Competitive enzyme inhibition immunoassay of apolipoprotein A-I: use of monoclonal antibodies.

An original competitive enzyme inhibition immunoassay has been developed for determination of total apolipoprotein A-I (apo A-I) in serum and in plasma. This specific assay involves a single monoclonal antibody (F59 4A12 2F4, directed to the -COOH terminal region of the apo A-I molecule) and a stable secondary plasma standard. Delipidation of serum samples exposed no additional antigenic sites, which suggests that all the apo A-I molecules express the epitope detected by Mab 4A12 on the surface of the apo A-I-containing particles.

[Temporal arteritis: a syndrome. From Horton's disease to periarteritis nodosa].

Four cases of histologically proven temporal arteritis presenting with atypical clinical, anatomical or evolutive features and raising nosological problems concerning the type of vasculitis involved are presented. In patients with temporal arteritis, some elements are suggestive of periarteritis nodosa. They include peripheral neurological lesions, renal or pleuro-pulmonary lesions and the histological appearance of the temporal artery.

[Behçet's diseases with multiple intracranial arterial aneurysms].

A case of multiple intracranial arterial aneurysms occurring in a 43 year-old patient with an 8-year history of Behcet's disease is reported. The diagnosis was based upon the past occurrence of polyarthritis, oral and scrotal aphthous ulcers and cutaneous hypersensitivity. There was a three year remission after a brief treatment with corticosteroids.

Rhabdomyolysis and acute renal failure in a patient with thermal injury.

We report a case of rhabdomyolysis with acute renal failure during recovery from thermal burn injury. The late occurrence of this unusual complication is emphasized and possible etiological factors are discussed.

[Diffuse recto-colic malacoplakia: association with cryptogenic colitis and remission following long-term antibiotic therapy].

Diffuse digestive malakoplakia appears exceptional. A case of rectocolic malakoplakia with multiple localisations is reported in a 22 year old man presenting with inflammatory bowel disease. The most prominent clinical features were deterioration of his general condition, fever, and rectal bleeding, with fistula.

[Horton's disease: a too often delayed diagnosis. Plea for an early biopsy of the temporal artery].

The diagnosis of temporal arteritis is made after a mean delay of four months. This delay is explained by the absence, in 50% of cases, of any clinical sign in the temporal area, the possible presence of alterations in liver function tests, and the frequency of anemia and loss of weight. These signs often suggest a mistaken diagnosis of hepatobiliary disease or cancer.

[Horton's disease: retrospective study of 33 cases and review of the literature].

Temporal arteritis is still often overlooked in 1982 as shown by the diagnostic delay reported in a retrospective review of 33 patients and in the series previously published in the medical literature. Clinical features to be especially kept in mind are the occasional nature of temporal signs, the pathognomonic value of jaw claudication and the existence of signs which may constitute a premonitory syndrome of blindness. The frequent rise in alkaline phosphatase levels is often misleading.

[The treatment of peripheral neuropathies in a case of IgA myeloma and one of mixed cryoglobulinaemia. Repeated plasmapheresis (author's transl)].

Peripheral neuropathies were the presenting feature of an IgA lambda myeloma in a 61-year-old man and a mixed cryoglobulinaemia in a 46-year-old woman. A spectacular improvement in these symptoms followed treatment including large volume plasma exchanges with appropriate chemotherapy. This efficacy of repeated plasmapheresis leads to a discussion of the possible mechanisms of these neuropathies.

[Malignant non-secreting cortico-adrenalomas. Four cases (author's transl)].

In three of these four cases of malignant tumour of the adrenal cortex, a prolonged fever and a major inflammatory syndrome were the presenting features. The precise diagnosis was made before surgery only once. In two cases, it was a surgical discovery (one patient operated upon with a false diagnosis and another with no precise diagnosis).

[Malignant lymphopathy in a patient suffering from acute disseminated lupus erythematosus (author's transl)].

The authors report a case of acute disseminated lupus erythematosus in a 55 years old patient, receiving small doses of corticosteroids, progressing over three years. During an acute exacerbation of the disease, the development of a cervical adenopathy led to a biopsy. Histological examination revealed a lymphocytic type malignant proliferation (centro-follicular lymphoma).

[Use of immunosuppressive agents in systemic diseases].

The use of immuno-suppressive agents in systemic diseases where the auto-immune origin is probable or certain is not yet based on definite physiopathological evidence. Therefore, it seems essential to use this treatment which has definite side effects only in cases where the progressive nature of the disease, renal complications or the incomplete or nil efficacy of less agressive treatments, leave no choice.

[Development and long term prognosis of lupus erythematosus (apropos of 124 cases)].

The authors report their experience of the course of lupus erythematosus. The ten year survival rate in 124 patients was 79.3 %.