RESUMEN
INTRODUCTION: Amyloid arthropathy occurs in 5-15% of patients with multiple myeloma. It is rarely inaugural. Some cases are reported in which the articular manifestations are present many months before the diagnosis of myeloma. We report two unusual cases where the amyloid arthropathy reveals the multiple myeloma. EXEGESIS: Case 1: A 54-year-old man take medical advice for a polyarthritis evolving for 6 months. He has no evidence of multiple myeloma except a hypercalcemia and a hypoalbuminemia. The diagnosis of multiple myeloma is based on an immunobinding of plasmatic proteins. It is a light chain multiple myeloma, lambda type. Amylosis is revealed by biopsy specimens from the synovial tissue of the knee. The patient died rapidly because of an intestinal hemorrhage. Case 2: A 78-year-old woman complains from a polyarthritis evolving for 4 months. She has besides an elevated erythrocyte sedimentation rate, an anemia and a renal insufficiency, a profound hypogammaglobulinemia. There is no radiological abnormalities. The diagnosis of multiple myeloma is based on serum and urine immunoelectrophoresis. It is a light chain multiple myeloma, lambda type. The patient is at her sixth monthly course of cyclophosphamid and prednisone. As far as amyloid arthropathy is concerned, it is relatively improved by corticoid intra-articular injections. CONCLUSION: These are two case reports of a light chain multiple myeloma of lambda type, associated to an amyloid arthropathy in its polyarticular presentation, mimicking a rheumatoïd arthritis. The revelatory nature of the amyloid arthropathy is interesting to report.
Asunto(s)
Artritis/etiología , Cadenas Ligeras de Inmunoglobulina/análisis , Mieloma Múltiple/complicaciones , Mieloma Múltiple/diagnóstico , Corticoesteroides/uso terapéutico , Anciano , Artritis/inmunología , Diagnóstico Diferencial , Femenino , Humanos , Inmunoelectroforesis , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana EdadRESUMEN
A sero-epidemiological survey, realized in the Medjez El Bab region (North-West of Tunisia), has concerned 180 dogs which status has been determined during the study. The animals were identified, then underwent an annual blood sampling during three successive years, in order to search for antibodies against E. canis and E. chaffeensis by indirect immunofluorescence. The results show that, in all sero-positive dogs, the levels of antibodies against E. canis were higher than those against E. chaffeensis. The sero-prevalence of E. canis was 42.8%, 50% and 48.9%, in 1994, 1995 and 1996, respectively, and was higher than that against E. chaffeensis during the three year studies. The incidence of E. canis infection was 12.6% during the three years whereas E. chaffeensis infection did not exceed 4.7%.
Asunto(s)
Enfermedades de los Perros/epidemiología , Ehrlichiosis/epidemiología , Ehrlichiosis/veterinaria , Análisis de Varianza , Animales , Anticuerpos Antibacterianos/sangre , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/inmunología , Enfermedades de los Perros/microbiología , Perros , Ehrlichia canis/inmunología , Ehrlichia chaffeensis/inmunología , Ehrlichiosis/diagnóstico , Ehrlichiosis/inmunología , Ehrlichiosis/microbiología , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Incidencia , Masculino , Vigilancia de la Población , Estudios Seroepidemiológicos , Índice de Severidad de la Enfermedad , Túnez/epidemiologíaRESUMEN
The authors describe an equine influenza epizootic that occurred in Tunisia during February and March 1998 in the regions of Tozeur, Sousse and Tunis. They relate the symptoms, the different stages of diagnosis and the serological results.