[Polymyositis: a rare complication of interferon alpha therapy].
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Biomedical subjects
Publications and source records attributed to N Schleinitz.
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Blood hypereosinophilia is a common finding in medical practice requiring further investigation. There are a wide range of potential causes including atopic disorder, drug allergy, parasitic infection, certain forms of immune deficiency, inflammatory process, hemopathy, and malignant disease. Diagnosis of persistent hypereosinophilia not associated with parasitic infection is one of the major diagnostic dilemmas in medicine. If through investigation fails to achieve diagnosis, idiopathic hypereosinophilia may be suspected including the possibility of essential hypereosinophilic syndrome or Chusid syndrome. The primary determination for diagnosis of hypereosinophilia involves the presence or absence of parasitic infection. If parasitic infection is ruled out, it is often difficult to distinguish benign, self-limiting forms from severe forms requiring careful surveillance and subsequent treatment. From a pathophysiological standpoint, one may ask if some eosinophilic conditions are not due to deregulation of immunologic mechanisms that normally protect the organism against parasitic infection.
Polynuclear eosinophils play a major role in host defense against infectious diseases and especially helminthiasis. Onset of hypereosinophilia can be attributed to two mechanisms which can occur separately or in combination. The first mechanism involves enhancement of medullary production and differentiation of eosinophils. The second is prolonged life span of eosinophils. Response to eosinophils depends on various cytokines including IL-5, IL-4, IL-3 and GM-CSF. Since it contains the genes coding for these cytokines, the 5q31-q33 region of chromosome 5 is the focus of study on genetic control of human hypereosinophilia. The goal of these studies is to allow screening of subjects predisposed to helminthic infection and to deregulation of immune responses that may lead to atopy and various types systemic inflammatory diseases.
Cryptococcal infections are usually described in immunosuppressed patients, but have also been described in patients with cirrhosis. We report a case of cryptococcal meningitis in a 62 year old man with Child class C alcoholic cirrhosis. Clinical signs associated mental confusion and discrete meningeal stiffness without fever. Diagnosis was confirmed by lumbar puncture which identified specific antigens and isolated Cryptococcus on Sabouraud medium. In patients with cirrhosis, cryptococcal meningitis infection should be considered in cases of isolated and unexplained mental confusion.
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Three cases of Critically Illness Polyneuropathy (CIP) are reported. The difficulty of weaning the patients from the ventilator, whereas sepsis and MOF had been successfully treated, was the main feature in the three cases. The diagnosis was established by eletromyogram, showing a primary axonal denervation of peripheral nerve fibres, which was confirmed by a pathological study in one patient.
Watermelon stomach is a rare disorder causing gastric blood loss and iron deficiency anemia. We report a case that occurred during the course of post-hepatitis C cirrhosis, which condition was dramatically improved by alpha-interferon treatment.
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