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V Fontès

Publications and source records attributed to V Fontès.

8 recordsLinked to original sources

[Pellagra and panniculitis induced by chronic bacterial colonisation of the small intestine].

INTRODUCTION: Pellagra is an exceptional disorder in France. The classical description of pellagra associates a photoinduced rash with neurological impairment and intestinal dysfunction. Without adapted treatment, the progression is fatal. CASE REPORT: A 62 year-old women developed a photoinduced rash, composed of circular and erythematous elements with pustular edges. She also had panniculitis, peripheral neuropathy, depressive mood and diarrhea. Her medical past was marked by epilepsy treated with sodium valproate and hydantoin. Biological exams revealed lowered plasma levels of vitamins PP, B1, B6 and zinc, secondary to intestinal impairment induced by bacteria proliferating in the small intestine. The rash resolved with vitamin PP and zinc supplementation. The bacterial colonisation was improved by long-term, sequential antibiotics. DISCUSSION: We report a rare clinical form of pellagroid rash. The rash was induced by chronic malabsorption resulting from excessive bacterial proliferation in the diverticules of the small intestine. The antiepileptic treatment could have facilitated vitamin PP et zinc deficiency. Panniculitis was related to the bacterial proliferation. We discuss in this paper the relationship between some vitamin deficiencies, their clinical manifestations and the direct role of intestinal bacterial proliferation in the cutaneous manifestations.

Anti-Bacterial Agents↗

[Clinical manifestations of the mouth revealing Vitamin B12 deficiency before the onset of anemia].

INTRODUCTION: The association of manifestations in the mouth and Vitamin B12 deficiency is already known. The signs are not specific to Vitamin B12 deficiency, however they may reveal the deficiency and this is often ignored and leads to delays in diagnosis. We report two cases of Vitamin B12 deficiency revealed by stomatodynia, glossitis and erosions in the mouth. OBSERVATIONS: Two women aged 51 and 76 years consulted, one for atrophic glossitis and the other for stomatodynia that had progressed over the past few months. No other symptoms were present. The biological examinations revealed isolated macrocytosis without anemia. Vitamin B12 could not be measured in the serum. The symptoms regressed in less than one month following replacement therapy. DISCUSSION: As with our two patients, the majority of cases of Vitamin B12 deficiency reported in the literature were only discovered several months or years after their onset, or were treated for other causes. Vitamin B12 deficiency leads to severe neuropathies. The neurological damage is reversible when replacement therapy is initiated early. Since the oral signs appear before the modification in the systemic markers of deficiency, it is crucial that these signs be recognized and diagnosed before the occurrence of severe after effects.

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