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D Christmann

Publications and source records attributed to D Christmann.

At least 55 records · Page 3Linked to original sources
PubMed1999

[A case report of post-rubella myelitis in an adult].

Neurological complications following rubella are only rarely encountered. We report a case of isolated myelitis. A 44-year-old healthy female suffered from an erythematous macular rash which rapidly cleared. However, the following days, dysuria initiated hospitalization. On admission, she was febrile but alert and in normal mental status. General physical examination was quite unremarkable. Four days later, she suffered from acute urinary retention, fecal retention and vaginal hypoesthesia. Routine laboratory data, chest skull and spinal column X-rays were unremarkable. The sterile cerebrospinal fluid contained 30 lymphocytes/mm3, 0.48 g/ml of protein but normal amount of glucose. Rubella antibody titers showed a significant elevation and specific IgM were detected by immunocapture. Improvement was rapid and recovery was uneventful except a mild vaginal hypoesthesia that persisted 5 weeks later. Diffuse myelitis occurring shortly after rubella vaccination have also been described. The immunopathological mechanisms by which involvement of the nervous system occurs is far from clear. Little is known about the pathogenesis of post-vaccination myelitis and although the mecanism of sensitization and the specific neural antigens are not known, post-infectious and post-vaccinal myelitis are thought to share a common pathogenic basis.

Adult↗
PubMed1999

[Prenatal and neonatal management of digestive tract duplications. Diagnostic difficulties and therapeutic implications].

OBJECTIVE: To insist on the difficulty of the antenatal diagnosis of digestive duplications, to show the importance of a complete malformative screening, and the need for immediate management at birth. MATERIAL AND METHODS: A cystic duplication of the tongue, a duplication, abdomino-thoracic transdiaphragmatic, and a duplication of the small bowel are described and compared with cases previously reported in th literature. RESULTS: Antenatal evacuation puncture of a duplication of the tongue must be reserved for exceptional situations. Foregut duplications are often associated with other malformations. The duplication of the small intestine can exceptionally expose to a mechanical complication, mostly during the postnatal period, which may require emergency surgery. CONCLUSION: Duplications of the alimentary tract should be detectable on prenatal ultrasound examination. A complete antenatal malformative screening is required and in utero transfer is warranted because emergency surgery may be required.

Abnormalities, Multiple↗
PubMed1998

[Group A Streptococcus pyomyositis].

BACKGROUND: Pyomyositis is a group of infectious diseases involving muscle tissue. Staphylococcus aureus is usually the causal agent. Group A Streptococcus infections are uncommonly isolated in pyomyositis. Streptococcal pyomyositis can be distinguished by its severity. Death rate may be as high as 50%. CASE REPORTS: Diagnosis of cervical pyomyositis was made in 2 patients on the basis of ultrasound and computerized tomography findings. Group A Streptococcus was isolated from local samples. The diagnosis was confirmed at surgery. Host defense mechanisms were not deficient in either patient. Outcome was favorable in both patients after antibiotic therapy. DISCUSSION: Because of the seventy of group A streptococcal pyomyositis, early diagnosis is essential for prognosis. Ultrasound and computerized tomography are very helpful. Group A streptococcal pyomyositis should be considered as a life-threatening disease.

Adult↗
PubMed1998

[Emphysematous pyelonephritis].

Pyelonephritis is a frequent infection of variable severity. Mortality is low since the era of antibiotics. Emphysematous pyelonephritis is however a rare but life threatening form of kidney infection, which affect more frequently diabetic subjects, characterized by gas producing bacteria. These gaseous lesions can be localized in the renal parenchyma or in the perirenal or retroperitoneal space. Diagnosis became easier with the advent of CT scan. Treatment usually requires surgery and antibiotics. We report a case of emphysematous pyelonephritis in a diabetic patient. The CT scan strongly suggested the diagnosis which was confirmed per-operatively. Proteus mirabilis is exceptionally described in emphysematous pyelonephritis.

Aged↗
PubMed1997

[Rheumatoid purpura and intravenous immunoglobulins].

