J. Bernet

Artérite inflammatoire mésentérique au cours de la maladie de Horton : à propos de deux observations et revue de la littérature

INTRODUCTION Mesenteric involvement has been rarely reported in giant cell arteritis (GCA). Our literature search using the Medline database (1966-2008), reviewing all articles in English and French languages identified only 31 cases of mesenteric ischemia related to GCA. We report two additional cases. CASE REPORTS We report two men with GCA. At diagnosis of GCA-associated mesenteric involvement, patients exhibited: fever/fatigue (n=2), abdominal complaints (n=1), clinical signs of GCA (n=1). In both patients, abdominal CT-scan showed circumferential halo around the superior mesenteric artery. At systematic follow-up, CT-scan revealed improvement of mesenteric damage in both patients. CONCLUSION Our study indicates that CT-scan is a useful technique in diagnosis of GCA-associated mesenteric involvement. Furthermore, we suggest that CT-scan may also be helpful in both the monitoring and the medical management of GCA-related mesenteric artery involvement.

Intestinal pseudo-obstruction as a manifestation of tumor necrosis factor receptor-associated periodic syndrome

First described by McDermott et al. (1) in 1998, tumor necrosis factor receptor–associated periodic syndrome (TRAPS) is an uncommon autosomal dominantly inherited auto-inflammatory disorder, belonging to hereditary periodic fever syndromes (including notably familial Mediterranean fever). It is related to missense mutations in the tumor necrosis factor receptor soluble form 1A (TNFRSF1A) on chromosome 12p13, which results in impaired shedding of the receptor’s soluble form leading to excessive unbalanced tumor necrosis factor-α (TNF-α) action (1–9); to date, about 23 mutations have been identified in TNFRSF1A of TRAPS patients, usually involving residues with the first cysteine-rich domains within exons of the receptor (2–9). TRAPS is characterized by repeated attacks of fever and clinical manifestations, including cutaneous (e.g., mainly centrifugal, migratory, and erythematous rash involving the limbs and torso, with histologic analysis of skin biopsy specimens revealing perivascular and interstitial infiltrates) and musculoskeletal (arthralgia in a monoor oligoarticular distribution, or myalgia) involvement, and particularly abdominal impairment (2–9). We recently observed a new case, where the patient exhibited recurrent episodes of intestinal pseudo-obstruction pattern, revealing TRAPS owing to C30S mutation. A 32-year-old man presented with a 5-day history of diffuse abdominal pain, nausea and severe constipation.

Leishmaniose cutanée au cours d'une polymyosite

Introduction The prevalence of cutaneous leishmaniasis is increasing, especially in immunocompromized subjects.

Cas cliniqueLeishmaniose cutanée au cours d'une polymyositeCutaneous leishmaniasis in polymyositis

Introduction The prevalence of cutaneous leishmaniasis is increasing, especially in immunocompromized subjects.