Diagnostic errors in rheumatology and medico-legal consequences.

Medical errors and adverse effects of treatment are inherent to medical practice. Like any other medical specialty, rheumatology is not exempt. Although the problem is imprecisely quantified, according to some authors it affects up to 10% of hospitalised patients.

Reactive arthritis after COVID-19 vaccination: 17 cases.

Objectives: The aim of the study is to report a series of 17 cases of ankle bi-arthritis that occurred shortly after coronavirus disease 2019 RNA vaccination, and to discuss the potential role of these vaccines in the pathogenesis of this rheumatological manifestation.

Methods: All patients were examined in the same department and received a full work-up to investigate the usual causes of ankle bi-arthritis. No rheumatic inflammatory disease occurred after 9 months of follow-up.

Quantifying lies in medical expert assessment.

Although lying is ubiquitous and present in all fields, there are very few medical references dealing with this subject. The aim of this study is to quantify and qualify lying in medical expert assessment. It is a retrospective study of 32 medical expert assessment cases, separated into two groups.

[Autoimmune hepatitis and CREST syndrome].

We report the case of an autoimmune hepatitis in a 59-year old woman who was referred for a progressive jaundice. The patient had an history of CREST syndrome. The particularity of this case report is the rare association between these two autoimmune diseases.

A reference standard for plasma proteins is required for nutritional assessment of adult burn patients.

Plasma levels of visceral proteins (VP) are commonly used for evaluation of nutritional status. Low values observed in burn patients are caused by several factors including microvascular hyper-permeability and inflammatory processes. The aim of the study was to define a range of standard values specific to burn patients.

Ankylosing spondylitis with primary Sjögren's syndrome: the first two case-reports.

Sjögren's syndrome and ankylosing spondylitis can occur either alone or in conjunction with other disorders. We report on two patients who met criteria for both primary Sjögren's syndrome and ankylosing spondylitis. Class I and II histocompatibility phenotypes were strikingly similar in the two patients and are in favor of a chance association.

Rheumatic manifestations due to human parvovirus B19. A report of four cases.

Human parvovirus B19 has been incriminated in the genesis of hematologic, dermatologic, neurologic, and rheumatic disorders. We report four cases in which inflammatory rheumatic manifestations developed during the course of human parvovirus B19 infection documented by the presence of IgM and IgG antibodies. There was one case each of monoarthritis, oligoarthritis, polyarthritis, and enthesitis.

Chronic eosinophilic pneumonia followed by Churg-Strauss syndrome.

Chronic eosinophilic pneumonia and Churg-Strauss syndrome are two uncommon conditions of unknown etiology that share similar pulmonary manifestations. Whereas chronic eosinophilic pneumonia mainly targets the lung, Churg-Strauss syndrome is a systemic diseases. We report three patients who developed Churg-Strauss syndrome about eight years after being diagnosed with chronic eosinophilic pneumonia.

Chronic interstitial cystitis occurring during the shift between rheumatoid arthritis and lupus.

This case reports documents the progressive development of chronic interstitial cystitis during the overlapping process from rheumatoid arthritis to lupus. Concomitantly high titer antinuclear antibody with an anti-68 KD RNP pattern and other biological markers of lupus were observed in the blood. The symptoms dramatically improved under methotrexate therapy.

Neurological manifestations of systemic lupus erythematosus: role of antiphospholipid antibodies.

Antiphospholipid antibodies (APL) are associated with venous and arterial thrombosis in SLE patients. Various thrombotic and non-thrombotic neurological manifestations have been reported in SLE but whether or not they are related to the presence of APL antibodies remains uncertain. To assess the possible association between neurological involvement in SLE and APL antibodies, IgG anticardiolipin antibodies (IgG ACL) were looked for using an ELISA technique in 92 consecutive SLE patients seen over a one-year period.

Elbow synovitis related to an intraarticular osteoid osteoma of the humerus, with immunologic and histochemical studies.

An 18-year-old boy presented with elbow synovitis. Investigations disclosed an osteoid osteoma of the coronoid fossa confirmed by histology. The synovium appeared hypertrophic with histologic patterns resembling those seen in synovitis in rheumatoid arthritis.

Multiple sclerosis: cell-mediated immunity to human brain gangliosides.

Cell-mediated immunity (CMI) to myelin components has been implicated in Multiple Sclerosis (MS) pathogenesis: two targets were suggested, Myelin Basic Protein with controversial results and, more recently, gangliosides. In order to investigate their possible involvement, we have performed Leukocyte Migration inhibition (LMI) tests in the presence of human brain gangliosides. Thirty nine MS patients (twenty four being "definite", according to McDonald and Halliday's classification), twenty nine patients with Other Neurological Diseases (OND), thirty six patients with Inflammatory diseases (ID) and forty healthy controls were tested.

Regulation of experimental autoimmune encephalomyelitis. Specificity of the 'recovery-associated' suppressor cells.

We previously reported the presence of suppressor cells in Lewis rats at the very time of spontaneous recovery from experimental autoimmune encephalomyelitis. As these 'recovery-associated' suppressor cells might be implicated in the self-cure process, we investigated their specificity on the in vitro lymphoproliferative responses of a T cell line specific for myelin basic protein (MBP). We report now that these suppressor cells found in the thymus are specific for MBP, and not for T cell receptors, contrasting with the 'post-recovery' suppressor cell specificity reported by others.

[Experimental autoimmune encephalomyelitis: immunoregulation and genetic control].

EAE is a good model of autoimmune diseases and an approximate one of MS, particularly in its chronic recurrent and demyelinating forms. The antigenic target of EAE has recently been better defined: in different species, as well as within a given one, the encephalitogenic determinant, target of T effector cells, is located in different parts of the basic protein of myelin. The recognition of the relevant epitope is influenced by the genotype of the antigen presenting cells.

An OKT4+ T-cell population in Sézary syndrome: attempts to elucidate its lack of proliferative capacity and its suppressive effect.

We have previously reported a case of Sézary Syndrome (SS), in which an OKT4+ T-cell population exhibited a defective response to non-specific mitogens, and an ability to suppress lectin-induced T-cell proliferation and pokeweed mitogen (PWM)-induced B-cell differentiation of normal donor peripheral blood mononuclear cells (PBMC). We report now that resting Sézary cells (SC) were essentially negative for activation antigens (Ag) detected by monoclonal antibodies (MoAb) B1.49.

Detection of HTLV-I (human T-cell lymphotropic virus, type I) proviral DNA in leukemic cells from a French patient with Sezary syndrome.

Human T-lymphotropic type I (HTLV-I) proviral sequences were detected in leukemic cells of a patient living in Marseilles (south of France) and suffering from Sezary syndrome. He did not have any travel history outside France and did not receive blood transfusion or hepatitis B vaccination. This case of HTLV-I positive Sezary syndrome is the first one described outside the known endemic regions for HTLV-I.

An OKT4+ T-cell population with suppressor activity in Sézary syndrome.

This report describes a case of Sézary syndrome with the surface marker phenotype of a mature distinct T-cell subset OKT3+, OKT4+, OKT8-, OKT17+, OKIal-(+). Functional studies indicated that the patient's peripheral blood cells showed a very low proliferative response to non-specific mitogens (phytohaemagglutinin, concanavalin A, pokeweed mitogen) and failed to differentiate into plasma cells in a pokeweed mitogen--immunoglobulin-synthesis-driven system. In coculture with normal cells the leukaemic cells were able to suppress lectin-induced T-cell proliferation and B-cell differentiation in a dose-dependent manner.