Involvement of the same TNFR1 residue in mendelian and multifactorial inflammatory disorders.

Objectives: TNFRSF1A is involved in an autosomal dominant autoinflammatory disorder called TNFR-associated periodic syndrome (TRAPS). Most TNFRSF1A mutations are missense changes and, apart from those affecting conserved cysteines, their deleterious effect remains often questionable. This is especially true for the frequent R92Q mutation, which might not be responsible for TRAPS per se but represents a susceptibility factor to multifactorial inflammatory disorders.

[Hypertrophic osteoarthropathy and aortic graft infection: Two cases].

Introduction: Hypertrophic osteoarthropathy (HOA) located to lower extremities may be the initial manifestation of an infected aortic graft.

Case Reports: We report two patients with HOA secondary to aortobifemoral vascular prosthesis infection and aortoenteric fistula. As reported in the literature, initial manifestations included fever, painful swelling of limbs, joint pain, clubbing and in one case intestinal bleeding.

[Inappropriate low glycated hemoglobin and hemolysis].

Hemoglobin A1c (HbA1c), measured regularly in the patients with diabetes, is the major form of stable glycated hemoglobin and has to be maintained below 6.5% to prevent or decrease the risk of chronic complications. HbA1c reflects mean blood glucose levels of the previous 3 months.

[Extrapontine myelinolysis of favorable outcome in a patient with autoimmune polyglandular syndrome].

Introduction: Extrapontine myelinolysis is a well-known complication of hyponatremia and its treatment. It rarely occurs without central pontine myelinolysis, usually after overly rapid correction of hyponatremia. Its prognosis is considered poor.

[What do general practitioners expect from internal medicine? Results of postal survey].

Subject: The place of internal medicine in the French health care system is a matter of debate. In the process of writing down a project for the department of internal medicine of a University hospital, we decided to assess the expectations of general practitioners toward internal medicine in general, and toward this department in particular.

Methods: We carried out a postal survey over a population of general practitioners working in the referral area of our University hospital.

[Silent myocardial ischemia in type 2 diabetes. Predictive value of intima-media thickness].

Context: The carotid intima-media thickness (CIT) is correlated with the prevalence of cardiovascular diseases. We studied the relationship between the thickness of the carotid intima-media and the existence of myocardial ischemia, detected by scintigraphy in a population of type 2 diabetic patients without coronary antecedents.

Methods: We conducted repeated Doppler measurements of the CIT of primitive carotid arteries in 52 diabetic patients aged 49 to 75.

Residual inflammatory process after aortoiliac reconstructive surgery.

Background: The aim of the present study was to investigate the inflammatory reaction and its evolution in patients who underwent a prosthetic vascular procedure. Moreover the participation of this chronic process, during the follow-up, as a promoting or a consequence of vascular injury must be discussed.

Methods: Thirty-four patients were enrolled in the study.

[Chronic fatigue syndrome: a critical review].

The term "chronic fatigue syndrome" (CFS) applies to a condition of unknown aetiology characterized clinically by an association of subjective symptoms, the most constant being an invalidating tiredness. The diagnostic criteria in current use do not permit to isolate an homogeneous subgroup among patients consulting for chronic asthenia. In the present state of research no infectious or immunological cause has been demonstrated conclusively, although a persistent enterovirus or herpesvirus type 6 infection or a state of chronic immune activation seem to play a role in some cases.

[Contribution of 99mTc MAG3 in hypertension in an elderly subject with renal artery thrombosis].

To ascertain the responsibility of renal artery thrombosis for the genesis of arterial hypertension, the methods available are not sufficiently sensitive and reproducible, and the residual revascularization maintained by a vicarious arterial network is not easy to demonstrate. Renal scintigraphy with technetium 99m-labelled mercaptoacetyltriglycine (MAG3) was performed in 4 old and severely hypertensive male patients with chronic thrombosis of one renal artery. With this tracer the thrombotic kidney was detected lately and weakly at the vascular and nephrographic stages.

[Pheochromocytoma disclosed by isolated inflammatory syndrome].

Among the atypical forms of phaeochromocytoma the isolated inflammatory form is rare and difficult to diagnose clinically. The authors report such a case, where computerized tomography and magnetic resonance imaging contributed enormously to the diagnosis.

[Antiprothrombinase and myocardial infarction. Apropos of 2 cases].

Among the thrombotic events associated with a circulating anticoagulant of the antiprothrombinase type, myocardial infarction is exceptionally reported, which justifies the presentation of two cases. In both patients, myocardial necrosis occurred some time after the antiprothrombinase was discovered, and there was nothing special in its clinical features. No obvious atherosclerotic lesion and no image suggestive of vasculitis were found at coronary arteriography, which suggested that the antiprothrombinase played a predominant role in the genesis of infarction.

[TeBG and thyrotoxicosis in the hot thyroid nodule].

The binding capacity of serum TeBG (testosterone-estradiol binding globulin), the plasma concentrations of thyroid hormones and the TSH response to TRF (200 micrograms i.v.) have been measured in female patients with a solitary autonomously functioning thyroid nodule (n = 26) or with a cold thyroid nodule (n = 20).