La Revue de médecine interne
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Cerebral small vessel diseases are frequent and can be seen through all ages. Although the most frequent forms related to age and hypertension or to cerebral amyloid angiopathy are mainly observed in subjects over 50 years of age, rarer forms may affect young people, sometimes even children. ⋯ Cerebral small vessel diseases thus raise both daily therapeutic issues and much rarer diagnostic questions, sometimes extremely complex. Our aim was to review the main clinical initial presentations and the clinico-radiological spectrum of associated underlying conditions.
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Review Case Reports
Characteristics of Systemic Sclerosis patients with positive anti-Th/To antibodies: About 6 patients and literature review.
Among the antibodies described in Systemic Sclerosis (SSc), anti-Th/To antibodies (anti-Th/To) are rare and have been poorly studied. Thus, little is known about the profile of anti-Th/To positive patients. From our local Biobank (Marseille, France), we retrospectively selected data for 6 patients positive for anti-Th/To with an Immunodot assay. ⋯ In order to further characterize patients positive for anti-Th/To, we performed a thorough literature review. From 402 studied patients positive for anti-Th/To, we confirmed that these antibodies are associated with the limited cutaneous form of the disease (88% of the patients), and with an SSc related-pulmonary involvement (50%). The review analysis pointed out the rarity of the anti-Th/To with an estimated mean frequency of 3.4% of all SSc patients worldwide, their usual exclusivity with respect to the specific antibodies of scleroderma, and their high specificity (around 98%) for the diagnosis of SSc.
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Review Case Reports
[Gynecological Lemierre's syndrome: A case report and literature review].
Lemierre's syndrome is defined as an oropharyngeal infection due to Fusobacterium necrophorum, associated with septic thrombophlebitis of the internal jugular vein. The uncommon pelvic variant of the syndrome is a rare condition, poorly described in literature. ⋯ Gynecological Lemierre's syndrome is a rare and unrecognized condition, which could be lethal. Early recognition of the disorder enables initiation of appropriate antibiotic therapy for 4 to 6 weeks, and discussion of anticoagulant therapy which indications are not yet well defined.
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Botulism is a rare syndrome resulting from the action of a neurotoxin produced by Clostridium botulinum, that it is potentially life threatening if diagnosis is delayed. ⋯ Although botulism is uncommon, better awareness of its manifestations and high clinical suspicion should shorten diagnostic delay that makes the use of specific antitoxin ineffective. An acute onset of a bilateral oculomotor palsy, a fixed pupillary dilation and descending weakness in the absence of fever is typical of botulism. Outcome is usually favorable with a slow but full neurological recovery.
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To evaluate the rate of seasonal influenza vaccination coverage (IVC) in incident giant cell arteritis (GCA) patients compared with controls. ⋯ Although suboptimal, IVC in incident GCA was statistically better than controls.