Pierre Dupont

Budd-Chiari Syndrome In A Patient With Systemic Lupus Erythematosus

SummaryA 28 year old woman with systemic lupus erythematosus presented with hepatomegaly and ascites.Clinical, histological and radiological investigations demonstrated the Budd-Chiari syndrome. The patient had two risk factors which could induce hepatic vein thrombosis: use of oral contraceptives and presence of the lupus anticoagulant. Despite fibrinolytic therapy followed by warfarin and corticosteroid, the patient died of hepatic failure five months after diagnosis. The so-called idiopathic Budd-Chiari syndrome could be due, at least in some patients, to the thrombogenous action of the lupus anticoagulant.

EARLY DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION BY MYOGLOBIN LATEX AGGLUTINATION TEST

long T relaxation times, should in turn give a higher signal than normal optic nerve when using this sequence. We have scanned eighteen patients aged 21-50 (mean 32 years) with optic neuritis and fifteen controls aged 21-64 (mean 35 years) using the STIR technique (IRl500/150/40), on a Picker 0-5 T superconducting system. We used a surface coil specially designed for orbital imaging (Picker International), to obtain 5 mm coronal and longitudinal slices through the orbits. All scans were reported by two neuroradiologists, without knowledge of the clinical status. Fourteen patients had an attack of acute unilateral optic neuritis 6 days to 18 months before being scanned (twelve were scanned within 4 weeks of the onset of symptoms). Ten of the fourteen had a high signal area in the appropriate optic nerve (see figure). Such a change was seen with clinically acute and chronic lesions. In two patients the affected nerve was larger than the unaffected one. Four patients had bilateral optic neuritis (three consecutive and one simultaneous) of whom three showed areas of increased signal in

Traitement A Long Terme De L’Hypertension Arterielle Severe Avec Le Minoxidil, Nouveau Vasodilatateur Puissant

SummaryTwenty-five severe hypertensive patients uncontrolable with conventional medication either because of resistance or because of dose limiting sideeffects received minoxidil, a powerful new vasodilator, for a total period of 300 months (1 to 36 months-mean duration: 12 months).Mean daily dosage varied from 15 mg during the first month (25 patients) to 47 mg at the 18th month (7 patients). Compared with initial values measured under conventional treatment (230/130), systolic and diastolic blood pressures dropped 20 % during the first month (180/100) and more than 40% at 18 months (130/80). During the following months these good results were maintaind with similar doses of minoxidil.Increased heart rate and cardiac output, hyperreninemia and fluid retention are usual physiological consequences of vasodilators. Therefore, betaadrenergic blocking agents and diuretics, sometimes in very large doses, have to be used with minoxidil.Hirsutism is a frequent side effect. It represents a serious limitation to t...