The involvement of the central nervous system (CNS) by a vasculitic process is an infrequent but serious manifestation of several systemic diseases. The neurological disturbances are most often due to cerebral ischemia; however, vascular inflammation is not the only pathogenetic factor of CNS disease in systemic vasculitis. Most often, the specific diagnosis of CNS vasculitis depends on identifying clinical or histologic evidence of target organ involvement outside the CNS. The primary angiitis of the central nervous system (PACNS) is a rare form of vasculitis limited to the central nervous system. The diagnosis of this disorder is difficult owing to its various clinical manifestations and to the poor specificity of the neurological investigations. The demonstration by cerebral angiography and/or tissue examination of an arteritic process is mandatory for establishing this diagnosis.

Biopsy↗

PubMedDate not supplied

[How does success in the 1st cycle of medical school relate to outcome in the 3rd doctorate? Behavior of 1st generation students at the Brussels Free University under the numerus clausus].

The aim of our work was to use the results of the 1st cycle of study in medical school to explore success in 3rd doctorate students in two cohorts (n = 82) of 1st generation students in the numerus clausus system. Because of the homogeneity of mean percentages in the two cohorts and the nil cohort effect on the evolution of performance across study years, the two samples were combined for further analyses. While success (end-of-year percentage) in each of the 3 years of the 1st cycle was positively correlated to success in the other two, the positions (according to ranks) of the students in their group only weakly coincided, if at all, between the 1st cycle and the 3d doctorate. The analysis of correlations between percentages in the 4 years (3 years in the 1st cycle and 3d doctorate) showed that 25% of the variance in the 3d doctorate is shared with outcome in the 1st year and only 7% with that in the 2d year; outcome in the 3d year of the 1st cycle did not contribute at all to outcome in the 3d doctorate. Besides, the chance of an excellent success in the 3d doctorate, defined as being among the 10 best performers, was positively associated to the end-of-year percentage in the 1st year, while neither 2d year nor 3d year results contributed to the prediction, as the logistic regression analysis demonstrated. These results, with a significant contribution of the 1st study year outcome to the success in the 3d doctorate of medical school, were obtained in the context of the numerus clausus and contrast with those obtained in a study preceding this selective procedure, and showing instead the 3d year of the 1st cycle as more predictive. This result could be taken as supporting the very newly established selection process at the end of the 1st study year.

Belgium↗

PubMedDate not supplied

Anti-pm/scl antibodies in connective tissue disease: Clinical and biological assessment of 14 patients.

INTRODUCTION: Anti-PM/Scl antibodies (Anti-PM/Scl) represent a rarely encountered type of antinuclear antibodies. They have mainly been reported in association with idiopathic inflammatory myositis - systemic sclerosis overlap syndromes (also called scleromyositis or sclerodermatomyositis) but also with polymyositis, dermatomyositis and systemic sclerosis without features of overlap syndromes. Studies concerning characteristics of patients with anti-PM/SCl are rare and include small numbers of patients. PATIENTS AND METHODS: Retrospective review of clinical and biological characteristics of 14 patients with anti-PM/Scl in two University Hospitals: one in Belgium (Erasme Hospital, Bruxelles) and one in France (Hautepierre Hospital, Strasbourg). RESULTS: Seven patients were identified in Erasme and 7 in Strasbourg: 5 with systemic sclerosis-(dermato)myositis overlap syndromes, 4 with dermatomyositis, 1 with polymyositis, 3 with systemic sclerosis, 1 with primary Sjögren's syndrome. The most frequently observed clinical characteristics (85% of patients) were: pulmonary interstitial disease and arthralgia or arthritis. No patient of our series died or developed cancer (mean follow-up:6.1 years). CONCLUSIONS: Our study failed to identify an homogeneous clinical pattern in patients with anti-PM/Scl, except for 2 characteristics shared by 85% of the patients. This lack of homogeneity is in agreement with preceding literature. We confirm the favourable prognosis associated with the presence of anti-PM/Scl, despite the high incidence of interstitial pulmonary disease. The absence of cancer associated with presence of anti-PM/Scl represents a partial explanation. Finally, we report herein the second case of primary Sjögren's syndrome associated with anti-PM/Scl.

Adult↗

PubMedDate not supplied

Wegener's granulomatosis masquerading as a renal cancer: a case report and review of the literature.

A 32 year-old man presented with sinusitis, proteinuria, mononeuritis multiplex, very increased acute phase proteins. Anti-PR3 ANCA were detected and Wegener's granulomatosis (WG) was diagnosed. As abdominal tomodensitometry detected a tumoral process of the left kidney, a paraneoplastic vasculitis associated with a renal cancer was suspected. Biopsy of the mass showed fibrosis, inflammatory infiltrates and necrotizing granulomas. No malignant cells were detected. The outcome was favourable after administration of methylprednisolone and cyclophosphamide. Characteristics of the nine previously reported renal inflammatory pseudotumors associated with WG are discussed.

Adult↗

PubMedDate not supplied

[Proximal tubular acidosis associated with deficiency osteomalacia in adults].

Explore the source record for details and available documents.

Acidosis, Renal Tubular↗

PubMedDate not supplied

[Methotrexate treatment in non-cancerous disorders].

Weekly administration of low doses methotrexate (7.5 mg to 25 mg a week) is considered as one of the most important progresses in the management of rheumatoid arthritis. Its efficacy has also been demonstrated for the treatment of other inflammatory processes such as psoriasis arthritis and, more recently, Crohn's disease. We here review the indications, the limits and the side effects of such therapeutic approach in various inflammatory and/or autoimmune diseases.

Antirheumatic Agents↗

PubMedDate not supplied

[Hypereosinophilia: focus on clinical aspects].

Hypereosinophilia may be associated with various clinical disorders. The severity of hypereosinophilia may be related to the underlying disease or to the possible deleterious effects of the eosinophils infiltrating most of the tissues, particularly the heart and the nervous system. Adverse reactions to drugs or other immunoallergic disorders are most often encountered. Among the parasitic diseases, helminthic infestations are especially incriminated. Cancers, autoimmune diseases and some T lymphoproliferative disorders represent the other reported conditions associated with hypereosinophilia. The detection of interleukin-5 (the most important cytokine involved in the control of eosinophils production and maturation) may contribute to the knowledge of some pathological hypereosinophilic disorders. In the absence of a well defined responsible factor, the idiopathic hypereosinophilic syndrome will be considered. The pathogenic role of a T lymphocyte disorder need to be considered in some cases.

Diagnosis, Differential↗