Autoimmune hemolytic anemia revealing classical Hodgkin lymphoma: Two case reports and literature review

BACKGROUND: Hodgkin Lymphoma (HL) is rarely associated with autoimmune hemolytic anemia. We report here two cases of such association: Case 1: 57 years old man who presented with tiredness and pallor. Physical examination revealed multiple left cervical lymph nodes. Blood count showed regenerative macrocytic anemia with signs of hemolysis. Auto immune hemolytic anemia was confirmed by a positive direct antiglobulin test for IgG and C3d; lymph node biopsy revealed lymphocytic rich HL. Case 2: a 50 year old man being treated for HL for few months presented to the emergency room for dyspnea and pallor. Blood count showed regenerative macrocytic anemia with positive direct antiglobulin test for IgG and C3d confirming the diagnosis of AIHA as a relapse of the lymphoma. These two cases show that clinicians should be aware of such association revealing the diagnosis or the relapse of the lymphoma to distinguish it from anemia of chronic disease.

[Association between oxidative stress parameters and inflammations markers according to the gravityt of the acute coronary syndrome]

Cardiovascular disease is the consequence of appearance and development of atherosclerosis lesions of associated with a inflammatory complication. To elucidate a possible association between several inflammation and oxidative stress markers according to the severity of coronary artery disease. This study was carried on 93 coronary subjects with: unstable angina [UA; n=42]; stable angina [SA; n=15] and acute myocardial infarction [AMI; n=36] and 140 control subjects to whom lipidic, oxidative and inflammatory parameters were determined. In addition to a moderate hyperhomocysteinemia observed in the coronary artery disease, a significant higher levels of the oxidized LDL [ox-LDL] were found among these patients [p< 0.001]. A positive correlation was found between the markers of the inflammation and the gravity of the acute coronary syndrome. One note a significant increase of the rate of ox-LDL and high sensitive CRP to AMI by reports in UA and SA [p=0.00, and p=0.001 respectively] which is linked to an elevation of the plasmatic concentration of the total homocysteine. This study suggests an association between the markers of the inflammation and oxidative parameters in the acute coronary syndrome

[ budd chiari syndrome and buer's disease. A case reort]

Buerger's disease is an inflammatory non atheromatous distal arteriopathy affecting mainly young male smokers. There is some controversy about the existence of visceral localisations of the disease. Raport a new case. We report the case of a 40 years old man who developed a Budd Chiari syndrome with thromboses of the right hepatic venous, Later, he presented with rheumatic and distal occlusive arterial manifestations diagnosed as Buerger's disease. We underline the fact that digestive manifestations and hepatic involvement are less known and sometimes misdiagnosed

[Ischemic colitis as a first sign of primary antiphospholipid ntibody syndrome. acase report]

The primitif antiphospholpid antibody syndrome is a clinico-biologic entity characterized by the arterio-venous thromboses and the presence of circulating antibodies against membranous phospholipids. The systemic demonstrations and in. particular ulcerated and ischemic colitises are brought back unusually during this affection. Report a new case. We bring back one observations of ischemic colitis complicated of perforation revealing a primitif antiphospholpid antibody syndrome at a male patient aged of 45 and requiring the surgical intervention. This observation recall an exceptional etiology but often unrecognized of ischemic colitises

[Cardiac amyloidosis revealing multiple myeloma]

Amyloidosis is a rare disease characterized by an extracellular accumulation of a protein polysaccharide complex [Amyloid]. Cardiac involvement is considered as a major prognostic factor. We report the case of two women, hospitalized for heart failure. The diagnosis of cardiac amyloidosis was suggested by echocardiography left ventricular concentric hypertrophy and typical amyeloid infiltration with hyperechoic. shiny and granite-like aspect of the interventricular septum. The histological confirmation was obtained by gastric biopsy in the first case and biopsy of the salivary glands in the second revealing an amyloidosis AL. This cardiac amyloidosis was secondary to multiple myeloma: monoclonal Gammopathy with immunoglobulin Lambda in the first and Kappa in the second, and the presence of a plasmocyte infiltration in the sternal puncture. Amyloidosis is a rare pathology, the cardiac involvement is frequent in the type AL and can occur with or without clinical manifestations. Echocardiography should be systematic in patients with confirmed amyloidosis