La Revue de medecine interne最新文献_第2页

[Hiccups in adults: Pathophysiology, diagnostic approach, and management]. [成人打嗝：病理生理学、诊断方法和治疗]。

La Revue de medecine interne Pub Date : 2026-10-09 DOI: 10.1016/j.revmed.2026.06.010

Mickael Aubignat

{"title":"[Hiccups in adults: Pathophysiology, diagnostic approach, and management].","authors":"Mickael Aubignat","doi":"10.1016/j.revmed.2026.06.010","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.06.010","url":null,"abstract":"Chronic hiccups, defined as lasting more than 48hours, represent an underestimated clinical entity with potentially severe impacts on patients' quality of life. The pathophysiology involves a reflex arc comprising the phrenic and vagus nerves, integrated at the pontomedullary level. Recent advances highlight the role of a central pattern generator and neurotransmitter systems (GABA, dopamine, serotonin) in the genesis and perpetuation of hiccups. Epidemiological data reveal a striking male predominance (82-92% of cases), with an organic cause identified in over 90% of men. Etiologies are dominated by gastrointestinal causes, particularly gastroesophageal reflux disease (up to 80% of cases), followed by central neurological causes including Wallenberg syndrome. The diagnostic approach relies on targeted history and physical examination, complemented by laboratory tests, chest radiography, upper gastrointestinal endoscopy, and brain imaging when clinically indicated. Therapeutic management follows a stepwise approach: etiological treatment, proton pump inhibitors as first-line therapy, followed by baclofen or gabapentin. Refractory cases may require neuroleptics or interventional techniques (phrenic nerve block, acupuncture). Despite the absence of formal guidelines, this review proposes a pragmatic diagnostic and therapeutic algorithm based on current literature evidence.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[A cutaneous fistula]. [皮瘘]。

La Revue de medecine interne Pub Date : 2026-10-07 DOI: 10.1016/j.revmed.2026.05.008

Stéphane Vignes

引用次数: 0

[Abdominal and pelvic multiple cysts]. [腹部及盆腔多发性囊肿]。

La Revue de medecine interne Pub Date : 2026-10-07 DOI: 10.1016/j.revmed.2026.08.015

Ouijdane Zamani, Rachida Saouab, Jamal El Fenni, Meryem Boui, Meryem Edderai

引用次数: 0

[AL amyloidosis associated with multiple myeloma revealed by cholestatic hepatomegaly: A case report]. [胆汁淤积性肝肿大显示AL淀粉样变性伴多发性骨髓瘤1例]。

La Revue de medecine interne Pub Date : 2026-10-07 DOI: 10.1016/j.revmed.2026.08.010

Tamba Marc Sandouno, Mathilde Vermersch, Jeremy Passos, Laté Mawuli Lawson-Ananissoh, Thomas Mercier, Esse Sylvestre Tsogli

{"title":"[AL amyloidosis associated with multiple myeloma revealed by cholestatic hepatomegaly: A case report].","authors":"Tamba Marc Sandouno, Mathilde Vermersch, Jeremy Passos, Laté Mawuli Lawson-Ananissoh, Thomas Mercier, Esse Sylvestre Tsogli","doi":"10.1016/j.revmed.2026.08.010","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.010","url":null,"abstract":"Introduction: AL amyloidosis is a rare disorder characterized by the extracellular deposition of immunoglobulin light chain fibrils produced by a clonal plasma cell population. Hepatic involvement as the initial manifestation is rare, and forms associated with jaundice and cholestasis carry a poor prognosis.Case report: We report the case of a 53-year-old man from Togo presenting with massive hepatomegaly, cholestatic jaundice, and weight loss. After a negative etiological workup, diffuse hepatic infiltration associated with a plasma cell dyscrasia raised suspicion of AL amyloidosis. Peripheral biopsies were negative. The diagnosis was confirmed by transjugular liver biopsy, showing κ light chain amyloid deposits associated with a monoclonal plasma cell proliferation. Despite anti-clonal therapy using the ANDROMEDA protocol, the clinical course was rapidly fatal.Conclusion: This case highlights the critical importance of early diagnosis when facing unexplained cholestatic hepatomegaly.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Testing gamma-glutamyl transferase (GGT) in clinical practice: Rationalizing its prescription to limit financial and ecological costs]. [在临床实践中测试γ -谷氨酰转移酶（GGT）：合理化其处方以限制经济和生态成本]。

La Revue de medecine interne Pub Date : 2026-10-07 DOI: 10.1016/j.revmed.2026.08.001

Etienne Rivière, Noémie Gensous, Benjamin de Sainte-Marie, Yann Nguyen, Nathalie Costedoat-Chalumeau, Marie-Lise Bats, Adèle Delamarre

