Leucémie à plasmocytes : A propos de 5 observations cliniques: Plasma cell leukemia: report of 5 cases report

Plasma cell leukemia is a malignant plasma cell proliferation in bone marrow and peripheral blood. It is the most agressive form of plasma cell malignancies. It occurs in two forms: primary and secondary plasma cell leukemia. Plasma cell leukemia is defined by the presence of more than 2Giga/l peripheral blood plasma cells or plasmocytosis more than 20% of leukocyte count. In this context, we report 5 observations of plasma cell leukemia (1 case of primary plasma cell leukemia and 4 cases of secondary plasma cell leukemia) encountered during 9 years in Farhat Hached Hospital in Sousse-Tunisia. Through these observations, we describe clinical, paraclinical, prognostic and therapeutic characteristics of this pathology. La leucémie à plasmocytes est une prolifération maligne de cellules plasmocytaires dans la moelle osseuse et le sang périphérique. Elle représente la forme la plus agressive des néoplasies plasmocytaires. Elle se présente sous deux formes : une forme primitive et une forme secondaire compliquant un myélome multiple. Elle est définie par une plasmocytose sanguine supérieure à 2 Giga/l ou un taux de plasmocytes supérieur à 20% des leucocytes. Dans ce contexte, nous rapportons 5 observations de leucémie à plasmocytes (1 cas de leucémie à plasmocytes primitive et 4 cas de leucémie à plasmocytes secondaire) survenus en 9 ans à l’hôpital Farhat Hached de Sousse (Tunisie). A travers ces observations, nous décrivons les caractéristiques cliniques, paracliniques, pronostiques et thérapeutiques de cette pathologie. &nbsp

Acquired hemophilia A following COVID-19 vaccine: a case report

Abstract Background In the literature, reported cases of Acquired hemophilia A (AHA) induced by COVID-19 vaccination occurred after Adenoviral Vector Deoxyribonucleic Acid (DNA)- and SARS-CoV-2 Messenger Ribonucleic acid (mRNA)-Based vaccines. Here, and to the best of our knowledge, we report the first case of AHA occurring after an inactivated Sinovac-coronavac COVID-19 vaccine. Case presentation A 69-year-old Tunisian male patient consulted for severe left leg pain limiting physical mobility due to a 5*6 cm large ecchymosis located at the left inner thigh, having spontaneously appeared 5 days prior consultation and without notion of trauma. The patient had no known personal medical history. He had received the second dose of CoronaVac-SinoVac vaccine 30 days prior to consultation. Further physical examination revealed the presence of two other ecchymoses: one at the inner face of the right forearm, starting at the wrist reaching the elbow and the other at the left flank of the abdomen. Diagnosis of AHA was based on clinical presentation and confirmed with prolonged a PTT, Factor VIII deficiency and the presence of an FVIII inhibitor. The patient was successfully treated with corticosteroids and low dose Rituximab. Conclusion Clinicians should consider AHA in front of prolonged aPTT with or without spontaneous bleedings even after inactivated virus COVID-19

Contribution of HLA class I (A, B, C) and HLA class II (DRB1, DQA1, DQB1) alleles and haplotypes in exploring ethnic origin of central Tunisians

Abstract Background Estimation of HLA (Human leukocyte Antigen) alleles’ frequencies in populations is essential to explore their ethnic origin. Anthropologic studies of central Tunisian population were rarely reported. Then, in this work, we aimed to explore the origin of central Tunisian population using HLA alleles and haplotypes frequencies. Methods HLA class I (A, B, C) and HLA class II (DRB1, DQA1, DQB1) loci genotyping of 272 healthy unrelated organ donors was performed by Polymerase Chain Reaction-Sequence Specific Oligonucleotide (PCR-SSO). We compared central Tunisians with other populations (Arabs, Berbers, Mediterraneans, Europeans, Africans, etc.) using alleles and haplotypes frequencies, genetic distances, Neighbour-Joining dendrogram and correspondence analysis. Results Among the 19 HLA A alleles, the 26 HLA B alleles, the 13 HLA C alleles, the 15 HLA DRB1 alleles, the 6 HLA DQA1 alleles and the 5 HLA DQB1 alleles identified in the studied population, HLA A*02 (22.8%), HLA B*50 (13.1%), HLA C*06 (21.8%), HLA DRB1*07 (17.8%), HLA DQA1*01 (32.1%) and HLA DQB1*03 (31.6%) were the most frequent alleles. The extended haplotypes HLA A*02-B*50-C*06-DRB1*07-DQA1*02-DQB1*02 (1.97%) was the most frequent HLA six-loci haplotype. Conclusion Central Tunisians were very close to other Tunisian populations, to Iberians and North Africans. They were rather distant from sub-Saharan populations and eastern Mediterraneans especially Arabs although the strong cultural and religious impact of Arabs in this population