[Propylthiouracil-induced multispecific antineutrophil cytoplasmic antibodies]. / Anticorps anticytoplasme des polynucléaires neutrophiles multispécifiques induits par le propylthiouracile.

We report the case of a 28-year-old woman who presented with arthralgia during a treatment with propylthiouracil (PTU) for hyperthyroidism. Detection of antineutrophil cytoplasmic antibodies (ANCA) against myeloperoxidase, proteinase 3 and elastase led to suspect PTU induced vasculitis.

[Acute generalized exanthematic pustulosis induced by hydroxychloroquine: case report]. / Pustulose exanthématique aiguë généralisée liée à l'hydroxychloroquine : à propos d'une observation.

We report a 45-year-old woman who presented an acute generalized exanthematic pustulosis induced by hydroxychloroquine. Acute generalized exanthematic pustulosis is a severe eruption that is usually drug related. This side effect should be known as new therapeutic challenge would induce more severe clinical features.

[Diagnosis and therapeutic usefulness of ultrasonography in unusual gout]. / Intérêt de l'échographie ostéo-articulaire dans le diagnostic et le traitement des arthropathies goutteuses atypiques.

We report a 72-year-old patient who presented with a third metacarpo-phalangeal arthritis of unknown origin. Ultrasonography proved to be useful to the diagnosis of gout and to initiate therapy with allopurinol in the presence of erosions. This observation adds evidence to recent reports that using a specific semiology, ultrasonography could be useful to distinguish gout from pseudo-gout.

[Rare complications of Lemierre's syndrome: septic sternoclavicular joint arthritis and cavitating pneumonia]. / Complications rares d'un syndrome de Lemierre: localisations sternoclaviculaires et pulmonaires excavées.

We report a 27-year-old man who presented with a Lemierre's syndrome associated with two uncommon complications: a septic sternoclavicular joint arthritis and a cavitating pneumonia.

A case-control study to assess sensitivity and specificity of a questionnaire for the detection of hip and knee osteoarthritis.

OBJECTIVE: To assess the performance of a telephone-administered questionnaire suitable for use in 2-phase surveys in the detection of symptomatic hip and knee osteoarthritis (OA) cases. METHODS: A questionnaire was designed based on typical symptoms and self-reported OA diagnosis. Three groups of subjects were consecutively enrolled from rheumatology units at French university hospitals. The disease status, based on American College of Rheumatology criteria, was first confirmed by a rheumatologist. Subjects then completed the screening questionnaire administered by interviewers unaware of the diagnosis and the clinical examination results. Three screening strategies were evaluated. RESULTS: In all, 119 subjects with hip OA, 137 with knee OA, and 111 subjects with other rheumatic diseases with lower extremity symptoms were recruited. The highest sensitivity for both hip and knee OA was obtained with the strategy based on reporting the presence or absence of symptoms (>96%). The specificity of this strategy was low (42% for both joints). When taking into account the self-reported OA diagnosis, the sensitivity slightly decreased (>91%), and the specificity increased greatly, from 76% to 78%. The highest specificity was obtained with the third strategy, requiring a rheumatologist opinion (from 82% to 85%) at the expense of lower sensitivity (>90%). CONCLUSION: The questionnaire tested in this study is a simple, valid, and reliable instrument to screen symptomatic hip and knee OA. As such, it fails to reach complete accuracy and clinical examination and radiographs remain necessary for complete ascertainment procedure.

Sensitivity and specificity of the American College of Rheumatology 1987 criteria for the diagnosis of rheumatoid arthritis according to disease duration: a systematic literature review and meta-analysis.

OBJECTIVE: To evaluate the ability of the widely used ACR set of criteria (both list and tree format) to diagnose RA compared with expert opinion according to disease duration. METHODS: A systematic literature review was conducted in PubMed and Embase databases. All articles reporting the prevalence of RA according to ACR criteria and expert opinion in cohorts of early (<1 year duration) or established (>1 year) arthritis were analysed to calculate the sensitivity and specificity of ACR 1987 criteria against the "gold standard" (expert opinion). A meta-analysis using a summary receiver operating characteristic (SROC) curve was performed and pooled sensitivity and specificity were calculated with confidence intervals. RESULTS: Of 138 publications initially identified, 19 were analysable (total 7438 patients, 3883 RA). In early arthritis, pooled sensitivity and specificity of the ACR set of criteria were 77% (68% to 84%) and 77% (68% to 84%) in the list format versus 80% (72% to 88%) and 33% (24% to 43%) in the tree format. In established arthritis, sensitivity and specificity were respectively 79% (71% to 85%) and 90% (84% to 94%) versus 80% (71% to 85%) and 93% (86% to 97%). The SROC meta-analysis confirmed the statistically significant differences, suggesting that diagnostic performances of ACR list criteria are better in established arthritis. CONCLUSION: The specificity of ACR 1987 criteria in early RA is low, and these criteria should not be used as diagnostic tools. Sensitivity and specificity in established RA are higher, which reflects their use as classification criteria gold standard.

[Acute renal insufficiency after flurbiprofen treatment in a patient treated with angiotensin converting enzyme inhibitor]. / Insuffisance rénale aiguë après prise de flurbiprofène chez un patient sous inhibiteur de l'enzyme de conversion.

We report a case of acute renal insufficiency in a 77 year-old patient who took flurbiprofen as antiplatelet therapy. This is an important observation because it illustrates the potential risk of acute renal insufficiency, when using flurbiprofen before invasive medical examination or surgery in patients receiving long-term treatment with angiotensin converting enzyme inhibitors or angiotensin II inhibitors. This risk is probably underestimated in usual clinical practice.