Résumé
Most large series of patients with systemic lupus erythematosus (SLE) have revealed a very small group of patients who are persistently antinuclear antibody (ANA) negative with prominent dermatologic involvement but infrequent neurological and renal involvement. We present a very unusual case report of a young female with ANA-negative SLE presenting with lupus nephritis and oculomotor palsy without any dermatologic manifestations.
Sujets)
Adolescent , Hormones corticosurrénaliennes/usage thérapeutique , Anticorps antinucléaires/sang , Diagnostic différentiel , Femelle , Humains , Lupus érythémateux disséminé/diagnostic , Néphrite/étiologie , Muscles oculomoteurs , Paralysie/étiologie , ProtéinurieRésumé
The epidemiology and clinical presentation of abdominal tuberculosis were studied retrospectively in 298 adult cases admitted in Safdarjang Hospital, New Delhi over a 3-year period. These constituted 17% of the total number of admissions for tuberculosis. Age at presentation was variable with maximum cases in 21 to 40-year age group (58% of cases) with a mean age of 32.7 years. There was a slight female preponderance (57%). Sixty-three per cent were residing in urban areas. Pain abdomen, ascites and subacute intestinal obstruction were the commonest modes of presentation (34%, 30%, 28% respectively). Other clinical features included fever (21%), altered bowel habits (19%), weight loss (8%) and lump abdomen (6%). Acute intestinal obstruction and lower gastro-intestinal bleeding were uncommon (5% and 4% respectively). Co-existent pulmonary tuberculosis was seen in 16% cases. Histological evidence was available in 41% cases. Majority improved with conservative management with only 21% requiring surgical intervention. Mortality recorded was 11%.