[Superficial cranial venous thromboses preceding the diagnosis of giant cell arteritis]. / Thromboses veineuses superficielles céphaliques satellites d'une artérite temporale de Horton, une manifestation exceptionnelle.

Temporal arteritis is a large-vessel vasculitis predominantly affecting the external carotid and its branches. Venous thrombosis is rarely found at the onset of temporal arteritis, particularly when venous symptoms precede arterial involvement. We report the case of a 70-year-old woman consulting for bilateral superficial frontal venous thrombosis. Superficial bilateral temporal venous thrombosis occurred under adequate anticoagulation before the onset of arterial symptoms suggestive of temporal arteritis. We then discuss the pathophysiology of venous thrombosis in patients with temporal arteritis.

[Cytomegalovirus and systemic lupus: severe infection and difficult diagnosis]. / Cytomégalovirus et lupus érythémateux systémique: une infection grave de diagnostic difficile.

INTRODUCTION: There are a few reports only on cytomegalovirus (CMV) reactivation in lupus. Diagnosis of this infection is difficult and can be associated with of a poor outcome. We report three cases of infection with CMV that occurred in patients with lupus and review the literature. CASE REPORTS: The three reported patients presented with fever, polyarthritis, myocarditis and enteritis. Lupus was longstanding and the patients were receiving corticosteroids or cyclophosphamide. There was no major CD4 lymphopenia. The diagnosis was obtained with the presence of antigenemia pp65. The outcome was favorable with antiviral therapy in two patients, while the remaining patient died. In the English literature, pulmonary and intestinal involvement seem frequent, and associated with poor prognosis. CONCLUSION: In systemic lupus CMV infection is often serious and difficult to diagnose. Risk factors, treatment and prophylaxis remain to be evaluated in this population. The incidence of this infection could increase among patients receiving a biotherapy.

[Euthyroid Graves' disease: a case report]. / Le syndrome de Means: à propos d'une observation.

Euthyroid Graves' disease is defined as an ophtalmopathy without any clinical or biological signs of thyroid dysfunction. It highlights the apparent dissociation between orbitopathy and thyroid disease. Diagnosis is often too late while early treatment could really improve functional prognosis. We report a 57-year-old woman who presented with this entity and that illustrates both the diagnostic difficulty and disease course after intravenous corticosteroid therapy.

[Protein-losing enteropathy revealing an idiopathic constrictive pericarditis]. / Entéropathie exsudative révélant une péricardite chronique constrictive idiopathique.

INTRODUCTION: The cause of protein-losing enteropathy is sometimes difficult to establish. It can be rarely due to a constrictive pericarditis. EXEGESIS: We report a patient presenting a protein-losing enteropathy revealing a constrictive pericarditis. CONCLUSION: Chronic pericarditis should be evoked in case of unexplained protein-losing enteropathy. Echocardiography can sometimes be normal. Therefore, chest computed tomography scan or cardiac MRI followed by confirmation right heart catheterization should be performed in case of persistent unexplained protein-losing enteropathy.

[Celecoxib induced toxiderma with positive patch-test]. / Toxidermie au célécoxib (Cerebrex(R)) avec test épicutané positif.

INTRODUCTION: Celecoxib (Celebrex(R)) is a new generation non-steroidal anti-inflammatory drug, recently introduced in France. We report a maculopapular rash due to this drug with positive patch-tests. CASE REPORT: A forty year-old man received with 3 tablets/day of celecoxib for intercostal pain. Nine days after initiation of treatment a maculopapular rash appeared. At the end of treatment, the eruption persisted for two days, then rapidly improved within one week. Six weeks later, patch-tests with celecoxib diluted at 20 p. 100 in petrolatum were positive at 48 hours. DISCUSSION: Cutaneous reactions due to celecoxib are rare. In our case report, the delay, clinical aspect, improvement on withdrawal of treatment and positive patch test all emphasize the imputability of celecoxib. We wish to underline the possible cutaneous reactions with this new non-steroidal anti-inflammatory drug.