Introduction L’angor mesenterique peut etre observe au cours evolutif de la maladie de Takayasu (... more Introduction L’angor mesenterique peut etre observe au cours evolutif de la maladie de Takayasu (MT) mais reste exceptionnellement revelateur. Nous rapportons une observation d’un angor mesenterique revelant une MT. Observation Il s’agissait d’un patient âge de 35 ans, sans antecedent pathologique, hospitalise pour bilan etiologique d’une hypertension arterielle resistante a une quadritherapie associee a des douleurs abdominales intenses evoluant depuis deux mois. L’examen physique a retrouve un patient asthenique, apyretique. L’abdomen etait sensible dans sa totalite sans defense. La tension arterielle etait estimee a 130/50 mmHg aux deux membres superieurs et a 180/120 mmHg aux deux membres inferieurs. Un souffle carotidien droit etait objective. Les differents pouls peripheriques etaient presents et symetriques. Le reste de l’examen clinique etait sans anomalie. L’echographie abdominale etait normale. L’angioscanner thoracique a revele un epaississement concentrique diffus de l’aorte abdominale rehausse apres injection du produit de contraste, une infiltration du tronc cœliaque stenose a 90 %, une infiltration majeure de l’artere mesenterique superieure sur 3,5 cm associee a une occlusion de l’artere mesenterique inferieure des son origine. L’artere renale etait egalement infiltree avec une stenose serree estimee a 70 %. Le bilan biologique etait sans anomalie. Le diagnostic de la MT a ete retenu. Devant la gravite de l’atteinte arterielle symptomatique d’un angor mesenterique et d’une HTA renovasculaire resistante, un pontage ilio-mesenterique superieur retrograde a ete pratique. Un traitement par prednisone a la dose de 30 mg/jour a ete instaure en association avec un traitement immunosuppresseur a base de methotrexate a la dose de 12,5 mg/semaine. L’evolution clinique etait favorable avec disparition totale des douleurs abdominales et la normalisation des chiffres tensionnels. Le recul evolutif actuel est de 5 mois. Conclusion L’angor mesenterique peut etre rarement revelateur d’une MT. Devant des douleurs abdominales, il faut toujours rechercher les differentes manifestations cliniques extra-abdominales orientant vers une pathologie sous-jacente en particulier la MT chez un sujet jeune meme de sexe masculin.
L'histiocytose langerhansienne a localisation hypothalamo-pituitaire est une entite anatomopa... more L'histiocytose langerhansienne a localisation hypothalamo-pituitaire est une entite anatomopathologique rare. Sa survenue chez l'adulte est inhabituelle. L'etude tomodensitometrique et IRM precise la taille de la lesion et permet une evaluation anatomotopographique qui sont des elements necessaires pour la conduite therapeutique. Nous rapportons une observation d'histiocytose langerhansienne hypothalamo-pituitaire associee a des atteintes osseuses survenant chez une patiente âgee de 31 ans et nous rappelons les aspects cliniques, histologiques et radiologiques (TDM/ IRM) de cette entite.
To study the clinical characteristics and the evolution of vena cava thrombosis (VCT) in Behçet&#... more To study the clinical characteristics and the evolution of vena cava thrombosis (VCT) in Behçet's disease (BD), as well as their association with other severe symptoms. Among 121 BD, we selected those with VCT. All patients fulfilled the diagnostic criteria of the international study group of Behcet's disease. Different clinical and paraclinical parameters were determined and compared with the remaining group of patients (not having VCT) with chi 2 test with Yates' correction. Protein C, protein S and antithrombin III and anticardiolipin antibody (aCL) levels were measured in 9 patients; anti-beta 2-glycoprotein I antibodies (a beta 2GPI) were determined in 3 patients. Ten patients had a vena cava thrombosis (8.2%). They were all male with an average age of 35 years (range: 30-42). We had 3 cases of superior vena cava thrombosis, 6 cases of inferior VCT, and one case of both. The average delay to diagnosis of the VCT from the date of the BD diagnosis was 4.5 years (range...
