[Myasthenia gravis and elderly persons. A case study].

Introduction: Myasthenia gravis is an uncommon autoimmune disease which affects all ages. There are late-onset occurrences whose diagnosis is not considered often enough in geriatrics.

Exegesis: We report a case of late-onset myasthenia gravis with a 78-year-old woman who was multi-pathologic and hospitalized for a diplopia check-up and recurrent falls.

[Isoform 4 of apolipoprotein E and Alzheimer disease. Specificity and clinical study].

We studied apolipoprotein E (apoE) phenotype in 113 patients with possible and probable Alzheimer's disease (AD), 49 patients with Parkinson's disease (including 11 patients with dementia) and 23 patients with mixed and vascular dementia. Normal controls were 498 young, healthy blood donors previously recorded. All patients were assayed for blood lipid parameters.

[Arterial hypertension in elderly patients, and difficulties in its treatment].

In treating elderly patients with hypertension, specific characteristics should be taken into account. These are related to general hemodynamics, renal function and neurohormonal systems. Medications are the same as those used in middle-aged hypertensive patients.

[Sarcoidosis disclosed by renal insufficiency (3 cases)].

Sarcoidosis was found in three patients referred for etiologic diagnosis of chronic or rapidly progressive renal failure. One patient presented as an isolated interstitial nephropathy and renal biopsy showed granulomatosis. The two other patients had hypercalcemia.

[Decrease of the 3rd fraction of serum complement. Study in a hospital population of 13000 patients].

Patients with serum concentrations of C3 lower than 0.40 g/l among 13 000 patients in a general hospital seen over an 18 months period were studied. 95 cases were eligible for study.

[First human case of Drechslera longirostrata mycosis. Spondylodiscitis complicating prosthesis endocarditis. Treatment with combined ketoconazole and amphotericin B].

In a patient with spondylodiscitis secondary to cardiac valve prosthesis infection with endocarditis the fungus Drechslera longirostrata, which had not yet been known to cause mycoses, was isolated from cultures of prosthetic material and an intervertebral disc. The cardiac prosthesis had to be replaced and the vertebral lesion, which extended along 3 lumbar segments and was destructive enough to produce neurological disorders, required surgical immobilization of the spine. The disc infection was cured after combined administration of amphotericin B and ketoconazole, both drugs having proved unsuccessful when given alone.

[Amyloidosis and polycythemia vera (author's transl)].

The authors report a case of systemic amyloidosis with predominantly hepatic, splenic and renal deposits and polycythemia vera with secondary myelofibrosis. The course of both diseases during a 9-year-follow-up and the late appearance of a monoclonal IgM lead the authors to examine a possible relationship between the two diseases.

[Granulomatous nephropathy of tuberculous origin revealed by prolonged fever (author's transl)].

In a 66-year-old female patient with a past history of tuberculosis, prolonged fever at 38 degrees C accompanied by a strong increase in ESR ultimately led to the diagnosis of renal cyst. Biopsies of renal tissue and of lymph nodes taken during surgery showed renal granulomatosis without caseum. Despite negative bacterial findings and anergy to tuberculin, an anti-tuberculous treatment was administered and the patient recovered.

[Severe aortic incompetence from dysplasia of the valve. A report on 19 cases of this real but often unrecognized disorder (author's transl)].

A total of 19 patients were found to have severe aortic incompetence from dysplasia of the valve (thin, spread-out valves having a tendency towards eversion). This type of valve abnormality is often unrecognized but is found in 13,6% of cases of severe aortic incompetence. The relationship between this condition and Marfan's syndrome or its aberrant forms are discussed, as well as its frequency when unrelated to this disease.