Henoch-Schönlein purpura is a vasculitis usually with a benign course. Abdominal symptoms occur in 70% of cases, with possible intussusception or intestinal perforation. There is no clear evidence of the efficacy of a treatment in complicated cases of Henoch-Schönlein purpura. Corticosteroids improve abdominal pain but they do not have any effect on renal involvement or prevention of relapses. Intravenous immunoglobulins have been efficient in some cases with recurrent abdominal symptoms or progressive renal lesions. We report the case of a 19-year-old patient with severe abdominal involvement and early renal manifestations of Henoch-Schönlein disease, rapid and sustained improvement was obtained by intravenous immunoglobulins given during 48 hours.

Adult↗
PubMed1997

[Superior sagittal sinus thrombosis and nephrotic syndrome: favorable outcome with low molecular weight heparin].

BACKGROUND: Nephrotic syndrome is known to be associated with thrombosis but rarely of cerebral vessels. CASE REPORT: A 3-year old child with steroid-dependent nephrotic syndrome was hospitalized for drowziness followed by a left hemiparesis. The CTscan showed a superior sagittal sinus thrombosis. The child completely recovered after treatment by low molecular weight heparin (LMWH). CONCLUSION: LMWH could be used for preventing and/or treating thrombosis associated with nephrotic syndrome. Nevertheless, controlled studies are necessary for assessing its efficacy and absence of risk in children.

Anticoagulants↗
PubMed1997

[Malaria brought into Strasbourg: an epidemiological, clinical, biological and therapeutic study].

In a retrospective study, we registered 210 patients hospitalized in Strasbourg for malaria from 1984 to 1995. The diagnosis was always confirmed by presence of the parasite on blood smears. We analysed the epidemiological, clinical, biological and therapeutic data. The number of cases rose each year, with a maximum in 1995. The majority of cases occurred in January and from August to October, these periods corresponding with the return of travelers. In most cases, infection took place in Africa. In this region, Plasmodium falciparum is the most frequent species of the parasite. The mean age of the patients was 33 years. The clinical manifestations were polymorphic: fever, chills, sweating, and headache were very frequent. We noted 15 serious infections (with the WHO's definition) and two cases of cerebral malaria. All cases had a favorable outcome. Five cases occurred in pregnant women; two of them had a severe form of malaria. Among the biological abnormalities, we found thrombopenia, haemolysis, hypocholesterolaemia and hypertriglyceridaemia. The significance of disturbance of the lipid metabolism is not known. Hypocholesterolaemia is very frequent, and hypertriglyceridaemia seems to be associated with severe malaria. Most malaria attacks occurred in patients without adequate chemoprophylaxis. This confirms the importance of prophylactic information given to patients by their physicians. Resistance develops against each new medication that is available; among these quinine remains the drug of choice to cure severe malaria.

Adult↗
PubMed1997

Cerebrospinal fluid transthyretin: aging and late onset Alzheimer's disease.

The deposition of insoluble beta-amyloid protein fibrils is probably the central event in the pathogenesis of Alzheimer's disease. Cerebrospinal fluid inhibits this fibril formation, likely by the intervention of one or several proteins binding to soluble beta-amyloid protein. In vitro, transthyretin (TTR), a CSF protein, impedes amyloid fibrillogenesis. Lowered concentrations of CSFTTR could therefore be associated with Alzheimer's disease. Concentrations of TTR in CSF samples from 149 consecutive patients were assayed, using a kinetic nephelemetric method. These concentrations were correlated positively with age, but were significantly lower in patients with Alzheimer's disease. These data raise the possibility that amyloid fibril formation could be promoted in patients with late onset Alzheimer's disease by the lack of sufficient concentrations of TTR.

Adolescent↗
PubMed1997

[Lymph node and cutaneous syndrome associated with bone plasmacytoma].

