[Thrombopenia and intravascular coagulation during heparin treatment].
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Biomedical subjects
Publications and source records attributed to H Dechy.
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Peripheral neuropathies were the presenting feature of an IgA lambda myeloma in a 61-year-old man and a mixed cryoglobulinaemia in a 46-year-old woman. A spectacular improvement in these symptoms followed treatment including large volume plasma exchanges with appropriate chemotherapy. This efficacy of repeated plasmapheresis leads to a discussion of the possible mechanisms of these neuropathies.
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The rheumatoid rosette test was performed in 33 patients with febrile valvular cardiopathy. In 19 cases bacterial endocarditis was proved by blood culture or by histological examination. The test was positive in 3 cases out of 5 during the first ten days of the fever (group A1), in 6 cases out of 6 after the tenth day (group A2), and in 4 out of the 8 already treated patients (group A3). In 3 positive cases, successive measurements, before and during treatment, showed a rapid fall in rosette levels. In controls patients, the test was positive 8 out of 9 cases with febrile valvular cardiopathy without endocarditis (group B) and in 5 out of 5 cases in which bacterial endocarditis was probable but not proved (group C). The increase in rheumatoid rosette levels seems therefore to be non specific of bacterial endocarditis. Nevertheless it could be a good test for biological activity of the disease in treated patients. The origin and signification of the rheumatoid rosette forming cells are discussed.
Five cases of severe encephalopathy due to chronic ingestion of bismuth have been studied by cerebral computed tomography (CT). In every case, areas of increased attenuation coefficient in the basal ganglia and the cortex of the cerebral hemispheres were demonstrated. These regions of increased attenuation were diffuse with irregular, patchy denser areas. The increased attenuation in the gray matter territories contrasted with decreased attenuation of the white matter, particularly evident in the centrum semiovale of each hemisphere and probably related to edema. Some ventricular dilatation was also present in three cases. In one patient, areas of increased attenuation were demonstrated in the cerebellum. Follow-up CT studies of one patient revealed regression of the pathological findings. This regression accompanied the clinical improvement, which, in every case, followed the termination of the bismuth intake.
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The authors report a case of bacterial endocarditis during which the precise nature of the heart lesions were only discovered at operation. There left ventricle and right atrium. The characteristics of the systolic murmur and the findings on phonocardiography together with left ventricular angiography had suggested mitral incompetence. There were no conduction disorders in this patient which might have helped in preoperative diagnosis. In connection with this case, the authors recall the characteristics of aneuryms of the membranous septum and congenital or acquired communications between the left venticle and the right atrium.
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