An unusual cause of optic neuritis：rickettsiosis disease

Optic neuritis (ON) may be associated to a range of autoimmune or infectious diseases. We report herein a case of ON induced by Rickettsia conorii. A 53-year-old woman presented with a recent decrease in visual acuity and headache. ON was diagnosed on the basis of ophthalmologic examination and flash visual evoked potentials. Etiological investigation made in our department eliminated first autoimmune disorders (vasculitis and connective tissue diseases). Rickettsial optic neuritis was confirmed by detection of specific antibodies in serum and the negativity of other serologic tests. An association between corticosteroids and cyclines was prescribed with improvement of visual acuity.

[Pregnancy in dermatomyositis and polymyositis]

To determine the incidence of pregnancies during the inflammatory myopathy [IM], its influence on this disease and the influence of IM on the pregnancy's outcome. From 1979 to 2007 we have collected retrospectively 67 cases of IM [53 women and 14 men] in the department of internal medicine CHU Hedi Chaker of Sfax [Tunisia]. Diagnosis criteria were those and Peter. We have included pregnancies occurring after diagnosis of DM or PM and cases of IM occurring during pregnancy or postpartum. Five women [4DM and PM], average age 30.6 years [range 26 - 41 years] concluded 10 pregnancies [9.4%]. The fertility rate is 2 pregnancies per patient. Nine pregnancies occurred after the diagnosis of myositis in 4 women. IM was inactive at conception in all this case. No flare-up in IM has been noted during these pregnancies. The DM was revealed to the 10th day post-partum in one patient. Therapeutic interruption of pregnancy was needed in 3 cases. 4 pregnancies were completed without incident and resulted in the birth of healthy newborns. Foetal complication were observed in the other two pregnancies occurring in one patient who also presents an APS associated with DM. it was a foetal death in utero and premature delivery of a newborn who died in 3rd day after birth. Pregnancy in the MI is rare. Its influence on the activity of the disease is variable, both during the pregnancy than post-partum. The foetal prognosis is good when the disease is in remission. However foetal complications are important in case of active IM