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Biomedical subjects

D Chaouat

Publications and source records attributed to D Chaouat.

At least 37 records · Page 2Linked to original sources

The syndrome of seronegative symmetrical synovitis with pitting edema (RS3 PE syndrome): a unique form of arthritis in the elderly? Report of 4 additional cases.

We describe 4 elderly patients who presented with peripheral seronegative inflammatory polyarthritis with pitting edema. All of these patients had a spontaneous benign evolution of their disease within 9 to 18 months. None developed erosions or relapse after prolonged followup. This particular pattern of arthritis in elderly patients might represent a separate benign clinical entity among inflammatory arthritis in aging patients.

Aged↗

[Primary hyperparathyroidism. History].

The term primary hyperparathyroidism currently refers to the clinical and biological manifestations resulting from the hypersecretion of parathyroid hormone by one or several parathyroid adenomas. This entity is a recent one since it goes back to 1925. The clinical picture resulting from this anomaly, were first described as Recklinghausen's fibrous osteitis, which was not justified since Recklinghausen had not established the relationship between the clinical manifestations and the adenoma discovered by Mandl, then under the name of parathyroid osteosis. This term was justified at a time when the disease presented only bony manifestations with biological evidence. Primary hyperthyroidism is the current appellation, demonstrating that the disease is now a biological disease, often discovered systematically, with therapeutic progress, progress in biological identification and possibility of medical forms without mandatory surgical outcome. Bibliographic references accompany the various stages of this historical reminder.

Adenoma↗

[Benign acute edematous polyarthritis in the elderly. Apropos of 4 cases].

Four retrospective cases of acute, benign, edematous polyarthritis are reported in elderly patients. These cases have in common a sudden onset of distal edema of the 4 extremities, which is severe, associated with primary or secondary joint pain and an inflammatory syndrome. A picture of symmetrical polyarthritis similar to rheumatoid polyarthritis develops secondarily. This polyarthritis is sero-negative. In less than 2 years, it spontaneously evolves into a complete cure without any clinical or radiological sequelae. This picture appears to be a specific entity in the elderly, different from rheumatoid polyarthritis. Ten identical cases have been reported by McCarty under the name of RS3PE syndrome. The onset with edema, sero-negativity and the spontaneous cure are the main characteristics. The nosology of this disease among "polyarthritis of the elderly", is discussed here.

Acute Disease↗

Comparison of once-daily evening versus morning sustained-release theophylline dosing for nocturnal asthma.

Eight diurnally active (approximately 0730-1100 hr) adults (41-61 yr) suffering from nocturnal asthma volunteered for a double-blind, cross-over randomized study of a once-daily dosing (600-900 mg/24 hr) of Armophylline (Rorer s.a., France), a sustained-release theophylline given either at 0800 hr or 2000 hr for 8-day durations. Study variables monitored daily were: (a) self-measured peak expiratory flow (PEF), heart rate, oral temperature and self-rated fatigue checked every 2 hr during the waking span as well as upon spontaneous nocturnal awakenings and (b) duration and subjective characteristics of sleep rated every morning. In addition, serum theophylline concentration (STC) plus the variables in (a) were sampled every 2 hr during the 24 hr of the eighth day of each timed treatment span. Rx at 0800 hr was associated with a nocturnal dip in PEF of 20 +/- 2.8% (X +/- S.E.M.) from the level achieved at the time of the diurnal crest; Rx at 2000 hr moderated the nocturnal fall; it was only 10 +/- 2.1% and within the physiologic limits of non-asthmatic persons. The STC peak height (Cmax) was greater (P less than 0.05) and time-to-peak (Tmax) shorter (P less than 0.005) with Rx at 0800 hr than at 2000 hr. With Rx at 2000 hr an STC plateau of approximately 12 hr resulted. A statistically significant correlation (r = 0.86; P less than 0.01) between PEF and the corresponding-in-time STC was observed with Rx at 2000 hr but not with Rx at 0800 hr. A small, but statistically significant, higher heart rate resulted from 2000 hr dosings in five out of eight subjects relative to the 0800 hr dosing. There were no differences in the sleep characteristics nor in oral temperature between dosing times. Once-daily (600-900 mg) SRT dosing at 2000 hr controlled the nocturnal dip of bronchial patency with no major side-effects in diurnally active adult patients with nocturnal allergic asthma.

