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Biomedical subjects

B Granel

Publications and source records attributed to B Granel.

At least 19 recordsLinked to original sources

[Necrotic myocarditis in acute eosinophilic lymphoblastic leukaemia].

INTRODUCTION: Hypereosinophilia can cause severe cardiac complications. The association between an acute lymphoblastic leukemia and hypereosinophilia was rare. We report a case of a 29-year-old man who presented a heart failure secondary to necrotic myocarditis related to an acute eosinophilic lymphoblastic leukaemia. EXEGESIS: The patient developed a heart failure and secondary a cardio-embolic stroke, due to a large mobile left ventricle thrombosis. His peripheral blood showed a total white count of 28,500 leucocytes/mm3 with 18,800 eosinophils/mm3. The myelogram cytology showed precursor B-cell acute lymphoblastic leukaemia with hypereosinophilia. CONCLUSION: The possibility of the rapid emergence of cardiac lesions in hypereosinophilic syndromes warrants very close physician vigilance. An Echocardiography and MRI performed at the early stage and in the follow-up allow to detect and to manage these cardiac disorders.

Acute Disease↗

[Is pure red cell aplasia a new extra digestive manifestation of celiac disease?].

INTRODUCTION: Celiac disease is an autoimmune enteropathy that appears on a predisposed genetic background. Its clinical presentation has been extended those last years by varied extradigestive manifestations. EXEGESIS: This is a case report of a twenty-year-old woman who presented simultaneously a celiac disease and pure red cell aplasia. The IgA and IgG antigliadin antibodies as well as antinuclear, anti-DNA, anti-SSA and anti-SSB antibodies were detected, without any clinical symptom supporting the diagnosis of systemic lupus erythematosus or Sjögren syndrome. Thoracic CT-scan reveals a thymus enlargement and biopsy concludes to thymus hyperplasia at histological examination. Pure red cell aplasia regressed after gluten-free diet, corticoid therapy and thymectomy. CONCLUSION: This observation, added to the three others paediatric cases previously published in the literature concern an uncommon association between pure red cell aplasia and celiac disease. However, they are not enough to conclude to a direct link between these two disorders. Pure red cell aplasia could represent un new dysimmune manifestation occurring in celiac disease, but this will need to be confirmed with others cases.

Adrenal Cortex Hormones↗

Urticarial vasculitis revealing relapsing polychondritis.

We report a case of hypocomplementemic urticarial vasculitis heralding a relapsing polychondritis in a 63-year-old woman. The patient, who had suffered in the past from polymyalgia rheumatica, suddenly experienced a generalized urticarial eruption with a dramatic decrease in C4 complement fraction and the presence of anti-C1q antibodies. Two months later, an ear chondritis occurred and the patient rapidly responded to steroids and dapsone. To our knowledge, this association has never been reported.

Journal Article↗

[Genetic factors predisposing to fibrosis in systemic sclerosis].

PURPOSE: Physiopathology of systemic sclerosis includes autoimmunity factors, endothelial lesions and abnormal fibrotic process which characterizes this disease in the field of systemic autoimmune disorders. Genetic factors of susceptibility are showed by possibility of familial forms of the disease, Choctaw American Indians homogenous population with high disease prevalence of systemic sclerosis and experimental animal models. KEY POINTS: We propose a review of the articles published to date in the literature concerning genetical analysis of genes coding for factors potentially involved in the fibrotic process of systemic sclerosis. This includes cytokines (TNF-alpha, interleukin-1, chemokines), growth factors (TGF-beta), extracellular matrix proteins (collagen, fibrillin, fibronectine) and agents acting on vascular tone (angiotensin-converting enzyme and NO synthase). PERSPECTIVES: Identification of genetic factors involved in the susceptibility to fibrosis of systemic sclerosis would lead to a better understanding of physiopathological mechanisms of this disease and to therapeutic targets using immunomodulation with drugs, such as already performed in rheumatoid arthritis.

