Focal non granulomatous orchitis in a patient with Crohn’s disease

Crohn’s disease is a systemic disease and sometimes involves the testicle, usually leading to granulomatous lesions. We report herein a case of focal non-granulomatous orchitis in a 21-year-old patient with active Crohn’s disease treated by an anti-tumor necrosis factor monoclonal antibody. This circumscribed testicular lesion mimicked a tumor, leading to orchiectomy. Pre-operative blood tests (i.e. alpha-fetoprotein, lactate dehydrogenase and human chorionic gonadotrophin) were strictly normal Pathological examination of the testicle revealed a focal inflammatory infiltrate predominantly composed of lymphocytes accompanied by few plasma cells, lacking giant cells or granulomas. Importantly, intratubular germ cell neoplasia, atrophy or lithiasis were not observed. After discussing and excluding other plausible causes (burnt-out /regressed germ cell tumor, infection, vascular or traumatic lesions, iatrogenic effects), we concluded that this particular case of orchitis was most likely an extra-digestive manifestation of inflammatory bowel disease. To our knowledge, this is the first described case of focal non-granulomatous orchitis associated with Crohn’s disease. Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/211774728416011

Focal non granulomatous orchitis in a patient with Crohn’s disease

International audienceCrohn's disease is a systemic disease and sometimes involves the testicle, usually leading to granulomatous lesions. We report herein a case of focal non-granulomatous orchitis in a 21-year-old patient with active Crohn's disease treated by an anti-tumor necrosis factor monoclonal antibody. This circumscribed testicular lesion mimicked a tumor, leading to orchiectomy. Pre-operative blood tests (i.e. alpha-fetoprotein, lactate dehydrogenase and human chorionic gonadotrophin) were strictly normal Pathological examination of the testicle revealed a focal inflammatory infiltrate predominantly composed of lymphocytes accompanied by few plasma cells, lacking giant cells or granulomas. Importantly, intratubular germ cell neoplasia, atrophy or lithiasis were not observed.After discussing and excluding other plausible causes (burnt-out /regressed germ cell tumor, infection, vascular or traumatic lesions, iatrogenic effects), we concluded that this particular case of orchitis was most likely an extra-digestive manifestation of inflammatory bowel disease. To our knowledge, this is the first described case of focal non-granulomatous orchitis associated with Crohn's disease. Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2117747284160112

Tumeur glomique rénale : localisation inhabituelle d’une tumeur mésenchymateuse rare

National audienceGlomus tumors are rare mesenchymal tumors, mostly cutaneous or subcutaneous, for which visceral locations have been described. We report the case of a solid renal glomus tumor incidentally discovered in a 60-year-old patient. The tumor was 25mm wide and was mainly composed of glomus cells expressing smooth muscle actin and vimentin. These cells were negative for cytokeratin, neuroendocrine markers and renin. Glomus cells were associated with blood vessels and bundles of smooth muscle fibers. The purpose of this work is to report the diagnostic criteria, signs of malignancy and main differential diagnosis of these rare tumors whose prognosis is usually excellent after complete surgical resection

Successful treatment of pityriasis rubra pilaris with risankizumab, a IL‐23/p19 antagonist

No abstract availabl

Tralokinumab improves clinical scores in adolescents with severe atopic dermatitis: A real-life multicentric observational study.

Dear Editor,Atopic dermatitis (AD) usually develops during early child-hood but may continue into adolescence. The exact preva-lence of AD in adolescents remains unknown but recent longitudinal studies indicate a similar prevalence in child-hood and adolescence. [...

