[Antineutrophil cytoplasmic antibodies and associated diseases]. / Anticorps anticytoplasme des polynucléaires neutrophiles et pathologies associées.

Antineutrophil cytoplasmic antibodies are classical serological markers of small-vessels vasculitis. However, they have been described in many other pathological situations. The aim of this study was to determine through our experience, the main antineutrophil cytoplasmic antibodies-associated diseases and to investigate antigen targets of these antibodies. Forty complete observations of antineutrophil cytoplasmic antibodies (ANCA) positive patients either by indirect immunofluorescence or by enzyme immunoassay were analysed. Only five (12.5%) patients have small-vessels vasculitis. Among these, antineutrophil cytoplasmic antibodies were detected only by Elisa in one patient and they were exclusively directed against bactericidal permeability increasing protein in another one. Our study confirms the presence of antineutrophil cytoplasmic antibodies in different diseases. It demonstrates that antineutrophil cytoplasmic antibodies should be investigated by Elisa when indirect immunofluorescence is negative. In small-vessels vasculitis, Proteinase 3 and myeloperoxidase are mainly but not exclusively the antigenic targets of antineutrophil cytoplasmic antibodies.

[Right tracheal bronchus associated with tuberculosis pneumonia. A case report]. / Bronche trachéale droite associée à une lobite segmentaire tuberculeuse. A propos d'un cas.

Right tracheal bronchus is a rare almost always asymptotic congenital malformation. We report a case of right tracheal bronchus associated with pneumonia tuberculosis of the apical segment of the upper right lobe. We describe the characteristic of this malformation and stress the role of computed tomography scan to detect these anomalies.

[Skin test reactivity to seven aeroallergens in a Sousse area population sample]. / Sensibilisation cutanee aux pneumallergenes courants dans une population generale de la region de Sousse.

INTRODUCTION: Allergy skin tests are an important tool in the diagnosis of allergy diseases. They are useful in epidemiologic studies. OBJECTIVES: The aim of our study is to estimate the prevalence of the skin sensitivity in a sample of unselected population and to study the relationship between skin test reactivity and clinical manifestations. PATIENTS AND METHODS: During 9 months, we undertake skin prick-test in 500 subjects. Our population was recruited in the blood sample room of the biochemistry laboratory of the University Hospital of Sousse. Seven aeroallergen was tested: Dermatophagoïdes pteronyssinus (DPT), Dermatophagoïdes farinae (DF), Pollens of Graminees, Olive-tree, Partetaure, Cockroach and Candidine. A positive and a negative control tests were made. RESULTS: 34% of the population was sensitized to one or more aeroallergens. In the litterature this prevalence vary from 9 to 55.5% according to the methodology applied. In our study the skin reactivity does not change with sex (p = 0.26) but was high in subjects aged between 15 and 35 years. 21.8% were sensitized to house dust mites (DPT, DF) and 18.2% to pollens (Olive-tree, Graminees, Parietaire). Skin reactivity was more common when subjects had personal atopic history (p < 0.003) and/or had actual allergic symptoms particularyrhinitis and asthma (p < 0.006). CONCLUSION: Skin reactivity to common aeroallergens is frequent in the general population, particularly in symptomatic subjects affected by rhinitis and/or allergic asthma. This skin sensitization is the result of genetic and environmental interaction, but skin sensitization does not mean allergy.

[Cutaneopulmonary blastomycosis]. / Blastomycose cutaneo-pulmonaire.

We observed a new case of blastomycosis in a patient with haemoptysis. The chest X-ray revealed a lesion confined to the upper right lobe of the lung and there was an ulcerating vegetation at the medial angle of the right eye. Skin biopsy and bronchial aspiration led to the identification of typical Blastomyces dermatitidis. Outcome was favourable after oral therapy with ketoconazole. Cutaneo-pulmonary blastomycosis is weakly endemic in Tunisia. Pulmonary lesions are more frequent because of airborne transmission. Cutaneous lesions may be clinically misleading. This disease is sensitive to antifungal imidazole derivatives.

[Superior caval syndrome in adults in central Tunisia. Apropos of 26 cases]. / Le syndrome cave supérieur de l'adulte en Tunisie centrale. A propos de 26 cas.

We report 26 cases of superior vena cava obstruction (SVC) observed in Sousse University Hospital (TUNISIA). The diagnosis was confirmed by CT scan and/or superior vena cava angiography. The underlying disease was revealed by SVC on 76.9% of cases. Malignant underlying disease was noted on 61.53% of cases. Non malignant causes of SVC was Behçet disease (4 cases) and mediastinal fibrosis (5 cases). SVC revealed Behçet disease in the 4 cases.