Cannabinoid Hyperemesis Syndrome: A Case Study in a Tunisian Young Man

The increasing prevalence of cannabis use in the world requires awareness of cannabis-related disorders such as cannabinoid hyperemesis syndrome. This syndrome includes cyclic episodes of nausea, vomiting, and the learned behavior of hot bathing in individuals with chronic cannabis use. We present the case of a suspected cannabinoid hyperemesis syndrome that required a review of the literature to retain the diagnosis. The following case illustrates how cannabinoid hyperemesis syndrome awareness may lead to the diagnosis

Combined analysis of interferon-γ and interleukin-10 gene polymorphisms and chronic hepatitis C severity

International audienceToday there is increasing evidence concerning the contribution of pro-/anti-inflammatory cytokine balance and genetic factors in hepatitis C pathogenesis and interindividual heterogeneity of disease outcome. In the current study, we investigated the influence of functionally described single nucleotide polymorphisms (SNPs) present in interferon-γ (IFNγ) and interleukin-10 (IL-10) genes, on chronic hepatitis C severity. IFNγ (+874T/A) and IL-10 (−1082G/A) genotypes were determined in 100 hepatitis C patients with different disease severities (chronic hepatitis, n = 42, liver cirrhosis [LC], and hepatocellular carcinoma in liver cirrhosis [HCC], n = 58) and 103 healthy controls using allele-specific polymerase chain reaction. No statistical differences in allele or genotype distributions of IFNγ and IL-10 genes were observed between patients and controls. However, some significant differences in IFNγ genotype frequencies were observed between the two groups of patients. IFNγhigh producer genotypes TT and TA were significantly more common in patients with LC and HCC (odds ratio = 2.65; p = 0.019). Although IL-10 genotypic frequencies were comparable between the different clinical forms of the disease, the combination of IFNγlow producer and IL-10high producer genotypes was significantly associated with a lower risk of LC and HCC (odds ratio = 0.21; p = 0.015). In conclusion, our findings suggest that the imbalance between the pro-inflammatory and anti-inflammatory responses mediated by polymorphisms in the IFNγ and IL-10 genes may influence the outcome of chronic HCV infection

Les virus de l'hépatite profitent des pratiques traditionnelles pour augmenter la charge du carcinome hépatocellulaire en Tunisie

International audienceHepatocellular carcinoma (HCC) is a major public health issue in Africa. In Tunisia, hepatitis B virus (HBV) is known to be an important risk factor for HCC in the south of the country, but the role played by hepatitis C virus (HCV) still remains unclear. The aim of the current case-control study was to identify risk factors for HCC development in the northern part of the country. Clinical and biological data including viral hepatitis status (serological and molecular) and non-infectious risk factors from 73 patients with HCC and 70 control subjects without hepatic diseases were collected. The mean age of the patients was 63 ± 10 years, and the ratio of males to females was 1.1. HCC occurred in cirrhotic liver in 72.0% of the cases. HCV infection was the dominant risk factor (64.3% of cases); the presence of HBV was observed in 53.4% of the cases. Occult hepatitis B and C were implicated, respectively, in 30.1% and 9.6% of the cases. HCV genotype 1b was predominant. Patients originating from western Tunisia formed a homogeneous group, characterized by significantly higher rates of tattoos or scarifications (83%) and HCV infection (80%) than those from other parts of the country. Chronic HCV infection is currently the primary risk factor for HCC in Tunisia; HBV infection remains frequent in its overt or occult infection forms. Traditional esthetic practices apparently contribute to increasing the burden of terminal liver diseases in western Tunisia