Increased serum levels of fractalkine and mobilisation of CD34+CD45− endothelial progenitor cells in systemic sclerosis

International audienceBackground: The disruption of endothelial homeostasis is a major determinant in the pathogenesis of systemic sclerosis (SSc) and is reflected by soluble and cellular markers of activation, injury and repair. We aimed to provide a combined assessment of endothelial markers to delineate specific profiles associated with SSc disease and its severity

Low-grade extraskeletal osteosarcoma of the chest wall: case report and review of literature

<p>Abstract</p> <p>Background</p> <p>Low-grade extraskeletal osteosarcomas (ESOS) are extremely rare.</p> <p>Case presentation</p> <p>We present the first case of low-grade ESOS of the chest wall, which occurred in a 30-year-old man. Because of initial misdiagnosis and patient's refusal of surgery, the diagnosis was done after a 4-year history of a slowly growing mass in soft tissues, leading to a huge (30-cm diameter) calcified mass locally extended over the left chest wall. Final diagnosis was helped by molecular analysis of <it>MDM2 </it>and <it>CDK4 </it>oncogenes. Unfortunately, at this time, no surgical treatment was possible due to loco-regional extension, and despite chemotherapy, the patient died one year after diagnosis, five years after the first symptoms.</p> <p>Conclusion</p> <p>We describe the clinical, radiological and bio-pathological features of this unique case, and review the literature concerning low-grade ESOS. Our case highlights the diagnostic difficulties for such very rare tumours and the interest of molecular analysis in ambiguous cases.</p

Peptide natriurétique B et évaluation de la fonction cardiaque (revue de littérature et intérêt pratique)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Amylose AA compliquant une maladie de Still de l'adulte

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

MANIFESTATIONS CARDIOVASCULAIRES DE LA MALADIE D'ERDHEIM CHESTER (DES MEDECINE INTERNE)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Atrophy of the vocal fold: An usual cause of hoarseness in scleroderma.

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Bilateral Breast Ulcers: Granulomatosis with Polyangiitis

International audiencePRESENTATION An investigation into the patient's unusual dermatologic symptoms identified an underlying autoimmune disease. Fourteen days after breast-reduction surgery, the patient, a 25-year-old white woman, was completely recovered. But at 20 days after surgery, she had bilateral mammary ulcera-tive lesions and was admitted to another hospital. The lesions were painless, and she was afebrile. Negative pressure wound therapy failed to accomplish secondary intention healing. For 6 weeks, she was treated with oral prednisolone, 1 mg/kg/day, and hyperbaric oxygen therapy, but these had limited effect. She then underwent a biopsy of the right breast. The specimen showed perivascular inflammation of the superficial and deep dermis, as denoted by an infiltrate of numerous neutrophils, eosinophils, lymphocytes, and some giant cells. Areas of nonfibrinoid necrosis were evident in the superficial dermis. Bacterial cultures of the wound and blood were negative. A diagnosis of pyoderma gangreno-sum was suspected based on the necrotic ulceration and characteristic violaceous undermined borders of the patient's lesions, the high proportion of neutrophils in the biopsy specimen, and the appearance of lesions on the scar site after a complete recovery. Yet, though the biopsy findings suggested pyoderma gangrenosum, there was some atypia, such as the absence of a central necrotic zone. Treatment with prednisolone and hyperbaric oxygen was restarted 5 days after biopsy results returned. She was then referred to our internal medicine department for further work-up. ASSESSMENT On admission, the patient was afebrile. She had bilateral, painless , inframammary ulcerations with inflammatory borders (Figure 1A). These measured 5 cm in diameter and ran horizontally across the surgical scar line. She also had pain in the sinus region. She reported a 1-year history of rhinitis with crusting and bleeding in both nostrils. Treatment had consisted of several courses of corticosteroids and antibiotics, which offered transient relief from symptoms, and ultimately, she underwent nasal septum surgery. Interestingly, the patient's ear, nose, and throat symptoms improved while she was being treated with prednisolone for her mammary lesions. Laboratory tests revealed elevations in the plasma fibrin-ogen level (5.4 g/L) and the C-reactive protein levels Figure 1 On presentation, the patient had bilateral ulcera-tive mammary lesions

Life-threatening toxicities upon Pembrolizumab intake: could pharmacokinetics be the bad guy?

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