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1.
J Mycol Med ; 21(3): 217-20, 2011 Sep.
Article in French | MEDLINE | ID: mdl-24451567

ABSTRACT

INTRODUCTION: Mucormycosis is a rare, devastating, fungal infection, which disproportionately affects non-controlled diabetic patients, notably during ketoacidosis. The authors report the case of cervical mucormycoses with a particularly favorable evolution in diabetic woman. REPORT: A 54-year-old woman, type 2 diabetic, had presented a left lateral cervical mass. The diagnosis was confirmed by histological examination. She was treated with Amphotericin B with favorable evolution. CONCLUSION: The mucormycose is a rare infection. The treatment is medical and surgical. The prognosis is severe with an overall mortality rate of 40%.

2.
Ann Cardiol Angeiol (Paris) ; 69(3): 148-150, 2020 May.
Article in French | MEDLINE | ID: mdl-32265026

ABSTRACT

Churg-Strauss syndrome (CSS) or eosinophilic granulomatosis with polyangiitis is a systemic vasculitis characterized by necrotizing arteritis, eosinophilic infiltration and extravascular granuloma; that may involve several organs. Cardiac involvement is the first cause of death in this vasculitis. These include myocarditis, pericarditis, coronary heart disease, dysrhythmias, and rarely valvular involvement. We report the observation of CSS revealed by acute perimyocarditis.


Subject(s)
Churg-Strauss Syndrome/complications , Granulomatosis with Polyangiitis/complications , Pericarditis/etiology , Adult , Churg-Strauss Syndrome/diagnosis , Female , Granulomatosis with Polyangiitis/diagnosis , Humans
3.
Ann Endocrinol (Paris) ; 70(1): 71-5, 2009 Mar.
Article in French | MEDLINE | ID: mdl-18937931

ABSTRACT

Islet-cell tumors are the most common neuroendocrine tumors that arise from the endocrine pancreas. They are typically benign and sporadic. Diagnosis is generally established late because clinical signs lack specificity. The insulinoma is difficult to localize since it is very small in size, often not exceeding 2cm. We report an exceptional case of giant insulinoma initially revealed by a pseudo-polycythemia in an 80-year-old man. He had been treated for hypertension for a few months. Routine biological investigations showed elevated hematocrit and haemoglobin, suggesting Vaquez disease. History taking revealed recent episodes of nocturnal agitation. On admission, he had reddish skin with a suspected enlarged spleen, but total blood volume was normal. Imaging studies showed a voluminous tumor located between the pancreas and the spleen. The presence of an insulinoma was confirmed on the basis of an elevated level of proinsulin at the time of an asymptomatic episode of hypoglycemia. Spleno-pancreatectomy was performed. Histopathological examination revealed a malignant, well-differentiated neuroendocrine malignant tumor.


Subject(s)
Insulinoma/pathology , Insulinoma/surgery , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/surgery , Aged , Humans , Magnetic Resonance Imaging , Male , Pancreatectomy , Proinsulin/blood , Splenectomy , Treatment Outcome
4.
Ann Cardiol Angeiol (Paris) ; 68(4): 221-225, 2019 Oct.
Article in English | MEDLINE | ID: mdl-30685083

