[Sacroiliac involvement drug rheumatoid arthritis]

The objective of the study is to illustrate the incidence of sacroiliac involvement during rheumatoid arthritis, among 1000 cases seen in a period of 22 years. All patients fulfilled the criteria of American college of Rheumatology [ACR 87]. Were included only those with sacroiliitis diagnosed by X-Ray and a positive rheumatoid serology. 7 cases of radiologic sacroileitis were found [0.7%]; sex-ratio was 0.4; mean age was 42.85 years old; the age at onset was about 5.42 years. All patient had hand and wrist involvement with respect to distal interphalange joints. Deformities were seen in 6 cases and the majority were classified stage II clinically and stage III radiologically [Stein Brocker classification]. We noted that 2 cases of coxitis were associated to the sacroileitis and also 2 cases of subcutaneous nodules. Sedimentation rate was increased around 78 mm. Sacroileitis was classified stage III in 2 cases, one patient presented the diagnosis of spondylarthropathy associated to nodular, destructive and erosive rheumatoid arthritis; the diagnosis of spondylarthropathy was retained on AMOR criteria [7 points] and European Group [ESSG] criteria. The treatment was based on salazopyrine. Sacroiliac involvement during rheumatoid arthritis is not rare and should be explored when suggestive clinical signs are present

[Kikuchi disease and systemic lupus erythematosus]

Kikuchi's disease or histiocytic necrotizing lymphadenitis is a rare anatomico-clinical entity affecting young females. It is clinically manifested by generalized lymphadenopathy, fever and neutropenia. Diagnosis depends on histological examination. The etiology is not well known yet, although an autoimmune hypothesis has been suggested. It may be associated with systemic lupus erythematosus. The authors reported a case of Kikuchi's disease associated with apparition of secondary systemic lupus erythematosus. It is about a 16 years old woman who presented with fever, generalized lymphadenopathy, inflammatory polyarthritis and myalgia. Laboratory tests revealed an important inflammatory syndrome with leucopenia. Immunological test were normal and lymph node biopsy was in favour of necrotizing histiocytic lymphadenitis. [Kikuchi disease]. Later on after one year lupus disease was finally identified. Kikuchi's disease is a rare less frequent benign condition, the clinical symptoms resolve spontaneously but a regular Follow up should be taken with these patients to detect secondary onset of another autoimmune disease especially the systemic lupus erythematosus

Behcet's Disease

Behcet's disease is a predominantly venous vasculitis. It was first described as a clinical triad associating oral aphthae, genital aphthae and anterior uveitis. It concerns mainly young subjects of male gender originating from the Far-East and the Mediterranean basin. Its pathogenesis is not well known. It comprises neutrophil hyperreactivity owing to genetic predisposition, abnormalities in gd T cell function and microbial agents that could act as triggering factors. The most frequent clinical manifestations are cutaneo-mucous, ocular, vascular, neurological and articular. There is no specific biological abnormality and diagnosis is actually still purely based on clinical evidence. Treatment is not codified and only suspensive. It is based on colchicine, anti-inflammatory drugs and different immuno-supressives. In this work, we present a review on this subject according to some recent bibliographic data