MÃ©decine et Maladies Infectieuses 12/2011; 41(12):663-4. · 0.72 Impact Factor
ABSTRACT: The prevalence of antiphospholipid antibodies (APA) in patients with immune thrombocytopenic purpura (ITP) varies from 25 to 75% in the literature. The risk of thrombosis in this subgroup of patients is debated. In parallel, thrombocytopenia is present in 22 to 42% of patients with antiphospholipid syndrome (APS). PATIENTS ET METHODS: The main study objective was to compare the profile at diagnosis of lupus anticoagulant (LA), anticardiolipin antibody (ACL) and anti-β(2)GP-I antibody between a cohort of 93 chronic ITP patients and a cohort of 27 primary APS patients. The secondary objectives were: to evaluate the risk of thrombosis in ITP patients depending on the presence of APA; to compare the profile of APA and to assess the occurrence of lupus in APS patients depending on the presence of thrombocytopenia.
In ITP patients, the prevalence of APA was 25%; association of several different APA was less frequent than in APS patients; mean titles of ACL and anti-β(2)GP-I antibodies were comparable between the two cohorts; two spontaneous venous thromboses occurred in ITP patients, with no particular profile of APA (median follow-up: 36 months). Thrombocytopenia was present in 26% of APS patients; it was always moderate and asymptomatic, and sometimes intermittent; no particular profile of APA was associated to thrombocytopenia; only one thrombocytopenic patient developed a systemic lupus and no particular profile of APA could be found associated (median follow-up: 48 months).
ITP patients with APA have less frequently an association of different APA than APS patients do; their risk of thrombosis appears low.
La Revue de Médecine Interne 08/2011; 32(12):724-9. · 0.61 Impact Factor
La Revue de Médecine Interne 01/2011; 32(1):46-7. · 0.61 Impact Factor
ABSTRACT: Pericarditis is rarely the presenting manifestation of giant cell arteritis. We report two additional patients.
Two patients aged over 70 years presented with acute chest pain. Echocardiography evidenced a pericarditis. Laboratory features showed increased level of acute phase reactants. On questioning, both patients had cephalic symptoms related to giant cell arteritis. Temporal artery biopsy histopathology was characteristic of giant cell arteritis in both. Oral prednisone therapy (20mg/D) led to a complete remission with no clinical relapse of pericarditis after a follow-up of one year and three years, respectively.
Giant cell arteritis must be evoked in elderly patients with pericarditis because corticosteroids are necessary to avoid ischemic complications of the disease. However, fortuitous association can also be considered. No severe complication of pericarditis has been reported in the literature on corticosteroid therapy.
La Revue de Médecine Interne 11/2009; 31(1):46-8. · 0.61 Impact Factor