ASSOCIATION D’HYPOTHYROIDIE ET DE MALADIE COELIAQUE. A PROPOS D’UNE OBSERVATION PEDIATRIQUE

Acquired hypothyroidism in child is a rare and unknown pathology. It is often secondary to an auto-immune chronic thyroiditis. In child, association hypothyroidism and celiac disease was rarely described. The authors report an observation of child presenting an association of hypothyroidism and celiac disease. A child, 30 months old year, without family antecedents of auto-immune pathology, the weight at birth was 5 kg, a test of tracking of the congenital hypothyroidism was revealed negative. At the 24 months age, this infant presented a stop of growth, a psychomotor slowing. The hormonal and immunological diagnostic test allowed posing the diagnosis of hypothyroidism at the 30 months age. After 6 month of hormonal treatment led good, the infant presented a clinical and biological relapse of hypothyroidism associated to a chronic diarrhea. The bilan of malabsorption and jejunal biopsy done at the 36 months age showed a total jejunal atrophy making keep the association of celiac disease and hypothyroidism. The evolution favored under gluten free diet and maintenance of hormonal replacement. .Through this observation, the authors discuss the diagnostic and therapeutic difficulties inherent to this association.L’hypothyroïdie acquise de l’enfant est une pathologie rare et peu connue. Elle est souvent secondaire à une thyroïdite chronique auto-immune. Son association à la maladie cœliaque est théorique mais rarement décrite. Les auteurs rapportent l’observation d’un enfant présentant à la fois une hypothyroïdie et une maladie cœliaque. Enfant âgé de 30 mois de sexe masculin, sans antécédents familiaux de pathologie auto-immune, le poids de naissance est de 5 kg, un test de dépistage de l’hypothyroïdie fait à la naissance s’est révélé négatif. A l’âge de 24 mois, on a constaté un arrêt de croissance et un ralentissement psychomoteur. Un bilan hormonal et immunologique a permis de poser le diagnostic d’hypothyroïdie acquise à l’âge de 30 mois. Après 6 mois de traitement hormonal bien conduit, l’enfant a présenté une rechute clinico-biologique de l’hypothyroïdie associée à une diarrhée chronique. Le bilan de la malabsorption avec la biopsie jéjunale effectuée à l’âge de 36 mois a montré une atrophie jéjunale totale faisant évoquer l’association de maladie cœliaque à l’hypothyroïdie acquise. L’évolution été favorable sous régime sans gluten et maintien du traitement hormonal substitutif. A travers cette observation, les auteurs discutent les difficultés diagnostiques et thérapeutiques inhérentes à cette association

Lung Fibrosis after Chemotherapy Containing Docetaxel in a Patient Treated for Breast Cancer

Docetaxel has proven effective in many solid tumors, including breast cancer. Hypersensitivity reactions are the most common toxicity associated with docetaxel. However, acute interstitial pneumonia is rarely reported in the literature. We report the case of a woman born in 1969, treated for invasive ductal carcinoma of the left breast and who presented 6 years later with an invasive ductal carcinoma locally advanced in the right breast. Neo-adjuvant chemotherapy based on docetaxel was indicated. Fifteen days after the third course, she had a stage IV dyspnea with a dry cough. Chest radiography showed a bilateral diffuse interstitial infiltrate appearance labeled as an acute interstitial lung disease secondary to docetaxel. The outcome was good after a high dose of corticosteroids. Clinicians should be aware of the risk of interstitial lung disease with docetaxel and introduce a special monitoring of lung function

Metachronous Bilateral Isolated Adrenal Metastasis from Rectal Adenocarcinoma: A Case Report

We report a case of adrenal metastasis from colorectal cancer in a 54-year-old woman. Nine months after resection for advanced rectal carcinoma, a computed tomography scan revealed bilateral adrenal metastasis. The level of serum carcinoembryonic antigen was normal. A bilateral adrenalectomy was performed after chemotherapy. Histopathological examination showed adenocarcinoma, compatible with metastasis from the rectal cancer. Adrenal metastasis should be considered in the patients’ follow-up for colorectal cancer