have greatly improved the prognosis, but failure of these therapeutics remains common in the myeloproliferative form of the disease. Because interferon-alpha was proven to effectively treat chronic myeloid leukemia, it has been proposed for the treatment of hypereosinophilic syndromes, and encouraging results have been obtained despite the high daily doses required to control the disease. In the future, its association with hydroxyurea could represent an alternative therapy capable of controlling the disease at low doses thereby limiting the risk of side effects.

Adult↗