[Chronic diarrhea with difficult diagnosis during HIV infection]

Diarrhea is a frequent symptom related to HIV infection. It may impose diagnostical and therapeutical problems. We reported an observation of two HIV patients presenting with chronic diarrhea. It concerns two patients, a female aged 43 years and a male of 27 years old who had diarrhea related to HIV-AIDS infection. Parasitological stool analysis and colonoscopy examinations were necessary in the aetiological researches for both of them. The founded aetiology of the first case was a cryptosporidisis associated with cytomegalovirus colitis, while the second case diagnosed as an indetermined origin colitis. The evolution of diarrhea was favourable in the first case by a treatment composed of an association of antiretroviral and Ganciclovir therapy, while only a tritherapy was needed for the second patient. HIV - related chronic diarrhea imposes rigourous parasitological and endoscopical researches in order to get an effective therapy against the eventually opportunist infection

Urticarial vasculitis revealing a lupus like syndrome

We report the case of a 38 years old woman with urticarial cutaneous lesions associated with multiple systemic involvemernt including arthralgias, myalgias, muscular weakness, persistant hypocomplementemia is noted. A biopsy of the urticaria demonstrated a leucocytoclasic vasculitis, the immunofluorescence study of the skin biopsy showed IgM, C3 and C1q deposits in the dermo epidermal junction and along the capillary wall. Antinuclear antibodies, anti DNA are present. The syndrome recognized in this patient and those few observations reported previously constitue a lupus like syndrome

Behcet's Disease

Behcet's disease is a predominantly venous vasculitis. It was first described as a clinical triad associating oral aphthae, genital aphthae and anterior uveitis. It concerns mainly young subjects of male gender originating from the Far-East and the Mediterranean basin. Its pathogenesis is not well known. It comprises neutrophil hyperreactivity owing to genetic predisposition, abnormalities in gd T cell function and microbial agents that could act as triggering factors. The most frequent clinical manifestations are cutaneo-mucous, ocular, vascular, neurological and articular. There is no specific biological abnormality and diagnosis is actually still purely based on clinical evidence. Treatment is not codified and only suspensive. It is based on colchicine, anti-inflammatory drugs and different immuno-supressives. In this work, we present a review on this subject according to some recent bibliographic data

macrophage hyperactivation syndrome with hemophagocytosis

The hemophagocytic syndrome is a benign systemic histiocytic proliferation which may be caused by several etiologies: infections, autoimmune diseases, hemopathy; << solid >> cancers, immunity deficits. The inadequatee activation of the loop << macrophage - lymphocyte >> with hypercytokinemia explain in the large proportion the physiopathological, clinical and biological features. This syndrome includes: fever, organomegaly, cytopenia, hypertriglyceridemia, hyperferritinemia and clotting disorders. The diagnosis is based on clinical, biological and especially histopathological criteria: with tissue and/or medullary histiocytic infiltration. We report two cases of hemophagocytic syndrome in which the etiology had remained undetermined and the evolution had been fatal

Manifestations neurologiques de la maladie de Behcet

Neurological affection exist in Behcet's disease from 10 to 20% of the cases. This frequency increases if we practice a rachicentesis in systemic way. Any part of the central nervous system may be affected from which the great clinical polymorphism. Seems particulary prevalent in our study which concerns sixteen patients [the increased intracranial hypertension]. It's present in sixty two and half per cent [62,5%] of the cases of our serie while in the literature it's only twenty per cent [20%] of the cases. Though the prognosis consired in case of neurological lesion pejorative either in the functional and the vital plan seems neatly improved these last years. The mortality is only notified in five per cent of the cases. The serious forms are always the encephalo-myelitis or the meningoencephalitis. The etiopathogenesis doubt explains the various therapeutics used