INTRODUCTION: We report two patients in whom a slowly growing erythematous thoracic lesion led to the diagnosis of an underlying plasmocytoma. After the treatment of the latter, the cutaneous lesions disappeared, strongly suggesting a link between the two manifestations. CASE REPORTS: The two male patients, aged respectively 66 and 73 years old, had erythematous thoracic plaques. In both cases, extensive laboratory work-up and a histological examination of a cutaneous biopsy did not allow a precise diagnosis. The two patients had a solitary bony plasmocytoma located beneath the cutaneous plaques. The plasmocytomas were discovered respectively 2 and 4 years after the first cutaneous manifestations and were associated to histological non-specific lymph node hyperplasia. Treatment of the plasmocytoma led to the disappearance of skin lesions in both patients. DISCUSSION: In both cases, an erythematous scleroderma-like plaque associated to palpable peripheral and mediastinal lymph nodes, was located over a solitary bony plasmocytoma. Treatment of the plasmocytoma led to the disappearance of the cutaneous lesions, strongly suggesting a link between the two manifestations. Such an association has not been previously reported. We think this is a new entity, characterised by a scleroderma-like cutaneous plaque overlying a solitary bony plasmocytoma and associated to superficial and deep lymph node hyperplasia. We suggest to call it "plasmocytoma associated cutaneous lymph node syndrome". Its relationship to the POEMS syndrome and scleromyxedema are discussed. The pathophysiology remains completely unknown; the syndrome regresses after the treatment of the plasmocytoma.

Aged↗
PubMed1996

Epithelioid sarcoma of the spine: a case report.

STUDY DESIGN: This case report illustrates a patient presenting with sciatica and diagnosed with epithelioid sarcoma involving the spine. OBJECTIVES: The treatment of this patient involved multiple mass resections and decompressions of the spinal canal. Radio- and chemotherapy were applied once a clear diagnosis was obtained. SUMMARY OF BACKGROUND DATA: Epithelioid sarcoma is a rare tumor mainly arising in the extremities. Confusion with a benign inflammatory process are possible. Treatment after histologic diagnosis involves wide resection. To our knowledge, this report represents the first case of epithelioid sarcoma involving the spine. METHODS: After initial discectomy, recurrent scarring and mass formation required multiple decompression procedures and fusion. The initial pathology revealed inflammatory reaction on fibrosis. In a later procedure, the histologic diagnosis of epithelioid sarcoma was made. Radiotherapy and chemotherapy were begun immediately. RESULTS: Despite aggressive resections, radiotherapy, and chemotherapy, the patient died 3 months after the last surgical procedure. CONCLUSION: Spinal epithelioid sarcoma can be mistaken for a benign inflammatory process. After a histologic diagnosis, aggressive wide resection is necessary. Multiple recurrences are documented with this tumor in other sites. Prognosis in trunk involvement is less favorable than involvement of the extremities. The role of adjuvant radio- and chemotherapy is unclear for spinal involvement.

Adult↗
PubMed1995

Spinal involvement in gout.

A 45-year-old man with severe gout was admitted to the hospital because of Staphylococcus aureus septicemia. He had also a biclonal dysglobulinemia, without signs of myeloma. An asymptomatic lytic lesion of the left pedicle of L5 was discovered on radiographs. Histologic examination of the biopsied lesion showed typical tophaceous gout.

Gout↗
PubMed1995

Prenatal diagnosis of a congenital astrocytoma: a case report and literature review.

Congenital intracranial tumors are very rare. We report an endovaginal ultrasonographic diagnosis of an anaplastic astrocytoma at 31 weeks' gestation. Other means, such as antenatal magnetic resonance imaging and fetal blood sampling were not shown to have any diagnostic advantage. A detailed literature review of the topic is provided.

Adult↗
PubMed1995

Accessory diaphragm--review of 31 cases in the literature.

The authors report a case history of a male newborn at term, presenting with an accessory diaphragm in the right hemithorax, and an associated lung hypoplasia, revealed by a transient respiratory distress. The review of 31 cases published in the literature confirm the rare occurrence of this malformation. The diagnostic difficulties are discussed. The advantages of both MRI and CT scanning are compared. Pulmonary, vascular, or diaphragmatic abnormalities were due either to the isolated diagnosis or to its possible associated malformations. Operative management is often considered in view of the progressive respiratory complications. Excision of the accessory diaphragm does not necessarily solve the problem of a coexisting lung hypoplasia.

Adult↗