Presse médicale (Paris, France : 1983), Jan 6, 2004
Several cases of vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) have bee... more Several cases of vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) have been reported in patients treated with synthetic anti-thyroid drugs but only 2 cases have incriminated benzylthiouracil. A 36 year-old woman, 3 years after treatment with benzylthiouracil, rapidly developed progressive kidney failure, related to a pauci-immune extra-capillary glomerular nephropathy and necrotic vasculitis lesions. The search for p-ANCA was positive with anti-myeloperoxidase specificity. She was treated with corticosteroids and 6 monthly intravenous pulses of cyclophosphamide substituted by azathioprine. Renal failure and proteinuria significantly improved. However the high level of p-ANCA. ANCA vascularities are a rare but serious complication of treatment with synthetic thiouracile-type anti-thyroid drugs. The ANCA must be measured when confronted with a systemic manifestation during treatment.
Polymorphisms in endothelial nitric oxide synthase (eNOS) gene may affect the risk of preeclampsi... more Polymorphisms in endothelial nitric oxide synthase (eNOS) gene may affect the risk of preeclampsia. This systematic review aimed to provide an updated review of the literature to better understand the association between the eNOS gene polymorphisms and the risk of preeclampsia. We searched electronic databases of the human literature in PubMed, EMBASE, and the Cochrane Library up to July 2012. A meta-analysis was conducted on the association of eNOS G894T, T786C, and intron 4b/a polymorphisms with preeclampsia using (1) allele contrast, (2) recessive, (3) dominant, and (4) additive models. Thirty-three studies comprising 10,671 participants met the inclusion criteria. There was statistically significant association between the G894T variant and increased risk of preeclampsia (TT versus TG + GG: odds ratio 1.43, 95% confidence interval: 1.13 to 1.82). However, no significant risk of preeclampsia was observed either in the T786C or the intron 4b/a polymorphism. Homozygosity TT in eNOS G894T variant is significantly associated with an increased risk of preeclampsia.
Introduction L’angor mesenterique peut etre observe au cours evolutif de la maladie de Takayasu (... more Introduction L’angor mesenterique peut etre observe au cours evolutif de la maladie de Takayasu (MT) mais reste exceptionnellement revelateur. Nous rapportons une observation d’un angor mesenterique revelant une MT. Observation Il s’agissait d’un patient âge de 35 ans, sans antecedent pathologique, hospitalise pour bilan etiologique d’une hypertension arterielle resistante a une quadritherapie associee a des douleurs abdominales intenses evoluant depuis deux mois. L’examen physique a retrouve un patient asthenique, apyretique. L’abdomen etait sensible dans sa totalite sans defense. La tension arterielle etait estimee a 130/50 mmHg aux deux membres superieurs et a 180/120 mmHg aux deux membres inferieurs. Un souffle carotidien droit etait objective. Les differents pouls peripheriques etaient presents et symetriques. Le reste de l’examen clinique etait sans anomalie. L’echographie abdominale etait normale. L’angioscanner thoracique a revele un epaississement concentrique diffus de l’aorte abdominale rehausse apres injection du produit de contraste, une infiltration du tronc cœliaque stenose a 90 %, une infiltration majeure de l’artere mesenterique superieure sur 3,5 cm associee a une occlusion de l’artere mesenterique inferieure des son origine. L’artere renale etait egalement infiltree avec une stenose serree estimee a 70 %. Le bilan biologique etait sans anomalie. Le diagnostic de la MT a ete retenu. Devant la gravite de l’atteinte arterielle symptomatique d’un angor mesenterique et d’une HTA renovasculaire resistante, un pontage ilio-mesenterique superieur retrograde a ete pratique. Un traitement par prednisone a la dose de 30 mg/jour a ete instaure en association avec un traitement immunosuppresseur a base de methotrexate a la dose de 12,5 mg/semaine. L’evolution clinique etait favorable avec disparition totale des douleurs abdominales et la normalisation des chiffres tensionnels. Le recul evolutif actuel est de 5 mois. Conclusion L’angor mesenterique peut etre rarement revelateur d’une MT. Devant des douleurs abdominales, il faut toujours rechercher les differentes manifestations cliniques extra-abdominales orientant vers une pathologie sous-jacente en particulier la MT chez un sujet jeune meme de sexe masculin.
