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Biomedical subjects

J Beylot

Publications and source records attributed to J Beylot.

At least 19 recordsLinked to original sources

[Syndrome of macrophagic activation with hemophagocytosis in human immunodeficiency virus infection].

The authors report two cases of hematophagic histiocytosis in HIV positive patients. In the first case, a patient with Kaposi sarcoma and Mycobacterium avium infection had a rapidly deteriorating course with progressive pancytopenia and death, as generally described in the literature. In the second case, hematophagic histiocytosis appeared during HIV primo infection and reversed spontaneously. Although few cases of hemophagocytic syndrome have been reported in HIV positive patient, it could represent an underestimated cause of pancytopenia. Both opportunistic microorganisms and HIV are able to cause hematophagic histiocytosis.

Adult

Chilblain lupus erythematosus: report of 15 cases.

In this retrospective study, the authors describe the clinical, histologic and laboratory features of 15 cases of chilblain or perniotic lupus. In winter, the patients (14 women, 1 man) develop chilblain-like lesions, chiefly in the toes (8 times) and fingers (11 times). Histologic features are identical to those of discoid lupus erythematosus. The damaged skin gives a positive fluorescent band test. Usually, these lesions occur in association with discoid lupus of the face. However, in 8 patients, they were the only cutaneous sign of lupus. This form of lupus can evolve to a systemic form, as was the case with 3 patients.

Adult

[Non-Hodgkin's malignant lymphoma and human immunodeficiency virus. Apropos of 34 cases].

The characteristics of 34 HIV-associated non Hodgkin's lymphomas diagnosed and treated at Bordeaux hospitals are described. The patients represented 7% of the AIDS cases observed in the Bordeaux area. HIV-lymphomas were almost always high-grade malignancies, usually disseminated (70%) with extranodal disease at presentation (91%) primarily in the bone marrow, meninges, gastrointestinal tract and liver. Twenty-eight patients were treated with different chemotherapy protocols or radiation therapy alone. Complete remission was achieved in 11 patients and partial remission in 3. The median survival was 3.9 months. Despite utilization of low-intensity chemotherapy regimens, opportunistic infections were not prevented. The only factor that accurately predicted complete remission was the WHO performance index. The total number of CD4-positive lymphocytes, the Ann Arbor stage and the WHO performance index were prognostic factors influencing survival. These results justify the use of high-intensity regimens, but only for patients without opportunistic infection and with a WHO performance index below 3.

AIDS-Related Opportunistic Infections

[Cutaneous vasculitis].

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Acquired Immunodeficiency Syndrome

Eosinophilia associated with a composite lymphoma.

We report a case of composite lymphoma heralded by a hyper-eosinophilia syndrome. Combination of immunophenotyping and gene rearrangement analysis allowed us to confirm malignancy and to detect a minor oligoclone B within a malignant T-cell predominant population. No evidence of retroviral infection was found using western blot and gene amplification techniques.

Adult

[Acute cardiac insufficiency and toxoplasmosis].

The authors report the case of a 21-year old, non-immunocompromised girl who presented with severe acute heart failure associated with Toxoplasma infection. The outcome was favourable: cure without sequelae was obtained in a few months with a symptomatic and specific treatment consisting of spiramycin and methylprednisolone. This case is interesting for several reasons. The occurrence of such an acute heart disease is extremely rare in patients with toxoplasmic myocarditis, and so is the presence of a septal focus suspected on the basis of a predominantly septal hypokinesia at echocardiography and of enzymatic changes. The development of an acute heart failure should suggest a diagnosis of toxoplasmic myocarditis, which is rare but important since a specific treatment is available.

Acute Disease

[Diagnosis of bilateral secondary tumors of the kidney. Contribution of cytology. Apropos of 2 cases].

The authors report bilateral secondary tumors of the kidney in two patients: one previously treated for an epidermoid tumor, the other for an anaplastic bronchial tumor. In both patients, clinical and radiological features were those of a malignant process. Scan-guided percutaneous fine needle aspiration provided the material necessary to make a definitive cytological diagnosis; it was thus possible to assess the malignancy and recognize the histological type of lesions.

Adult

Peripheral neuropathy with essential mixed cryoglobulinemia: biopsies from 5 cases.

Essential mixed cryoglobulinemia, which can cause hypersensitivity vasculitis, was observed in five patients with peripheral neuropathy. Three cases presented with multifocal neuropathies and two cases with symmetrical polyneuropathy. One had cryoglobulinemia with IgM monoclonal gammopathy IgG polyclonal gammopathy, and the other four had cryoglobulinemia with polyclonal gammopathy. Biopsies showed perivascular infiltration by mononuclear cells around medium, and mainly small-sized blood vessels. This was observed in the epineurium (five cases) and muscular fragments (three cases). At ultrastructural examination two cases showed severe damage of most myelinated fibers, which presented acute stages of Wallerian-like degeneration, and the three other cases showed a less widespread destruction of myelinated fibers. Most endoneurial capillaries showed swollen endoneurial cells. Myelino-axonal degeneration of myelinated fibers is probably due mainly to the vasculitis always present in the epineurium. This damage was probably worsened by the modifications of endoneurial capillaries. These lesions and their mechanisms are quite different from those observed in cases of cryoglobulinemia with an isolated monoclonal gammopathy.

Aged

[Kaposi's sarcoma and malignant lymphoma. Discussion of this association (author's transl)].

Kaposi's sarcoma was diagnosed in a 62 year old female at the last stage of an indefined malignant lymphoma. Clinically and histopathologically, some cutaneous aspects were consistent with mycosis fungoides. However, the histological examination of lymph-nodes led to the diagnosis of Hodgkin's disease, sometimes associated with features of Kaposi's sarcoma. During the past few years, the occurrence of Kaposi's sarcoma in the course of cancers, malignant lymphomas and especially during Hodgkin's disease, has been reported. It has been suggested that immunosuppressive therapy undertaken for the initial tumor could account for a viral carcinogenesis. In this respect, the vascular proliferation observed in Kaposi's sarcoma could be compared with the lymphocyte induced angiogenesis, which occurs during the experimental graft versus host reaction. Therefore, Kaposi's sarcoma could be the result of a tumoral rejection. In the case of our observation, it does not seem possible to diagnose an angio-immunoblastic lymphadenopathy; but it is of interest to note that, in this later disease, histological features of vascular neogenesis have also been reported.

Diagnosis, Differential

[Streptozotocin and malignant insulinomas. Apropos of the case. Review of the literature].

In spite of possible toxicity streptozotocin now appears to be the best treatment for malignant islet cell tumour with liver metastases, i.e. inoperable tumours with a poor prognosis either due to extension of the tumour itself or due to hypoglycemic attacks. Out of about 60 patients thus treated, 1 to 2 years survival were obtained. 22 out of 52 patients reported by Broder and Carter are still alive and one may estimate the overall percentage of favourable results at 65%. On the other hand out of another 100 patients treated elsewhere with this antineoplastic agent, only a few cases of carcinoid tumour gave encouraging results. The course of the others was not modified significantly.

Adenoma, Islet Cell