Central retinal vein occlusion revealing celiac disease

Introduction: Thrombosis has been widely reported in coeliac disease (CD) but central retinal vein occlusion (CRVO) is rarely described. Case presentation: A 27-year-old woman presented with acute visual loss and was diagnosed with CRVO. Her protein S and protein C levels were low and CD was diagnosed on the basis of endoscopic, immunological and histological results. A gluten-free diet resulted in favourable evolution. Conclusion: CD should be considered in young patients with thrombosis, especially if in an unusual location. Treatment is based on a gluten-free diet

Panniculite au cours d’un traitement d’une dermatomyosite par du méthotrexate

La panniculite est une manifestation rare au cours des dermatomyosites (DM). L’apparition d’une panniculite au cours d’un traitement par du méthotrexate (MTX) est exceptionnelle et n’a été décrite que dans 3 cas. Nous rapportons l’observation d’une patiente âgée de 50 ans atteinte d’une DM diagnostiquée en 1997 et traitée par une corticothérapie avec une évolution favorable aux plans clinique et biologique. A l’occasion d’une rechute 2 ans plus tard, la corticothérapie a été majorée et du méthotrexate à une dose hebdomadaire de 7,5 mg a été rajouté. L’évolution était rapidement favorable. Dix huit mois plus tard, la patiente présentait de multiples nodules sous cutanés siégeant aux 4 membres et aux fesses, dont l’examen anatomopthologique concluait à une panniculite. Il n’existait aucun signe d’évolutivité de la DM. La dose de prédnisone a été augmentée à 0,5 mg/kg/j toujours en association au MTX mais sans aucune amélioration. Le MTX a été arrêté et les lésions cutanées ont complètement disparu en 2 mois sans aucune récidive avec un recul actuel de 42 mois. Notre observation est particulière par la survenue d’une panniculite chez une patiente ayant une DM traitée par du MTX et illustre la difficulté diagnostique. Cette entité doit être connue malgré son caractère exceptionnel puisque l’arrêt du MTX induit en général la disparition des nodules sous cutanés.Pan African Medical Journal 2016; 2

Une colite à CMV révélant un lupus érythémateux systémique

Le cytomégalovirus (CMV) est responsable d’infections souvent asymptomatiques chez les immunocompétents mais également d’infections graves chez les immunodéprimés notamment chez les patients lupiques. La réactivation du CMV au cours du lupus est une complication fréquente mais rarement inaugurale. Nous rapportons l’observation d’un patient ayant présenté une colite à CMV révélatrice d’un lupus érythémateux systémique. Le diagnostic a été retenu sur les données sérologiques, de la biopsie colique et la bonne évolution après un traitement par ganciclovir

A Rare Cause of Lobular Panniculitis: Munchausen's Syndrome

We describe a case of a 40-year-old woman who presented with ecchymoses of the right leg and who was found to have lobular panniculitis in biopsy due to Munchausen's Syndrome

Primary Sjögren’s syndrome complicated by anti-neutrophil cytoplasmic antibody-mediated crescentic glomerulonephritis

Ocular and oral dryness are the hallmark of Sjögren’s syndrome (SS). However, SS can be associated with a variety of complications, affecting organs such as the liver, kidneys, lungs, muscle, and nervous system. Renal involvement has been usually in the form of tubulointerstitial nephritis. However, glomerulonephritis is rare in primary SS. We report three clinical cases of SS with anti-neutrophil cytoplasmic antibody-mediated crescentic glomerulo-nephritis treated with prednisone and cyclophosphamide, with favorable outcome

Deep vein thrombosis in Behçet's disease.

Archives en ligne du journal Clinical and Experimental Rheumatology (https://www.clinexprheumatol.org/article.asp?a=1287)International audienceObjective : We aimed to describe the epidemiological and clinical aspects of deep vein thrombosis (DVT) in Behçet's disease (BD) and to determine the patients at high risk for this complication. Methods : Among 113 patients with BD according to the international criteria for classification of BD, those with DVT were retrospectively studied. The diagnosis of DVT was made in all cases using conventional venous angiography, venous ultrasonography and/or thoracic or abdominal computed tomography. Patients were divided in two subgroups according to the occurrence of DVT other than cerebral thromboses. The medical records of these patients were reviewed in order to investigate their past medical history and evaluate their response to the treatment prescribed. Clinical and genetic factors (HLA B51 and MICA 6) that might contribute to DVT were analysed by comparing patients with and without DVT. Results of our series were compared to those of other series in the literature. Statistical analysis was by Chi square with necessary correction and Fischer tests.Results : Forty-four patients (38.9%) had deep vein thrombosis of various systems with 81 localisations. There were 40 men and four women (mean age 28.1 years; range 17-60). DVT appeared after the onset of disease with a mean delay of 3.8 years. In 6 cases, DVT revealed BD. When we evaluated the risk of DVT coexistence with other clinical findings and genetic factors (HLA B51 and MICA 6), we found a significant positive correlation with sex, and positive pathergy test.Conclusion : In our series, occurrence of DVT was significantly associated with male gender and positive pathergy test

Erdheim‐Chester disease: A multisystem disease case illustration with rare manifestations and treatment challenges

Abstract Erdheim‐Chester disease is a rare multisystemic disease. A 50‐year‐old woman, presented with a recurrent pain and swelling of the left knee. Bone scintigraphy showed increased tracer uptake of peripheral skeleton. The computed tomography showed tissular infiltration in the retroperitoneum, around the vessels. Immunohistochemistry showed CD68 (+) and CD1a (−)

Comparison of Clinical Features of Behcet Disease According to Age in a Tunisian Cohort

Behcet's disease (BD) is a multisystemic inflammatory disease that occurs most often between the second and fourth decade of life. Patients have been reported during the first months of life and after 70 years. Our objective was to determine the clinical, paraclinical and genetic characteristics of BD in patients aged 40 years. We conducted a comparative retrospective study including patients with BD (Criteria of International Study Group on BD). Patients were divided into two groups: those 40 years (Group two). The clinical, paraclinical and genetic (HLA) characteristics were determined and compared in the two groups. The data were compiled and analyzed using SPSS 11.0. Thirty totals of 430 patients were included. Group one included 81 patients (55 men and 26 women). Group two included 68 patients (45 men and 23 women). Cutaneous involvement (88.9 versus 76.5%; P=0.043), pseudofolliculitis (84 versus 64.5%; P=0.004) and vena cava thrombosis (11.11 vs 0%; P=0.004) were significantly more frequent in group one while joint involvements were more common in group two (57.4 versus 40.7%; P= 0.043). The frequency of erythema nodosum as well as ocular, vascular and neurological disorders was comparable between the two groups. Few studies in the literature have compared the clinical, paraclinical and genetic characteristics of BD, who had first symptom onset after 40 years of age. Late-onset BD, usually, affects both genders equally. According to present results, the frequency of severe organ involvement is equal regardless of age, except for vena cava thrombosis