[D-penicillamine in rheumatoid arthritis : hematological incidents and accidents (author's transl)]. / La D-pénicillamine dans la polyarthrite rhumatoide : incidents et accidents hématologiques.

From literature data and their own experience, the authors comment hematological complications, related to the use of D-penicillamine, mainly in theumatoïd arthritis. Hypereosinophilia is more common than thrombopenia, but, both complications are usually benign. Anemia alone is very rare. Leukopenia appears in 6% of treated patients, but pancytopenia is rare. Leukopenia and pancytopenia are the most severe complications, even fatal in some cases. The safest dose of D-penicillamine seems to be between 600 and 900 mg per day, provided that, however, regular hematological controls may be achieved.

[Dorsal medullary compression in vertebral hyperostosis]. / Compression médullaire dorsale au cours de l'hyperostose vertébrale.

The authors present two observations of dorsal medullary compression by intraspinal benign osseous proliferations developing in subjects who present with anterior vertebral hyperostosis. In the second observation operative intervention confirmed the site and nature of the lesion. The authors have researched the same radiological findings in other cases of vertebral hyperostosis. They describe the lesions which are of considerable practical importance as they are able to injure the spinal cord and the nerve roots, resulting in a hyperostotic dorsal myelopathy. All unexplained paraplegias should be investigated for such lesions by meticulous tomographic studies.

[The hip in vertebral hyperostosis]. / La hanche dans l'hyperostose vertébrale.

The study of two series of cases affected by vertebral hyperostosis allows the authors to underline the frequency with which the hip joint is affected and to describe the destructive forms seen in hyperostosis of the hip. In a first series of 101 cases the authors picked up 145 pathological hips which were probably or surely associated with hyperostosis. These hip disorders presented in three types: Type I (already described by J. Forestier et al.) with peri-articular proliferation and radiological integrity of the joint space; Type II with hyperostotic proliferation and narrowing of the joint space; Type III with epiphysial destruction. The study of a second series "of the development of 58 cases of hyperostotic hip disease" followed for 2-16 years raises the consideration that these three types are in fact three stages in the evolution of the condition.

[Quantitative bone biopsy and primary hyperparathyroidism, its role in diagnosis. Apropos of 45 cases]. / Biopsie osseuse quantitative et hyperparathyroïdie primitive. Intérêt pour le diagnostic. A propos de 45 cas

Iliac bone biopsy, including a quantitative study, was carried out in 38 patients with primary hyperparathyroidism (34 surgical patients, 4 with typical syndromes based on laboratory analysis). A second biopsy was carried out in 7 cases. By studying both the surface resorption of the strands of the spongy tissue and periosteocyte osteolysis (an indirect measure by assessment of the surface aera of the periosteocyte lacunae), it is possible to arrive at a histological diagnosis of hyperparathyroidism in 98 percent of cases: surface resorption is increased in 82 percent of cases; the periosteocyte lacunae are enlarged in 91 percent of cases; the two criteria together give a positive result in 44 cases out of 45 (98 percent). This morphometric study is particularly valuable in those cases in which the qualitative histological appearance is not very informative.

[Role of vertebral hyperostosis in cervical myelopathies]. / Rôle de lhyperostose vertébrale dans les myélopathies cervicales

The authors analysed the case histories of 40 patients with cervical myelopathy and were struck by the frequency of associated vertebral hyperostosis (Forestier and Rotès-Quérol disease). They found 17 cases in which dorsal vertebral hyperostosis was indiscutable and in which there was acquired stenosis of the cervical canal related to the bony proliferations that had developed on the anterior face of the cervical canal and to the type of cells described by Forestier and Rotes-Querol on the anterior and lateral faces of the vertebral column. According to the present authors these posterior growths occurred in a site that has not previously been described for hyperostosis. These growths are likened to those observed by Japanese neurosurgeons since 1960. Their particular interest concerns their role in pathology.