Behçet disease and priapism.
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Biomedical subjects
Publications and source records attributed to H Ben Ayed.
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The clinical significance of antibodies directed against extractable nuclear antigens with currently well-known antigenic targets, is studied in 100 patients affected with various connective tissue inflammations. The anti-Sm is the most frequently encountered antibody in lupus disease and overlapping connective tissue inflammations with a lupus component while the anti-RNP is related to mixed inflammation of the connective tissue and the dry syndrome. These antibodies, without being specific markers for a given disease, represent an additional biological argument for a better nosological classification of connective tissue inflammations. The use of immuno-impression, a more sensitive technique than immunodiffusion, could provide a better understanding of the immune response during these diseases and specify the diagnostic and prognostic value of various auto-antibodies. Analysis by immuno-impression of 36 sera among the 100 with antibodies directed against extractable nuclear antigens has enabled us to compare the two techniques and study the different specificities of these antibodies.
We report the observation of a 40 year old man who was admitted with acute renal failure. Renal biopsy revealed massive interstitial infiltration by lymphocytes. Bone marrow examination was diagnostic for acute lymphoblastic leukemia. This presentation of acute leukemia is unusual. The mechanism of renal failure is discussed.
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A prevalence survey of diabetes mellitus was carried out in Tunisia on two random samples of households. The first sample (3826 adult subjects) was drawn from the Gouvernorat of Tunis, the second one (1787 adult subjects), was drawn from a rural area, the Gouvernorat of Siliana. The families were investigated at home and diabetes assessed on the basis of an interview (to determine known cases) and of fasting blood glucose level in subjects having no personal history of diabetes (new cases). Prevalence rates were estimated considering known cases and newly found ones together. Overall, the age-standardized prevalence rate was found to be much higher in the urban sample compared to the rural one, especially for women (4.6% versus 2.3% in men, 3.5% versus 0.6% in women). Diabetes was often associated with obesity, especially in men. Within the urban sample, the prevalence rate was similar in subjects born in Tunis and in those born in the rest of the country, thus mainly of rural extraction. In contrast, a family history of diabetes was more often reported in the former group. The results are consistent with other epidemiological findings, showing that a dramatic increase in diabetes morbidity parallels the rapid westernization of urban centres in developing countries.
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Two patients with non-systemic idiopathic glomerulonephritis were found to have a complete deficiency of C2, the second component of complement; the clinical course and serological abnormalities are reported in detail. An immunogenetic analysis of the patients of two families was carried out. It was demonstrated that the homozygous C2 deficiency was associated with homozygosity for HLA-A25-B18-DR2-BfS-C4A4-C4B2 haplotype.
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Treatment of end-stage renal disease started in Tunisia in 1968 and has been used for 543 patients; 364 of them are still living. There are now 10 centers, 4 in public hospitals and 6 in private centers. Transplantation is still performed abroad. Among living patients, 312 (86%) are on hemodialysis, 11 (3%) are on CAPD and 41 (11.2%) are living with a transplanted kidney. The mean survival rate of patients is similar to the European mean and professional rehabilitation is good in most cases. New dialysis centers are planned to open and renal transplantation with related living donors will probably be performed soon.