Biomedical subjects
Publications and source records attributed to J L Gerbal.
The first case of fatal fulminant hepatitis probably caused by nilutamide, a non steroidal antiandrogen derivative, is reported. Nilutamide administration had been continued for 6 days after the occurrence of jaundice, 52 days after beginning of treatment. The rapidly fatal outcome might have been promoted by coadministration of phenobarbital.
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A case of cardiopulmonary bilharziasis is studied in a female, 21 years old, from Senegal, infested by Schistosoma haematobium. With praziquantel, the patient was cured in 16 months. The cardiopulmonary bilharziasis is more frequent on pathological examination than in clinical features. The diagnosis of cardiopulmonary bilharziasis is made by pulmonary biopsy which shows an occlusive angiitis with chronic inflammatory cells, and arteriolar medial hypertrophy. The prognosis is dependent upon development to schistosomal cor pulmonale and right ventricular failure. The newly developed drugs are effect in cardiopulmonary bilharziasis, in experimental studies.
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HBs antigen was found in the cerebrospinal fluid of a patient with acute type B virus hepatitis and Guillain-Barré syndrome. At the onset of the neurologic disease, immunological study of the spinal fluid revealed local synthesis of immunoglobulins and, in particular, anti-double-stranded DNA IgG antibodies. These abnormalities disappeared when the neurologic syndrome remitted. These findings suggest the extension of viral aggression to the central nervous system, perhaps at the onset of the neurologic disease.
A 21-year-old man with coeliac disease and dermatitis herpetiformis presented successively with erosive ileitis (warranting surgical resection) and erosive jejunitis (proven by jejunoscopy). Discontinuous antibiotic therapy was associated with a gluten-free diet and evolution was favorable as judged with five years follow-up. Malabsorption with mucosal ulcerations can be due to: a) chronic ulcerative duodeno-jejuno-ileitis or Jeffries' disease; b) coeliac disease which may be classified as possible, probable, or certain according to the strictness of criteria. Our case is the fourth in which a villous response was proven after gluten-free diet. It is also particular in that the erosions were superficial; c) malignant lymphoma which can reasonably be excluded here. This observation confirms that a gluten-free diet may be effective after surgical resection of the ulcerated segment in complicated coeliac disease and shows that antibiotics may be an useful adjuvant to therapy.
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Malignant hemangioendothelioma, localised to the skeleton of the lower limbs, to the exclusion of any other bony or visceral involvement, complicated by hemolytic anemia and spontaneous fractures, edl to death in spite of bilateral amputation, less than one year after its chance discovery. The multifocal character of the bony lesions, which is common, may suggest either rapidly developing metastases, or multicentric development of the tumour. The clinical, radiological and laboratory signs--pure osteolysis of large size without condensation nor periostosis, are not specific. Pathological examination permits recognition of the vascular origin of the tumour but does not always permit one to recognize its malignant nature. Treatment, which is mainly surgical, is often ineffective.
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