Animals↗

[Ileum inflammatory fibroid polyp revealed by intussusception. About one familial case].

INTRODUCTION: Acute ileum intussusception is a frequent and mostly benign condition in childhood. Conversely, it is a rare condition during adulthood and generally associated with an underlying malignancy. We report a familial form of benign inflammatory fibroid polyps, revealed by an acute ileum intussusception. EXEGESIS: A 41-year-old man, whose mother had undergone three surgical procedures for acute ileum intussusception associated with inflammatory fibroid polyp, was admitted for a abdominal pain that started three month ago. The patient displayed alteration of the intestinal transit, weight loss and sub-occlusive syndrome. Upper and lower endoscopies, performed before admission, were normal. In the emergency room, the abdominal computed tomography-scan revealed an acute intussusception of the last loop of the small intestine, probably caused by a tumor and leading to an occlusive syndrome. Surgical resection and histological analysis concluded to an inflammatory fibroid polyp. Clinical outcome was excellent. CONCLUSION: Inflammatory fibroid polyp is always a benign tumor. It is usually isolated, expressing itself mainly in the form of an acute intussusception when located in the small bowel. The familial form presented here is exceptional and illustrates the possibility of an inherited transmission of this disease. However the pathogenesis of this type of polyp is still unclear.

Abdominal Pain↗

[Asymptomatic gastric phytobezoar and anaemia due to iron deficiency revealing an autoimmune gastritis].

UNLABELLED: This observation recalls that gastric phytobezoar should lead to a search for an underlying disease and that a iron deficiency can be associated and hide macrocytosis related to a vitamin B12 deficiency. CASE REPORT: A 19 year-old woman consulted for asthenia. Microcyte anaemia associated with iron deficiency was diagnosed. Upper digestive endoscopy revealed severe, totally asymptomatic phytobezoar. Biological investigations revealed a vitamin B12 deficiency, high serum gastrin level and strong positivity for gastric antiparietal anti-cell antibodies, suggestive of an autoimmune gastritis. Total immunoglobulin A deficiency was also noted. DISCUSSION: Autoimmune gastritis is responsible for megaloblastic anaemia (vitamin B12 deficiency) but can also provoke microcytic (iron-deficiency) anaemia due to insufficient absorption of the latter and related to gastric achlorhydria. Phytobezoar might also be related to achlorhydria and/or gastroparesia associated with autoimmune gastritis. Hence, autoimmune gastritis should be searched for when confronted with unexplained gastric bezoar or iron-deficiency anaemia.

Adult↗

Q fever and lymphadenopathy: report of four new cases and review.

Coxiella burnetii, the causative agent of Q fever, is responsible for various clinical syndromes, but lymphadenitis has been described during Q fever in only three recent case reports. Four new cases of acute Q fever associated with lymphadenopathy are reported here, and these cases are discussed along with the three previously reported cases. Coxiella burnetii was isolated for the first time from a lymph node. Q fever should be considered an etiologic agent of lymphadenitis.

Adult↗

[B-type natriuretic peptide].

INTRODUCTION: B-type natriuretic peptide is a neurohormone synthesized in the cardiac ventricles upon ventricular pressure overload and ventricular dilatation. This peptide with many favourable physiological properties has emerged as important candidate for development of diagnosis and prognostic tools and therapeutic agents in cardiovascular disease. EXEGESIS: Literature published until now shows the interest to measure B-type natriuretic peptide in the diagnosis of ventricular dysfunction or congestive heart failure. B-type natriuretic peptide is also a prognostic marker in patients with congestive heart failure and acute coronary syndrome. It could even help to guide patient treatment management. It is easily and rapidly measured at a reasonable cost. In general, a level less than 50 ng/l has a strong negative predictive value for congestive heart failure. CONCLUSION: B-type natriuretic peptide is available in daily clinical practice. Future interest has focused on development of drugs that modulate its effects in treatment of decompensated congestive heart failure. Studies are in progress and first results seem to be promising.

Biomarkers↗