[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

[ sarcoidosis]

Sarcoidosis is a multisystemic granulomatosis seen mainly in the young adult. This is a retrospective study which evaluated 35 cases of sarcoidosis confirmed histologically, during periods from 1985 to 1999. In this study, 88.57% of patients were female with a mean age of 47.5 years old. The main complaint was often a peripheral node lesion followed by an ocular lesion. This clinical study had a very polymorphic presentation. The endothoracic lesions were largely predominant [94.28%], followed by extra thoracic lesions such as cutaneous lesions [big nodules and erythema nodosum], ocular lesions [25.7%], represented by anterior uveitis [4 cases], posterior uveitis [2 cases] and one case of panuveitis. Lymphatic node lesions were present in 63% of cases. The articular involvement was mainly made of inflammatory arthralgia. The bone lesions seen in 5 cases were made of sarcoid dactylitis confirmed histologically in 3 cases. We observed one case of sarcoidosis associated to spondylarthropathy. Prednisone was indicated in 27 patients at a dose of 0.5 to 1mg/kg/day, leading to a good recovery in 58.33 of cases. The mean follow-up was 20 months. Sarcoidosis in Morocco seems to be rare. The association of sarcoidosis and spondylarthropathy was rarely described. Posterior uveitis was present in this series

[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

Erythroblastopenie acquise a rechute de l'adulte; a propos d'un cas, revue de la litterature

A case of acquired chronic erythroblastopenia of the adult has been observed during ten years with successive relapses all the same responding to prednisone. Immunological disorder presence and prednisone response plead for an autoimmune pathogenesis

Hand Schuller Christian disease. About a case and litterature review

We report a case of Hand Schuller Christian's disease, which is chronical and disseminated form of Histiocytosis X. This case involving a young adult, includes diabetes insipidus skin abnormalities, bilateral knee arthritis which occured after a five year's evolution. We point out that for detecting the disease skin abnormalities are of extreme importance and we notice the scarcity of the articular localization except when thesaurismosis is caused by the treatment of diabetes insipidus. Different aspects are confronted with literature data

[Arterial complication of thoracic outlet syndrom. report of a case]

The authors report a case of cervical rib with post stenotic sub clavian aneurism and acute ischemia of right upper limb with digital necrosis. Etiologic, anatomic, physiologic, clinic, radiologic, and therapeutic aspect of thoracic outlet syndrome are reviewed

[Gastro-intestinal tuberculosis [21 cases]]

21 cases of gastrointestinal tuberculosis were diagnosed within 4 years ileocaecal [10], colic [7], small bowel [4] and gastroduodenal [2]. More than one localisation was encountered in 7 patients. In 10 cases, the presence of fistulas whether blind or communicating was noticed. The diagnostic criterious were either a positive histological examination, or the association of suggestive radiological aspects and a pulmonary or peritoneal tuberculosis, or a positive tuberculous test treatment. The clinical, biological, pathological and the radiological aspects of the gastrointestinal tuberculosis as well as the problems of the differential diagnosis, are discussed

[Light chains type multiple myeloma and amyloid intestinal obstruction]

A case of light chain type multiple myeloma is diagnosed in a 26 year-old patient who presented a gastrointestinal amyloidosis revealed by an intestinal obstruction. The authors recall the diagnostic difficulties of non typical multiple myeloma, the links between multiple myeloma and amyloidosis and emphasize their bad prognosis when associated

Alpha heavy chains disease: an intermediate stage

The authors report a case of alpha heavy chains disease associated with a lambliasis affecting a forty-year-old Moroccan women. Histologically, the stage of this case has not been described yet. It is intermediate between the stage A and B: there is a transparietal and plasmocytic infiltration of the small bowel as well as a ganglionic and periganglionic mesenteric infiltration and without any immunoblastic participation. This particularity warrents the tetracycline and cyclophosphamid association. This study is completed with a review of literature dealing with the alpha heavy chains disease