Boyan Christoforov

Cyclic sciatica. A manifestation of compression of the sciatic nerve by endometriosis. A case report.

Study design A case of cyclic sciatica secondary to ovarian cyst endometriosis is presented. Objectives To report the clinical description and magnetic resonance imaging aspects of cyclic sciatica. Summary of Background Data Endometriosis of the sciatic nerve is rare, but must be included in the differential diagnosis of sciatic mononeuropathies. Methods The authors report a new case of a woman whose cyclic sciatica was caused by an ovarian cystic endometriosis lesion. Results Magnetic resonance imaging was described as hyper‐ and hypointense on T1‐weighted sequences, and hyperintense on T2‐weighted sequences at the sciatic notch. Conclusion Magnetic resonance imaging may permit a specific diagnosis of this unusual cause of sciatica by showing a hemorrhagic mass in the region of the sciatic nerve. Early recognition is necessary to prevent permanent damage to the sciatic nerve.

Central retinal vein thrombosis associated with resistance to activated protein C.

PURPOSE/METHODS Activated protein C resistance was recently described as a major cause of venous thrombosis. We observed a central retinal vein thrombosis in a woman with activated protein C resistance. RESULTS/CONCLUSION DNA analysis showed the patient to be heterozygous for the factor V gene mutation, which is related to activated protein C resistance. Patients with retinal vein thrombosis should be examined for activated protein C resistance.

Polymorphonuclear leukocyte-elastase in Crohn's disease: correlation with 99mtechnetium hexamethyl propylene amine oxime leukocyte scintigraphy.

In Crohns disease (CD), labeled leukocyte scintigraphy results are highly correlated with radioendoscopic findings and the degree of histologic inflammation. We evaluated the correlation between leukocyte activity measured by two complementary methods, polymorphonuclear leukocyte (PMN)-elastase concentration and leukocyte scintigraphy. In 20 patients with CD, labeled leukocytes, 99m technetium hexamethyl propylene amine oxime (99mTc-HMPAO) scintigraphy, and PMN-elastase concentration were evaluated on the same day. A good correlation was found between PMN-elastase concentrations and the scintigraphic scores (p = 0.005; rs = 0.60; 95% CI, 0.20–0.83). Scintigraphy results were significantly correlated with CD activity index (p = 0.023, rs = 0.50). In four patients, scintigraphic scores and clinical disease activity were not consistent due to the state of PMN leukocyte activation, measured by elastase concentration. In CD, PMN-elastase can provide information about the degree of activation of PMN leukocytes and may explain discrepancy between clinical and scintigraphic indexes.

Adénite granulomateuse à Propionibacterium acnes

Summary An unusual observation of granulomatous lymph node infection in a 50 year-old patient treated for tuberculosis is reported here. Lymph node biopsy showed intracytoplasmic bacilli. After two weeks, cultures were positive for Propionibacterium acnes. P. acnes must be considered when confronted with lymph node granuloma.