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A M Chamot

Publications and source records attributed to A M Chamot.

At least 19 recordsLinked to original sources

Prognostic significance of nailfold capillary microscopy in patients with Raynaud's phenomenon and scleroderma-pattern abnormalities. A six-year follow-up study.

The aim of this study was to assess the prognostic significance of scleroderma capillary pattern (SD-pattern) in patients with Raynaud's phenomenon. Thirty patients with a capillaroscopy examination suggestive of scleroderma (megacapillaries and/or avascularity) but without clinical criteria of scleroderma (ARA criteria) were reevaluated 6 years after the initial clinical and capillaroscopy examinations. SD-pattern abnormalities were classified according to a semiquantitative method. Eight out of the 28 evaluated patients (28%) developed a scleroderma spectrum disorder (SDS). The presence of avascularity and/or a mean of more than two megacapillaries digit greatly enhanced the percentage of evolution toward SDS (70%/88% respectively). Most of the patients with few enlarged capillaries and no capillary rarefaction at entry had primary acrocyanosis (11/15). None of them developed SDS. The microangiopathy disappeared during the follow-up period in most of these patients (14/15). These results confirm the prognostic value of SD-pattern capillary abnormalities for SDS. Primary acrocyanosis, a benign clinical entity should be considered in presence of few megacapillaries and without capillary rarefaction.

Aged

SAPHO syndrome.

SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome put together osteoarticular lesions described separately under numerous denominations, such as multifocal osteomyelitis, pustulotic arthroosteitis, acne rheumatism. The association of sterile inflammatory bone lesions and neutrophilic skin eruptions is the cornerstone of this new syndrome, which also has links with spondyloarthropathies and plain psoriasis.

Acne Vulgaris

[Chronic enterocolopathies and SAPHO syndrome. 8 cases].

In a group of 61 patients with SAPHO syndrome involving bone, 8 cases of chronic inflammatory bowel diseases have been observed. 6 cases are considered as Crohn's disease and 2 as ulcerative colitis. 5 patients presented with sacro-iliitis, 4 with palmoplantar pustulosis, 3 with plain psoriasis and 1 with disseminated acne. 4 patients have HLA B27 antigen. These findings bring some evidences to lump SAPHO syndrome with the spondylarthropathies.

Acne Vulgaris

[Still's disease in adults with disseminated intravascular coagulation].

Coagulation abnormalities are not included in the definition of adult onset Still's disease (AOSD). Nevertheless, eight cases with disseminated intravascular coagulopathy (DIC) sometimes associated with hepatopathy have been reported in the literature. The first patient, a 39-year-old woman, presents an AOSD well stabilized under steroid therapy since 1986. In 1989, she develops a DIC, a pancytopenia and a non-specific hepatopathy with a good response to an intensive steroid therapy and heparin. The second patient, a 30-year-old woman, presents since the age of three years, with juvenile Still's disease in remission since the age of 19. At the age of 28, she presents an AOSD, complicated by DIC which necessitated the introduction of methotrexate given for the poor response to high doses of steroids. The etiology of AOSD and DIC is still unknown. An iatrogenic cause (salicylates, indomethacin, chrysotherapy) has been suggested. An AOSD with DIC (sometime associated with an important hepatopathy and/or pancytopenia) should be treated early with corticosteroids and heparin in order to prevent a possible lethal outcome.

Adult

[Low-dose oral methotrexate in the treatment of rheumatoid polyarthritis].

28 patients with severe rheumatoid arthritis were treated with pulse weekly oral methotrexate over a mean follow-up of 24 months (6-36 months). Within one month the patients improved significantly by all clinical standards of efficacy and erythrocyte sedimentation rate. Maximum improvement tended to occur after 6 months' therapy and was maintained for up to 36 months in most patients. 11 patients discontinued treatment because of adverse effects. It is concluded that this trial confirms the efficacy of methotrexate in rheumatoid arthritis. Careful baseline and follow-up monitoring is recommended due to frequent adverse reactions.

Adult

[Symptomatic and prognostic differences according to ethnic group in systemic lupus erythematosus. A controlled study of 3 populations].

Systemic lupus erythematosus (SLE) has been found in all ethnic groups, but some of these groups--notably the black populations of the United States--seem to develop severe forms of the disease. We compared the signs and course of SLE in 20 black patients from the French West Indies, 20 patients of North African origin and 40 European Caucasians. At the onset of the disease, most of the West Indian and North African patients were living in France, and their social level was similar to that of the European patients. On the whole, our study confirmed that SLE is particularly severe in black populations. This severity is primarily due to renal involvement: 7 of the 13 renal biopsies we performed showed diffuse proliferative glomerulonephritis. In North African patients the severity of SLE was intermediate between that observed in West Indians and in European Caucasians. Five out of our 40 West Indian and North African patients died, as against only one female patient among the 40 European Caucasians. These differences seem to be ascribable to genetic factors rather than to environmental factors.

Adolescent

[Acne-pustulosis-hyperostosis-osteitis syndrome. Results of a national survey. 85 cases].

The authors report the data collected by a national investigation organized by the French Society of Rheumatology, concerning the osteo-articular manifestations of severe acne, palmo-plantar pustulosis and primary thoracic and peripheral hyperostosis. This investigation collected 85 case-reports including 13 severe acne, 44 PPP and 28 hyperostosis without the dermatitis mentioned above. From this investigation, it appears that dermatological and osseous pictures described under various denominations, present common characteristics and transition forms justifying their common study under the acronym SAPHO (Syndrome Acne-Pustulosis-Hyperostosis-Osteitis). The bony involvement, especially anterior thoracic, but also vertebral and even peripheral seems to be the common denominator between these diseases. It realizes a true rheumatoid inflammatory osteitis, osseous counterpart of synovial and cartilagenous affections in inflammatory rheumatoid diseases. This group has rather loose connections with common psoriasis and slightly more definite relationships with primary ankylosing spondylarthritis. These clinical and immunogenetic connections occur also through bony involvement.

Acne Vulgaris

[Indications for nailbed capillaroscopy in Raynaud's phenomenon].

175 patients with Raynaud's phenomenon underwent nailfold capillaroscopy. 22 had suspected connective tissue diseases, 48 idiopathic Raynaud's disease and 105 a variety of other diagnoses. A normal capillaroscopy is fully consistent with Raynaud's disease. A pathological capillaroscopy with megacapillaries prompts suspicion of underlying connective tissue disease. The other abnormal capillaroscopies are suggestive of Raynaud's phenomenon secondary to one of the numerous associated diseases, and do not rule out evolution to connective disease ("waiting group"). The proposed simplified classification seems to offer reasonably good discrimination. The probability of an abnormal capillaroscopy increases with the age of onset of Raynaud's phenomenon but is not insignificant in younger patients. The (53-year-old) Allen's criterion (3 years follow-up without signs of underlying diseases such as scleroderma, etc.) is disappointing and should be discarded. Nailfold capillaroscopy is a non-invasive procedure which is useful at any age.

Adult