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Biomedical subjects

D Van Linthoudt

Publications and source records attributed to D Van Linthoudt.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Efficacy of intravenous pamidronate in osteoporosis, mineralometric evaluation].

Therapeutic efficacy of some molecules, predicted by scientific studies, is not systematically confirmed when the substance is used in general practice. In osteoporosis, certain studies show an efficacy of intravenous (i.v.) pamidronate similar to oral alendronate. These results could be a valuable alternative for non compliant patients or those suffering from digestive problems. For this reason we have studied the efficacy of i.v. pamidronate in osteoporotic patients, not available to oral alendronate. This is a retrospective study of 20 unselected osteoporotic patients from our general practice. Each patient had a bone mineral density (BMD) of less than -2.5 DS for the T-score, measured by a dual energy X-ray (DXA) densitometer at the lumbar spine and the hip. Thirty milligrams of pamidronate were administered intravenously every three months. Each patient was controlled by a DXA after eighteen months minimum. Thirteen patients had increased on average their BMD by 6.2% in the lumbar spine and by 4.7% in the hip. All patients responded at least at one site, but seven patients did not improve their BMD at both sites. We have confirmed that intermittent i.v. pamidronate given in common practice increases BMD in the lumbar spine and the hip in 2/3 of the patients. The increase in bone mass in the hip is similar to that published in the scientific literature, but less for the lumbar spine.

Anti-Inflammatory Agents↗
PubMed1996

Miscellaneous metabolic diseases.

Musculoskeletal manifestations are commonly observed in metabolic disorders. Here we review the recent literature on several metabolic arthropathies. Hemochromatosis should be suspected in patients with the sign of the "iron salute". Screening for this disorder by routine measurement of transferrin saturation appears to be a cost-effective procedure in white men aged 30 years or older. In dialysis arthropathy, radiologic lesions of the hand joints increased in size and frequency with the duration of dialysis. However, destructive arthropathy of the fingers is not necessarily related to amyloid deposition. In patients with dialysis-related beta 2-microglobulin amyloid deposition, renal transplantation improved clinical rheumatologic manifestations but did not prevent progression of destructive arthropathies nor dissolution of amyloid deposits. In ochronotic arthropathy, spinal changes may resemble those seen in ankylosing spondylitis and can lead to cord compression. The presence of brownish-blackish rods in the synovial fluid is an unusual but useful diagnostic tool. Metabolic factors are likely to play a role in the pathogenesis of diffuse idiopathic skeletal hyperostosis, and recent studies have demonstrated elevated insulin and growth hormone but normal insulin-like growth factor-1 levels in these patients. Other metabolites that may play a role in this condition include retinoids and bone morphogenetic protein-2.

Humans↗
PubMed1996

Scleromyxedema with myopathy and hyperthyroidism.

We describe a 62-year-old woman who developed extensive papular skin eruption with dysphagia and proximal muscle weakness. Laboratory studies showed a progressive increase of muscle enzymes, lambda monoclonal gammopathy, and elevated serum thyroid hormones. Several skin and muscle biopsies were necessary to reach the correct diagnosis of scleromyxedema in association with hyperthyroidism. Muscle biopsies contained rimmed vacuoles with some necrosis and regeneration, but no increased mucopolysaccharides. Hyperthyroidism was treated without appreciable improvement of the skin and muscle lesions. Myopathy is an increasingly recognized feature of scleromyxedema; its pathogenesis is still unexplained.

Biopsy↗
PubMed1996

Citrate in synovial fluid and its relation to inflammation and crystal presence.

OBJECTIVE: To investigate the role of citrate in the pathophysiology of arthritides with calcium pyrophosphate dihydrate (CPPD) crystals and/or apatite-like material. METHODS: We measured citrate concentrations in the plasma and synovial fluid (SF) of 23 joints whose SF contained these crystals and 33 joints without crystals. The SF originated from 25 joints each of patients with rheumatoid arthritis (RA) and primary osteoarthritis (OA) and 10 patients with various other inflammatory joint diseases. RESULTS: There was significant correlation between citrate concentrations in the SF and plasma with values globally twice as high in the SF as in the plasma. Citrate concentrations in the SF of patients whose SF contained CPPD crystals and/or apatite-like material were not significantly lower than those without crystals. On the other hand, citrate concentrations were significantly lower in the SF of patients with RA and other inflammatory joint diseases versus those with OA. CONCLUSION: We have no evidence that lower amounts of citrate in SF favor the presence of CPPD crystals or apatite-like material. Our results, however, do suggest a complex regulation of the citrate concentration in SF where cellular metabolic processes and citrates arising from the plasma and neighboring tissues probably interact to produce the levels recorded.

Adult↗
PubMed1994

[Isolated bone marrow mastocytosis: a rare cause of osteoporosis not to be missed].

Osteoporosis can be secondary to other diseases. Among these, mastocytosis is easily recognized when typical skin lesions and systemic symptoms are present. When mastocytosis is confined to bone, as in our case, diagnosis is based on the presence in the bone marrow of an increased number of mastocytes with a nodular arrangement near the bone trabeculae. The diagnosis has to be suspected when severe vertebral and peripheral osteoporosis occurs in middle aged people, especially men. Bisphosphonates are the most frequently applied treatment but their efficacy is limited. Early diagnosis is recommended because the use of several drugs, including fluoride, which is frequently used in osteoporosis.

Aged↗
PubMed1993

Diffuse chondrolytic arthritis in sickle cell disease.

A young black man with sickle cell disease with recurrent painful vasoocclusive crises developed at 16 years of age a rapid disabling polyarticular chondrolysis leading to a bilateral hip arthroplasty in 1 year. Light microscopy showed erosion and chondrocyte loss with deep clones in the cartilage and congested vessels with extravasation of red blood cells and mononuclear cells in the synovium. Electron microscopy of the synovium disclosed partially occluded blood vessels and phagocytic cells containing red blood cell debris and crystalline hemoglobin-like material. These observations suggest a role for the phagocytic cells in the joint destruction.

Adult↗
PubMed1991

[Osteoporosis in Turner's syndrome].

Axial and appendicular osteoporosis are common features of Turner's syndrome. The histology of this osteoporosis is similar in some respects to postmenopausal osteoporosis. Therefore, we treated a woman with Turner's syndrome who developed a vertebral wedge fracture, despite estrogen substitution since adolescence, with bone stimulating drugs. Absence of a beneficial effect on bone biological indices or bone mineral density, could be explained by other pathogenetic factors like a direct result of the chromosomal abnormality or other hormonal deficiencies.

Alkaline Phosphatase↗
PubMed1991

[Fatal hepatic necrosis due to a treatment course of rheumatoid arthritis with gold salts].

Gold salts are still a first choice for treatment of rheumatoid arthritis. Although adverse reactions are relatively frequent, hepatic abnormalities are rare. They consist largely of reversible cholestasis, and, exceptionally, the evolution can prove rapidly fatal due to extensive hepatic necrosis. We present an additional case of this kind which occurred after a total dose of 450 mg intramuscular Aurothiopropanol over 6 weeks. The pathogenetic mechanism is complex, toxic and/or immuno-allergic. Nevertheless, regular hepatic enzyme testing is not recommended.

Antirheumatic Agents↗