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Biomedical subjects

A Grasland

Publications and source records attributed to A Grasland.

At least 19 recordsLinked to original sources
PubMed2002

[Febrile form of ankylosing spondylitis].

INTRODUCTION: Ankylosing spondylitis is a chronic inflammatory disorder that is rarely associated with severe systemic manifestations. EXEGESIS: We report the case of a 29-year-old man presenting with an atypical ankylosing spondylitis. The patient presented with a high spiking fever, a marked weight loss, and an unusual increase of acute phase response markers. Such features are rarely associated with ankylosing spondylitis and the review of the few similar reported cases in the literature showed that this presentation is usually associated with a severe disease course, and an asymmetrical joint involvement that is unresponsive to nonsteroidal anti-inflammatory agents. CONCLUSION: Clinicians should be aware of this unusual presentation of ankylosing spondylitis, which should be included in the list of aetiologies of fever of unknown origin, to avoid useless diagnostic procedures. The severity of the disease course may lead to the consideration of a more aggressive treatment strategy.

Acute-Phase Proteins↗
PubMed2002

[Moving meningitis].

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Diagnosis, Differential↗
PubMed2001

[Algodystrophy].

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Diagnosis, Differential↗
PubMed2000

[Facial diplegias during pregnancy].

BACKGROUND: Facial diplegia is a rare event, most commonly of unknown origin. We report the case of a woman who presented bilateral Bell's palsy a few days after a normal delivery. CASE REPORT: Five days after the delivery of gemellary pregnancy, a 34-year old woman developed complete bilateral facial palsy. No treatment was initially prescribed. She was first seen in our department two weeks after the onset of her illness. The diagnostic work-up was negative and we considered that our patient had bilateral Bell's palsy. Treatment with methylprednisolone and intravenous acyclovir, initiated since admission, have had very limited effect. DISCUSSION: As has already been shown for facial palsy, idiopathic facial diplegia, although exceptional, seems to be more frequent during the last trimester of pregnancy and in the early puerperium. Seven cases have been reported in the literature over the last 30 years. We discuss here the pathophysiology.

Acute Disease↗
PubMed2000

[Livedoid vasculopathy (white atrophy) associated with anticardiolipin antibodies].

BACKGROUND: Livedoid vasculopathy is an uncommon condition that affects young patients. It must be clinically distinguished from cutaneous vasculitis. CASE REPORT: A 27-year-old man presented pain and skin eruptions involving the lower limbs, hands and trunk. The skin eruption predominated on the feet with purpuric lesions producing a livedoid pattern, ulcerations on both ankles and white atrophic scars on the dorsum of the feet. Skin biopsy showed dermic vessel thrombosis without leukocytoclasia. These features favored livedoid vasculopathy rather than vasculitis. Anticardiolipin antibodies were positive. The patient was started on antithrombotic therapy. The skin ulcerations regressed and no recurrence has been observed at 7-months follow-up. DISCUSSION: Livedoid vasculopathy is characterized by painful purpuric lesions that generally occur on the lower limbs, and frequently ulcerate and heal leaving porcelain white atrophic scars (atrophic blanche). The histology evidences a thrombotic process. Livedoid vasculopathy is normally described as occurring as a sole entity, however thera have been reports of an association with anticardiolipin antibodies. This suggest a possible link with antiphospholipid syndrome.

Adult↗
PubMed2000

Adhesive capsulitis of shoulder and treatment with protease inhibitors in patients with human immunodeficiency virus infection: report of 8 cases.

