Cyclosporine-induced hyperuricemia and gout in renal transplants.
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Biomedical subjects
Publications and source records attributed to Z Bahloul.
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Treatment of rheumatoid arthritis (RA) with D-penicillamine (DP) is associated with development of dermatopolymyositis (DPM) in 0.2 to 1.2% of cases. A case of DPM which developed after four years DP therapy in a 58-year-old female with RA is reported. The favorable outcome after discontinuation of DP and administration of corticosteroids and the absence of recurrence or malignant disease after 4 years 9 months follow-up demonstrated the causal relationship between DP therapy and development of DPM. An analysis of 34 previously published cases of DP-induced DPM (DP/DPM) showed the following: development of DPM was not influenced by the dosage or duration of DP therapy; reported cases of DP/DPM were clinically identical with primary DPM but had a different outcome, with permanent recovery of DP/DPM occurring 1.5 to 6 months after withdrawal of DP; patients with DP/DPM had immune disorders, including antinuclear antibodies in 14 of 34 patients; the high prevalence of the B18, B35, DR4 haplotype in these patients denotes immunogenetic differences with primary DPM patients (B8-DR3) and DP-induced myasthenia (DR1).
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The occurrence of Gougerot-Sjögren syndrome in a context of dysthyroidism is not a chance happening, as is reflected by the 37% rate of incidence. Routine labial biopsy, carried out in 59 cases of primary hypothyroidism due to atrophic thyroiditis, 20 of Basedow's disease and 4 of Hashimoto thyroiditis identified Gougerot-Sjögren syndrome (3-4 Chisholm grade) in 3 of the 59 cases of hypothyroidism i.e. in 5 percent, and in one Basedow case out of 20, i.e. 5 percent. Using Kaplan's criteria, the incidence of Gougerot-Sjögren syndrome rises to 22 percent in hypothyroidism and 30 percent in Basedow's disease. Consequently, the incidence of Gougerot-Sjögren syndrome is higher in Basedow disease than in primary hypothyroidism. Gougerot-Sjögren syndrome is seen particularly in dysthyroidism involving manifest and all-round clinical signs. This association does not seem to result from one disease being caused by the other, but the outcome of the onset of entities to which a genetically determined context predisposes the subject, as is shown by the prevalence of HLA DRW3 and HLA B8 groupings in Gougerot-Sjögren syndrome, in primary hypothyroidism, in Basedow's disease and in Hashimoto's thyroiditis.
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