[Intraorbital involvement in multiple myeloma]. / Localisation intraorbitaire du myélome multiple.

According to data from the literature, intraorbital involvement in multiple myeloma is rare. Such involvement may result in exophthalmia, itself the first manifestation and presenting feature of myeloma. These lesions can respond remarkably to radiotherapy. The authors present a new case report.

[Superior caval syndrome caused by chronic mediastinitis in Behçet's disease]. / Syndrome cave supérieur par médiastinite chronique au cours d'une maladie de Behçet.

We report a case of Behçet disease complicated by superior vena cava syndrome secondary to extrinsic compression by mediastinal fibrosis. This association is not reported in literature. The habituel etiology of vena cava syndrome in Behçet disease is venous thrombosis. Radiological investigations of this syndrome are necessary to avoid an useless anticoagulant therapy.

[Spontaneous subcapsular hematoma of the kidney during periarteritis nodosa]. / Hématome spontané sous-capsulaire du rein au cours d'une périartérite noueuse.

The authors report a case of spontaneous bilateral subcapsular haematoma of the kidney in a patient with polyarteritis nodosa. Although often easy to diagnose, the aetiology of these spontaneous subcapsular haematomas is sometimes difficult to establish despite ultrasonography and computed tomography. The authors emphasise the value of arteriography in these cases, which may reveal pathognomonic signs of polyarteritis nodosa. In this case, the diagnosis was established on the basis of arteriographic findings and the American College of Rheumatology criteria and not on histological criteria.

Embolization of cardiac myxomas masquerading as polyarteritis nodosa.

Cardiac myxomas are rare tumors which can mimic other diseases. We describe a 19-year-old man who presented clinically with polyarteritis nodosa (PAN). Muscle biopsy showed vasculitis, but corticosteroid and immunosuppressive therapy was initially effective. Cardiac myxomas were found by echocardiogram when the disease relapsed and were resected surgically. Segmental arterial aneurysms and stenoses were found on angiography after leg ischemia. We suggest that echocardiography should be performed in all cases of clinically suspected PAN.

[Lupus vasculitis]. / Vascularites lupiques.

Anatomical studies have demonstrated the high incidence of vasculitis in SLE, the appearances of which are variable and non-specific, ranging from necrotizing angiitis which is undistinguishable from periarteritis nodosa, to scarring lesions. Micro-angiitis is easily demonstrated in skin lesions and is also encountered to varying degrees in CNS, renal, cardiac, pulmonary and gastrointestinal localisations. Disease of large vessels is more rare and sometimes causes gangrene of the limbs. In SLE, vasculitis should be distinguished from thrombosis related to lupus anticoagulant and from atherosclerosis favoured by chronic steroid therapy but perhaps initiated by vascular deposits of immune complexes during the acute inflammatory stage. The treatment of lupic angiitis is mainly based on steroid therapy. The results are variable, probably due to the fibrous nature of some of the vascular lesions.