[Viral B reactivation: Risk factors and prevention]. / Réactivation virable B: facteurs de risqué et prevention.

BACKGROUND: The viral B reactivation is associated to deadly serious forms. There exist populations suffering this risk yet with a possibility of prevention through a pre-emptive treatment. PURPOSES: Establishing the diagnosis of a viral B reactivation. Identifying the patients with risk of exposure to viral B reactivation and implementing the means of prevention of viral reactivation. METHODS: literature review RESULTS: the diagnosis of reactivation is not consensual. It is evoked facing a fast increase of aminotransferases with the ALAT superior to 5-10 times normal or superior to 3 times the basic value, an ascension of the HBV DNA within the serum, a reappearance of anti Hbc of IgM type with, most often, a weak title and /or a reversion Hbs. The reactivation depends on the type of treatment and of the viral B status. It was described under chemotherapy concerning the solid tumors particularly that of the breast, in haematology and increases with the resort to monoclonal antibody (anti-CD20). Under anti-TNFα a reactivation is possible within a variable deadline from the 1st to the 12th perfusion. Besides the type of treatment, the risk is more important with the patients Ag Hbs positive and correlated with the viremia. However, the patients having an occult hepatitis B or even a recovered from hepatitis are equally exposed to the risk of reactivation. CONCLUSION: viral reactivation is frequent since the larger use of immunosuppressive therapy, anti-TNFα and monoclonal antibody. The determination of the initial viral B status by a serology is indispensable. In order to indicate either surveillance or a preemptive treatment.

Malignant epithelioid hemangioendothelioma: a case report.

Malignant epithelioid hemangioendothelioma (EH) is a rare tumor of vascular origin. We report a case of a woman who was found to have multiple hepatic masses in the right lobe of the liver on radiologic investigations, initially misdiagnosed as a metastatic carcinoma. The diagnosis of EH was made on histopathological study and confirmed by immunohistochemistry, which showed diffuse response for CD34 marker and no response to tissue CEA, HMB-45 or S-100 protein. Partial hepatectomy was made with good results.

[Autoimmune hepatitis type 1 triggered by cytomegalovirus infection. One rare case report]. / Infection à cytomégalovirus révélatrice d'une hépatite auto immune de type 1.

BACKGROUND: Autoimmune hepatitis is chronic and uncommon disease. The pathogenesis is a complex process. Several triggers for autoimmune hepatitis particularly viral herpesviridae infection, which may induce the development of autoimmunity in predisposed individuals. AIM: Report a new case. CASE REPORT: We report a case of 17-year- woman presented with autoimmune triggered by cytomegalovirus infection. Cytomegalovirus induced autoimmune hepatitis has not been reported previously. Evolution was favourable under antiviral treatment, corticosteroid and azathioprine.

[Nephrogenic ascites: an exceptional diagnosis. About one case]. / L'ascite Nephrogenique, Un Diagnostic Rare Auquel Il Faut Penser. A Propos D'une Observation.

BACKGROUND: Nephrogenic ascites is a clinical entity that manifests as refractory and exsudative ascites with unknown etiology in patients with end stage renal disease and often undergoing hemodialysis. This entity presents in practice many diagnostic and therapeutic difficulties. AIM: The aim of this study is to focus on these difficulties through a new observation. CASE REPORT: We report one case of nephrogenic ascites in chronic renal failure related to an idiopathic neurologic bladder. It's a 38 years old patient on hemodialysis for three years who consulted for exsudative ascites with a low rate of leucocytes. CONCLUSION: We conclude that nephrogenic ascites is rare. Its diagnosis is an exclusion diagnosis based on exclusion of other causes of ascites, particularly exsudative forms with low leucocytes rate. Its management is based essentially on renal transplantation and its prognosis is very poor.

[Thrombosis in inflammatory bowel disease: mechanisms and risk factors]. / Thromboses au cours des maladies inflammatoires chroniques de l'intestin: mecanismes et facteurs de risque.

BACKGROUND: Thromboembolic manifestations are frequent in patients with inflammatory bowel disease. AIMS: To explaim the mechanisms of thromboembolic manifestations in inflammatory bowel disease. METHODS: Literature review. RESULTS: Risk factors of thrombosis in inflammatory bowel disease are acquired or genetic. The most important factors are thrombocytosis, increased of activation of platelets and hyperhomocysteinemia. Other factors such factor V leiden, antithrombin III and antiphospholipid antibodies are observed in inflammatory bowel disease patients but not always correlated with thromboembolic manifestations. CONCLUSION: The mechanisms of thrombosis in inflammatory bowel disease are complex are intricate.