ABSTRACT

PURPOSE: There are authentic observations of combination of systemic lupus erythematosus (SLE) with systemic sclerosis (SS) and with polymyositis defined as overlap syndromes. The prevalence of pulmonary hypertension is unknown in SS-SLE overlap syndrome because of its rarity. The aim of our study was to precise clinical, paraclinical and evolutive features of pulmonary hypertension in patients with systemic sclerosis-systemic lupus erythematosus (SS-SLE) overlap syndrome. METHODS: Sixteen cases of SS-SLE overlap syndrome were retrospectively studied in a period of 16 years (2000-2015). SS-SLE overlap syndrome was diagnosed in the presence of at least 4 criteria of the American College of Rheumatology (ACR) for the diagnosis of SLE and a major criterion or 2 minor criteria of ACR of SS classification. Pulmonary arterial pressure (PAP) was estimated with doppler echocardiography. Pulmonary hypertension (PAH) was defined by a PAP superior than 30mmHg. We distributed groups according to the existence (Group 1) or not (Group 2) of a PAH. Epidemiological, clinical and evolutive features were compared between the two groups with bilateral fisher test (P significant if inferior at 0.05) RESULTS: Sixteen cases of female patients with SS-SLE overlap syndrome with a middle-age of 39 years, extreme (29-58 years) were studied. PAH complicated the evolution of SS-SLE overlap syndrome in six cases with a middle-age of 41 years. Ten patients of the group 2 had an average age of 40 years. The average age of the beginning of the disease was 28 years in the group 1 and 31 years in the group 2. SS preceded SLE in 6 among 16 cases (Group 1: 2/6, Group 2: 4/10). SS was revealed most frequently by Raynauw's Syndrome in both groups (Group 1: 4/6, Group 2: 7/10). Cutaneous and articular involvements were the most frequent observed manifestations of SLE (Group 1: 5/6, Group 2: 6/10). In the group 1, the PAH was discovered approximatively11 years after the beginning of the SS-SLE overlap syndrome. The average PAP was 52mmHg, extreme (32-80mmHg). A right cardiac insufficiency complicated the evolution of the PAH in 3 cases. The PAH was primitive in 3 cases. There was no significant difference concerning the SS-SLE overlap syndrome onset disease symptoms, the frequency of lung involvement and esophageal, neurological, articular and trophic manifestations. PAH was not associated with lupic proliferative renal disease, neither with cutaneous proximal sclerosis nor with anti-Scl70 positivity. Patients were treated with vasodilator treatment in eleven cases: prostacyclin derivates in five cases and endothelin receptor antagonist in six cases. Two patients received corticosteroids and boli of cyclophosphamide for renal involvement and neurologic involvement in each case. Stabilization of PAP was observed in these two cases. Mean follow-up disease was 67 months, extreme (4-124 months) Cutaneous sclerosis evolution was not significantly different between both groups. Global cardiac insufficiency secondary to PAH caused death in one case. CONCLUSION: According to the results of our study, SS-SLE overlap syndrome complicated with PAH seems to be associated more frequently with limited and distal cutaneous manifestations. Patients that have developed lupus nephropathy and/or had positive anti-Scl70 seem to be protected from appearance of PAH during the SS-SLE overlap syndrome.


Subject(s)
Hypertension, Pulmonary/complications , Hypertension, Pulmonary/etiology , Lupus Erythematosus, Systemic/complications , Scleroderma, Systemic/complications , Adult , Female , Humans , Hypertension, Pulmonary/diagnosis , Lupus Erythematosus, Systemic/diagnosis , Male , Middle Aged , Retrospective Studies , Scleroderma, Systemic/diagnosis , Syndrome
5.
Ann Cardiol Angeiol (Paris) ; 68(4): 279-282, 2019 Oct.
Article in French | MEDLINE | ID: mdl-31466725

ABSTRACT

Cerebral amyloid angiopathy (CAA) is a entity characterized by degenerative Amyloïd deposits in the walls of the meningeal and cortical vessels. It is considered as the second cause of primitives cerebral hemorrhage in elderly. The differential diagnosis between AAC and hypertension-related cerebral small vessel diseases is difficult and represent a true challenge for the clinician. We report two cases of cerebral small vessel diseases revealed by malignant hypertension.


Subject(s)
Cerebral Amyloid Angiopathy/diagnosis , Cerebral Small Vessel Diseases/diagnosis , Cerebral Small Vessel Diseases/etiology , Diagnosis, Differential , Humans , Hypertension/complications , Male , Middle Aged
6.
J Med Vasc ; 42(4): 248-251, 2017 Jul.
Article in French | MEDLINE | ID: mdl-28705345

ABSTRACT

Venous aneurysms are rare lesions, they have been reported in most venous territories. Abdominal location is unusual. A 61-year-old man presented with chest pain and dyspnea attributed to pulmonary embolism. Computed tomography of the abdomen showed multiple thrombosed venous aneurysms of the left external iliac vein and the inferior vena cava. There were no signs of rupture. The patient received anticoagulant treatment. He had no surgical treatment.


