[A systemic disease mimicking a rheumatoid arthritis]. / Une maladie systémique mimant une polyarthrite rhumatoïde.

INTRODUCTION: Rare systemic diseases such as amyloidosis can mimic inflammatory rheumatic diseases. Because of their poor prognosis, physicians should rule them out at the onset of inflammatory rheumatism. We report a case of AL amyloidosis misdiagnosed as rheumatoid arthritis. CASE REPORT: A 71-year-old woman was referred for seronegative rheumatoid arthritis, resistant to three biologic therapies. She had an IgA lambda monoclonal gammopathy of undetermined significance (MGUS). The patient subsequently developed glomerular proteinuria. Abdominal fat and accessory salivary glands biopsies revealed amyloid light-chain (AL) amyloidosis. Treatment with bortezomib-cyclophosphamide-dexamethasone, led to complete hematologic, renal and rheumatologic remission. Ten months after treatment interruption, the patient had an articular and hematologic relapse. CONCLUSION: Amyloid light-chain amyloidosis arthropathy is probably underdiagnosed. A review of amyloid arthropathy associated with multiple myeloma found that 33% of patients had been misdiagnosed with rheumatoid arthritis.

Two outbreaks of botulism associated with consumption of green olive paste, France, September 2011.

Two family outbreaks of botulism (a total of nine cases) were identified in south-east and northern France in early September 2011. The source of infection was considered to be a ground green olive paste. Botulinum type A toxin was identified in seven cases and in the incriminated olive paste. Incorrect sterilisation techniques were observed at the artisanal producer's workshop. These episodes highlight the potential public health threat of Clostridium botulinum linked to inadequate sterilisation of food products.

Rat hepatonuclear factor PS-1 regulates tissue-specific activity of the S14 promoter in vitro.

We have previously identified a rat hepatonuclear factor, PS-1 that binds to the thyroid hormone responsive gene, S14. To determine whether PS-1 is involved in regulating tissue-specific expression of the S14 gene, we have correlated the DNA binding activity of PS-1 with mRNA-S14 expression in a variety of tissues. Gel retardation analysis revealed a pattern of binding to the recognition site that was characteristic of tissues with high levels of mRNA-S14, a different pattern was found in tissues which do not express the gene. Competition studies using mutant oligonucleotides showed that the first 4 nucleotides and the CAAT motif contained within the PS-1 recognition sequence are essential for protein binding. C/EBP, a CCAAT-transcription factor binds to the PS-1 recognition site thus raising the possibility that both C/EBP and PS-1 may belong to the same family of proteins. Next we used a cell-free transcription assay to measure activity of a template, pS14-GFC(-72), that contained the PS-1 sequence. The pS14-GFC(-72) template was active in hepatonuclear extracts but deletion of or competition with the PS-1 binding sequence rendered the construct inactive. A template containing three PS-1 binding sequences increased S14 promoter activity by 12- to 13-fold. In nuclear extracts from spleen and testis, relative S14 promoter activity was only 2% of that in the liver, this observation mimicked closely in vivo expression of the gene. Mixing together extracts from liver and spleen in varying proportions, prior to incubation with S14 template, yielded a linear increase in S14 promoter activity that correlated with the amount of liver extract in the reaction. This finding is consistent with the absence of an essential factor or factors in spleen that is/are required for S14 promoter activity in vitro. In summary, PS-1 binds to a DNA sequence that contains a CAAT motif and appears to play a critical role in determining tissue-specific activity of the S14 promoter in vitro.

Binding of nuclear proteins to the rat liver S14 gene is influenced by thyroid state.

The rat hepatic S14 gene is regulated by L-triiodothyronine (T3) and codes for a cytosolic protein (pI 4.9 and Mr 17,010) that is believed to be involved in lipogenesis. Recent studies have identified at least five DNase I hypersensitive sites (HS 1-5) in hepatic chromatin flanking the 5' region of the gene. The HS-1 site is situated immediately adjacent to the transcription initiation site. We have isolated a DNA fragment (USS-1) which contains a portion of the HS-1 site to examine the binding of nuclear proteins to S14 DNA. DNase I footprinting studies demonstrated that material extracted from hepatic nuclei with 0.42 M NaCl contained proteinase K-sensitive factors (presumed to be proteins), which bind to USS-1 DNA between positions -63 and -48 (PS-1) relative to the transcription initiation site. Examination of the binding activity with a synthetic oligonucleotide identical to the protected sequence indicated the formation of at least three protein-DNA complexes. The DNA binding activity of the PS-1 binding protein or proteins correlated with the T3 regulated expression of mRNA-S14. Although the nucleotide sequence of PS-1 closely resembles the binding site for the CCAAT transcription factor (CTF/NF-1), competition studies attempting to displace protein binding from the PS-1 sequence with DNA fragments containing the CTF/NF-1 binding motif were unsuccessful. In vitro transcriptional assay studies suggested that the DNA fragment (-441 to -2) containing the PS-1 site promotes the transcription of the S14 gene in an orientation fashion. The in vitro transcriptional activity of the S14 DNA containing the PS-1 sequence was significantly higher in hepatonuclear extracts from hyperthyroid compared with euthyroid or hypothyroid animals. In summary, our findings indicate that the DNA binding activity of proteins which bind to PS-1 site is influenced by the thyroid status of the animal.