La Revue de médecine interne
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Extracolonic manifestations of Clostridium difficile infections have rarely been reported as a reactive arthritis. We report a 43-year-old woman who presented with a polyarthritis following pseudomembranous colitis. ⋯ Corticosteroids were prescribed and clinical manifestations resolved within 3 weeks. Ten months later, there was no relapse and no sequela.
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Regulatory/suppressor T cells (Tregs) maintain immunologic homeostasis and prevent autoimmunity. They are the guardians of dominant tolerance. Recent research reveals quantitative and/or functional defect of Tregs in systemic autoimmune diseases. ⋯ Immunosuppressive treatments, like corticosteroids and anti-TNF, modulate Tregs cells population. There is increasing interest in the use of Tregs as a biological therapy to preserve and restore tolerance to self-antigen. However, difficulties to characterize these lymphocytes and controversies in the results of studies refrain their use in current clinical practice.
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Case Reports
[Repeated intestinal tract perforations secondary to cryoglobulinemia and cytomegalovirus infection: a case report].
Cryoglobulinemia associated vasculitis is usually related to hepatitis C virus. Clinical features include purpura, glomerulonephritis, or peripheral neuropathy. ⋯ The related immunodepression exposes to a reactivation of cytomegalovirus (CMV) infection that may also be potentially responsible for intestinal injury. We report a 68-year-old man who presented with iterative intestinal perforations secondary to a cryoglobulinemia vasculitis and then to a CMV infection.
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Giant cell arteritis of the limbs is rarely reported. It may be underestimated because it is usually asymptomatic. The aim of this study was to describe the distinctive features of this involvement. ⋯ Specific limb involvement may be the presenting feature of temporal arteritis. It can mimic arteriosclerosis vascular disease, particularly prevalent in this age group.