Extreme hypogammaglobulinemia disclosing large granular lymphocytes with hepatosplenorenal infiltration

We report a case of large granular lymphocytosis, or chronic "natural killer" lymphocytosis, a newly described entity. We were able to demonstrate the proliferative character of the disease by the finding of karyotype abnormalities. This case was remarkable for the pre-existence, for at least three years, of severe hypogammaglobulinaemia, for the very slow course of the proliferative process and for the progressive and tumoral infiltration of the spleen and liver, then kidney.     

Thrombotic microangiopathy and the antiphospholipid antibody syndrome.

A 23-year-old woman with the antiphospholipid syndrome developed severe thrombocytopenia (14 x 10(9)/l) and microangiopathic hemolytic anemia after plasma exchange. A relation was suspected between rising anticardiolipin level and development of thrombotic microangiopathy. The mechanism responsible may be interference between anticardiolipin antibody, platelet membrane and endothelial cell.     

The pineal and endocrine changes in heat exposed male hamsters

Summary Decreased testicular weight with damaged seminiferous tubules were observed in hamsters pinealectomized and exposed continuously to high ambient temperature. In hamsters with intact pineals, exposure to heat resulted in reduced testicular weight without recognizable histological damage. In both groups, serum testosterone levels were elevated, evidently through a compensatory mechanism in the interstitial cells, which did not appear to be damaged. Concomitantly with these findings, reduced serum LH, and pituitary LH and proclactin concentrations were encountered in the heat-exposed pinealectomized hamsters, compared to those of their heat-exposed sham-operated counterparts.These results in hamsters reaffirm a previous postulation of a moderating, protective role for the pineal, against adverse effects of prolonged exposure to heat, in rodents.     

Chemotactic agents induce IL-6Ralpha shedding from polymorphonuclear cells: involvement of a metalloproteinase of the TNF-alpha-converting enzyme (TACE) type

Interleukin (IL)-6 transsignaling plays a pivotal role in the shift from neutrophil to monocyte recruitment at the inflammatory site. Release of neutrophil IL-6 receptor-alpha (IL-6Ralpha, CD126) in its soluble form is a key step of IL-6 transsignaling, however, its physiological inducers are poorly known. Here, we observed that the neutrophil chemoattractants IL-8, C5a complement fraction, platelet activating factor, leukotriene B4 and N-formyl-methionyl-leucyl-phenylalanine rapidly decreased IL-6Ralpha membrane expression and increased soluble IL-6Ralpha concentrations in the neutrophil supernatants, consistent with a shedding process. IL-6Ralpha shedding involved a TNF-alpha-converting enzyme-type metalloproteinase since it was partly decreased in the presence of a specific inhibitor, but not cathepsin G since PMSF or alpha1 antichymotrypsin had no effect. Neutrophil IL-6Ralpha shedding may be a common feature of neutrophilic infiltrates in various inflammatory situations, allowing IL-6 transsignaling, decreasing neutrophil infiltration and in the meantime favoring monocyte recruitment, thus the initiation of an immune response and subsequently the resolution of inflammation.     

Quantitative study of the osteoblasts and osteoclasts in the bones of rats during the simulation of weightlessness

Tibia and vertebrae of rats exposed to hypokinesia or head-down suspension were investigated by quantitative histomorphometry. It was found that 35- and 60-day hypokinesia as well as 35-day suspension caused osteoporosis in the tibial and vertebral spongiosa. The development of osteoporosis was accompanied by a significant reduction in the number of osteoblasts in the primary spongiosa of tibia and vertebrae whereas no noticeable changes in osteoclasts were observed either in hypokinetic or suspended rats. The only exception was lumbar vertebrae in which the amount of osteoclasts decreased as a result of 60-day hypokinesia. It is assumed that the reduction in the number and activity of osteoblasts plays the major part in the development of osteoporosis during hypokinesia and suspension.     

Morphological study of early changes in rat bones during exposure to simulated weightlessness

By histomorphometric methods tibial bones and lumbar vertebrae of rats exposed for 7 days to hypokinesia or head-down suspension were investigated. Both hypokinesia and suspension led to osteoporosis of the tibial metaphyseal spongiosa which was primarily induced by bone growth inhibition and probably by increased bone resorption. No signs of osteoporosis were seen in tibial diaphyses. In contrast to tibial bones, osteoporosis of the spongiosa of lumbar vertebrae was found only in hypokinetic rats. It is concluded that during exposure to simulated microgravity early signs of osteoporosis occur in the tibial spongiosa and that changes in the spongy matter of tubular bones and vertebrae are similar and systemic. It is suggested that an acute stress-reaction in response to simulated microgravity plays a certain role in the development of osteoporosis.     

Central nervous tuberculosis in patients non-VIH: seven case reports

PURPOSE: Tuberculosis involving the central nervous system (CNS) is rarely observed in non immuno-compromised hosts. We report herin the various clinical, biological and radiological manifestations observed in 7 patients with CNS tuberculosis. METHODS: Clinical and biological records of 7 patients with CNS tuberculosis were retrospectively studied. All patients had encephalic CT-scan and MRI in the course of the disease. RESULTS: 5 women and 2 men with a mean age of 38.4 years initially initially presented with headache (n = 6), fever (n = 5), meningeal irritation (n = 3), localizing neurological signs (n = 1). Lumbar punction revealed lymphocytic meningitis (n = 6/7). Mycobacterium tuberculosis or bovis was isolated in 3 patients only. Cerebral tomodensitography or magnetic resonance imaging were initially normal in most of cases (n = 4/7), but discovered in the course of disease basilar meningitis (n = 6), hydrocephalus (n = 6), abcess or tuberculoma (n = 4). In all the patients, initiation of the treatment was complicated by clinical and/or biological deterioration, called paradoxal reaction, leading in all cases to glucocorticoid adjunction, with various final results. Indeed, 4 patients developed neurological sequelae. No patient died. CONCLUSION: CNS tuberculosis is a rare disease in non immunocompromised patients whose diagnostic may be difficult due to the absence of specific clinical symptoms, negative initial radiological examination, as well as delayed and often negative bacterial isolation. Paradoxal reaction appeared to be frequent despite specific antibiotherapy and underlines the beneficial effects of addictive corticosteroids.