[Immunological profile of coeliac disease in a subgroup of patients with symptoms of irritable bowel syndrome]

The purpose of this study was to determine if authentic cases of irritable bowel syndrome could be secondary in a latent or potential coeliac disease. All new patients who consulted for irritable bowel syndrome fulfilling Rome II criteria between 01/04/2003 and 30/03/2004 were included. All patients had upper endoscopy with duodenal biopsy and colonoscopy or enema. Then they were investigated for celiac disease by analysis of serum IgA antigliadin, IgG antigliadin, and endomysial antibodies. One hundred patients with irritable bowel syndrome were included. They had an average age of 45.5 +/- 0.98 and they were 61 women. Clinical signs were dominated by abdominal pains associated to constipation [69% of the cases]. Five patients had positive antigliadin antibody [IgG for 2 patients and IgA for 3 patients]. None of them had endomysial antibodies nor abnormal duodenal biopsy. This study didn't provide a relation between celiac disease and irritable bowel syndrome when it is associated to constipation

[Holoprosencephaly: Foetopathologic study of 15 cases]

Holoprosencephaly [HPE] is a rare and serious brain anomaly of heterogeneous aetiology. Description of neuropathologic patterns of HPE to eventually integrate it into recognized syndrome. The authors report 15 cases of HPE, examined at the department of pathology of Sousse [Tunisia] over a period of 11 years. The average age of mothers was 32 years and 46% of them were primigestes. The rate of consanguinity was 45%. The population of the study was formed of 13 foeti, 12 of which arose from a medical interruption of pregnancy, and 2 newborns. The average foetal age was of 25.5 weeks of gestation. Antenatal diagnosis was performed on ultrasounds signs represented by a hydrocephalus [7 cases], a microcephaly [4 cases], a harmonious delay of growth [3 case] and a facial dysmorphy [38%] dominated by cyclopia. Neuropathologic Exam identified 13 cases of alobair HPE and 2 cases semi lobar. The HPE was isolated in 2 cases with an unknown caryotype, it was syndromic in 13 cases, associated with a chromosome abnormality confirmed in 3 observations. The neonatal outcome of this deformation remains very poor justifying the interruption of pregnancy except in the lobar forms. An exhaustive domestic inquiry is compulsory to propose to parents a most adequate genetic counselling

[Lobular idiopathic granulomatos mastitis About 10 cases]

Our retrospective study was performed on 10 cases of granulo-matous mastitis registered in Obstetric Gynaecology Department and Pathology Department of CHU F. Hached Sousse, during 8 years period. The mean age was 36.4 years [range 32-59]. Among these 10 cases, 8 were observed in reproductive-age women and 2 were noted in menopausal women. Clinical findings showed unilateral breast nodule associated with inflammatory signis in 4 cases, mammelonary retraction in 2 cases and serous or sero-purulent mamelonnary flow in 4 cases. Mammographic examination suggested a malignant tumor in 5 patients. In all cases, the diagnosis is made by histopathology. Surgical treatment consisted in wide excision with drainage or radical mastectomy, eventually with combination with antibiotic therapy and non steroid anti-inflammatory drugs. Prognostic features showed a good cicatrisation in 4 cases, local recurrence and cutanonus fistulization in one patient. Granulomatous mastitis aetiology is still unclear, auto-immune aetio-pathologenesis appears more interesting and should be clarified

[Primary myxoid leiomyosarcoma of the ovary, a case report with review of the literature]

A case of primary myxoid leiomyosarcoma of the ovary in a 50-year-old Tunisian woman is presented. Bilateral salpingooophorectomy and hysterectomy were carried out without any adjuvant therapy. The tumour were investigated histologically and immunohistochemically. Smooth-muscle actin and progesterone receptors was strongly demonstrated in neoplastic cells, bcl-2 was weakly and diffusely demonstrated. Relevant literature is reviewed based on the histologic and immunohistochemical features with emphasis on diagnosis and therapeutic problems and prognosis indicators