[Hepatosplenic lesions due to a systemic bartonellosis in an immunocompetent patient]. / Atteinte hépato-splénique et bartonellose systémique chez une patiente immunocompétente.

We describe a case of a young healthy patient who presents a lot of hepato-splenic lesions caused by a systemic cat scratch disease. This case allows us to discuss the uncommon manifestations of the cat scratch disease and to describe the two types of hepatic lesions caused by a systemic bartonella infection : the granulomatosis and peliosis.

Nous rapportons le cas d'une jeune patiente immunocompétente présentant de multiples lésions hépato-spléniques secondaires à une infection systémique à bartonella. L'opportunité nous est ainsi donnée de discuter des manifestations rares de la maladie des griffes du chat ainsi que de décrire les deux types d'atteintes hépatiques causées par cette infection : la granulomatose et la péliose.

[HLA-B58.01 and allopurinol hypersensitivity renal vasculitis in a Chinese patient]. / HLA-B58.01 et vascularite rénale d'hypersensibilité à l'allopurinol chez un patient chinois.

INTRODUCTION: Allopurinol, widely used in the treatment of hyperuricemia and gout, has been shown to cause severe cutaneous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, as well as systemic reactions such as DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms). The HLA-B*5801 allele is known to be a risk factor for severe cutaneous manifestations of hypersensitivity to allopurinol, mostly in Asian populations. OBSERVATION: We report the observation of a 47-year-old Chinese patient, with no previous medical history, carrying the HLA-B*5801 allele, who developed an isolated allopurinol hypersensitivity necrotizing renal vasculitis without cutaneous manifestations. DISCUSSION: . The identification of this allele should be proposed before prescribing allopurinol in patients originating from certain regions of Asia, and the imputability of allopurinol should be evoked in case of necrotizing renal vasculitis, even without associated cutaneous involvement.

Detection of secondary causes of spontaneous pneumothorax: Comparison between computed tomography and chest X-ray.

PURPOSE: The aim of this study was to compare the effectiveness of chest X-ray to that of thoracic computed tomography (CT) for the detection of the causes of secondary spontaneous pneumothorax (SP). METHODS: A prospective cohort of patients with SP was studied. All chest X-ray and CT examinations of the patients were reviewed retrospectively by an expert radiologist blinded to clinical data. The concordance between the CT examination and chest X-ray was assessed using the Cohen Kappa coefficient (κ), based on a bootstrap resampling method. RESULTS: A total of 105 patients with SP were included. There were 78 men and 27 women, with a mean age of 34.5 years±14.2 (SD) (range: 16-87 years). Of these, 44/105 (41%) patients had primary SP and 61/105 (59%) had secondary SP due to emphysema (47/61; 77%), tuberculosis (3/61, 5%), lymphangioleiomyomatosis (3/61; 5%), lung cancer (2/61, 3%) or other causes (6/61; 10%). Apart from pneumothorax, CT showed abnormal findings in 85/105 (81%) patients and chest X-ray in 29/105 (28%). Clinically relevant abnormalities were detected on 62/105 (59%) CT examinations. The concordance between chest X-ray and CT was fair for detecting emphysema (κ=0.39; 95% CI: 0.2420-0.55), moderate for a mass or nodule (κ=0.60; 95% CI: 0.28-0.90), fair for alveolar opacities (κ=0.39; 95% CI: -0.02-1.00), and slight for interstitial syndrome (κ=0.20; 95% CI: -0.02-0.85). CONCLUSION: Chest X-ray is not sufficient for detecting the cause of secondary SP. As the detection of the cause of secondary SP may alter the therapeutic approach and long-term follow-up in patients with SP, the usefulness of a systematic CT examination should be assessed in a prospective trial.

One-dimensional magnetic fluctuations in the spin-2 triangular lattice alpha-NaMnO2.

The S=2 anisotropic triangular lattice alpha-NaMnO2 is studied by neutron inelastic scattering. Antiferromagnetic order occurs at T< or =45 K with opening of a spin gap. The spectral weight of the magnetic dynamics above the gap (Delta approximately equal to 7.5 meV) has been analyzed by the single-mode approximation. Excellent agreement with the experiment is achieved when a dominant exchange interaction (|J|/k(B) approximately 73 K), along the monoclinic b axis and a sizable easy-axis magnetic anisotropy (|D|/k(B) approximately 3 K) are considered. Despite earlier suggestions for two-dimensional spin interactions, the dynamics illustrate strongly coupled antiferromagnetic S=2 chains and cancellation of the interchain exchange due to the lattice topology. alpha-NaMnO2 therefore represents a model system where the geometric frustration is resolved through the lowering of the dimensionality of the spin interactions.