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Biomedical subjects

S Lecoules

Publications and source records attributed to S Lecoules.

At least 19 recordsLinked to original sources

[Pancreatic peritoneal fistula with bisalbuminemia].

INTRODUCTION: Pancreatic fistulas are a complication that occur in 3 to 15% of cases during the progression of chronic or acute pancreatitis, usually alcohol-induced. Bisalbuminemia is characterised by two albumin fractions on serum protein electrophoresis. The presence of Bisalbuminemia is inconsistent and has only rarely been reported. OBSERVATION: A 42 year-old man, excessive drinker, developed pancreatic ascites related to a pancreatic-peritoneal fistula and associated with transitory bisalbuminemia. Treatment was medical with good short term results. DISCUSSION: Ascites was secondary to a pancreatic-peritoneal fistula. It can be constitutional or acquired and transitory, and secondary to prolonged treatment with b-lactamines in a patient with kidney failure or a pancreatic fistula.

Adult↗

[Inflammatory pseudotumor of lymph node].

INTRODUCTION: Inflammatory pseudotumor of lymph node is a rare case in the etiology of fever of unknown origin. OBSERVATION: We report the observation of a woman, aged 40, hospitalized with intermittent fever revealing under-diaphragm adenopathy related to inflammatory pseudotumor of lymph node. CONCLUSION: Inflammatory pseudotumor of lymph node is a rare pathology whose nosological definition is unclear. It should probably be considered as belonging to a category different from the inflammatory pseudotumor of other organs. The diagnosis presents itself in case of isolated adenopathy or prolonged fever and is based on an anatomopathology that essentially calls to mind a lymphoma. The evolution of the condition is shown to be favorable : it can lead to a spontaneous remission, or call for a non-steroid anti-inflammatory treatment, or a steroid therapy.

Adult↗

[Laryngeal disorder revealing unrecognized pulmonary tuberculosis].

Laryngeal tuberculosis is exceptional and identification in this localization can reveal clinically unrecognized pulmonary tuberculosis. We report two cases illustrating this situation. The pseudo-tumor aspect observed at endoscopy may be wrongly suggestive of neoplasia. Bacteriological examination provides the diagnosis. New methods of genomic diagnosis (Gen-Probe) and culture now allow particularly rapid diagnosis. Outcome is always favorable with standard anti-tuberculosis treatment.

Adult↗

[Recurrent Kikuchi's disease in a patient with discoid lupus].

INTRODUCTION: Histiocytic necrotizing lymphadenitis, also called Kikuchi-Fujimoto's disease (KD), usually occurs in young women and is characterized by localized lymphadenitis (mostly cervical) usually associated with fever. Diagnosis relies on histopathological and immunohistochemical analysis of involved lymph node. KD is considered to be the clinical expression of an inadequate immunological reaction, resulting in a self-limited hyperstimulation of the lymphoid tissue, trigerred by an antigenic infectious stimulation. The clinical course is usually benign with a spontaneous remission of symptoms. Recurrence is very rarely observed. KD may be associated with systemic lupus erythematosus, whereas the association with chronic discoid lupus has only been rarely reported. EXEGESIS: We report a case of KD recurrence, 9 years after the initial diagnosis, in a young eurasian woman, with a chronic discoid lupus erythematosus. CONCLUSION: KD is a benign disease with a spontaneously good outcome. Recurrence may rarely occur many years after the initial diagnosis but needs a new histopathological confirmation. Systemic or even cutaneous lupus erythematosus may be associated with KD. Although unfrequent, this association suggests that both diseases could share a common pathogenesis.

Adult↗

[Hip arthroplasty in genetic hemochromatosis. Report of 5 cases].

INTRODUCTION: Half of the patients with genetic hemochromatosis will have arthritis. Two of these articular involvements are well-known: the arthropathy involving the phalangeal and the metacarpophalangeal joints of the hand, useful for diagnosis, and hip arthropathy. Iron deposits seem to be involved in articular cartilage destruction. EXEGESIS: We report five cases of patients with hemochromatosis hip involvement. Hip arthropathy revealed hemochromatosis in one case and appeared despite efficient phlebotomies in another case. Three of these patients required hip arthroplasty. CONCLUSION: Hip arthropathy remains a frequent but unknown event in genetic hemochromatosis (12.5%) and it involves the functional prognosis.

Aged↗

[A new type of iliac fracture caused by bone insufficiency].

BACKGROUND: The iliac bone is an uncommon localization for bone insufficiency fractures. We report a new type. CASE REPORT: A 51-year-old woman with post-menopause osteoporosis was seen for a fracture of the ischio-pubic branch of the iliac bone. X-ray also revealed an unknown fracture situated above the anterior superior iliac spine continuing cranially and medially towards the iliac crest. DISCUSSION: Three types of iliac fractures due to bone deficiency have been described. Type 1, (oblique iliac), the fracture is oblique beginning in the greater sciatic notch and extending a more or less into the iliac wing. Type 2 (superior medial iliac) involves the most medial part of the iliac wing, approximately parallel to the sacroiliac joint. In type 3 (supra-acetabular), the fracture is in a supra-acetabular localization. Our case suggests a fourth type should be individualized.

Alendronate↗

[Tiopronin-induced nephrotic syndrome with minimal glomerular lesions].

BACKGROUND: In the very large majority of cases, nephrotic syndrome with minimal glomerular lesions is an idiopathic condition. Drugs can favor the glomerulopathy. The effect of non-steroidal antiinflammatory drugs is well known, but other drugs, particularly tiopronin may be incriminated. CASE REPORT: A 73-year-old patient developed severe nephrotic syndrome with minimal glomerular lesions 6 weeks after tiopronin therapy was initiated. Complete and spontaneous remission of the nephrotic syndrome was achieved 5 weeks after drug withdrawal. No recurrent lipoidic nephrosis has been observed at 3 years follow-up. CONCLUSION: Tiopronin-induced nephrotic syndrome with minimal glomerular lesions is usually severe and develops rapidly. Remission occurs rapidly after drug withdrawal. Weekly urine checks with dip-strips should be proposed in patients treated with tiopronin.

Aged↗