Réactivation d’hépatite virale B chez un patient traité pour lymphome non hodgkinien B diffus à grandes cellules par rituximab: à propos d’un cas

La réactivation du virus de l'hépatite B est secondaire à une diminution de l'immunité de l'hôte et peut être suivie d'une poussée d'hépatite aigue potentiellement mortelle. Nous rapportons le cas d'un patient D.H, 47 ans, sexe masculin, AgHBs négatif, jamais transfusé, jamais vacciné contre l'hépatite B qui avait présenté en mars 2013 un LNH B diffus à grandes cellules stade IV par moelle. Traité par 8 cures R-CHOP, il était en rémission complète clinique et paraclinique. Neuf mois après, il fait une rechute de son lymphome classé  stade III, associée à une hépatite virale B en réplication virale (18.000 copies/mL): réactivation virale B chez  porteur occulte traité avec entécavir 0.5mg par jour pendant 6 mois, l'ADN du VHB était indétectable en fin de traitement. Il avait reçu deux cures de DHAP puis deux cures R-DHAP avec une rémission complète. Lors du recueil des cellules souches en vue de l'autogreffe, l'AgHBs est à nouveau positif. Il a été greffé le 12/01/2015 et continue son traitement antiviral pour 6 mois encore.Key words: Hépatite virale B, immunosuppression, réactivatio

A Case of Acquired Hemophilia A with Maxillary Osteitis

Abstract Acquired hemophilia A (AHA), is a rare bleeding disorder with an incidence of approximately 1 per million/year.The disease is caused by the development of autoantibodies directed against clotting factor VIII and associated with an increased morbidity and mortality. In 50% of cases, FVIII autoantibodies occur in patients lacking any relevant concomitant disease; the remaining cases may be associated with postpartum period, autoimmune diseases, underlying hematologic or solid cancers, and infections. We report the case of a 32-years-old woman, admitted in hemorrhagic shock, following a non-reversible bleeding after dental extraction. The Laboratory tests prolonged activated prothrombin thromboplastin time (APTT at 54s), and normal Prothombine time (PT at 75%). The mixing test revealed the presence of a circulating anticoagulant with a Rosner index at 15. Factors specific to the intrinsic pathway determined that the patient had a factor VIII deficiency. Acquired hemophilia was diagnosed. At the local level, CT scan of the face objectified a right maxillary osteitis without sinus damage.The patient received transfusion of Red Blood Cells units and FFP (fresh frozen plasma) concentrates.but kept bleeding until an antibiotic treatment and corticosteroids (60mg/d) were added

“Sickle cell trait and haemophilia: a rare association”

In this paper we analyze the combination of HbAS disease and haemophilia A must be exceedingly rare. Because of this rarity we report the case of two brothers with sickle cell trait and major haemophilia A. We conclude that it is about a post-circumcision bleeding due to major hemophilia A associated to sickle cell AS, this association was a systematic discovery

Lead poisoning in children: a case report

Lead colic is a rare cause of abdominal pain. The diagnosis of lead poisoning is most often mentioned in at risk populations (children, psychotic). We report the case of a 2 year old child that was presented for acute abdomen. Abdominal plain radiograph showed multiple intra-colonic metallic particles and suggested lead poisoning diagnosis. Anamnesis found a notion of pica and consumption of peeling paint. Elevated blood lead levels (BLL) confirmed the diagnosis. The lead poisoning is a public health problem especially in children, but its manifestation by a lead colic is rare and could simulate an acute abdomen table.The Pan African Medical Journal 2016;2

Venomics and antivenomics profiles of North African Cerastes cerastes and C. vipera populations reveals a potentially important therapeutic weakness.