Subject(s)
Aneurysm/complications , Iliac Aneurysm/complications , Pulmonary Embolism/etiology , Vena Cava, Inferior , Aneurysm/diagnosis , Humans , Iliac Aneurysm/diagnosis , Male , Middle Aged
8.
Rev Pneumol Clin ; 72(2): 122-8, 2016 Apr.
Article in French | MEDLINE | ID: mdl-26651932

ABSTRACT

Pulmonary involvement during systemic sclerosis (SS) is dominated by interstitial lung disease and arterial pulmonary hypertension. It is about a retrospective study analyzing 65 cases of SS over a period of 13 years. We compared cases with and without interstitial lung disease. The diagnosis of SS was retained according to American College of Rheumatology (ACR)/EULAR 2013 criteria. The diagnosis of interstitial lung disease was retained in TDM and EFR. Pulmonary hypertension is defined by a pulmonary arterial pression higher than 25 mmHg. The mean delay of diagnosis of interstitial lung disease and the diagnosis was of 48 months (extremes 0-78 months). The comparison between both groups according to average age of the patients, prevalence of pulmonary hypertension, frequency of Raynaud phenomenon and trophic disorders did not find any significant difference. Lung involvement was associated with an esophageal involvement in 71% of the cases (P=0.059). Antibodies anti-Scl 70 were noted more frequently in patient's with interstitial lung disease (79% of the cases, P=0.001). Patients were treated with colchicine and vitamin E. A corticotherapy had been indicated at a single patient. The evolution of SS was marked by the stabilisation of the restrictive syndrome in 71.8% of the cases and a worsening in 25% of the cases. Early and appropriate diagnosis of SS and screening of lung involvement are essential for a early care.


Subject(s)
Lung Diseases, Interstitial/epidemiology , Lung Diseases, Interstitial/pathology , Scleroderma, Systemic/epidemiology , Scleroderma, Systemic/pathology , Adult , Aged , Aged, 80 and over , Disease Progression , Female , Humans , Lung Diseases, Interstitial/complications , Male , Middle Aged , Respiratory Function Tests , Retrospective Studies , Scleroderma, Systemic/complications
9.
Gynecol Obstet Fertil ; 33(10): 783-90, 2005 Oct.
Article in French | MEDLINE | ID: mdl-16139552

ABSTRACT

The role of exogenous estrogen in the initiation and maintenance of human systemic lupus erythematosus (SLE) remains very controversial. To review the current literature of the safety of using exogenous estrogens in patients with SLE, a Medline search for articles published between 1970 et 2004 regarding this relationship was performed. Although cohort studies suggest an increase in the incidence of SLE with both oral contraceptives and hormone replacement therapy, recent retrospective studies suggest that the risk of flares is not increased with hormone replacement therapy. Large prospective double blind placebo controlled studies inclusive of all ethnic groups such as the Safety of Estrogen in Lupus Erythematosus National Assessment (SELENA) trial had to provide the basis for definitive recommendations but it had been interrupted after WHI study results.


Subject(s)
Contraceptives, Oral, Hormonal/therapeutic use , Estrogen Replacement Therapy , Estrogens/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Contraceptives, Oral, Hormonal/adverse effects , Estrogen Replacement Therapy/adverse effects , Estrogens/adverse effects , Female , Humans , Lupus Erythematosus, Systemic/chemically induced , Safety
13.
J Radiol ; 85(7-8): 1074-6, 2004.
Article in French | MEDLINE | ID: mdl-15332013

ABSTRACT

Pulmonary hyalinizing granuloma is a rare fibrosing nodular disease of the lung characterized by solitary or multiples pulmonary nodules. This report describes two cases of this rare disorder. MRI was available in one case. For the first case, the stability of the lesions and past history of retroperitoneal fibrosis suggested the diagnosis. For the second case, open lung biopsy was required for diagnosis. When multiple nodules are present, metastatic disease cannot be excluded and biopsy may be required. Evolution is usually benign but follow up is necessary.


