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Biomedical subjects

S Lecoules

Publications and source records attributed to S Lecoules.

28 records · Page 2Linked to original sources

[Renal manifestations of sarcoidosis. A report of nine cases].

PURPOSE: Clinical renal outbreaks occurring in the course of sarcoidosis are polymorphous. METHODS: Nine patients presenting with sarcoidosis were followed up for 18 years. RESULTS: Five patients presented with chronic interstitial nephritis. Renal failure accompanying granuloma was also present in three of them. Corticotherapy allowed rapid improvement in renal function in three patients. In two other cases, late treatment prevented recovery and led to end-stage renal failure in one case. In another case, persistent hypercalciuria was responsible for bilateral nephrolithiasis further treated via extracorporeal lithotrity. One case of mesangial glomerulonephritis and two morbid associations (retroperitoneal fibrosis and Henoch-Schönlein purpura) were observed. CONCLUSION: Interstitial nephritis is still a severe clinical renal outbreak. Corticotherapy must be prescribed early to avoid renal failure. Calcium metabolism disorders are frequent and often combined with interstitial nephritis. Hypercalcemia can often and rapidly be improved via corticotherapy, while monitoring of hypercalciuria proves to be more difficult. Membranous glomerulonephritis is still the most frequently reported glomerular lesion.

Adrenal Cortex Hormones↗

[Spontaneous dissecting aneurysm of the internal carotid artery].

INTRODUCTION: Dissecting aneurysms of the internal carotid artery are due to arterial wall dissection caused by hematoma. We report a case of spontaneous dissection. EXEGESIS: A 65-year-old man presented with painful Horner's syndrome and hypoglossal palsy, without a history of arterial traumatism. Magnetic resonance imaging showed carotid artery dissection. CONCLUSION: Distal and subadventicial dissection can induce compression of adjacent nerves without modifications of the arterial lumen. This type of wall hematoma may not be detected by ultrasonography and angiography. Magnetic resonance imaging proves to be the best method of investigation and should be primarily advocated. Anticoagulation treatment is necessary.

Aged↗

Cystic rheumatoid arthritis with Felty's syndrome and ankylosing spondylitis.

A 63-year-old man with strictly axial ankylosing spondylitis since the age of 28 years had a seven-year history of cystic seronegative rheumatoid arthritis with Felty's syndrome. Cysts were present in the hands, feet, wrists, shoulders, hips, one elbow, and one knee. There was no evidence of juxtaarticular demineralization, joint space loss, erosions, or joint destruction. Rheumatoid pannus was demonstrated within the cysts, particularly at the hip, ruling out cystic hip disease due to ankylosing spondylitis. HLA typing demonstrated the B27 and DR4 haplotypes. HLA B27 may be associated with a worse prognosis of rheumatoid hip involvement.

Arthritis, Rheumatoid↗

[Importance of the blood pressure exercise graph in the diabetic].

The evaluation of the real blood pressure in the diabetic population has a major interest. Arterial blood pressure measure during standardised exercise test could be a supplementary aid in this field of research. This retrospective work is based on 134 diabetic patients compared with age, sex and body mass index matched controls. All of them were tested with a standardised protocol of bicycle ergometer. In the diabetic group, 62 patients present a microalbuminuria over 30 mg/day. The heart rate and arterial pressure do not differ between diabetics and controls before, during, and after the exercise. The registered parameters at the top of the effort are exactly the same for the pulse the systolic and the diastolic blood pressure. Systolic blood pressure gradient during effort is not different between the two groups. The presence of microalbuminuria into the diabetic group do not provoke any modification of cardiac frequency or pressure during the effort. Nevertheless a decrease in systolic blood pressure gradient is noted into the microalbuminuria group despite their older age is in favour of an increase in this parameter. Exercise test has a main place to track down coronary disease and the field of interest is the same that non diabetic patients to find white coat hypertension, to value arterial pressure reactivity during effort of hypertensive athletes or border line hypertensives. The signification and interest of the modification of systolic blood pressure gradient should to be evaluated by other works.

Blood Pressure↗

Acute sacroiliitis as a manifestation of calcium pyrophosphate dihydrate crystal deposition disease.

While radiographic lesions of the sacroiliac joint (SIJ) are common in patients with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, they are rarely accompanied by clinical symptoms. We report the case of a 69-year-old woman who presented with an acute sacoiliitis and a linear calcification in the right SIJ on CT scan. The patient recovered well after intra-articular steroid injections.

Acute Disease↗