[Cystic fibrosis: how to use pulmonary function tests]. / Mucoviscidose: du bon usage des explorations fonctionnelles respiratoires.

INTRODUCTION: Neonatal screening for cystic fibrosis (CF) leads to early dedicated specialist care for all patients. BACKGROUND: Pulmonary function tests (PFT) are mandatory for routine monitoring of CF patients. The aim of this article is to review the current guidelines for PFTs in CF, particularly the type of test, the age and the clinical status of the patient. VIEWPOINT: The regular use of spirometry is generally accepted. Many other tests are used but their clinical value in the routine follow-up of CF patients remains to be established. CONCLUSION: Further efforts should be made to evaluate the value of PFTs in CF, particularly in very young children.

[Familial Waldmann's disease]. / Maladie de Waldmann familiale.

We report the observation of a mother and her daughter who presented edema, hypoprotidemia and lymphopenia due to protein-losing enteropathy. Radiological, endoscopic and histological investigations revealed the diagnosis of primary intestinal lymphangiectasis or Waldmann's disease. Dietary treatment with middle chained triglycerides was effective. Familial cases are rarely described.

[A rare cause of paroxysmal eosinophilia: eosinophilic gastroenteritis]. / Une cause rare d'éosinophilie paroxystic: la gastroentérite à éosinophiles.

The authors report the case of a 16 year-old boy admitted for the seventh acute occurrence in 18 months of abdominal pain associated with hypereosinophilia. Each episode was identical in nature and receded spontaneously after 5 or 6 days. Biopsy of a fiber colonoscopically obtained specimen of small intestine was performed. The diagnosis of eosinophilic gastroenteritis was based upon an infiltration of the digestive mucosa by eosinophils, the absence of elements in favor of other types of digestive-tract disease (parasitic, allergic, hematologic, or inflammatory), and the absence or other illness outside the digestive system. However, the incidental discovery of a distal dilation of both of the patients ureters during one such episode, that disappeared with the other symptoms, raises the possibility of a bladder location as well, and thus of a hypereosinophilic syndrome. Corticoids were administered then tapered down. A relapse occurred 2 months later. Currently, he is taking 20 mg of a corticoid every other day and has presented no manifestations over the last 9 months.

[Epidemiological, clinical, biological and developmental aspects of leptospirosis: apropos of 30 cases in Aquitaine]. / Aspects épidémiologiques, cliniques, biologiques et évolutifs de la leptospirose: à propos de 30 observations recueillies en Aquitaine.

We have studied retrospectively 30 cases of leptospirosis observed in Aquitaine (South West France) from 1980 till 1992. This review was made in three internal and a nephrology department in Bordeaux hospital. Most cases occurred by indirect contact with infected animals or by occupational exposures. Onset was brutal with fever often associated with painful syndrome and sometimes conjunctival suffusion. Jaundice (70%), acute renal failure (67%), meningitis (50%) and hemorrhagic signs (50%) were among the major visceral manifestations. Diagnosis was always confirmed by micro-agglutination test. Leptospira ictero-hemorrhage was the predominant serogroup found. The outcome was favorable in 22 patients; reversible complications were seen in six cases (five acute renal failure with hemodialysis myocarditis and pulmonary edema in two hemodialysed patients, polyradiculoneuritis). Two patients died (acute respiratory failure and meningo-encephalitis with diffuse hemorrhagic syndrome). The characteristic of our series is the high frequency of hepatorenal syndrome due to the importance of our nephrologist recruitment. Furthermore our study confirm the vital prognostic characters of the pulmonary, renal, hemorrhagic and neurologic complications. No absolute relationship was found between the clinical and laboratory findings and the serotype of leptospira. Penicillin remains the treatment of choice and should be started as soon as possible the avoid the life threatening visceral complications.

[Coprologic survey in Bilharzia infected children of the Adzope region (Ivory Coast)]. / Enquete coprologique chez des enfants bilharziens de la région d'Adzopé (Cote-D'Ivoire)

During a stool examination survey on 174 bilharzia attained children living in a rural area of Ivory Coast, 93% were found to have intestinal parasites mainly Entamoeba coli, Necator americanus and Ascaris lumbricoides. The prevalence of the cysts of Entamoeba histolytica (4,7%) is lower than the one found in France (7%). Concerning the other intestinal parasites, their respective occurrence have been compared with those noted in other regions of Ivory Coast and of Africa.