Duodenal intraepithelial lymphocytosis during Helicobacter pylori infection is reduced by antibiotic treatment.

AIM: To evaluate clinical, biological and immunological features of patients with increased duodenal intraepithelial lymphocytes (IELs), and its relation to Helicobacter pylori (HP) and coeliac disease (CD). METHODS: We have studied all patients accrued over a 4-year period with increased duodenal IELs. Those patients were recalled for biological and immunological evaluation and a second endoscopy. RESULTS: Twenty-three from a total of 639 patients were identified and 17 of them were included in the study. The median duodenal IEL count was 59 per 100 epithelial cells. Twelve (71%) patients were HP+; eight of them received HP eradication. At the second endoscopy the duodenal IEL count was significantly lower 2 months after HP eradication (73 versus 28), while the IEL count was unchanged in those patients seronegative for HP (n = 5) or those in whom it was not eradicated (n = 4) (55 versus 55). No patient had coeliac antibodies, four expressed HLA-DQ2, lower than in the general population, and the prevalence of CD was 2% (12/639 patients). CONCLUSION: In some cases an increased duodenal IEL count may be due to an inappropriate host response to HP. HP screening and eradication should be considered before recommending a gluten-free diet.

[Aspergillous bronchitis in an immunocompetent patient]. / Bronchite aspergillaire chez un patient immunocompétent.

We report a case of aspergillous bronchitis in an immunocompetent patient, recalling the clinical signs, laboratory findings and therapeutic management of this uncommon bronchopulmonary disorder related to aspergillus.

[Atypical involvement of undifferentiated carcinomas of the nasopharyngeal type. Apropos of 3 cases]. / Localisations atypiques des carcinomes indifférenciés de type nasopharyngé. A propos de 3 cas.

We report 3 cases of undifferentiated carcinomas of nasopharyngeal type (UCNT) found in unusual sites and compare them with histologically identical tumors found in the nasopharynx. Using viral serology and viral marquers found in the tumor cells, we looked for a link with the Epstein Barr Virus (EBV) which exists in the nasopharyngeal site. It appears that UCNT found in unusual sites have a poorer prognostic than the same nasopharyngeal tumors; no link was found with EBV. The number of published cases is too small to form a conclusion, therefore, we propose a systematic search for EBV, presenting our protocol, each time is discovered UCNT in an unusual site.

[Cryptococcal chorioretinitis and acquired immunodeficiency syndrome]. / Choriorétinite à cryptocoque et syndrome d'immunodéficience acquise.

We report a case of cryptococcal chorioretinitis discovered at ophthalmological examination of a 68-year-old woman with acquired immune deficiency syndrome. This localization revealed cryptococcal septicemia, without involvement of the central nervous system unlike most cases reported. Therapy with fluconazole (400 mg per day) led to gradual regression of the chorioretinal lesion.