A. Chapman

Une nouvelle cause de « fièvreprolongée inexpliquée: les traitements oestroprogestatifs. (A propos de 12 cas)

Twelve female patients treated by progestogens with or without estrogens presented with prolonged (1 to 48 months) elevation of body temperature above 37° C but below 38° C. They had usually continued taking their temperature after and initial transitory febrile episode. Most had had multiple diagnostic tests which remained negative. Temperature became normal after cessation of hormonal treatment.

Alternance sarcoïdose/lymphome non hodgkinien : association forfuite ou lien pathogénique ?

A patient was found to have a low-grade non Hodgkins lymphoma, followed by a typical sarcoidosis, tiself followed by a high-grade non Hodgkins lymphoma. This succession of diseases does not seem fortuitous and the pathogenic mechanisms are discussed.

Étude rétrospective des fièvres prolongées inexpliquées chez les patients infectés par le VIH

Aretrospective study of 15 cases of fever of unknow origin in HIV positive patient showed that a cause was found in 9 patients, 6 of whom had mycobacterial infection often suspected on clinical grounds. Anti-mycobacterial drugs should then be considered while awaiting histological or basterial confirmation.

Positive Nitrogen Balance in Hypercatabolic States: Results Obtained with Parenteral Feeding after Major Surgical Procedures

Conclusive evidence that positive nitrogen balance can regularly be achieved during hypercatabolic states has not yet been established. Nitrogen balance has been measured in 15 patients over the first ten days following major surgical procedures whilst they were receiving parenteral alimentation with constant high caloric intake. A linear correlation was found between daily nitrogen intake and balance. The slope of the regression lines (0.430 to 0.837) and the nitrogen needs (9 to 18 g/m2 /day) vary from one patient to another. All patients were in positive nitrogen balance when intake was high, regardless of the post-operative day considered. Positive or equilibrated cumulative nitrogen balance could be obtained when mean nitrogen intake was kept over 13 g/m2 /day. This positive nitrogen balance can be obtained during hypercatabolic states. From this study and from data found in the literature it can be concluded that parenteral hype ralimentation is beneficial in the immediate post operative period after major surgical procedures.

Indications de la sérologie de l'hépatite C en médecine interne

A sero-epidemiological study was carried out in an Internal Medecine unit to identify high risk groups for HCV infection. Intravenous drug users, patients reported previous surgery usually requiring large blood transfusions, and alcoholic patients with cirrhosis and elevated transaminases should benefit from anti-HCV detection in priority.

Fibrose rétropéritonéale révélée par un diabète insipide néphrogénique

Idiopathic retroperitoneal fibrosis was found in a 47 year old patient presenting with nephrogenic diabetes insipidus. Nephrogenic diabetes insipidus is an exceptional complication of incomplete ureteric obstruction and its mechanism is unclear.