[Evaluation of urinary metanephrines for the diagnosis of pheochromocytoma]

Evaluate the assay of urinary metanephrines in diagnosis of pheochromocytoma [PH] and determine diagnostic cut-off values.This is a retrospective study about 87 patients suspected of pheochromocytoma,whose of 24-h urinary fractionated metanephrine was measured. These cases were collected from Internal Medecine Departments [A and B] at Charles Nicolle's Hospital. Two groups of patients were studied: a pheochromocytoma group [n=33] with a histologically-proven pheochromocytoma and a control group of 54 patients. Receiver Operating Characteristic [ROC] curves were used to determine the best sensitivities and specificities. The analysis of biological parameters showed that means and standard deviation of urinary fractionated metanephrines in pheochromocytoma group were significantly higher than those of control group. Sensitivity and specificity of urinary normetanephrine test [95% and 98.1% respectively] were higher than those of urinary metanephrine and 3-methoxytyramine. A correlation between urinary normetanephrine and tumor size of pheochromocytoma was found. Urinary fractionated metanephrines is an efficient biochemical test for the diagnosis of pheochromocytoma

[Chronic dissiminated intravascular coagulation caused by aortic dissection]

Disseminated intravascular coagulation [DIC] is a severe disease. It's can be caused by lost of pathology. We report the case of chronic aortic dissection discovered during the evaluation of disseminated intravascular coagulation [DIC]. This case is characterised by the severity of clinical presentation, challenging diagnosis and difficulty of therapeutic approach. Low dose of heparine may reduce the severity of this situation; but vital prognosis remains obscure. Aortic dissection is a rare but a severe cause of disseminated intravascular coagulation

[Renal amyloidosis during behcet's disease. study of one case]

Amyloidosis in Bethel's disease is rare and has a poor outcome. Report a new case. We report a case of a 38-year-old tunisian woman who presented with Behcet's disease and nephrotic syndrome. Renal biopsy showed amyloid deposition consistent with AA type. She had not any associated disease that might be an additional cause of secondary amyloidosis. She was treated by colchicine. After 3 years, proteinuria had disappeared and persisted negative 11 years after the diagnosis. A second renal biopsy showed the persistence of amyloidosis. As amyloidosis is one of the prognostic factors affecting survival in Behcet's disease, patients with this disease should be screened for amyloidosis. Administration of colchicine to these patients may be beneficial

Spontaneous ovarian hyper stimulation syndrome and deep vein thrombosis in a non pregnant woman: case report

To assess aetiological factors and complications in a patient with severe ovarian hyperstimulation syndrome [OHSS] and internal jugular vein thrombosis

Case: A 27-year-old non pregnant woman with bilateral ovarian masses who had underwent laparotomy for suspicion of malignant tumor. The pathological examination disclosed malignancy and the diagnosis of OHSS were confirmed. The postoperative evolution was complicated by internal jugular, subclavian vein thrombosis and pulmonary embolism. All biological parameters were negative. The evolution was good

Conclusion: The incidence of thromboembolism in women with OHSS is low and the typical finding is deep venous thrombosis in the neck area. Preventive measure of OHSS is very important, and the patients must be treated timely and correctly once OHSS occurs