[Clofazimine-induced enteropathy: a case report with ultrastructural study (author's transl)].
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Biomedical subjects
Publications and source records attributed to J Devaux.
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The authors report a case of enteropathy due to clofazimine treatment for prurigo nodularis. The drug usually restricted to the treatment of leprosy has sometime been given to patients suffering from skin diseases because of its assumed anti-inflammatory effects. When high dosage of clofazimine treatment is carried on during a long period, and drug accumulates in the tissues and precipitates as a solid. This crystal storage in the lamina propria of the jejunal mucosa and in the mesenteric lymph nodes accounts for an enteropathy, sometime severe but slowly regressing after drug withdrawal. The electron microscopic study shows the prints of these crystals in autophagic vacuoles of histiocytes.
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Human embryonic cell cultures, infected with the Mouse sarcoma virus, complex (Moloney isolate), produced a virus that specifically transformed mink lung cells. The non-transforming helper virus could infect Mouse cells as well as a wide range of other mammalian cells. These observations could suggest the presence of either several viruses in the virus stock and/or stable recombinants.
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The authors report four cases of cardiovascular signs in pancreatitis in patients aged between 31 and 42 years. They then consider the main aspects observed. T-wave disorders, pericarditis, myocardial infarction and coronary heart disease and arterio-pancreatic syndrome. They consider the points in common between myocardial infarction and acute pancreatitis and then review the various pathogenic theories proposed.
The lacrimals glands may be the focus of the pleomorphic tumours with the same property as the major and minor salivary glands. Their localisation causes different clinical and therapeutic consequences. The cylindromes or Adenoid Cystic Carcinoma are to be put on a parallel with the pleomorphic tumours, though the issue of the clinical evolution is very different for each of them.
Seasonal changes in size-fractionated alkaline phosphatase activity (APA) were studied in the hypereutrophic Villerest reservoir (Roanne, France) to determine whether the APA showed seasonal variations coupled to abiotic and biotic variables. Samples were collected at different depths from November 1992 to October 1993. The phosphatase activities were measured spectrophotometrically with pnitrophenyl phosphate as the substrate and related to protein concentrations. No correlations were found between APA and soluble reactive phosphorus concentrations during an annual cycle. Free phosphatases were particularly high in the epilimnion (54.5% of total activity was at 5 m) and decreased with depth (4% of total APA at 40 m). The contribution of small microorganisms to APA increased with depth. It was concluded that APA is not a valid quantitative test of the phosphorus status of aquatic microorganisms.
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Méditerranean Periodic Disease is frequently encountered in non-aschenazic Jews and in Armenians. Aside from the classic triad of pseudo-palustral febrile crises, paroxysms of abdominal and articular pain, and a biological syndrome of inflammation; cutaneous manifestations were noted in 25 to 35% of the cases according to various authors. The most commonly encountered lesions consisted of erysipel-like plaques and subcutaneous nodules. We observed the case of a 47 years old Armenian male, afflicted with Mediterranean Periodic Disease for 30 years in which the dermatologic symptoms are quite classic aside from a vitiligo having progressively appeared since 15 years. Possibly a coincidental association, but to the best of our knowledge, which has not as yet been reported.
A typical case of Montgomery xanthomatosis is reported by the authors. Out of this case and of a hundred other ones gathered from the literature, they outline the main features of the disease. It is revealed as being stereotyped and particularly the prognosis is usually good. Whether the ultra structural study may show Langerhans corpuscules or not, it brings us a material to the discussing of border-line cases (xanthomatosis with diabetes insipidus, Hand-Schüller-Christian disease with cutaneous lesions similar to Montgomery's.
The authors report a case of a forty-six year old woman suffering from generalized prurigo nodularis. This dermatosis was associated with a cellular immunodeficiency; therefore a clofazimine therapy 300 mg/a day was instituted for six months. Ten months after the cessation of the clofazimine therapy, there appeared a malabsorption syndrome that was temporarily improved by gluten--free diet the real etiology was only ascertained during laparotomy, when masses of crystals in the small intestine mucosa as well as in mesenteric lymph nodes were observed. Therefore when it is necessary to prescribe clofazimine to take advantage of become its immunoregulating properties, it must always become in mind that an intestinal complication may ensue: this is well recognized in articles appearing in journals devoted to leprosy.