Subject(s)
Granuloma , Lung Diseases , Biopsy , Diagnosis, Differential , Female , Follow-Up Studies , Granuloma/diagnosis , Granuloma/diagnostic imaging , Granuloma/pathology , Humans , Lung/pathology , Lung Diseases/diagnosis , Lung Diseases/diagnostic imaging , Lung Diseases/pathology , Magnetic Resonance Imaging , Middle Aged , Radiography, Thoracic , Retroperitoneal Fibrosis/diagnosis , Retroperitoneal Fibrosis/diagnostic imaging , Time Factors , Tomography, X-Ray Computed
14.
Tunis Med ; 79(12): 655-1, 2001 Dec.
Article in French | MEDLINE | ID: mdl-11892438

ABSTRACT

It's well known that hepatitis C virus (HCV) related chronic liver disease may be associated with various extra hepatic disorders. These manifestations can revealed the hepatic disease. We review the available data on the conditions and asses their clinical implications: vascular, cutaneous, articular, neurological or renal disorders. There is no correlation between these extra hepatic manifestations and the severity of liver disease. Several recent studies have established a strong link between HCV infection and essential mixed cryoglobulinemia but some other extra hepatic associations are just fortuitous. Others datas are necessary to better analyze these extra hepatic disorders and to offer the beneficial treatment of patients with chronic hepatitis C.


Subject(s)
Cryoglobulinemia/etiology , Hepatitis C, Chronic/complications , Kidney Diseases/etiology , Skin Diseases/etiology , Vascular Diseases/etiology , Fatigue Syndrome, Chronic/etiology , Humans , Nervous System Diseases/etiology , Rheumatic Diseases/etiology , Sjogren's Syndrome/etiology
15.
Rev Pneumol Clin ; 70(6): 375-9, 2014 Dec.
Article in French | MEDLINE | ID: mdl-25459352

ABSTRACT

Renal involvement in sarcoidosis is rare and more often related to calcium metabolism disorders or granulomatous interstitial nephritis. Glomerulonephritis is exceptional. There may be a long latency period between the development of active sarcoidosis and glomerular involvement and inversely. We report a case membranous glomerulonephritis revealing systemic sarcoidosis.


Subject(s)
Glomerulonephritis, Membranous/complications , Kidney/pathology , Sarcoidosis/complications , Female , Glomerulonephritis, Membranous/diagnosis , Humans , Middle Aged , Sarcoidosis/diagnosis
16.
Ann Cardiol Angeiol (Paris) ; 63(4): 271-5, 2014 Sep.
Article in French | MEDLINE | ID: mdl-23806862

ABSTRACT

INTRODUCTION: The successive occurrence of pericardial tamponade and myocarditis during a Churg-Strauss syndrome is exceptionally described. We report a patient in whom pericardial tamponade and myocarditis were the presenting manifestation of a Churg-Strauss syndrome. CASE REPORT: A 58-year-old woman was admitted because of alteration of the clinical status with eosinophilia. One month ago, she was hospitalized for a pericardial tamponade treated by pericardial drainage. Acute myocarditis was diagnosed on chest pain during the second hospitalization. The etiologic inquiry ended in the diagnosis of Churg-Strauss complicated with a double cardiac involvement. A good response of clinical and biological anomalies was obtained after corticosteroid and immunosuppressive treatment. CONCLUSION: Isolated or multiple involvements of cardiac tunics should lead to make diagnosis of systemic vasculitis. A complete initial assessment and a close observation of the patients followed for Churg-Strauss syndrome is imperative to detect a cardiac achievement and set up an early treatment.


Subject(s)
Cardiac Tamponade/etiology , Churg-Strauss Syndrome/complications , Myocarditis/etiology , Female , Humans , Middle Aged
17.
Rev Med Interne ; 34(1): 12-6, 2013 Jan.
Article in French | MEDLINE | ID: mdl-22884286

ABSTRACT

PURPOSE: The occurrence of acute pancreatitis in systemic lupus erythematosus (SLE) is known but rare, and is exceptionally the presenting manifestation. Its pathogenesis is multifactorial, and it is difficult to separate what belongs to vasculitis, thrombotic phenomena in the context of an associated antiphospholipid syndrome, or iatrogenic complications. We report on six cases of lupus pancreatitis. METHODS: This is a retrospective monocenter study of 110 patients with SLE. The diagnosis of lupus pancreatitis was established after exclusion of other causes of pancreatitis. RESULTS: Five women and one man (5.4%) with a mean age of 36.3 years presented with lupus pancreatitis. In four patients the pancreatitis was concurrent with the diagnosis of SLE and it occurred later during an exacerbation of the disease in the two remaining patients. In all patients, pancreatic manifestations were associated with other organ involvement. Clinical manifestations were: abdominal pain (n=6), vomiting (n=3), and fever (n=3). Elevated pancreatic enzyme was noted in all cases. All patients were treated by high doses of glucocorticoids. The outcome was favorable in five patients, and one patient died. CONCLUSION: Pancreatitis may be the presenting manifestation of SLE. Its pathogenesis is often multifactorial. The outcome is usually favorable with corticosteroids.


