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D Vittecoq

Publications and source records attributed to D Vittecoq.

97 records · Page 6Linked to original sources

[Isolated ACTH deficiency associated with leukoneutropenia (author's transl)].

The paper describes the case of a 38 year's old alcoholic patient. The investigation of his severe asthenia led to the discovery of an isolated ACTH deficiency: plasma cortisol was less than 1 microgram 100 ml reactivable by tetracosa-peptide beta 1-24. Plasma ACTH was low and remained so after LVD and metyrapone. Persistent leuconeutropenia without myelogram and agar cultures abnormalities was noted. Etiocholanolone test was negative and epinephrine induced a significant rise in blood leucocytes. The authors review the mechanisms of corticoid action on leucopoiesis. After 10 months corticoid treatment, leuconeutropenia improved but was still present suggesting an other underlying mechanism than cortisol insufficiency per se.

Adrenal Insufficiency↗

[Primary biliary cirrhosis associated with acute disseminated lupus erythematosus (author's transl)].

A 39 years old man experienced typical primary biliary (P.B.C.). Additional symptoms occured during the next four years including constitutional symptoms, polyarthralgias, nephrotic syndrom and chronic polyarthritis. Biologically, at the beginning of the disease, antimitochondrial antibodies were at the titer of 1/50,000, and the antinuclear antibodies at the titer of 1/10,000 (speckled pattern). During the course of the disease antimitochondrial antibodies decreased progressively and disappeared at the last control. The antinuclear antibodies progressed until 1/500,000 with anti Sm specificity. The association of P.B.C. and S.L.E., very seldom mentioned in the literature, is discussed among the auto-immune diseases.

Acute Disease↗

No evidence of frequent human immunodeficiency virus type 1 infection in seronegative at-risk individuals.

The possible existence of human immunodeficiency virus type 1 (HIV-1) infection in asymptomatic seronegative at-risk individuals was investigated in a prospective study of 55 seronegative high-risk individuals (42 homosexual men and 13 heterosexual individuals) and 32 seronegative hemophiliacs treated with factor VIII or IX concentrates before viral inactivation by heat treatment and systematic screening of blood donations. Tests used include the polymerase chain reaction assay with three primer pairs (one in the gag region and two in the pol region) and tests for serum p24 antigen, anti-nef serology (Western blot), and five biologic markers frequently altered by HIV infection (CD4 lymphocyte count, serum beta 2-microglobulin and neopterin concentration, and serum IgG and IgA concentration). Although 91 of 92 HIV-1-seropositive persons were positive in testing with at least one primer pair, no positive result was observed in seronegative at-risk individuals or in 117 seronegative low-risk controls. No nef antibody was found in seronegative at-risk individuals or seronegative controls, but 44 (47%) of 92 HIV-1-seropositive persons had nef antibodies. These findings do not support the existence of frequent HIV-1 infection in seronegative at-risk individuals.

Acquired Immunodeficiency Syndrome↗

Lung in acquired immune deficiency syndrome: infectious and immunological status assessed by bronchoalveolar lavage.

Bronchoalveolar lavage (BAL) has been performed in 63 patients with acquired immune deficiency syndrome (AIDS) and 20 patients with chronic generalized lymphadenopathy (CGL) for the diagnosis of lung opportunistic infections and analysis of immune effector cells of the lower respiratory tract. In patients with AIDS, Pneumocystis carinii was found in 63%. Cytomegalovirus (CMV) pneumonia was assessed by viral cultures of BAL fluid and microscopic examination: CMV was found in 62% and 39% respectively. Mycobacteria were encountered in 22% of cases. Altogether BAL yielded at least one opportunistic agent in 94% of patients who presented with clinical and/or radiographic pulmonary involvement, and in 80% of patients who presented with fever only. Conversely BAL was negative in all patients with CGL, except one positive CMV culture. Analysis of BAL cells revealed an increased cellularity in AIDS and CGL patients with normal numbers of alveolar macrophages. Alveolar lymphocytes were surprisingly increased in most patients with AIDS (mean 26.1 +/- 21.9%; range 1-76%) and CGL (mean 26.6 +/- 22.6%; range 3-76%) with criteria of activation contrasting with the blood lymphopenia. Evaluation of lung lymphocyte phenotypes revealed a marked decrease in T4 cell percentages, specially in AIDS, whereas the large majority of alveolar lymphocytes expressed the T8 phenotype. We conclude that BAL is a very reliable means for diagnosis of opportunistic lung infections and give interesting prospects to study local immunity in patients with AIDS and CGL.

Acquired Immunodeficiency Syndrome↗