Publications by authors named "Gepner P"

Introduction: Crowned dens syndrome is due to a microcrystalline infringement (hydroxyapatite or calcium pyrophosphate) of the retro-odontoidal ligament of atlas, often leading to the erroneous diagnosis of meningitis or spondylitis. We report on three new cases diagnosed from 1996 to 1999.

Exegesis: The patients complained of cervicalgies, headaches or fever.

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We report four cases of the side effects of minocycline seen during the last two years in our department. There was one case of drug-related lupus and three cases of hypersensitivity reactions, including one eosinophilic pneumopathy with pericarditis, one nephropathy and one severe, pseudo-infectious episode of high fever, rash, lympadenopathy, hepatitis and eosinophilia. Minocycline is a tetracycline agent widely used for acne therapy in France and all over the world.

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We retrospectively studied the epidemiological, clinical, histological and evolutive aspects of vertebral tuberculosis diagnosed in all consecutive patients recruited in 2 Parisian hospitals between January 1990 and July 1997. The diagnosis relied on a vertebral involvement associated with evidence of tuberculosis (culture of local puncture yielded Mycobacterium tuberculosis) or presumption of tuberculosis (evidence of other tuberculous focus, histological data, good outcome under specific treatment). Sixteen patients (mean age: 41 years; sex ratio: 1.

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Objectives: Over the last 3 years, we examined 15 patients on progesterone substitution therapy who presented prolonged fever. Many explanations had been put forward before the diagnosis was suggested. We recall the thermogenic effect of progesterone.

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This 20 year old white patient complained of progressive thickening of his fingers over a period of four years. The second, third and fifth fingers of each hand indeed appeared podgy. The soft tissue on each side of the first phalanx was swollen, firm without adherence to the bone.

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Objectives: We analyzed the clinical and biological characteristics as well as the clinical course and outcome observed in 20 patients with antiphospholipid antibodies and clinical signs including thrombosis or repeated spontaneous abortion to better identify the recently described antiphospholipid syndrome.

Methods: We retrospectively studied all patients observed in our unit from 1981 to 1992 who fulfilled the following inclusion criteria: a) at least one episode of arterial or venous thrombosis and/or repeated spontaneous abortions, b) positive for antiphospholipid antibodies.

Results: Twenty patients were included, 3 with systemic lupus erythematosus (according to the American Rheumatism Association criteria).

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We report a case of hyperthyroidism complicating and revealing a metastatized adenocarcinoma of the stomach with high circulating levels of human chorionic gonadotropin and its beta component. To our knowledge, this is the first reported case of a non-trophoblastic tumor with hyperthyroidism and secreting quantities of these hormones. High circulating levels of beta component in such patients have been considered to be a sign of malignancy.

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Nephrogenic diabetes insipidus is an exceptional complication of incomplete ureteric obstruction with hydronephrosis. We report one case of this condition revealing idiopathic retroperitoneal fibrosis. Pathogenic mechanisms are discussed.

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Twelve female patients treated by progestogens with or without estrogens presented with prolonged (1 to 48 months) elevation of body temperature above 37 degrees C but below 38 degrees C. They had usually continued taking their temperature after and initial transitory febrile episode. Most had had multiple diagnostic tests which remained negative.

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Occurrence of monoarthritis or oligoarthritis during the course of zoster is exceedingly rare (three previously reported cases). In the additional case reported herein, an immunocompetent female exhibited oligoarthritis (right shoulder followed by two metacarpophalangeal joints in her right hand) a few days before developing a typical zoster eruption in the ipsilateral upper limb. Pathogenesis of zoster-related arthritis is discussed.

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We report two cases of pulmonary arterial hypertension (PAHT) in HIV infected patients who never were, or had ceased to be, drug addicts. A study of these cases and a review of the literature show that this association is not fortuitous and persists after the classical causes of PAHT (pulmonary embolism, toxic factors, cirrhosis) have been excluded. The clinical features and the results of complementary cardiovascular examinations are identical with those of the so-called "primary" PAHT.

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In a patient treated with high doses of corticosteroids for giant cell arteritis, a renewed rise in sedimentation rate accompanied by painful limitation of mobility of the shoulder led to the discovery of an intra-deltoid fluid collection. Aspiration yielded pus, culture showing the presence of Nocardia asteroides (NA). No portal of entry nor extramuscular sites of infection were found, justifying a diagnosis of primary nocardial muscle abscess.

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D-dimers are specific fibrin degradation products which have been measured in plasma and used as a diagnostic test for deep vein thrombosis of the lower limbs. However, the results published so far have often been conflicting. We compared the results of D-dimer assays by the latex method (positivity threshold: 0.

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Clinical, usually moderate myopathy, frequently develops in patients with hypothyroidism and may reveal the thyroid dysfunction. Biological signs of myolysis, essentially a, usually moderate, rise in creatine phosphokinase plasma levels, are often found. On the other hand, rhabdomyolysis seems to be exceptional in this context.

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In a recent work, we provided evidence that the in vitro inhibitory effect of cyclosporin A (CsA) was potentiated by the addition of another immunosuppressive molecule, the 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). In the present study, we investigated the in vivo influence of the association of both drugs administered at infratherapeutic doses, using an experimental model of autoimmune thyroiditis in CBA mice. Treatment regimen of the animals was initiated at priming with thyroglobulin (Tg) and consisted of daily administration of CsA (10 and 20 mg/kg/day, intragastrically) and/or 1,25(OH)2D3 (0.

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