Adult↗

[Enthesopathies in ankylosing spondylitis and seronegative inflammatory rheumatism. 28 cases].

A few demonstrative cases of severe and disabling enthesopathy in patients with ankylosing spondylitis (AS) and related syndromes, psoriatic arthritis (PA) or Reiter's disease (RD) have prompted the authors to investigate the incidence of enthesopathy in such patients. A retrospective clinical and radiological study was conducted in 48 patients (mean age: 34.8 years) 27 of whom had AS, 9 RD and 12 PA. The overall incidence of enthesopathy was 58.3%. Beside the classical calcaneal lesions (50%), extracalcaneal manifestations of the disease involving the knees and shoulders were found in 39% of the patients. The HLA B27 antigen was detected in 87% of patients with enthesopathy, while 82% had clinical inflammation of the spine. The mean duration of clinical symptoms due to enthesopathy was 2-6 weeks in 36% and 6 months to 1 year in 45%. One striking feature of enthesopathy in this series was the lack of response to steroidal and non-steroidal anti-inflammatory drugs contrasting with the response of the associated arthritis. Since enthesopathies appear to be of diagnostic significance in the group of arthropathies of the spine, their incidence in other articular diseases should be the object of systematic comparative evaluations. A diffuse exacerbation of enthesopathy may constitute the initial manifestation of seronegative HLA B27 positive arthropathy, which is not without therapeutic implications.

Female↗

[Comparative changes in sedimentation rate, haptoglobin and orosomucoid during the development of rhizomelic pseudopolyarthritis and temporal arteritis. Attempted definition of the biological parameters for monitoring these diseases].

In pseudo-polyarthritis of the extremities as well as in temporal arteritis we have noted a very marked correlation between sedimentation rate (ESR) and inflammatory proteins at the beginning of the disease. By contrast there is a dissociation during the course of the illness and sometimes at the time of onset in those rare forms with a normal ESR. It was therefore concluded that the ESR was not sufficiently accurate as an index of surveillance in such diseases. Study of inflammation proteins is in rare circumstances of diagnostic value at the time of onset of the disorder, in forms with a normal ESR. Comparative study of their variations with that in ESR would appear to provide an accurate factor in surveillance during the course for peripheral pseudo-polyarthritis and temporal arteritis. At that time, even though a return to a satisfactory clinical state and a normal ESR may be accompanied by a persistent increase in such proteins, it is not felt to be desirable to attempt to obtain their normalization. Finally, it would appear that their return to normal at the end of the course of the disease provides a reliable test of cure.

Adrenal Cortex Hormones↗

[Rhizomelic pseudopolyarthritis and Horton's disease. A search for correlations with HLA system, HB virus and Beta 2 microglobulin (author's transl)].

The authors studied 31 patients with either rhizomelic pseudopolyarthritis or Horton's disease. Contrary to others, they found no significant correlation between these diseases and hepatitis B virus infection or HLA gene. However, beta 2 microglobulin assays showed that it was significantly higher in these patients than in a control population. In the absence of close correlation between beta 2 microglobulin levels and those of inflammatory proteins, it is suggested that the rise in microglobulin reflected an immunological mechanism requiring further investigation.

Aged↗

[Comparative variations of the sedimentation rate, haptoglobin and orosomucoid in rhizomelic pseudopolyarthritis and temporal arteritis. Attempt at a definition of biological parameters for monitoring these diseases].

In pseudo-polyarthritis of the extremities as well as in temporal arteritis we have noted a very marked correlation between sedimentation rate (ESR) and inflammatory proteins at the beginning of the disease. By contrast there is a dissociation during the course of the illness and sometimes at the time of onset in those rare forms with a normal ESR. It was therefore concluded that the ESR was not sufficiently accurate as an index of surveillance in such diseases. Study of inflammation proteins is in rare circumstances of diagnostic value at the time of onset of the disorder, in forms with a normal ESR. Comparative study of their variations with that in ESR would appear to provide an accurate factor in surveillance during the course of peripheral pseudo-polyarthritis and temporal arteritis. At that time, even though a return to a satisfactory clinical state and a normal ESR may be accompanied by a persistent increase in such proteins, it is not felt to be desirable to attempt to obtain their normalization. Finally, it would appear that their return to normal at the end of the course of the disease provides a reliable test of cure.

Aged↗