{"title":"[Testing gamma-glutamyl transferase (GGT) in clinical practice: Rationalizing its prescription to limit financial and ecological costs].","authors":"Etienne Rivière, Noémie Gensous, Benjamin de Sainte-Marie, Yann Nguyen, Nathalie Costedoat-Chalumeau, Marie-Lise Bats, Adèle Delamarre","doi":"10.1016/j.revmed.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.001","url":null,"abstract":"Gamma-glutamyl transferase (GGT) is a membrane-bound enzyme involved in extracellular glutathione metabolism and amino-acid transport, widely expressed in hepatobiliary epithelium and other tissues. In clinical practice, serum GGT is primarily used as a sensitive but non-specific marker of hepatobiliary injury and cholestasis, and as a companion test to alkaline phosphatase (ALP) to confirm hepatic origin. Beyond liver disease, elevated GGT reflects systemic oxidative stress and inflammation and has been associated with cardiometabolic disorders, some cancers, and drug-induced liver injury. This review summarizes the biology and function of GGT and proposes practical indications for ordering GGT in adult clinical practice based on PubMed-indexed literature. GGT measurement is most informative in: (1) evaluation of abnormal liver tests, particularly isolated or predominant ALP elevation; (2) suspected alcohol-related liver disease; (3) suspected cholestatic or pancreatic disease; (4) monitoring for drug-induced liver injury; and (5) selected contexts of cardiometabolic risk stratification and liver cancer risk assessment. Given its lack of specificity, GGT should always be interpreted alongside clinical context, other liver enzymes, imaging, and metabolic risk factors. It is imperative that clinicians address the issue of streamlining so-called \"routine\" laboratory tests, including gamma-GT, which ultimately proves to be of limited value in most cases.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Rational use of troponin testing]. 【合理使用肌钙蛋白检测】。

La Revue de medecine interne Pub Date : 2026-10-01 DOI: 10.1016/j.revmed.2026.09.007

Jérémy Boyer, Jennifer Cautela

引用次数: 0

[Post-traumatic diplegia of the upper limbs]. [创伤后上肢双瘫]。

La Revue de medecine interne Pub Date : 2026-10-01 DOI: 10.1016/j.revmed.2026.09.010

Noëline Bezanger, Raphael Amar, Léonard Chatelain, Jean-Emmanuel Kahn, Alexandre Terré

引用次数: 0

[Focus on alveolar echinococcosis]. 【重点治疗肺泡包虫病】。

La Revue de medecine interne Pub Date : 2026-09-28 DOI: 10.1016/j.revmed.2026.09.008

Anne-Pauline Bellanger, Emeline Scherer, Laurence Millon

引用次数: 0

[Myelitis Associated with Visceral Leishmaniasis Due to Leishmania infantum in Burkina Faso: A Case Report]. [在布基纳法索由幼年利什曼原虫引起的与内脏利什曼病相关的脊髓炎：一例报告]。

La Revue de medecine interne Pub Date : 2026-09-24 DOI: 10.1016/j.revmed.2026.09.006

Lassina Sere, Thierry K Guiguemde, Fabienne Sanou, Arielle Belem, Nadine Ouedraogo, Bertille Ouedraogo, Marcel P Sawadogo, Achille Aouba

{"title":"[Myelitis Associated with Visceral Leishmaniasis Due to Leishmania infantum in Burkina Faso: A Case Report].","authors":"Lassina Sere, Thierry K Guiguemde, Fabienne Sanou, Arielle Belem, Nadine Ouedraogo, Bertille Ouedraogo, Marcel P Sawadogo, Achille Aouba","doi":"10.1016/j.revmed.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.09.006","url":null,"abstract":"Introduction: Visceral leishmaniasis with Leishmania infantum (VL/LI) remains unreported in West Africa. We describe here an unprecedented autochthonous case of VL/LI in Burkina Faso, associated with myelitis.Case report: A teenage girl was hospitalized for prolonged fever, flaccid paraplegia, severe pancytopenia, hepatosplenomegaly, and immobilization-related pulmonary embolism with pleural effusion. Immunological, hematological, and microbiological investigations, including tuberculosis, particularly on pleural, bone marrow fluids, and salivary gland biopsy were non-diagnostic. Spinal MRI revealed thoracic myelitis. Empirical anti-tuberculous and immunosuppressive drugs for sarcoidosis (methylprednisolone/adalimumab) were ineffective and favoured ulcero-necrotic cutaneous nodules emergence, prompting VL diagnostic, confirmed by LI PCR positivity on cutaneous and blood samples.Conclusion: Although VL/LI is reported in local domestic dogs, this case provides the first documentation of human VL/LI in West Africa, endemic region for L. major, associated with a probable specific myelitis. This case is reminiscent of the exceptional involvements of central nervous system in the clinical spectrum of VL.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Fever, asthenia and weight loss in a 67-year-old woman]. [一位67岁妇女的发热、虚弱和体重下降]。

La Revue de medecine interne Pub Date : 2026-09-24 DOI: 10.1016/j.revmed.2026.09.004

Prunelle Getten, Nolven Guilbard, Alois Castro, Édouard Flamarion, Maxime Lacroix, Charles Aboudaram, Marie Talabard, Pierre Sohier, Frédérique Larousserie, Adrien Michon, Damien Dillie

引用次数: 0