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Biomedical subjects

E Delaporte

Publications and source records attributed to E Delaporte.

At least 163 records · Page 9Linked to original sources

[Pemphigoid mimicking epidermolysis bullosa acquisita].

INTRODUCTION: Subepidermal autoimmune bullous dermatoses form a clinical entity for which there is not always an individualized clinical and pathological description. CASE REPORT: A patient presented with bullous skin disease of atypical nature. There was an almost total desepidermization of the legs, vast areas of erosion on the trunk and arms with a Nikolski sign in an area of healthy skin, buccal involvement, multiple milium cysts and ungueal dystrophies with nail loss. DISCUSSION: This clinical presentation in this patient suggested acquired bullous epidermolysis. However, according to the recently defined clinical criteria for pemphigoid, the probability of correct diagnosis of pemphigoid was greater than 95 p. 100 since nearly three fourths of the major criteria were present. This diagnosis was confirmed by reference techniques (electron microscopy, indirect electron immunomicroscopy and immunoblotting). Thus, bullous autoimmune diseases of the dermoepidermal junction can be reliably differentiated on the bases of the clinical features, together with direct and indirect immunofluorescence on salt-split skin.

Aged↗

[The prevalence of anti-hepatitis C antibodies in pregnant women and blood donors in Bénin].

In order to precise if the hepatitis C virus (HCV) represents a potentially important infection for public health in Benin, the authors have studied the seroprevalence rate of this virus in august 1991, among two groups of population in Cotonou: 349 donors of blood (including 321 males); mean of ages: 28.7 y.-o., 149 pregnant women (mean of ages: 24.5 y.-o.). They have used an ELISA test (Innotest HCV Innogenetis NV, Antwerpen, Belgium) and retested the positive serums by LIA (Line Immuno Assay, Inno LIA HCV). A serum reacting with at least one peptide has been considered as positive. In the donors of blood and the pregnant women, a prevalence rate of respectively 2.3% (+/- 1.2) and 0.7% (+/- 0.9) has been established. These rates are worthy to be compared to those reported in Niger among the same types of population and with the same serologic tests. They are much inferior to those noted in East Gabon or South Cameroon: respectively 6.5% and 9.8%. This preliminary study has to be enlarged by investigations, which may precise the consequences of HCV presence in Benin for public health in this country.

Adult↗

[Cutaneous pseudolymphoma during treatment of rheumatoid polyarthritis with low-dose methotrexate].

INTRODUCTION: Over the last three years, there have been over twenty case reports of lymphoma in patients given low-dose methotrexate for rheumatoid arthritis. We observed the first case of cutaneous pseudolymphoma. CASE REPORT: A 56-year-old man had been treated with methotrexate (15 mg/day) for 6 years due to rheumatoid arthritis. He developed three isolated papulonodular ulcerations on the limbs. The histology and immunohistochemical examinations demonstrated T and B lymphoplasmocyte infiltration without epidermotropism nor destruction of the annexes. Immunolabelling for anti-Epstein-Barr virus was negative. There was a IgG lambda type monoclonal hypergammaglobulinaemia, Bence-Jones proteinuria and an increase in beta 2-microglobulin. The thoracoabdominal scan, bone marrow biopsy and gallium scintigraphy were normal. There was no sign of a Gougerot-Sjögren syndrome nor of a Felty syndrome. The skin lesions and the Bence-Jones proteinuria disappeared rapidly after withdrawal of methotrexate. There has been no recurrence with a follow-up of 16 months. DISCUSSION: The diagnosis of pseudolymphoma was retained on the basis of the clinical features, the histological and immunohistochemical evidence and especially on the clinical course after methotrexate withdrawal, i.e. spontaneous regression of the lesions within 3 weeks. A similar course has been observed in three cases of lymphocyte proliferation suggesting that this immunosuppressor would be the most probable causative agent. Lymphocyte proliferation, mainly B-cell lymphomas in haematopoietic organs occurring under methotrexate administration have occurred mainly in patients with rheumatoid arthritis. Three cases have also been described in patients with dermatomyositis, but none have been reported in patients with psoriasis. This would suggest that cofactors involved in these autoimmune diseases could also have an effect: immunodepression, potentialization due to associated treatment (corticosteroids), Epstein-Barr virus... CONCLUSION: Data on these observations should be combined in order to analyse the question of the safety of low-dose methotrexate in these patients.

Arthritis, Rheumatoid↗

[Seroprevalence of hepatitis C virus among persons visiting the Burundi health services].