Mapping the paratope of anti-CD4 recombinant fab 13B8.2 by combining parallel peptide synthesis and site-directed mutagenesis

We analyzed antigen-binding residues from the variable domains of anti-CD4 antibody 13B8.2 using the Spot method of parallel peptide synthesis. Sixteen amino acids, defined as Spot critical residues (SCR), were identified on the basis of a 50% decrease in CD4 binding to alanine analogs of reactive peptides. Recombinant Fab 13B8.2 mutants were constructed with alanine residues in place of each of the 16 SCR, expressed in the baculovirus cell system, and purified. CD measurements indicated that the mutated proteins were conformationally intact, with a β-sheet secondary structure similar to that of wild-type Fab. Compared with the CD4-binding capacity of wild-type Fab 13B8.2, 11 light (Y32-L, W35-L, Y36-L, H91-L, and Y92-L) and heavy chain (H35-H, R38-H, W52-H, R53-H, F100K-H, and W103-H) Fab single mutants showed a decrease in CD4 recognition as demonstrated by enzyme-linked immunosorbent assay, BIAcore, and flow cytometry analyses. The five remaining Fab mutants showed antigen-binding properties similar to those of wild-type Fab. Recombinant Fab mutants that showed decreased CD4 binding also lost their capacity to inhibit human immunodeficiency virus promoter activation and the antigen-presenting ability that wild-type Fab displays. Molecular modeling of the 13B8.2 antibody paratope indicated that most of these critical residues are appropriately positioned inside the putative CD4-binding pocket, whereas the five SCR that were not confirmed by mutagenesis show an unfavorable positioning. Taken together, these results indicate that most of the residues defined by the Spot method as critical matched with important residues defined by mutagenesis in the whole protein context. The identification of critical residues for CD4 binding in the paratope of anti-CD4 recombinant Fab 13B8.2 provides the opportunity for the generation of improved anti-CD4 molecules with more efficient pharmacological properties

Study of the air-sea interactions at the mesoscale: The SEMAPHORE experiment

International audienceThe SEMAPHORE (Structure des Echanges Mer-Atmosphere, Proprietes des Heterogeneites Oceaniques: Recherche Experimentale) experiment has been conducted from June to November 1993 in the Northeast Atlantic between the Azores and Madeira. It was centered on the study of the mesoscale ocean circulation and air-sea interactions. The experimental investigation was achieved at the mesoscale using moorings, floats, and ship hydrological survey, and at a smaller scale by one dedicated ship, two instrumented aircraft, and surface drifting buoys, for one and a half month in October-November (IOP: intense observing period). Observations from meteorological operational satellites as well as spaceborne microwave sensors were used in complement. The main studies undertaken concern the mesoscale ocean, the upper ocean, the atmospheric boundary layer, and the sea surface, and first results are presented for the various topics. From data analysis and model simulations, the main characteristics of the ocean circulation were deduced, showing the close relationship between the Azores front meander and the occurrence of Mediterranean water lenses (meddles), and the shift between the Azores current frontal signature at the surface and within the thermocline. Using drifting buoys and ship data in the upper ocean, the gap between the scales of the atmospheric forcing and the oceanic variability was made evident. A 2 degrees C decrease and a 40-m deepening of the mixed layer were measured within the IOP, associated with a heating loss of about 100 W m(-2). This evolution was shown to be strongly connected to the occurrence of storms at the beginning and the end of October. Above the surface, turbulent measurements from ship and aircraft were analyzed across the surface thermal front, showing a 30% difference in heat fluxes between both sides during a 4-day period, and the respective contributions of the wind and the surface temperature were evaluated. The classical momentum flux bulk parameterization was found to fail in low wind and unstable conditions. Finally, the sea surface was investigated using airborne and satellite radars and wave buoys. A wave model, operationally used, was found to get better results compared with radar and wave-buoy measurements, when initialized using an improved wind field, obtained by assimilating satellite and buoy wind data in a meteorological model. A detailed analysis of a 2-day period showed that the swell component, propagating from a far source area, is underestimated in the wave model. A data base has been created, containing all experimental measurements. It will allow us to pursue the interpretation of observations and to test model simulations in the ocean, at the surface and in the atmospheric boundary layer, and to investigate the ocean-atmosphere coupling at the local and mesoscales