J. Constans

Thrombose veineuse profonde contemporaine d'une varicelle de l'adulte

INTRODUCTION Some viral infections are associated with deep venous thrombosis. We report a case of deep venous thrombosis in an adult with varicella. He had neither known predisposing factors for thrombosis nor thrombophilia. EXEGESIS Transient significant level of antiphospholipid antibodies and lupus circulating anticoagulant were observed. There was no evidence of thrombophilia. Deep venous thrombosis has been mostly associated with varicella in children. A transient protein S deficiency was present in almost all cases, though it was sometimes related to an anti-protein S antibody. This association is exceptional in adults. Some viruses such as herpesvirus and HIV are responsible for endothelium dysfunction, but this is still unclear in the case of varicella-zoster virus. CONCLUSION In our observation, endothelium activation or antiphospholipid antibodies might be responsible for thrombosis.

Acides gras membranaires et anti-oxydants sériques chez 77 patients infectés par le VIH

We have measured the fatty acid (FA) composition of erythrocyte membranes and plasma anti-oxidants in HIV+ patients. Saturated FA are higher and poly-unsaturated FA lower than in controls (P = 0.02). Selenium (Se) is lower in patients less than 400 CD4 cells/mm3 (P = 0.002). Vitamin A is lower in the HIV+ regardless of the CD4 cell count. Se and vitamin A are correlated to nutritional markers (body mass index and albumin).

Cinétique des lipides plasmatiques au cours des infections bactériennes aiguës

We have measured plasma lipids in 30 patients with 32 bacterial infections before (d0) and 3 (d3), 7 (d7) and 14 (d14) days after the beginning of therapy and 1 month after (d30). A decrease in IDL-cholesterol (p 0.01) occurred at d3. These abnormalities were negatively correlated to inflammatory parameters: HDL to CRP (p = 0.001) and fibrinogen (p = 0.001), and cholesterol to CRP (p = 0.01).

Atteintes cardiaques au cours des sclérodermies: étude en écho-cardiographie et doppler cardiaque chez 38 patients

A study of heart lesions has been conducted in 38 patients with systemic sclerosis using echocardiography, doppler and colour doppler. Abnormalities were found in 66% patients. Valvulopathies (mainly mitral regurgitation) were the most frequent lesions (45%). The presence of anti-SCL70 antibody was correlated to right cavities dilatation. Pulmonary hypertension was found in 6 patients.

Interféron et facteur de nécrose tumorale sériques chez 95 patients infectés par le VIH

We have measured TNF-α and interferonα in 95 HIV positive patients and 20 healthy subjects. TNF-α was higher in the HIV+ patients ( P = 0.0001) and was correlated to the CD4 cell count ( P = 0.02) and cholesterol (negatively) ( P = 0.04). Interferon-α was correlated to the wasting syndrome ( P = 0.002), hypertriglyceridemia ( P = 0.004) and haematocrit ( P = 0.04).

Sclérodermie systémique et leucémie à tricholeucocytes

Abstract We report the simultaneous occurrence of systemic sclerosis and the relapse of hairy cell leukemia. This is to our knowledge the first published observation of this association and it raises the question of its mechanism.

Lymphœdème chronique isolé des membres inférieurs: penser au sarcome de Kaposi

We report two cases of chronic lymphedema revealing Kaposis sarcoma in one African and one Mediterranean HIV negative patient. In one case lymphedema remained the only sign of disease for as long as four years. Kaposis sarcoma often gives lymphedema but revealation of the disease by chronic lymphedema without any node has not been described to our knowledge.

Sclérodermies « fulminantes : trois observations

We report three cases of systemic sclerosis leading to death some months after the first symptoms of the disease. In both cases heart, kidney and brain were mainly involved.

Fibrose pulmonaire et syndrome sec précédant une vascularite cutanée liée à une cryoglobulinémie associée à l'hépatite C

We report the case of a 64 year-old woman who had pulmonary fibrosis and sicca syndrome for 4 years and in whom vascular purpura occurred, leading to the diagnosis of C hepatitis related cryoglobulinemia. The nosologic links between diseases are discussed.

Porphyrie cutanée tardive au cours de l'infection par le VIH: rôle déclenchant possible de l'hépatite C

We report on porphyria cutanea tarda (PCT) in a HIV positive woman who had chronic B and C hepatitis. The latter virus has been reported elsewhere to act as a revealing factor in this disease and might explain the 41 cases of PCT now reported in HIV + patients in the literature.