The epidemiology of hepatitis C (HCV), especially on the African continent, is not well known. In this study, we investigated the presence of antibodies to HCV in 685 out-patients, seen in several health care centers or hospitals in different regions in Burundi from January to February 1991. Serological tests of the second generation were used. The global prevalence varied from 3.2% to 14.1% according to the center. Urban seroprevalence tended to be higher than rural prevalence. Also, with increasing age, a higher prevalence was observed. Anti-HCV antibodies were absent in patients younger than 21, while specific antibodies were detected in 23.1% of patients older than 50. Although the prevalence in men (10.4%) was higher than in women (7.4%), this difference was not statistically significant. Taking into account the selection of subjects participating in this evaluation, the results can not be extrapolated to the general population. No association between HCV and human immunodeficiency virus (HIV) was seen in this study. In contrast to previously described results from studies using reagents of the first generation, no cross-reactions were observed with anti-malarial antibodies.

Adolescent↗

[Sclerosing lipogranuloma in a male].

INTRODUCTION: Major trauma was the only aetiologic factor found in a male patient presenting sclerosing lipogranuloma. This condition is well-known in women but is rarely described in men. CASE REPORT: A 31-year-old non-obese man with no sign of gynaecomasty presented with well-delimited plaques of pigmented and sclerosous tissue located at the pubis and both breasts as well as hard nodules of the scrotum and the penis. The lesion developed progressively after a major trauma involving the anterior aspect of the thorax and the public area. An inflammatory border persisted eight years after the initial trauma. Histological examination of a biopsy specimen showed evidence of adipocyte necrosis with lipophagia and lipogranuloma. No foreign body was found. DISCUSSION: The diagnosis of post-trauma cytosteatonecrosis was retained on the basis of the clinical history and the clinical, histological and radiographic evidence. This condition is a well-identified clinical entity which is sometimes confounded with false panniculitis resulting from self-injection of oily products. The endogenous origin of the fatty acids found within the cytosteatonecrosis tissue has recently been proven. Usual localizations are the breast in women and genital organs in men. Favouring factors in women include obesity, age, anticoagulants, frequency and intensity of trauma. The exceptional localization in our patient was strongly related to the earlier trauma.

Adipose Tissue↗

[Behçet disease. Comparative aspect of diagnostic criteria].

OBJECTIVES: Different diagnostic criteria for Behçet's disease are proposed in the literature. We compared the criteria proposed by Mason and Barnes with those proposed by the International Study Group and with those proposed by the Japanese committee. METHODS: This retrospective study included 41 patients with Behçet's disease according to the criteria set by Mason and Barnes. There were 16 patients of French origin and 25 patients of North African origin. RESULTS: Genital ulcerations were more frequent in the North African population (p < 0.007) and typical Behçet skin lesions were more frequent in the French population (p < 0.021). Comparing the clinical data among the 41 patients with Behçet's disease according to the Mason-Barnes criteria revealed that only 83% met the criteria set by the International Study Group and only 54% the criteria of the Japanese committee. For the International Study Group criteria, the requirement for recurrent buccal ulcerations with at least 3 episodes over a 12 month period (a major criteria) was the most limiting element. Likewise, genital ulcerations were not always recurrent. CONCLUSION: These findings confirm the variability of clinical manifestations of Behçet's disease with ethnic origin. Proposed diagnostic criteria vary depending on the study committee and should be used as diagnostic guidelines rather than as criteria required for positive diagnosis.

Adult↗

Classification of hepatitis C viruses based on phylogenetic analysis of the envelope 1 and nonstructural 5B regions and identification of five additional subtypes.

Genotyping of hepatitis C virus-positive sera by means of a line probe assay indicated that < 3% of European samples, but up to 30% of Gabonese sera, could not be classified as either 1a, 1b, 2a, 2b, 3a, 3b, 4c, 5a, or 6a. Such samples were analyzed in the 5' untranslated region and in the nonstructural 5 (NS5) region. Classification based on phylogenetic analysis of the commonly used 222-bp-long NS5B region was possible for most but not all of the selected sera. Therefore, the core/envelope 1 region (579 bp) and a larger NS5B (340 bp) region were also analyzed. Only the phylogenetic analysis of the 340-bp NS5B region of these newly identified and published isolates provided unambiguous classification into types and subtypes. Furthermore, unequivocal evidence for four subtypes in type 2 and eight subtypes in type 4 was provided. A specific recognition sequence in the 5' untranslated region was observed for every newly identified subtype. Based on 1830 pair-wise comparisons in NS5B, isolates belonging to the same subtype showed evolutionary distances of < 0.127 and isolates of the same type exhibited evolutionary distances of < 0.328. These phylogenetic border distances can be conveniently used for classification of hepatitis C virus isolates into types and subtypes.

