La Revue de médecine interne
-
Case Reports
[Hypercalcemia of double origin: association of multiple myeloma and ectopic parathyroidal adenoma].
Multiple myeloma and primary hyperparathyroidism are two causes of hypercalcemia. This association has already been described to be not casual, despite their link is still unknown. ⋯ Multiple myeloma and parathyroidal adenoma should be both explored in all hypercalcemia, because they can be associated.
-
Helicobacter pylori (H. pylori) infection is a chronic gastric Gram-negative infection that increases with age. Acquired in childhood, H. pylori infection may induce a whole cascade of events leading to gastric pathologies such as peptic ulcer diseases, gastric precancerous lesions, and gastric lymphomas (MALT). The characteristics of the diagnosis and the treatment of this infection in geriatrics are thus particularly important to take into account. ⋯ Recent work showed the part played by H. pylori chronic infection in gastric aging and in appetite regulation in the elderly. Research tasks should be continued in this field in order to better understand the part played by this chronic infection in gastric aging and in other pathologies (i.e. neurological or cardiovascular diseases) in this population.
-
We report a case of a serious myopathy related to hypothyroidism with pituitary enlargement and hyperprolactinemia. ⋯ Proximal myopathy may rarely be displayed as the sole manifestation of hypothyroidism. Therefore, it is recommended that hypothyroid myopathy should be taken into account during differential diagnosis of proximal muscle weakness.
-
The availability of a sensitive, specific and prognostic marker of bacterial infection is a major issue. More than ten years after the first publication assessing the usefulness of serum procalcitonin dosage (PCT), its exact place in the diagnostic process remained to be defined. The purpose of this review is to point out the indications of PCT measurement in clinical practice in the adult population. ⋯ After the first published study reporting the usefulness of PCT as a screening biological tool in emergency medicine, future studies will probably refined the place of PCT in such practice fields: decision about inpatient or outpatient management or antibiotics dispensation. Finally, PCT measurement could help physician in screening which septic patients should benefit from sepsis innovative therapeutics.
-
To analyze and coordinate the prescription of IVIg in the university hospitals of the AP-HP, the CEDIT, an administrative office created to study new technologies and innovative drugs prescribed in Paris hospitals, nominated a group of experts in 1992. ⋯ The coordination of IVIg prescriptions in Paris hospitals resulted in optimization of indications, better adapted guidelines and their improved observance, and more prospective trials for potential indications.