Subject(s)
Lupus Erythematosus, Systemic/complications , Pancreatitis/etiology , Abdominal Pain/etiology , Adult , Amylases/blood , Antibodies, Antinuclear/blood , Antibodies, Antiphospholipid/blood , Cohort Studies , Diagnosis, Differential , Female , Fever/etiology , Follow-Up Studies , Glucocorticoids/therapeutic use , Humans , Immunologic Factors/blood , Lipase/blood , Lupus Erythematosus, Systemic/diagnosis , Male , Middle Aged , Pancreatitis/diagnosis , Retrospective Studies , Ribonucleoproteins, Small Nuclear/blood , Treatment Outcome , Vomiting/etiology , Young Adult , snRNP Core Proteins/blood
18.
Rev Pneumol Clin ; 68(5): 300-2, 2012 Oct.
Article in French | MEDLINE | ID: mdl-22766491

ABSTRACT

Although pericarditis is the most frequent cardiac involvement in systemic lupus erythematosus (SLE), cardiac tamponade is very rare as an initial manifestation of this disease. We report the case of a 27-year-old patient in whom the diagnosis of SLE was discovered during cardiac tamponade.


Subject(s)
Cardiac Tamponade/diagnosis , Lupus Erythematosus, Systemic/diagnosis , Adult , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/etiology , Diagnosis, Differential , Electroencephalography , Female , Humans , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnostic imaging , Radiography, Thoracic
19.
Rev Pneumol Clin ; 68(5): 311-4, 2012 Oct.
Article in French | MEDLINE | ID: mdl-22749953

ABSTRACT

Pulmonary artery aneurysm in Behcet disease compromises seriously the diagnosis since its fatal rupture is still the major cause of death in this disease. Pulmonary artery aneurysm requires urgent management and several treatments have been proposed, including steroids, immunosuppressive drugs, embolisation and surgery. Herein, we report a patient with Behçet's disease in whom multiple pulmonary artery aneurysms were completely resolved after a combined treatment with corticosteroids and azathioprine. Pulmonary artery aneurysms in Behçet's disease are reported to indicate poor prognosis and high mortality. Computed tomographic scans of the chest and angiography are the most common diagnostic procedures used in the diagnosis or evaluation of pulmonary artery aneurysm. Immunosuppression is the main therapy for the treatment of a vasculitis.


Subject(s)
Adrenal Cortex Hormones/administration & dosage , Aneurysm/drug therapy , Azathioprine/administration & dosage , Behcet Syndrome/drug therapy , Pulmonary Artery , Adult , Aneurysm/etiology , Behcet Syndrome/complications , Behcet Syndrome/diagnostic imaging , Drug Combinations , Humans , Immunosuppressive Agents/administration & dosage , Male , Pulmonary Artery/diagnostic imaging , Radiography, Thoracic , Remission Induction
20.
Rev Pneumol Clin ; 68(3): 194-8, 2012 Jun.
Article in French | MEDLINE | ID: mdl-22197156

ABSTRACT

Amyloidosis limited to bronchopulmonary apparatus is expressed as tracheobronchial deposits in diffuse plaques that can cause stenosis or parenchymal nodules or masses. In this regard, we report four cases of pulmonary amyloidosis and discuss the diagnostic difficulties of this location. These are two women and two men aged 60, 68, 44 and 57 years. They presented a pulmonary parenchymal amyloidosis in all cases associated with bronchial in one case. The diagnosis was confirmed by histology in all cases. The staging was negative in all cases. The evolution was marked by the stabilization of the lesions in all cases. Localized amyloidosis, which may be the only telltale sign of a systemic illness, its diagnosis requires finding other locations to better tailor the treatment strategy.


Subject(s)
Amyloidosis/diagnosis , Lung Diseases/diagnosis , Lung/pathology , Adult , Aged , Female , Humans , Lung/diagnostic imaging , Male , Middle Aged , Plaque, Amyloid/diagnosis , Radiography
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