We report the proteomic analysis of the venom of the medically relevant snake, Cerastes cerastes, from Morocco, and the immunoreactivity profile of an experimental monospecific (CcMo_AV against Moroccan C. cerastes venom) and a commercial (Gamma-VIP against Tunisian C. cerastes and M. lebetina venoms) F(ab')(2) antivenoms towards geographic variants of C. cerastes and C. vipera venoms. The venom of C. cerastes is a low-complexity proteome composed of 25-30 toxins belonging to 6 protein families, mainly targetting the hemostatic system. This toxin arsenal explains the clinical picture observed in C. cerastes envenomings. Despite geographic compositional variation, the monospecific CcMo_AV and the Gamma-VIP divalent antivenom produced at Institut Pasteur de Tunis, showed similar immunocapturing capability towards Moroccan, Tunisian, and Egyptian C. cerastes venom proteins. Proteins partially escaping immunorecognition were all identified as PLA(2) molecules. Antivenomic analysis showed low degree of cross-reactivity of Moroccan CcMo_AV and Tunisian Gamma-VIP antivenoms towards C. vipera venom toxins. This study indicates that a more complete therapeutic cover could be achieved by including C. vipera venom in the formulation of venom immunization mixtures, thereby generating a pan-Cerastes antivenom

Mass spectrometry‐based top‐down and bottom‐up approaches for proteomic analysis of the Moroccan Buthus occitanus scorpion venom

International audienceButhus occitanus (B. occitanus) is one of the most dangerous scorpions in the world. Despite the involvement of B. occitanus scorpion in severe cases of envenomation in Morocco, no study has focused yet on the proteomic composition of the Moroccan B. occitanus scorpion venom. Mass spectrometry-based proteomic techniques are commonly used in the study of scorpion venoms. The implementation of top-down and bottom-up approaches for proteomic analyses facilitates screening by allowing a global view of the structural aspects of such complex matrices. Here, we provide a partial overview of the venom of B. occitanus scorpion, in order to explore the diversity of its toxins and hereafter understand their effects. To this end, a combination of top-down and bottom-up approaches was applied using nano-high liquid chromatography coupled to nano-electrospray tandem mass spectrometry (nano-LC-ESI MS/MS). The LC-MS results showed that B. occitanus venom contains around 200 molecular masses ranging from 1868 to 16 720 Da, the most representative of which are those between 5000 and 8000 Da. Interestingly, combined top-down and bottom-up LC-MS/MS results allowed the identification of several toxins, which were mainly those acting on ion channels, including those targeting sodium (NaScTxs), potassium (KScTxs), chloride (ClScTxs), and calcium channels (CaScTx), as well as antimicrobial peptides (AMPs), amphipathic peptides, myotropic neuropeptides, and hypothetical secreted proteins. This study reveals the molecular diversity of B. occitanus scorpion venom and identifies components that may have useful pharmacological activities

Anti-Cancer Activity of Buthus occitanus Venom on Hepatocellular Carcinoma in 3D Cell Culture

Hepatocellular carcinoma (HCC) is the most dominant primary liver cancer, which can be caused by chronic hepatitis virus infections and other environmental factors. Resection, liver transplantation, and local ablation are only a few of the highly effective and curative procedures presently accessible. However, other complementary treatments can reduce cancer treatment side effects. In this present work, we evaluated the activity of Moroccan scorpion venom Buthus occitanus and its fractions obtained by chromatography gel filtration against HCC cells using a 3D cell culture model. The venom was fractionated by gel filtration chromatography, each fraction and the crude venom was tested on normal hepatocytes (Fa2N-4 cells). Additionally, the fractions and the crude venom were tested on MCTSs (multicellular tumor spheroids), and this latter was generated by cultivate Huh7.5 cancer cell line with WI38 cells, LX2 cells, and human endothelial cells (HUVEC). Our results indicate that Buthus occitanus venom toxin has no cytotoxic effects on normal hepatocytes. Moreover, it is reported that F3 fraction could significantly inhibit the MCTS cells. Other Protein Separation Techniques (High-performance liquid chromatography) are needed in order to identify the most active molecule