[Value of plasmapheresis in the treatment of Behçet's syndrome].
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Biomedical subjects
Publications and source records attributed to A A Audebert.
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Twenty-seven reports (26 from the literature) of radiation ischemic heart diseases are studied in order to specify their clinical and pathological findings and their natural history. This complications appear after treatment of radiation-curable diseases with a mean delay of 4 years in young patients (mean age of 31). Several coronary arteries are often injured with fibrous and or atherosclerotic anatomical lesions. The frequency of this coronary artery diseases is certainly more important than reported since they are often latent but probably progressive. However, atherogenic factors increase the risk and must be lowered in a preventive aim; as a rule, the radiotherapeutic technique must also be as perfect as possible. The prognosis of this radiation induced coronary artery diseases is poor: 19 myocardial infarctions and 12 deaths are observed but no cardiac death occurred in patients who received a by-pass graft. So, radiation ischemic heart disease needs active investigation and therapy.
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Twenty-five patients with Hodgkin's disease and evidence of bone marrow involvement (BM +) were compared with 25 other Hodgkin patients, chosen at random, who had visceral lesions but free bone marrow (BM -). Both groups were observed throughout the same period. The first evaluation showed that bone marrow involvement was more frequent in male patients and that it produced medullary hypoplasia with WBC and platelet counts lower than in BM - patients. However, bone marrow involvement can only be ascertained by medullar biopsy. BM + patients were treated with multiple chemotherapy (mostly MOPP). Positive response was obtained in 64% and complete remission in 50%, as compared with 70% and 50% respectively in BM - patients. There was no significant difference in overall survival rate between the two groups. It remained in plateau at 50.5% after two years in BM + patients and at 63% after 27 months in BM - patients. When complete remission was obtained the survival rate after one year was 90% for BM + patients and 100% for BM - patients. In the absence of complete remission, however, the median survival time was inferior to one year in both groups. The dosage levels and side-effects of chemotherapeutic agents were similar in both groups, but cytopenia was more pronounced in BM + patients.
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Two cases of agnogenic myeloid metaplasia associated with chronic lymphocytic leukemia are reported. Both cases are documented by clinic, bone marrow biopsy, immunologic and isotopic studies. Such observations allow to point out the lymphoproliferative pattern that can be found among any agnogenic myeloid metaplasia. It is suggested that this disease includes a monoclonal lymphoid proliferation which may become the prevailing symptom.
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A 39 years old man experienced typical primary biliary (P.B.C.). Additional symptoms occured during the next four years including constitutional symptoms, polyarthralgias, nephrotic syndrom and chronic polyarthritis. Biologically, at the beginning of the disease, antimitochondrial antibodies were at the titer of 1/50,000, and the antinuclear antibodies at the titer of 1/10,000 (speckled pattern). During the course of the disease antimitochondrial antibodies decreased progressively and disappeared at the last control. The antinuclear antibodies progressed until 1/500,000 with anti Sm specificity. The association of P.B.C. and S.L.E., very seldom mentioned in the literature, is discussed among the auto-immune diseases.
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The authors discuss the clinical and bacterial characteristics and progressive changes occurring in Yersinia pseudotuberculosis septicemia, basing their observations on one personal case and 30 adult cases reported in the published literature. The roles played by a generally poor condition of the patient and martial overloading are emphasized, and the changes brought about by the introduction of antibiotic therapy evaluated.
A patient with the Zollinger-Ellison syndrome was found to have increased blood gastrin levels associated with the secretion of a compound which produced high blood calcium levels. This compound differed from immunoreactive parathormone, and caused the clinical picture of primary neoplastic hyperparathyroidism. This case is compared with other cases of multiple-secreting Zollinger-Ellison syndrome reported in the published literature, within the framework of the "A.P.U.D." system.
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A case of Kala Azar with prevailing hemolytic anemia is reported. The hemolysis has been associated during a short time with positive PNH test (i.e.: Crosby and sucrose tests). According to the data found in the Litterature, the hemolysis occurs quite frequently. One of the possible mechanisms is an abnormal sensitivity of the erythrocyte membrane to complement, which had not yet been described.
Twenty-four patients, in a condition considered to be pre-leukaemic underwent study of marrow caryotype. Nine of them (37.5%) had an abnormal caryotype. The prevalence of abnormalities varied according to the type of pre-leukaemic state: 17% in acquired idiopathic sideroblastic anaemia, 33% in refractory anaemias with excessive myeloblasts, 100% in 3 cases of simple refractory anaemia. The abnormalities were non-systematised. However, in one case there was an abnormality already described in the literature and considered to be specific: deletion of the long branch of chromosome 5. In refractory anaemias with excess myeloblasts transformation to acute leukaemia appeared to be more frequent in patients with an abnormality (4/5) than in patients with a normal caryotype (0/10).
Observations on a 32 year old male are described. Hematological examination demonstrated leukocytosis with circulating blastosis and dystrophic hypereosinophilia of the blood and bone marrow, with cells at various stages of maturation. Cytotoxic chemotherapy led to complete remission for 5 months followed by a terminal relapse. No features in favor of an "eosinophilic collagenosis" were revealed at autopsy. Repetitive ultrastructural studies performed during evolution of the illness demonstrated considerable anomalies of the eosinophil line. The present observation thus shows the clinical, evolutional, cytological and autopsy criteria of an acute eosinophilic leukemia.
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