[Acute interstitial lung disease revealing antisynthetase syndrome]. / Pneumopathie interstitielle aiguë révélatrice d'un syndrome des antisynthétases.

INTRODUCTION: The antisynthetase syndrome is characterized by the presence of myositis, interstitial lung disease, arthritis, Raynaud's phenomenon, mechanics hands and anti-Jo1 antibody (histidyl tRNA synthetase). The prognosis of this syndrome is closely related to the severity of lung disease. Myositis can occur several years after lung disease and some patients with interstitial lung disease associated with anti-Jo1 antibodies will not suffer from muscle disease. CASE-REPORT: We report the case of a 69-year-old man admitted to the medical intensive care unit for acute respiratory insufficiency related to rapidly progressive interstitial lung disease. Antisynthetase syndrome was diagnosed the presence of wrists' arthritis, 'mechanic's hands and anti-Jo1 antibodies. Despite the dramatic efficacy of corticosteroid therapy on ventilation parameters, the patient died from a Pseudomonas Aeruginosa nosocomial ventilator-acquired pneumonia. CONCLUSION: Our case emphasizes the importance to search for anti-Jo1 antibodies in the presence of interstitial lung disease. During the course of antisynthetase syndrome, the occurrence of interstitial lung disease is almost always constant and is correlated with poor prognosis.

[Acute cardiac failure due to itraconazole]. / Insuffisance cardiaque aiguë sous itraconazole: une complication prévisible ?

INTRODUCTION: Itraconazole is an azole derivative used for the treatment of aspergillosis. Cardiac failure is a rare complication of treatment. Most cases occur in patients with cardiovascular risk factors, or taking multiple medications, and a causal relationship is not well-established. CASE REPORT: We report the case of a patient, without cardiovascular risk factors, presenting with cardiac failure during treatment with itraconazole. Pre-treatment stress testing and echocardiography were normal. Resolution was complete without sequelae. CONCLUSION: Cardiac failure can occur in association with itraconazole despite normal cardiological investigations before treatment.