[Autoimmune abortive disease. A new entity of gynaeco-obstetrical expression].

The relationship between abortive disease and systemic lupus erythematosus is complex as shown by data from the literature and by our 9 patients selected for presenting with abortive disease, circulating anticoagulant and biological signs of autoimmunity. The risk of transformation into a systemic disease is real, although difficult to evaluate in the absence of prospective studies, but the major problem with these patients is the severity of the obstetrical pathology. The sombre foetal prognosis, already reported in the literature, requires close supervision and sustained treatment during pregnancy.

[Abdominal lymph node tuberculosis: diagnostic value of echography and x-ray computed tomography].

The aspects of abdominal ultrasonography and computed tomography (CT) were studied in 4 patients (3 African and 1 Haitian) with abdominal tuberculosis. All were markedly debilitated and three patients had protracted fever. Tuberculosis was documented in all cases by demonstrating Mycobacterium tuberculosis in cultures of lymph nodes taken during laparotomy and/or cultures of products of gastric aspiration.

Autoimmunity, fetal losses, lupus anticoagulant: beginning of systemic lupus erythematosus or new autoimmune entity with gynaeco-obstetrical expression?

Among the various autoantibodies commonly found in women with systemic lupus erythematosus, the so-called lupus anticoagulant has been described in association with fetal losses. Recently, women with repeated spontaneous abortions and lupus anticoagulant, but no apparent systemic lupus erythematosus have been described. We have studied prospectively the possible connections between fetal losses and autoimmunity in a large control study of 130 idiopathic habitual aborters.

[Trial treatment of severe Raynaud's phenomenon with prostacyclin (PGI2)].

Severe forms of Raynaud's phenomenon are very disabling. In a randomized, single-blind trial, we have evaluated the effects of PGI2, a natural compound with strong vasodilator and anti-platelet activities, in 14 patients presenting with Raynaud's phenomenon. The patients received a 24-hour infusion of either PGI2 in doses of 10 mg/kg.

[Psychic disorders in systemic lupus erythematosus. Prospective study of 35 cases].

In the prospective study reported, 35 patients with systemic lupus erythematosus underwent thorough psychiatric examination. They were divided into three groups according to whether their psychiatric symptoms were acute (10 patients), subacute (9 patients) or non-existent (16 patients). Particular attention was paid to such factors as obstetrical events (pregnancy, spontaneous or induced abortion), history of psychiatric disorders, emotional traumas and treatment with corticosteroids.

[Collagen diseases and microcirculation].

The microcirculation (terminal vessels with a calibre of less than 30 mu) was examined by means of capillaroscopy which was correlated with histological studies. According to the classification of vasculitis, microvasculitis is a pathological process involved in a number of collagen diseases. The study of the cutaneous lesions of leukocytoclastic angiitis is one of the best method for approaching the study of these microangiopathies, especially in the context of hypersensitivity vasculitis.

[Uveitis in acquired syphilis].

Syphilis is a well-established cause of uveal disease and is thought to be responsible for several distinct types of intraocular inflammation. Four cases of acquired syphilitic uveitis are reported. The diagnosis was essentially based on the clinical picture, the elimination of other possible causes, the results of reliable blood immunologic tests eg, the TPHA, FTA and Nelson tests, and the rapid response to penicillin therapy.

[Superior caval syndrome. Diagnostic and therapeutic management. Apropos of 20 cases].

Superior vena cava obstruction (SVCO) is an infrequent syndrome. Clinical diagnosis is often late. 20 cases of SVCO collected in 7 years are being reported.

[Necrotizing angiitis with or without asthma. Clinical, biological and etiological differences. Role of hepatitis B virus].

Sixty-five cases of necrotizing angiitis, including 20 with asthma (group A) and 45 without asthma (group B) were studied retrospectively. All patients were investigated for markers of hepatitis B, at least the HBs antigen. Skin lesions and arthralgias were more common in group B patients.

[Treatment of human brucellosis with rifampicin].

Rifampin, which exhibits good intracellular diffusion and in vitro bactericidal activity on brucella, is effective in experimental brucellosis in mice, without selection of resistant strains. It was therefore legitimate to use rifampin in man since conventional treatment of acute brucellosis is followed by recurrence in 15% (tetracycline alone) or 3.7% (streptomycin-tetracycline combination) of cases.

[Inferior caval syndromes. Apropos of 45 cases].

The authors report their experience with 45 cases of inferior vena cava thrombosis. Diagnosis was delayed for an average of 55 days. One-third of cases were revealed by an embolic complication.

[A case of purpura, or the return to natural diseases].

With reference to a case of vitamin C deficiency in a strict vegetarian, the authors recall the clinical findings and current diagnostic procedures in scurvy. Serum and urine ascorbic acid assays are now available and established the diagnosis. Management rests upon vitamin C given in a curative dosage of 1 to 2 g per day for 15 days followed by a preventive dosage of 10 mg per day.

[Splenic involvement in infectious endocarditis. 5 clinical cases and 78 necropsies].

Splenic involvement is a classical complication of infective endocarditis (IE). Clinical manifestations are rare, 5 out of 100 IE: unexpected rupture (1 case), abscess causing reinfection (2 cases), pseudo-tumour (1 case) and terminal infarction (1 case). In addition to a review of the literature, a post mortem histological study of the spleen of 78 cases of IE was undertaken.

[Periungual capillaroscopic aspects in Behçet's disease. Apropos of 30 cases].

Nailed capillaroscopy was systematically performed in 30 patients with Behcet's disease to search capillary dystrophies with paradoxal normal number of capillary loops; some indirect signs of microvascular disease were noted: pallor of the background; petechiae; sludge; abnormal visibility of the venous plexus and of irregularly arranged venules. Eight patients had a normal capillaroscopy: thirteen had direct signs of microvalvular abnormalities (nine cases with two direct signs and at least two indirect signs; and four cases with two direct and one indirect, or one direct and three indirect signs). Nine patients had only sludge and/or petechiae.