Autoantibodies to lamins in rheumatoid arthritis

The presence of autoantibodies reacting with lamins A and C was demonstrated in sera from 2 patients with rheumatoid arthritis (RA). One patient developed antilamin antibodies several years after being diagnosed as having RA; she was also found to have chronic active hepatitis. The second patient had severe nodular RA. We describe the other serologic findings in these 2 patients and discuss the relationships between antilamin antibodies and RA.     

An Apical Mass of the Left Ventricle After a Myocardial Infarction: Imaging Contribution

Intramyocardial dissecting hematoma (IDH) is a rare complication of myocardial infarction (MI). It can affect the left ventricular free wall, the right ventricle, or the interventricular septum. We report a case of a 58-year-old man with an IDH following an acute anterior wall myocardial infarction detected by echocardiography and confirmed by Cardiac magnetic resonance (CMR).     

Démarche diagnostique devant une lymphopénie : quand penser à la lymphopénie CD4 idiopathique ?

Lymphocytopenia is defined by a lymphocyte count less than 1500/mm³ in adults and less than 4500/mm³ in children before the age of 8 months. Lymphocytopenia can be global or selectively affect a peculiar lymphocyte subpopulation. The patient's age, the context as well as the associated clinical manifestations and treatment prescribed must be taken into account in order to identify the etiology of lymphocytopenia. In adults, lymphocytopenia can be caused by: (1) insufficient thymic output (primary immune deficiencies, corticosteroid treatment, zinc deficiency, etc.), (2) increased lymphocyte catabolism (radiotherapy, chemotherapy, immunosuppressant, HIV infection, systemic lupus, etc.), (3) modified lymphocyte distribution (viral infections, septic shock, extensive burns, splenomegaly, granulomatosis, etc.), (4) multifactorial or unknown etiology (end-stage renal disease, lymphoid malignancies, solid tumor, ethnicity, etc.). In children, in addition to these etiologies, other immune deficiencies may be responsible for severe lymphocytopenia (thymocytes apoptosis, cytokine deficiencies, altered B-cell and T-cell receptor synthesis, signal transduction and cellular interactions deficiencies). Idiopathic CD4⁺ lymphocytopenia is a rare disorder. It is defined by a persisting lymphocyte CD4⁺ count less or equal to 300/mm³ or less or equal to 20% of total lymphocytes in the absence of alternative diagnosis. Clinical symptoms can be absent or include opportunistic infections, auto-immune manifestations, lymphoma or solid tumors. Treatment is similar to that of HIV-infected patients and sometimes relies on specific immunotherapy even though clinical benefit has not been evaluated.     

An unusual complication following stenting in a patient with chronic mesenteric ischaemia due to radiation therapy

The endovascular treatment is the first-line revascularization technique in chronic mesenteric ischaemia. We report a case of reperfusion haemorrhage complicating endovascular repair of severe stenosis of the superior mesenteric and coeliac arteries’ anatomic variant following abdominal radiation therapy. The haemorrhage resolved spontaneously after medical management, with successful outcome.     

Synovial hemangioma of the knee joint. A case report

Synovial hemangioma of the knee joint was diagnosed in a young woman 15 years after the first signs. The principal clinical manifestation involved repeated episodes of hemorrhagic joint effusion. MRI is the exploration of choice for this vascular tumor of the synovial membrane, although a pathology study is needed to confirm the diagnosis. Cure is achieved with surgical resection.     

Acute pancreatitis due to a metallic foreign body

We report a case of acute pancreatitis caused by a metallic foreign body located in the pancreatic head in a 38-Year-old woman. Only 15 cases of acute pancreatitis due to foreign bodies, metallic in five cases, have been published to date. In our case, diagnosis was established by the computed tomography scan. The patient declined surgery.     

Esophageal involvement in Behcet's disease

Esophageal involvement in Behcet's disease is very rare, and normally is observed as aphtosis and esophagitis, but serious complications such as erosions, perforations, and stenosis may occur. We carried out this prospective study to evaluate the prevalence of esophageal involvement in Behcet's disease and to establish if routine endoscopy and/or manometry are necessary. Twenty-three patients who fulfilled the diagnostic criteria of the international study group for Behcet's disease were enrolled. None were taking drugs or had disease that might produce esophageal abnormalities or alter any existing changes due to the Behcet's disease itself. Twenty- three patients underwent esophagogastroduodenoscopy by a single observer. Esophageal biopsies were performed in thirteen patients and esophageal manometry in twenty. At the beginning of the study, the disease activity was defined by the presence of more than one symptom related to Behcet's disease, and upon the classification of Behcet's disease. Of the twenty three patients enrolled two were excluded from final analysis because of the presence of hiatus hernia. Thus, 13 men and 8 women, ranging in age from 20 to 63 years with a mean age of 36.2 years were included. Ten patients (47.6%) had active disease and four (19%) complained of upper gastrointestinal symptoms at the time of the study. Fourteen patients had endoscopic, manometric and/or microscopic abnormalities. Esophageal manometry was performed in twenty patients and was abnormal in 7 cases (35%). Esophageal biopsies were done in 13 patients and revealed histopathological abnormalities in 5 cases. Microscopic findings showed vasculities in one case, and non-specific inflammatory infiltration mainly consisting of neutrophils in 4 cases. Our results suggest that the prevalence of esophageal involvement in Behcet's disease is rather high and occur even in asymptomatic patients, but that this usually does not result in specific abnormalities.