[Diagnostic workup in front of an adult thrombocytosis].

During a blood test, the discovery of thrombocytosis is a frequent phenomenon with multiple origins. False thrombocytosis linked to analytical interferences is rare but must be eliminated before confirming the anomaly. The reaction origin, often very easily demonstrated by the context and/or the presence of a biological inflammatory syndrome, is the most frequent.

[Rare sideroblastic anemias: about 2 cases, review of the literature and reminder of the main etiologies].

Sideroblastic anemias in adults are often quickly labeled as myelodysplasias. We report two unfrequent observations of secondary acquired forms. The first one is a 15-year-old girl presented with severe cytopenias.

[Diagnostic workup in front of an hypereosinophilia in 2020].

The discovery of eosinophilia above 1.5 G/L should not be considered innocuous, requiring monitoring for etiology and possible secondary organ damage. Among these, cardiac localization is the most worrying, sometimes indolent, to be systematically sought by ultrasound and magnetic resonance.

[Lymphomas in immunocompromised patients].

Immunosuppression is a well known risk factor for the development of lymphoid pathologies. The classification of these neoplasias is becoming more precise and complex, some features being common to all immunocompromised patients, primarily the important influence of Epstein-Barr virus. Whatever the origin of the immunodepression, these lymphoid proliferations are very heterogeneous, constituting a wide range between polymorphic aspects and clearly lymphomatous morphologies indistinguishable from those observed in immunocompetent subjects.

[A new case of rare erythrocytosis due to EGLN1 mutation with review of the literature].

Introduction: The origin of polycythemia is often simple to detect. Sometimes it is necessary to look for hereditary forms, the decisive parameters being the dosage of erythropoietin and the measurement of the oxygen dissociation curve (P50). These rare diseases are related to high oxygen-affinity haemoglobins, abnormalities of the erythropoietin receptor or dysfunction of the HIF (hypoxia-inducible factor) pathway.

[Diagnostic workup in front of an adult monocytosis].

The discovery of a monocytosis is a frequent phenomenon, requiring confirmation by reading under a microscope by an experimented biologist, to overcome usual cytological traps such as the presence of hairy cells, promonocytes or monoblasts. In the vast majority of cases the secondary origin is very easily found by the context and/or the presence of a biological inflammatory syndrome. More rarely the diagnosis is directed towards an eosinophilic pathology or an acute leukemia.

[Monoclonal gammopathy of undetermined significance (MGUS): interpretative shades of analysis and sometimes serious clinical consequences].

The etiological assessment of a monoclonal gammopathy is currently standardized, the decisional algorithms allowing a sufficiently precise classification to consider the care, wait or therapeutic. The purpose of this review is to recall the difficulties concerning the interpretation of certain biological investigations and to point out the potential complications of monoclonal gammopathies labeled as "benign". The cooperation between clinicians and biologists is in all cases essential, allowing to propose on a case-by-case basis the best adapted explorations.

Diagnostic workup in front of an adult neutropenia.

Adult neutropenia, defined as a blood neutrophil count below 1.5 G/L, is a common condition. The most common cause of acute neutropenia is a drug-related reaction or an acute infectious disease.

[IgM Myeloma: case report and literature review].

The presence of serum monoclonal IgM is often associated with the diagnosis of Waldenström macroglobulinemia (WM) or other chronic lymphoproliferative disorders. IgM myeloma is a rare entity (0.5%).

[How I do in front of an hemolytic anemia of unknown etiology?].

The most frequent causes of hemolytic anemias are immune or infectious diseases, drug induced hemolysis, thrombotic microangiopathies, hereditary spherocytosis, glucose-6-phosphate dehydrogenase or pyruvate kinase deficiencies, thalassemia's and sickle cell disease. Sometimes no cause is found because a rarer etiology is involved. The goal of this review is to remember some unfrequent constitutional or acquired causes and to point out difficulties to avoid wrong interpretations of analysis results.

[A fatal septic shock due to Capnocytophaga canimorsus and review of literature].

Introduction: Capnocytophaga canimorsus is a Gram-negative bacterium present in normal dogs and cats mouths. It can be responsible for septic shocks after dog or cat bite, especially in asplenic patients.

Case Report: We report here a case of C.

[Diagnostic workup in front of an atypical non hemolytic anemia].

The most potential causes of "non hemolytic" anemias are iron, folate or vitamin B deficiencies, severe renal impairment, endocrine diseases, inflammation and medullary disorders. In a non-exceptionnal way no cause is found, sometimes because of a wrong interpretation of analysis results and sometimes because of a little known etiology. The goal of this review is to point out analytical difficulties and to remember some rarer etiologies.

A new case of IgE multiple myeloma with review of literature.

