Presse Med
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THE TREATMENT OF DM AND PM: Among primary inflammatory muscle diseases, there are three principle subsets depending on immuno-histochemical and clinical aspects: dermatomyositis (DM), polymyositis (PM) and inclusion body myositis (IBM). Despite their physiopathogenic differences, the treatment of PM and DM is very similar. It relies on principally on oral corticosteroid therapy, occasionally initiated via the intravenous route and which is active in 50 to 70% of cases. In patient with primary or secondary resistance, intolerance or dependence regarding corticosteroids, a second treatment line with immunosuppressive agents or intravenous immunoglobulin should be added.
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Case Reports
[Acute severe leukoencephalitis with posterior lesions due to Borrelia burgdorferi infection].
Central nervous system manifestations represent 0.54 to 8% of neurological complication in Lyme disease. ⋯ Acute meningo-encephalitis is often benign, protein-like and of good prognosis: the gnosic visual disorders with posterior leukoencephalopathy are unusual. A blood level of specific antibodies slightly positive on Elisa at the early stage of the infection warrants confirmation by Western blot in the blood and by Elisa in the CSF. Additional corticosteroid therapy may be required in the severe forms that evoke acute disseminated encephalomyelitis.
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Syphilis remains a current infection in France, with an increase in cases associated with the increase in sexual practices at risk. ⋯ This case report underlines the possibility of discovering syphilis when confronted with cholestatic and cytolytic hepatitis that regresses with penicillin and is isolated or associated with evocative cutaneous signs.