Amino Acid Sequence↗

High-affinity IgE receptor on eosinophils is involved in defence against parasites.

Parasitic infections are often associated with eosinophilia and high levels of immunoglobulin E (IgE). This observation has led to speculation that eosinophils and IgE may act together in the immune response against parasites. In support of this hypothesis, IgE and eosinophils participate in cytotoxic reactions directed against Schistosoma mansoni larvae in vitro. Furthermore, epidemiological studies have shown an inverse correlation between levels of specific IgE and rates of infection with Schistosoma. The low-affinity IgE receptor (Fc epsilon RII/CD23) was first incriminated in eosinophil activation. The fact that the high-affinity IgE receptor (Fc epsilon RI) is not only expressed on mast cells and basophils but also on Langerhans cells led us to investigate the presence of Fc epsilon RI on eosinophils. Here we show that Fc epsilon RI is expressed on eosinophils from hypereosinophilic patients, is involved in eosinophil degranulation, and participates in eosinophil-mediated cytotoxicity against S. mansoni. Our results indicate that Fc epsilon RI may play a major part in immune defence against parasites.

Animals↗

Genetic and antigenic variability of HIV type 1 in Brazil.

Six Brazilian strains of human immunodeficiency virus type 1 (HIV-1) were isolated from infected individuals residing in different regions of Brazil between 1987 and 1989. Phylogenetic analysis based on an 860-base pair env fragment, including V3, V4, V5, and the beginning of gp41, classified the Brazilian strains significantly in genotype B, with interhost distances between 5.9 and 13.1% (mean value, 10%). Amino acid sequence analysis of the V3 loop revealed that three strains contained the North American/European GPGR motif as the tip of the loop whereas in the other three strains proline (P) was substituted by tryptophan (W), methionine (M), or phenylalanine (F). A consensus peptide, Bra-cons, was designed containing GWGR as the tip of the loop. Serological reactivity to the Bra-cons peptide and other V3 peptides (MN, SF2, HBX2, RF, MAL, ELI, Z6, and a Côte d'Ivoire peptide, CI-cons) was compared for 114 HIV-1-positive sera from Rio de Janeiro. Sixty-nine sera (60.5%) reacted with peptides belonging to genotype B, of which 10 sera also reacted with peptides belonging to genotype A (n = 7) and D (n = 3). Eighteen sera (15.8%) had binding antibodies to the Bra-cons peptide. A high number of sera (n = 43; 37.7%) had no antibodies to any of the V3 peptides tested. This result suggests that HIV-1 variants with aberrant V3 loops may circulate in Rio de Janeiro.

Acquired Immunodeficiency Syndrome↗

Isolation of simian immunodeficiency viruses from two sooty mangabeys in Côte d'Ivoire: virological and genetic characterization and relationship to other HIV type 2 and SIVsm/mac strains.

OBJECTIVE: To search for the presence of SIV in sooty mangabeys and other monkey species in Côte d'Ivoire, West Africa, and to compare viral isolates with HIV-2 strains from the same region. METHODS: Forty-three captive housed monkeys (28 African green monkeys, 6 sooty mangabeys, 6 baboons, and 6 patas monkeys) were tested for the presence of HIV and SIV antibodies. Virus was isolated from the peripheral blood lymphocytes of seropositive animals and from HIV-2 antibody-positive patients originating from Côte d'Ivoire, Ghana, Senegal, and Belgium. Viruses were characterized by Western blot and radioimmunoprecipitation assay. Proviral DNA was amplified by PCR, cloned, and sequenced to construct a phylogenetic tree. RESULTS: One African green monkey and three sooty mangabeys had antibodies that cross-reacted with HIV-2. From two mangabeys lentiviruses were isolated and designated as SIVsmCI2 and SIVsmCI8. Serological, virological, and sequence data showed that these isolates are members of the HIV-2/SIVsm/SIVmac group of primate lentiviruses. Furthermore, in the phylogenetic tree, these two new viruses form a distinct subgroup that is equidistant to the HIV-2 strains and the previously described SIVsm/SIVmac viruses. CONCLUSION: This study provides additional evidence that sooty mangabey monkeys can be infected with a lentivirus in their natural habitat. Within the SIVsm and SIVmac viruses extensive genetic variation is observed.

Acquired Immunodeficiency Syndrome↗