[Periarteritis nodosa and Australia antigen. Comparative study apropos of 25 cases]

The authors compared two series of 27 cases of périateritis over a period of 5 years. The determined the frequency of the nodosa HBs+ (series B) and HBs-- (series A) collected clinical and laboratory signs in both series. There resulted that apart from the hepatic signs constant in series B and absent in series A, the only statistically significant differences were the joint sings and the hypertension more common in series B and the respiratory signs more common in series A. Furthermore, the course of HBs+ cases appears much mote severe than that of HBs-- cases which emphasises the importance of the hepatic involvement but this finding should be interpreted with circumspection for the mode of selection of the patients and the treatment were different in the two series.

[Pericarditis in recent myocardial infarct]

Epistenocardial pericarditis, usually associated with anterior infarct, was noted in 64/400 myocardial infarct subjects admitted to an intensive care unit. No significant difference was observed with respect to this group in the case of mortality (20.6% as opposed to 26.2% in the controls) or complications of the acute stage, such as cardiac insufficiency and arrhythmia, though atrial fibrillation was more frequent (25% as against 15%). In all but one case, anticoagulant management was suspended on the appearance of pericarditis. In spite of the high frequency of atrial fibrillation, thromboembolic complications were not more frequent during brief (48-72 hr) suspension of anticoagulants. Dressler's syndrome was noted in 7 cases (1.7%), with epistenocardial pericarditis (4/7) or ventricular ectasia (3/7). Haemopericardium occurred in the case where anticoagulant management was not suspended.

[Pericarditis and fresh myocardial infarction (author's transl)]

Among 400 patients with myocardial infarction who had been admitted to the intensive care department, pericarditis was observed in 64 cases (16%). It occurred more frequently with anterior wall infarctions. The influence of the pericarditis on the mortality and complications threatening in the acute period were particularly investigated: There was no significant difference with regard to the mortality (20.6% in the group with pericarditis, 26.2% in the control group) or the occurrence of cardiac insufficiency or arrhythmias as complications. Atrial flutter, however, is more frequent (25% against 15%). Anticoagulant therapy was discontinued when pericarditis appeared, with one exception. In spite of the high frequency of atrial flutter, embolic complications were not more frequent after discontinuing the anticoagulant therapy. A postmyocardial infarction syndrome was observed seven times (1.7%), it was frequently found in a pericarditis with angina pectoris (4/7) and with ventricular aneurysm (3/7). Hemopericardium occurred in one patient in whom anticoagulant therapy had not been discontinued.

[Thrombopenic purpura revealing Hodgkin's disease]

The authors report a case of Hodgkin's disease at the subdiaphragmatic II B b stage with cell type III, revealed by thrombopenic purpura. Laparotomy and splenectomy confirmed the invasion of the spleen whereas there was no clinical splenomegaly and splenic radio-isotope scan was normal. The course is at present favourable, the purpura has been treated by corticotherapy then splenectomy, and the disease has been brought under control by classical treatment (cobalt radiotherapy and chemotherapy). The authors then discuss eight other cases in the world literature. Splenectomy is of dual interest for the assessment of Hodgkin's disease, on the one hand, and for the treatment of thrombopenic purpura on the other hand.