[Juvenile granulosa cell tumor of the ovary: a case report]

Juvenile granulosa cell tumors of the ovary [JGCTs] are a rare form of neoplasm that makes up less than 5% of ovarians tumors in childhood and adolescence. About 90% are diagnosed in stage I [FIGO] with a favorable prognosis, whereas those at higher stages have a less favorable outcome. The authors describe a juvenile granulosa cell tumor expressed by an early pseudopuberty occurring in a 6 year old child. Clinically, an endocrine syndrome was associated with a pelvic mass. Hyperoestrogenia and serum alphafoetoprotein level were biologically detected. Tumor was localized strictly to the ovary, so conservative surgery was applied and proved sufficient to remove all tumor tissue. Histological examination showed typical microscopic aspect of a juvenile.granulosa cell tumor. The patient is well, 14 years after surgery with a normal growth and mental development

Anticorps antiphospholipides et grossesse

The presence of antiphospholipid antibodies is associated with a clinical syndrome characterised by thrombocytopenia, arterial and venous thromboses and recurrent fetal loss. Among theses antibodies currently detectable in laboratory are the lupus anticoagulant and anticardiolipin antibody. The antigens for these antibodies are phospholipid-binding-proteins [prothrombin and beta 2 glycoprotein. I]. The exact mechanism of action of antiphospholipid antibodies remains controversal. The pathogenesis of pregnancy loss seems related to the increased incidence of placental infraction. In spite of the improvement in our knowledge on the pathogenic mechanisms of the antiphospholipid syndrome, the standard therapy is still based on anti-platelet or anticoagulant drugs, both for vascular and obstetrical problems. Larger prospective clinical studies are needed to validate therapeutic implications

Epilepsie et grossesse: Necessite d'une prise en charge combinee.

Pregnant women with epilepsy are at risk for a variety of complications, that require an interdisciplinary cooperation between neurologists, pediatricians and obstericians. We report a retrospective study of 50 pregnant women with epilepsy over a 5 year period. Phenobarbital is largely the most used [74%]. During pregnancy, an increase in seizure frequency was noticed in 27 cases [54%]. Baribituric were essentially maintained in 74% of cases. We have reported a relatively high intervention rate during the delivery. Forty eight babies [96%] were born at term. There were no cases of neonatal haemorrhage or perinatal death. Symptoms of drug impregnation were found in 7 cases [14%]. Four children born to epileptic mothers treated during pregnancy had congenital malformations. Pregnancy doesn't have a catastrophic effect on the course of epilepsiy apart from the risk of an increase in the frequency of the fits. This risk must be reduced thanks to an optimal use of an anti-convulsive therapy before and during pregnancy. The major risk being foetal, mainly foetal malformations and hemorrhages