L'histiocytose langerhansienne a localisation hypothalamo-pituitaire est une entite anatomopa... more L'histiocytose langerhansienne a localisation hypothalamo-pituitaire est une entite anatomopathologique rare. Sa survenue chez l'adulte est inhabituelle. L'etude tomodensitometrique et IRM precise la taille de la lesion et permet une evaluation anatomotopographique qui sont des elements necessaires pour la conduite therapeutique. Nous rapportons une observation d'histiocytose langerhansienne hypothalamo-pituitaire associee a des atteintes osseuses survenant chez une patiente âgee de 31 ans et nous rappelons les aspects cliniques, histologiques et radiologiques (TDM/ IRM) de cette entite.
To study the clinical characteristics and the evolution of vena cava thrombosis (VCT) in Behçet&#... more To study the clinical characteristics and the evolution of vena cava thrombosis (VCT) in Behçet's disease (BD), as well as their association with other severe symptoms. Among 121 BD, we selected those with VCT. All patients fulfilled the diagnostic criteria of the international study group of Behcet's disease. Different clinical and paraclinical parameters were determined and compared with the remaining group of patients (not having VCT) with chi 2 test with Yates' correction. Protein C, protein S and antithrombin III and anticardiolipin antibody (aCL) levels were measured in 9 patients; anti-beta 2-glycoprotein I antibodies (a beta 2GPI) were determined in 3 patients. Ten patients had a vena cava thrombosis (8.2%). They were all male with an average age of 35 years (range: 30-42). We had 3 cases of superior vena cava thrombosis, 6 cases of inferior VCT, and one case of both. The average delay to diagnosis of the VCT from the date of the BD diagnosis was 4.5 years (range...
Presse médicale (Paris, France : 1983), Jan 6, 2004
Several cases of vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) have bee... more Several cases of vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) have been reported in patients treated with synthetic anti-thyroid drugs but only 2 cases have incriminated benzylthiouracil. A 36 year-old woman, 3 years after treatment with benzylthiouracil, rapidly developed progressive kidney failure, related to a pauci-immune extra-capillary glomerular nephropathy and necrotic vasculitis lesions. The search for p-ANCA was positive with anti-myeloperoxidase specificity. She was treated with corticosteroids and 6 monthly intravenous pulses of cyclophosphamide substituted by azathioprine. Renal failure and proteinuria significantly improved. However the high level of p-ANCA. ANCA vascularities are a rare but serious complication of treatment with synthetic thiouracile-type anti-thyroid drugs. The ANCA must be measured when confronted with a systemic manifestation during treatment.
Polymorphisms in endothelial nitric oxide synthase (eNOS) gene may affect the risk of preeclampsi... more Polymorphisms in endothelial nitric oxide synthase (eNOS) gene may affect the risk of preeclampsia. This systematic review aimed to provide an updated review of the literature to better understand the association between the eNOS gene polymorphisms and the risk of preeclampsia. We searched electronic databases of the human literature in PubMed, EMBASE, and the Cochrane Library up to July 2012. A meta-analysis was conducted on the association of eNOS G894T, T786C, and intron 4b/a polymorphisms with preeclampsia using (1) allele contrast, (2) recessive, (3) dominant, and (4) additive models. Thirty-three studies comprising 10,671 participants met the inclusion criteria. There was statistically significant association between the G894T variant and increased risk of preeclampsia (TT versus TG + GG: odds ratio 1.43, 95% confidence interval: 1.13 to 1.82). However, no significant risk of preeclampsia was observed either in the T786C or the intron 4b/a polymorphism. Homozygosity TT in eNOS G894T variant is significantly associated with an increased risk of preeclampsia.
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Papers by Habib Houman