OBJECTIVE: To describe our experience with human immunodeficiency virus (HIV) infected patients receiving protease inhibitor therapy who presented with adhesive capsulitis of the shoulder. METHODS: Between July 1996 and December 1999, 8 HIV-infected patients (7 male) treated with protease inhibitors who presented with adhesive capsulitis of the shoulder were retrospectively identified. Diagnosis of adhesive capsulitis relied on clinical features including shoulder pain and both active and passive restricted range of motion (ROM). All available clinical and radiographic data were reviewed. RESULTS: Onset of symptoms was insidious, and at presentation, patients complained of shoulder pain, which was bilateral in 4 of the 8 cases. Physical examination showed global restriction of active and passive ROM of the glenohumeral joint. The mean delay between initiation of HIV protease inhibitors and onset of shoulder pain was 14 months (range 2 to 36). The protease inhibitor therapy always included indinavir. No underlying condition associated with secondary adhesive capsulitis of the shoulder, including shoulder trauma, diabetes mellitus, thyroid disease, pulmonary or cardiac diseases could be identified. In all 8 patients, despite continuation of therapy with indinavir, both shoulder pain and restricted ROM completely resolved, after a mean disease course of 7.4 months. CONCLUSION: Adhesive capsulitis of shoulder seems to be a new adverse event of HIV protease inhibitor therapy. In all reported cases, patients were treated with indinavir. Further observations will be necessary to confirm adhesive capsulitis as a side effect.

Adult↗
PubMed1999

[Psoriasis. Rheumatologic manifestations].

THE CONTEXT: Psoriasic arthritis lies somewhere between rhumatoid polyarthritis and spondyloathropathy. Its prevalence is about 0.1% with a 1/1 sex ratio. Mean age at onset of symptoms is 40 years. In 10 to 15% of the cases, rhumatological manifestations are observed before skin lesions. Ungueal involvement is particularly frequent. FIVE CLINICAL FORMS: Classically, five clinical forms are described: arthritis limited to the distal interphalangeal joints, mutilating arthritis, symmetrical polyarthritis, asymmetrical mono- or oligoarthritis, and spondylitis. Asymmetrical oligoarticular forms and polyarithrtis predominate. DISEASE SEVERITY: In general psoriasic arthritis is a benign condition. Severe forms have however been described with erosion and osteolysis involving the distal interphalangeal joints. Typical radiological may be observed. THERAPEUTIC OPTIONS: Non-steroidal antiinflammatory drugs help control disease progression in about one-third of the cases. In other patients, gold salts, D-penicillamine, methotrexate, or sulfasalazine may be required.

Adult↗
PubMed1998

[Pneumatosis cystoides intestinalis in systemic diseases: 3 cases].

BACKGROUND: Pneumatosis cystoides intestinalis (PCI) is usually a complication of digestive tract or respiratory tract diseases, but rare cases have been described in systemic diseases, mainly systemic sclerosis. CASE REPORTS: Three patients, one with temporal arteritis and two with polyarteritis nodosa (complicating rheumatoid arthritis in one case) were treated by prednisone. All three developed PCI, complicated in one case by a retropneumoperitoneum. Medical treatment led to a favorable outcome in all cases. DISCUSSION: Sixty-two cases of PCI have been reported in patients with various systemic diseases (systemic sclerosis, systemic lupus erythematosus, mixed connective tissue disease, dermatopolymyositis, polyarteritis nodosa, rheumatoid arthritis, Sjögren's syndrome, amyloidosis). Systemic sclerosis is the most frequent condition (45%). In the other cases, corticosteroid therapy or digestive tract vasculitis are the main causal factors. Outcome is usually favorable with medical treatment. Laparotomy is rarely needed.

Female↗
PubMed1998

[Pneumatosis cystoides intestinalis].

AIR-FILLED CYSTS: Pneumatosis cystoides intestinalis (PCI) is a benign air-filled cystic formation lying in submucosal or subserous digestive tissue. PCI has been reported all along the digestive tract. CLINICAL SIGNS: Manifestations of PCI vary greatly. Some cases are asymptomatic, while others are revealed by abdominal pain or pneumoperitoneum. Outcome is usually favorable. EXPLORATION: The plain radiogram of the abdomen shows gaseous cysts of various forms lying between the liver and the diaphragm. Pneumoperitoneum may be present. Computed tomography is the ideal diagnostic test. Endoscopy may be useful for colonic localizations. PATHOGENESIS: Many causes have been suggested and debated. Fifteen percent of all cases of PCI are idiopathic. In the other cases, digestive tract or respiratory tract diseases, are usually the underlying cause. Exceptionally systemic disease may be associated with PCI, particularly systemic sclerosis. TREATMENT: Surgery should be reserved for particularly severe cases.

Adolescent↗