[Prevalence of extra-hepatic manifestations in infection with hepatitis C virus: study of 140 cases]

To determine the extrahepatic manifestations [EHM] in chronic hepatitis C and to correlate signs with age, sex, degree of fibrosis and genotype of hepatitis C virus. One hundred forty cases of chronic infection by hepatitis C virus were investigated in a period of 10 years. By interrogation, clinical examination and laboratory tests, the EHM were determined. Correlations with age, sex, viral genotype and degree of fibrosis were determined by the chi2 test. Mean age of our patients was 59 years [16-85 years]. 74% were women. The genotype 1b was found in 75% of cases. The clinical EHM were found in 62% of cases: buccal dryness in 17.1% of cases, arthralgias in 33% of cases and fatigue in 65% of cases. 25% of patients had at least one biological EHM associated with chronic hepatitis C: proteinuria in 3 cases, cryoglobulinemia in 4 cases, dysthyroidism in 8 cases and more frequently a positive immunologie test. During the follow-up, we found one case of breast cancer, one case of rectal cancer, 2 cases of MALT lymphoma and one case pf splenic lymphoma. A positive correlation was found between the prevalence of EHM in chronic hepatitis C and the female sex. A degree of fibrosis[3] 2 in METAVIR classification was significantly associated with more important frequency of EHM. EHM should be screened systematically in chronic infection with HCV. Pathogenic mechanisms in a B lymph node proliferation or diabetes and outcome of these abnormalities under antiviral therapy should be further investigated

[Survival and causes of mortality of cirrhotic patients in Tunisian center a study of 114 patients]

The aim of this study is to determine the survival and the principal causes of death in our cirrhotic patients in whom the B and C viral infection represented the principal causes. It's a retrospective studs that includes 114 cirrhotic patients hospitalized between 2000 and 2005 in the department of hepato-gastro-enterology of sahloul. The mean age was of 53 years with extremes of 15 to 85 years; 65 were men 57%] and 49 were women [43%]. After a follow-up of 29, 4 months, 51 patients died [44, 7%]. The causes of death were hepatocellular carcinoma in 19 cases [16, 7%], hepatorenal syndrome in 17 cases [14, 9%], hepatic encephalopathy in 12 cases [10, 5%], infection of ascitis in I case and upper digestive hemorrhage in 2 cases [1, 8%]. The global survival of patients was 66%for 2 years and 47%for 5 years. The survival for 5 years of viral B cirrhosis was 34%, but it was 51%in non B viral cirrhosis but the difference was not statistically significant [p=0, 6]. The cirrhotic patients have a premature mortality in comparison to the general population. The hepatocellular carcinoma remains one of the principal causes of death, where the interest of early screening for degeneration

[Prevalence of celiac disease in patients with type 1 diabetes mellitus]

The aim of our study was to determine the prevalence of celiac disease in patients with type 1 diabetes mellitus. Between january 2004 and december 2005, 72 patients with type I diabetes mellitus and having pseudo ulcerous dyspepsia were included in this prospective study. Upper gastrointestinal endoscopy with proximal intestinal biopsies was performed in all patients. Patients with villous atrophy were tested for anti-gliadine antibodies, anti-endomysium antibodies and for anti-human tissue transglutaminase antibodies. Villous atrophy was observed in three patients [4, 1%]. It was subtotal in two cases and total in one case. Anti-gliadine antibodies, anti-endomysium antibodies and anti-human tissue transglutaminase antibodies were positive to three patients. The prevalence of celiac disease in patients with type 1 diabetes mellitus is high [4, 1%]. Early screening of celiac disease must be recommended to this diabetic population

[ sump syndrome - about a case report]

We report a case of Sump syndrome [SS] that occured in a 72 years old man that was operated 12 years before for a biliary lithiasis. He had a cholecystectomy with a choledocoduodenal anastomosis. This syndrome had been revealed by an angiocholitis presentation. Duodenoscopy revealed bezoars obstruction of choledocoduodenal anastomosis. Ablation of bezoars and endosopic extraction of lithiasis leaded to recovery after a follow up of 24 months

[Diabetes in chronic pancreatitis- about 22 cases]

The aim of our study was to determine the diabetes profile in chronic pancreatitis, through an analysis of 22 chronic pancreatitis cases seen over 14 years in the service of gastroenterology. There were 6 men and 2 women. The average age is 50 years, the age oscillating between 20 and 67 years. The diabetes revealed chronic pancreatitis in 5 cases. These patients were alcoholic. The diabetes appeared in average after 4 years of evolution. Seven patients had pancreatic calcifications. This diabetes was insulin dependent in 4 cases. Through the reported cases, a literature review is done in order to point on features of diabetes when occurring with chronic pancreatitis