IgE myeloma is an extremely rare disease characterized by frequent plasma cell leukemia, little monoclonal-spike on electrophoresis, an high incidence of t(11;14) translocation and a worse survival than those with common myelomas. We report here a new case of IgE myeloma and discuss clinical presentation, biological features and therapeutic option.

[Two cases of myeloid sarcomas with review of literature].

Introduction: Myeloid sarcomas are uncommon proliferations of immature myeloid cells occurring in any extramedullary organ. We report here two cases of myeloid sarcomas in patients with, respectively, a polycythemia vera and a myelodysplastic syndrome.

Case Reports: The first is an 81-year-old woman who presented with osteolytic lesions.

[The flexibility of family medicine].

We are a European academic group of family doctors and we propose a definition of flexibility in family medicine. A review of the literature shows that flexibility and complexity are emerging concepts in the field of family practice. The outcomes of a workshop at the WONCA-Europe congress in 2014 are discussed.

Structure and assembly of the pseudopilin PulG.

The pseudopilin PulG is one of several essential components of the type II pullulanase secretion machinery (the Pul secreton) of the Gram-negative bacterium Klebsiella oxytoca. The sequence of the N-terminal 25 amino acids of the PulG precursor is hydrophobic and very similar to the corresponding region of type IV pilins. The structure of a truncated PulG (lacking the homologous region), as determined by X-ray crystallography, was found to include part of the long N-terminal alpha-helix and the four internal anti-parallel beta-strands that characterize type IV pilins, but PulG lacks the highly variable loop region with a disulphide bond that is found in the latter.

Type IV-like pili formed by the type II secreton: specificity, composition, bundling, polar localization, and surface presentation of peptides.

The secreton or type II secretion machinery of gram-negative bacteria includes several type IV pilin-like proteins (the pseudopilins) that are absolutely required for secretion. We previously reported the presence of a bundled pilus composed of the pseudopilin PulG on the surface of agar-grown Escherichia coli K-12 cells expressing the Klebsiella oxytoca pullulanase (Pul) secreton genes at high levels (N. Sauvonnet, G.

Pilus formation and protein secretion by the same machinery in Escherichia coli.

The secreton (type II secretion) and type IV pilus biogenesis branches of the general secretory pathway in Gram-negative bacteria share many features that suggest a common evolutionary origin. Five components of the secreton, the pseudopilins, are similar to subunits of type IV pili. Here, we report that when the 15 genes encoding the pullulanase secreton of Klebsiella oxytoca were expressed on a high copy number plasmid in Escherichia coli, one pseudopilin, PulG, was assembled into pilus-like bundles.

Multiple interactions between pullulanase secreton components involved in stabilization and cytoplasmic membrane association of PulE.

We report attempts to analyze interactions between components of the pullulanase (Pul) secreton (type II secretion machinery) from Klebsiella oxytoca encoded by a multiple-copy-number plasmid in Escherichia coli. Three of the 15 Pul proteins (B, H, and N) were found to be dispensable for pullulanase secretion. The following evidence leads us to propose that PulE, PulL, and PulM form a subcomplex with which PulC and PulG interact.

[Measurement of the variation in the thickness of lumbar disks over time in patients with lumbago].

The average thickness of the last 3 lumbar disks was measured using an automatic image analyzer in 53 patients who were regularly followed-up both clinically and radiographically for an average period of 14.8 years (extremes: 6 and 39 years). This retrospective study showed that disks do not necessarily become pinched with age, even in patients with lumbago, that the rate of disk pinching is extremely variable from one patient to another, that disk collapse takes an average of 20 to 30 years, that there is a correlation between the severity of the lumbago and the rate at which the disk pinches, and that there are rapidly evolutive discopathies which are responsible for severe lumbago.

Cartilage destruction in experimentally induced osteoarthritis.

Section of the anterior cruciate ligament in the knee joint of mature dogs resulted in a progressive fibrillation of both tibial and femoral condylar cartilages. Reduced tissue microhardness and increased water content preceded fibrillation while fixed charge density remained unchanged. A different histological pattern of initial fibrillation was found, however, in femoral and tibial cartilages which exhibited tangential cleft and vertical splits, respectively.

[Methods for evaluating non-steroidal anti-inflammatory agents in rheumatoid polyarthritis].

The study of the effectiveness of non-steroidal antiinflammatory drugs in rheumatoid arthritis requires only short term trials using simple, sensitive and reproducible tests based upon evaluation of pain. The estimation of spontaneous pain by the visual pain scale, number of nocturnal awakenings, Ritchie joint index, morning stiffness, grip strength and Lee functional index are the most informative parameters. The results of these quantitative tests of pain are usually in close agreement with patient judgement which remains the most important criterion.