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Biomedical subjects

M A Hamidou

Publications and source records attributed to M A Hamidou.

13 recordsLinked to original sources
PubMed2002

Value of autoantibodies to beta(2)-glycoprotein 1 in the diagnosis of antiphospholipid syndrome.

OBJECTIVES: To define the specificity and positive predictive value of anti-beta(2)-glycoprotein 1 (anti-beta(2)GP1) antibodies for the diagnosis of antiphospholipid syndrome (APS). METHODS: We determined the presence of anticardiolipin (aCL) antibodies and anti-beta(2)-glycoprotein 1 (anti-beta(2)GP1) immunoglobulin (Ig) G and IgM in 191 consecutive sera from 191 patients and reviewed clinical data separately. aCL IgG and IgM were detected separately using commercial ELISA kits. Anti-beta(2)GP1 antibodies were detected with an in-house ELISA using beta(2)GP1. RESULTS: Seven patients were diagnosed as having APS and 184 as having other diseases. Thirty-six patients were aCL-positive and 12 were anti-beta(2)GP1-positive, seven of these 12 were APS patients. The specificity for anti-beta(2)GP1 in our population was 97%, with a positive predictive value (PPV) of 58%. Among the aCL-positive patients, specificity was 90% and PPV 70-87%. CONCLUSIONS: This study shows that anti-beta(2)GP1 antibodies have a higher specificity and PPV than aCL for APS. The PPV of anti-beta(2)GP1 was greater in aCL-positive than in all patients. We conclude that screening for anti-beta(2)GP1 antibodies in aCL-positive patients increases the specificity and the PPV of aCL testing. In addition, we show that there is no need to screen for anti-beta(2)GP1 antibodies in the absence of aCL antibodies and in the absence of strong clinical suspicion of APS.

Adult↗
PubMed2001

Systemic medium-sized vessel vasculitis associated with chronic myelomonocytic leukemia.

OBJECTIVE: To determine the clinical aspects of systemic vasculitis associated with chronic myelomonocytic leukemia (CMML). METHODS: In this retrospective study, 8 patients suffering from systemic vasculitis associated with CMML are described. The French and English literature on systemic vasculitis associated with myelodysplasia was reviewed. RESULTS: All 8 patients had a systemic medium-sized vessel vasculitis which fulfilled the American College of Rheumatology criteria for polyarteritis nodosa in the setting of active CMML. Antineutrophil cytoplasmic antibodies (ANCA) were negative in 7 patients. One patient had cytoplasmic ANCA by indirect immunofluorescence without antiproteinase 3 or antimyeloperoxydase antibodies on the enzyme-linked immunosorbent assay. At presentation, 6 patients had fever of unknown origin, 5 had polymyalgia rheumatica, 3 had sensory hearing loss, and 4 had eosinophilia. None had viral infection or drug-associated vasculitis. Diagnostic procedures included renal or hepatic angiography in 6 patients which showed microaneurysms in 4, skin and temporal artery biopsy in 2 which showed vasculitis, and 1 postmortem examination which showed gastroduodenal arteritis. All patients were treated with corticosteroids, and 7 received immunosuppressive drugs. Death was attributable to vasculitis in 2 cases, infection in 3, and other vasculitis-related causes in 2. In a review of the French-English literature, we found 11 similar cases of ANCA-negative systemic vasculitis, generally associated with refractory anemia, with or without blast excess. CONCLUSIONS: Systemic ANCA-negative polyarteritis nodosa-type vasculitis seems closely associated to CMML. Clinical presentation is nonspecific, and systemic vasculitis should be suspected when a patient with myelodysplasia develops atypical manifestations. Renal, gastrointestinal, or hepatic angiography are useful diagnostic procedures when more invasive biopsies should be avoided because of low platelet count. The prognosis of CMML-associated systemic vasculitis is poor.

Aged↗
PubMed2001

Systemic antineutrophil cytoplasmic antibody vasculitis associated with lymphoid neoplasia.

Two cases of systemic antineutrophil cytoplasmic antibody (ANCA) vasculitis in the setting of chronic lymphocytic leukaemia and angioimmunoblastic lymphadenopathy type T cell lymphoma are reported. The two patients had fever of unknown origin associated with cutaneous vasculitis and "pulmonary-renal syndrome" with alveolar haemorrhage. Despite anti-infectious treatments, steroids, and chemotherapy, the vasculitis had a fatal paraneoplastic course in several weeks. When infection is excluded in patients with malignancy, atypical features should be promptly investigated for systemic vasculitis, and an ANCA test performed.

Aged↗
PubMed2000

Prevalence of rheumatic manifestations and antineutrophil cytoplasmic antibodies in haematological malignancies. A prospective study.

OBJECTIVE: To evaluate the prevalence of antineutrophil cytoplasmic antibodies (ANCA) and rheumatic manifestations associated with chronic haematological malignancies. METHODS: Two groups of patients were prospectively studied (group I: 60 patients with myelodysplastic syndromes and group II: 140 patients with lymphoid malignancies) for clinical 'immune' manifestations and ANCA. RESULTS: In the myelodysplastic group, six patients had ANCA-negative systemic medium-size vasculitis, one had systemic vasculitis with cytoplasmic ANCA, one relapsing polychondritis, one giant cell arteritis, one polymyalgia rheumatica, one polyarthritis and two fasciitis. In group II, two patients had ANCA-negative systemic vasculitis, two had leucocytoclastic vasculitis associated with tuberculosis, two had polyarthritis, one polymyalgia rheumatica and one giant cell arteritis. Six sera were ANCA-positive with perinuclear pattern in four cases, atypical pattern in one and cytoplasmic pattern in one. Two sera had anti-myeloperoxidase (MPO) specificity, and others had no known specificity; none had anti-proteinase 3 (PR3) specificity. Global prevalence of ANCA in our cohort was 3%, similar to the French general population. CONCLUSION: Polyarteritis nodosa-type systemic vasculitis and polymyalgia rheumatica were the most frequent findings (18%) in myelodysplastic syndromes and particularly in chronic myelomonocytic leukaemia. ANCA were not helpful for the diagnosis of vasculitis. Vasculitis associated with infection, in particular tuberculosis, must be ruled out.

Adult↗
PubMed1999

Henoch-Schönlein purpura associated with Toxocara canis infection.

We describe a case of Henoch-Schönlein purpura in the onset of Toxocara canis infection. The diagnosis was made in a 17-year-old boy based on the association of palpable purpura, oligoarthritis, acute abdominal pain, microhematuria, and cutaneous vasculitis. Toxocariasis, suggested by hypereosinophilia and domestic contact with a puppy, was confirmed by anti-Toxocara IgG and IgE and Western blot. Complete spontaneous resolution occurred within a few days. Transient presence of antinuclear antibodies and the absence of larvae in the skin biopsy favor an immunologic parasite induced disorder. A hypersensitivity vasculitis to Toxocara canis is suggested.

Adolescent↗
PubMed1995

Captopril and aspirin in treatment of renal microangiopathy in primary antiphospholipid syndrome.

Treatment of antiphospholipid syndrome (APS) is controversial. We report a case of renal microangiopathy in a 40-year-old woman with APS. The nephropathy was isolated without signs of disseminated thrombotic microangiopathy or progressive systemic sclerosis. Similarities with sclerodermatous kidney and an increase in plasma renin activity led us to initiate treatment with aspirin and captopril, with excellent control of the renal syndrome. We believe this therapeutic regimen may be an effective means of treating the renal microangiopathy of APS.

Adult↗