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X Puechal

Publications and source records attributed to X Puechal.

10 recordsLinked to original sources
PubMed2005

The usefulness of bone remodelling markers in predicting the efficacy of pamidronate treatment in SAPHO syndrome.

OBJECTIVES: Pamidronate has recently been used in SAPHO syndrome due to its anti-osteoclastic effect. The aim of this study is to determine the usefulness of bone remodelling markers for determining the efficacy of pamidronate treatment. METHODS: Thirteen patients with SAPHO syndrome were treated with pamidronate. The treatment evaluation was done using a visual analogue scale (VAS) and also erythrocyte sedimentation rate, C-reactive protein, serum crosslaps (sCTX) and osteocalcin initially and after 3 months. A relevant clinical response was defined as an improvement in VAS of at least 40%. RESULTS: At 3 months, 7 of 13 patients had a good clinical response, as previously defined. Five of the seven patients maintained the good response over 6 months. Before the first perfusion 6 of the 13 patients had increased sCTX (upper 3250 pmol/l). In this small cohort we tried to analyse whether the increase in bone remodelling markers was associated with a good clinical response. In the responders group the mean levels of sCTX and osteocalcin at baseline were 6783.17 and 24.66, respectively, and in the non-responders group the levels were 2152 and 11.8, respectively. There was a significant difference in sCTX between the responders and the non-responders (P = 0.0044). CONCLUSION: Infusion of pamidronate is effective in SAPHO in some patients. Increased sCTX might be a prognostic marker for a good clinical response but results have to be confirmed in a larger cohort.

Acquired Hyperostosis Syndrome↗
PubMed2005

No evidence for association between 1858 C/T single-nucleotide polymorphism of PTPN22 gene and primary Sjögren's syndrome.

One-third of first-degree relatives of patients with primary Sjögren's syndrome (pSS) suffer from other autoimmune diseases, including type I diabetes, systemic lupus erythematosus and autoimmune thyroiditis. Recently, 1858 C/T polymorphism of PTPN22 gene was reported to predispose to these autoimmune diseases. We decided to investigate whether PTPN22 gene polymorphism was also involved in the genetic predisposition to pSS in a case-control study, including 183 patients with pSS and 172 healthy controls. No significant differences in allele (T allele frequency: 7.7% in patients with pSS vs 7.8% in controls, P=0.9) and genotype frequencies of PTPN22 polymorphism were detected between patients with pSS and controls. PTPN 22 gene polymorphism was not associated with a specific pattern of autoantibody secretion either. Thus, 1858 C/T polymorphism of PTPN22 gene is not involved in genetic predisposition to pSS.

Autoantibodies↗
PubMed2001

Treatment resistant Lyme arthritis caused by Borrelia garinii.

Lyme arthritis is caused in Europe by three main pathogenic species of Borrelia burgdorferi sensu lato: Borrelia burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii. Because few synovial samples have yet been analysed by species-specific DNA amplification methods, further studies are needed to define the spectra of clinical manifestations associated with these different species. Two cases of treatment resistant Lyme arthritis are reported here, in which DNA amplification of the flagellin gene followed by dot-blot hybridisation in the synovial fluid identified B garinii as the causative agent. Clinical and biological data did not differ from the usual descriptions of Lyme arthritis, but as the recently reported molecular mimicry between OspA and hLFA1 is not applicable to B garinii, the pathogenesis of the present cases remains unclear. Future studies should aim at assessing the role of B garinii in European Lyme arthritis and its possible pathogenic and therapeutic consequences.

Adult↗
PubMed2001

[Septic arthritis of a lumbar facet joint. A case report].

Septic arthritis of the posterior lumbar joints is extremely rare in comparison with spondylodiscitis which is much more common. We report a case of an 86-year-old women with septic arthritis of the left L4-L5 lumbar facet joint associated with endocarditis. Arthritis diagnosis was made on CT scan and MRI, infection by Staphyloccocus aureus was proved by blood cultures. Heart growth was seen by echocardiography. Twenty-three cases were reported in the literature. Clinical and biological data failed to discriminate between facet joint septic arthritis and spondylodicitis. Diagnosis is established on imaging findings, computed tomography and magnetic resonance imaging, completed by blood cultures and, if they are negative, by aspiration-biopsy. Appropriate antimicrobial therapy is usually successful. Some back pain generally persists. In conclusion, lumbar pain with fever without spondylodiscitis is suggestive of septic arthritis of a lumbar facet joint. Epiduritis associated in 60% patients requires rapid treatment.

Aged↗
PubMed1997

[Hepatic distomatosis of tumor form after prolonged treatment with corticoids].

A 49-year woman, living in Cameroun and treated by steroids for connective tissue disease, was admitted for a liver mass and epigastric pain. An increase in blood count of eosinophils (1,590.10(9)/L) was observed. Imaging examination showed the presence of a voluminous, multilocular, and heterogeneous hepatic lesion. Pathological examination of the liver showed no evidence of tumor but revealed a rounded cuticle remnant, compatible with bilharziosis eggs or loase transversal section, and Charcot-Leyden's crystals. Due to the uncertainty of diagnosis, a right hepatectomy was performed. Pathological and parasitological examination of the surgical specimen confirmed the diagnosis of hepatic distomatosis, with typical eggs of Fasciola hepatica within necrotic tissue, surrounded by eosinophilic inflammatory infiltrates. Specific serology was positive. The presence of intraparenchymatous eggs was unusual and reflected the ectopic migration of a mature fluke into the hepatic parenchyma, even though the worm was not found in the surgical specimen. Serology for fascioliasis should be performed in any patient suffering from hepatic lesions with eosinophilia.

Diagnosis, Differential↗
PubMed1995

Treatment of rheumatoid arthritis with platelet activating factor antagonist BN 50730.

OBJECTIVE: To determine the efficacy and safety of a platelet activating factor (PAF) antagonist, BN 50730, in patients with rheumatoid arthritis. METHODS: Ten patients with an active disease were treated for 4 weeks with a PAF receptor antagonist, BN 50730, given orally (40 mg twice daily). The treatment period was followed by a 4 weeks followup period. RESULTS: Clinical indicators of disease activity significantly improved during the treatment period, with a progressive return to baseline values during the followup period. No significant change in laboratory variables was observed. The tolerance of the treatment was excellent, and no clinical or laboratory evidence of side effects was recorded. CONCLUSION: These results need to be confirmed in a controlled study, but suggest an antiinflammatory effect. PAF antagonists could represent a new class of therapeutic agents in inflammatory arthropathies.

Adult↗
PubMedDate not supplied

Chronic erosive arthritis associated with an unusual intestinal bypass.

We describe an unusual intestinal bypass arthritis in a 37-year-old man. The intestinal bypass was unusual because the intestinal blind loop was entirely composed of colon. The arthritis was first a typical bypass arthritis but later resembled rheumatoid arthritis. In spite of this resemblance, all rheumatic symptoms disappeared after jejunocaecal reanastomosis.

Adult↗