La Revue de médecine interne
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Review Comparative Study
[Potential importance of antileukotrienes in the treatment of asthma and other inflammatory diseases: apropos of a new pharmacological class].
Among the mediators involved in the asthma bronchoconstriction and inflammation mechanisms, there is now substantial evidence that the sulfidopeptide leukotrienes (LTs) are important. Antagonists of their receptors and inhibitors of their synthesis have been developed. ⋯ Antagonists of receptors and synthesis inhibitors of LTs have known a recent and important development. They constitute a new therapeutic class: further studies are needed to better define the place of these new drugs in the treatment of asthma and other inflammatory diseases.
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Review Comparative Study
[Buerger's disease or thromboangiitis obliterans].
To review clinical data, pathophysiology and treatment of thromboangiitis (Buerger's disease). ⋯ If pathophysiology is still poorly understood, spontaneous evolution can be avoided by stopping tobacco and prostacyclin.
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Review Case Reports
[Acute pancreatitis in rheumatoid purpura. Apropos of 2 cases].
Abdominal pain observed in Henoch-Schönlein purpura (HSP) is usually attributed to digestive tract involvement. Pancreatic involvement is a rare and benign complication. The authors report two cases of acute pancreatitis as a complication of HSP. ⋯ Abdominal pain can be explained by a digestive tract involvement but also by an acute pancreatitis. This later occurrence is not as exceptional as reported in the literature. Thus, serum amylase levels should be evaluated in patients with HSP who have intense epigastric or abdominal pain, in order to recognize a pancreatic involvement.
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Peripheral neuropathy in primary Sjögren's syndrome is common although often unrecognized in mild forms of this affection. They are characterized by a predominently sensory deficiency and can be divided in several entities, of which the most important are: axonal distal symmetric polyneuropathy, either of sensory or sensory-motor presentation, which are supposed to be consecutive to ischemia induced by the vasculitis of the vasa nervorum; sensory neuronopathy mimicking the paraneoplastic syndromes from a clinical and electrophysiological point of view which are supposed to be linked to neuronal degeneration secondary to a lymphocytic infiltration of the dorsal root and ganglia; trigeminal sensory neuropathy, either alone or associated with one of the previously cited forms. ⋯ Tracking down systematically these peripheral neuropathies in patients affected by Sjögren's syndrome is the best way to recognize them. Alternatively, patients with unexplained neuropathies should be evaluated for the presence of Sjögren's syndrome.
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Review Case Reports
[Primary granulocytic sarcoma of the pancreas: efficacy of early treatment with intensive chemotherapy].
In the absence of systemic chemotherapy after the diagnosis of primary granulocytic sarcoma (PGS), all patients will subsequently develop acute myelogenous leukemia (AML). The authors describe a case of PGS of the head of the pancreas found at laparotomy in a 32-year-old man. The patient received early after surgery, two courses of high-dose chemotherapy and, with a follow-up of 2 years, never developed AML. This rare observation illustrates the necessity of further early systemic chemotherapy after surgical excision of PGS.