Introduction. –
L'hippocratisme digital est classiquement associé aux affections cardiopulmonaires. La pachydermopériostose ou syndrome ostéodermopathique est une maladie héréditaire qui en est une ...cause rare, de diagnostic difficile, notamment dans sa forme incomplète.
Exégèse. –
Nous rapportons l'observation d'un homme de race noire âgé de 36 ans, souffrant de polyarthralgies depuis de nombreuses années et présentant des doigts et orteils boudinés, renflés à leur extrémité. Cet hippocratisme digital est également présent dans sa fratrie. Le reste de l'examen clinique est normal ; il n'y a notamment pas d'épaississement cutané, ni dermatose psoriasiforme, ni signe d'atteinte pleuropulmonaire.
Les examens complémentaires suivants sont normaux : hémogramme, fibrinémie, protéine C réactive, sérologie rhumatoïde, bilan phosphocalcique, hormones thyroïdiennes, hormone de croissance (STH), radiographie pulmonaire, fibroscopie œso-gastroduodénale, électrocardiogramme. Les radiographies conventionnelles révèlent une apposition périostée du squelette appendiculaire, une ostéosclérose de l'articulation sacro-iliaque et des ossifications interosseuses péronéotibiales.
Conclusion. –
Le diagnostic de pachydermopériostose est retenu sur la base de 3 des 4 critères de Borochowitz. L'absence de pachydermie définit cette forme incomplète ; les manifestations ostéoarticulaires posent des problèmes diagnostiques essentiellement avec l'ostéoarthropathie hypertrophiante secondaire et les rhumatismes inflammatoires chroniques. Les mécanismes pathogéniques de l'affection restent encore indéterminés.
Introduction. –
The finger clubbing is most of the time associated with cardiovascular and pulmonary diseases. Pachydermoperiostosis also known as osteodermopathic syndrome, an hereditary disorder, is a rare cause of finger clubbing which might be difficult to diagnose in an incomplete form.
Exegesis. –
We report a 36 years old black man presenting over many years polyarthralgias, broadning of fingers and clubbing of the fingers and toes extremities.
This was mentionned on other family members. The physical examination was otherwise unremarkable. There were no skin thickening, no psoriasis-like and cardio-pulmonary disease features.
These following exams were normal; Hemogram, fibrinogen, C reactive protein, rheumatoïd factor, serum calcium and phosphorus, thyroid hormones, growth hormone, chest X-ray, gastroduodenoscopy, electrocardiogram. The skeletal X-ray documented a widespread bone formation, a sacro-iliac osteosclerosis and interosseous ossifications beetwen tibias and fibulas.
Conclusion. –
Pachydermoperiostosis diagnosis was set up on 3 out of the 4 Borochowitz criteria. The absence of pachyderma defines this incomplete form. The osteoarticular manifestations lead mainly to differential diagnosis with the secondary hypertrophic osteoarthropathy and chronic inflammatory rheumatisms.
The underlying pathogenic mechanism of this disease remains still unclear.
Tuberculosis may be difficult to diagnose because its presentation may be very misleading. Here is a report of Poncet's disease, which occurred in a 61-year-old man, and revealed recurrence of ...tuberculosis (pulmonary and spinal) 12 years after first episode. The patient recovered from his rheumatism with antibiotherapy against TB. Poncet's disease is a chronic rheumatism, in reaction to Mycobacterium tuberculosis that can occur even if the infection is in a latent form. Practitioners must know this disease, even if it's rare: tuberculosis is a differential diagnosis of chronic polyarthritis, especially in patients with risk factors.Original Abstract: la tuberculose est une maladie pleieomorphe, dont la presentation clinique, meme chez un patient a risque, peut etre particulierement trompeuse. Nous rapportons un cas de rhumatisme de Poncet (RP), revelateur d'une recidive de tuberculose-maladie (avec atteinte pulmonaire et rachidienne) chez un senegalais de 61 ans, 12 ans apres l'infection initiale. la mise en place d'un traitement antituberculeux permettait la guerison du rhumatisme, devenu corticoresistant. la maladie de Poncet est une polyarthrite reactionnelle au BK, peu destructrice, d'evolution chronique. Bien que rare, cette entite ne doit pas etre meconnue des cliniciens : une infection a Mycobacterium tuberculosis doit etre recherchee en cas de rhumatisme chronique ne faisant pas sa preuve, a fortiori chez les patients a risque ou aux antecedents de tuberculose
Urinary bilharziasis is a parasitic infection responsible for vesical, urethral and renal lesions. The authors demonstrate the importance of ambulatory echography on a large scale and describe ...various echographic lesions. Vesical attacks occurred in 27% of the wall irregularity, 44% of the masses and polyps. Pyelic and urethral abnormalities occurred in 16.6% and 29.9% of cases respectively at the baseline in 1991. These prevalence rates decreased after seven years, in 1998. The authors discuss the utility of chemotherapy with praziquantel and the necessity of a periodical mass treatment in the areas with high bilharziasis endemicity in Mali.
Resume
Les lésions génitales masculines dues à
Schistosoma haematobium
sont rares dans nos régions. Pourtant les travaux de Chaker en 1889 et de Lortet et Vialleton qui ont décrit les premières ...lésions des vésicules séminales en sont le témoignage. Nous rapportons un cas de prostatite bilharzienne de découverte anatomo-pathologique chez un patient de 65 ans après résection transurétrale de prostate.
The overall results of the proton and metal ion binding measurements suggest that the uptake of Cu(II) by EDA core PAMAM dendrimers involves both the dendrimer tertiary amine and terminal groups. ...However, the extents of protonation of these groups control the ability of the dentrimers to bind Cu(II). Analysis of the EXAFS spectra suggests that Cu(II) forms octahedral complexes involving the tertiary amine groups of Gx-NH2 EDA core PAMAM dendrimers at pH 7.0. The central Cu(II) metal ion of each of these complexes appears to be coordinated to 2-4 dendrimer tertiary amine groups located in the equatorial plane and 2 axial water molecules. Finally, we combine the results of our experiments with literature data to formulate and evaluate a phenomenological model of Cu(II) uptake by Gx-NH2 PAMAM dendrimers in aqueous solutions. At low metal ion-dendrimer loadings, the model provides a good fit of the measured extent of binding of Cu(II) in aqueous solutions of G4-NH2 PAMAM dendrimers at pH 7.0
WHO and IUAT-LD recommend repeated microscopy in order to improve the detection of contagious cases of pulmonary tuberculosis. Our aim was to determine the contributions of radiology and microscopy ...in the diagnosis of pulmonary tuberculosis. From January 1998 to April 1999 radiography and microscopy were performed for 275 patients who were admitted to the pneumology service. Pulmonary tuberculosis prevalence was higher among women aged 10 to 29 years than among men of the same age (p = 10(-6)). 188 (68.4%) women tested positive, 49 (17.8%) tested positive at the second microscopy and 1 (0.36%) at the the third. The main radiological lesions were nodules + infiltrats (46.2%), nodules + infiltrats + cavity (26.2%) and infiltrats + cavity (6.5%). Repeated microscopy significantly increased the proportion of pulmonary tuberculosis cases detected (from a prevalence 68.4% to 86.5%).
