[Increased cardiovascular risk and premature atherosclerosis in rheumatoid arthritis]. / Augmentation du risque cardiovasculaire et accélération de l'athérosclérose au cours de la polyarthrite rhumatoïde.

UNLABELLED: Patients with rheumatoid arthritis (RA) are at increased risk of mortality compared with the general population. Evidence suggests that this increased mortality can largely be attributed to increased cardiovascular (CV) death. In a prospective study, 34 patients with RA were compared with age- and sex-matched controls. RESULTS: We found a lower C-HDL, apolipoprotein A1 and B in patients with RA. However, CT/C-HDL and C-LDL/C-HDL were significantly higher than control patients. The intima-media thickness was significantly higher in patients with RA (0.759 mm vs 0.558 mm; P<0.001). CONCLUSION: Increased attention to cardiovascular risk in RA will be necessary to reduce the excess CV mortality and morbidity in RA patients. It appears that the excess risk that is observed in the RA population can be explained, in part, by promotion of CV disease through increased systemic inflammation associated with RA.

[Rosai-Dorfman disease: therapeutic issues in 2 cases]. / La maladie de Rosai - Dorfman : enjeux thérapeutiques à propos de 2 observations.

Rosai-Dorfman disease (RDD) is a benign lymphoproliferative disorder characterized by cervical lymph node enlargement with a consistent risk of airway compression and esthetic damage. Extranodal localizations are also described. There is no therapeutic consensus for pediatric forms of RDD. Through 2 pediatric cases with nodal involvement in 1 patient and a sinonasal and soft tissue localization in the other, we focus on the management problems of both nodal and extranodal RDD.

[Sciatica in a Tunisian teenager: pelvic hydatid cyst]. / Lombosciatique chez un adolescent tunisien. Kyste hydatique pelvien.

The purpose of this report is to describe the case of a 13-year-old boy presenting typical sciatica leading to the discovery of primary pelvic hydatid cyst extending to the ischiatic bone. Diagnosis was suspected based on echography and magnetic resonance imaging and confirmed by surgical exploration.

Back pain caused by a pseudo-tumorous vertebral collapse: atypical presentation of primary vertebral hydatidosis.

Hydatidosis, also known as echinococcosis, is a rare but serious parasitic disease in endemic areas. Primary spinal location is extremely rare. This case report describes a rare instance of hydatid cyst that caused severe and progressive low-back pain and neurologic dysfunction. Spine MRI showed a unique vertebral collapse of Th12 body with multicystic lesions filling the spinal canal. In addition, hydatidosis serodiagnostic test was positive at 1/725. Treatment depended on the actual surgical removal of the cysts. Surgery consisted in excision and extirpation of the cysts, associated with decompressive laminectomy. The diagnosis was confirmed on the basis of histological results. No coincidental hydatid visceral involvement was found. Antihelminthic drugs (Albendazole) were promptly given before surgery for a long period. The outcome was satisfactorily marked by total regression of the motor deficit and sphincter disorders.

Brucellar spondylodiscitis affecting non-contiguous spine levels.

Brucellosis is a zoonosis that affects several organs. The spine is the most common site of musculoskeletal involvement. However, multiple-level spinal involvement is rare in brucella spondylodiscitis. The authors report a case of a 56-year-old male shepherd who had developed a spondylodiscitis affecting simultaneously the cervical, thoracic and lumbar regions. The diagnosis was established by using MRI after the brucella-agglutination test was found to be positive. A high degree of suspicion in the diagnosis of brucellar spondylodiscitis is essential to reduce the delay for the treatment. Thus, it should be essentially included in the differential diagnosis of longstanding cervical, thoracic or back pain, particularly in regions where brucellosis is endemic. Screening serological tests for brucella should be used more widely in cases with low index of suspicion, especially in endemic areas.

Spine fracture in patient with ankylosing spondylitis: A case report.

Spinal fractures in patients with ankylosing spondylitis may be the result of minor trauma. These fractures may lead to severe neurological deficits, and they are difficult to detect using standard radiography. Often, CT-scans and MRI are required for diagnosis.

[Budd-Chiari syndrome associated with celiac disease]. / Syndrome de Budd-Chiari associé à une maladie coeliaque.

The association of Budd-Chiari syndrome and celiac disease is rare and has been reported in only 13 cases. We report a 23-year-old man with celiac disease, treated with gluten-free diet since the age of 16 years. He presented with epigastric pain that was secondary to a Budd-Chiari syndrome. No other cause than celiac disease could be identified.

[Giant retroperitoneal liposarcoma. One case report]. / Liposarcome rétropéritonéal géant. A propos d'un cas.

INTRODUCTION: Retroperitoneal Liposarcoma is a rare and primary malignancy developed from mesenchymal tissue. It's generally unique and shows an only one histologic component. We report a case of multicentric and synchronous liposarcoma (intraperitoneal and retroperitoneal) and with different histologic types. EXEGESES: A 53-year old man presented with abdominal pain, increased abdominal girth and weight loss. Physical examination revealed two abdominal masses. Computed tomography scan showed a very large retroperitoneal mass displacing the left kidney, digestive loops and vessels. The patient underwent surgery. One enormous mass of the left renal lodge measuring 50 cm, a retroduodenal mass measuring 15 cm and a nodule of the coecum were removed. Histological examination of the mass of the left renal lodge revealed mixed type liposarcoma (dedifferentiated and myxoid). Histological examination of the retroduodenal mass and of the nodule of the coecum revealed well-differentiated liposarcoma. CONCLUSION: Pathological, therapeutic and prognostic aspects of abdominal liposarcoma will be reviewed in this article.

[Diagnosis of an opacity at the lung base: intrathoracic kidney]. / Diagnostic d'une opacité de la base pulmonaire: le rein intra-thoracique.

A 72-year-old patient was admitted for exploration of an opacity of the left base discovered fortuitously on a routine chest x-ray. Initial blood tests were normal. Fiberoptic bronchoscopy was normal. Computed tomography (CT) led to the diagnosis of a left kidney which had risen into a retro-cardiac position. Magnetic resonance imaging established the sub-diaphragmatic position of the kidney. Renal excretion was normal on intravenous urography. An ectopic kidney in an intrathoracic position is very uncommon and may raise a major challenge when visualized as a mediastinal or pulmonary opacity. Computed tomography or intravenous urography can provide the diagnosis and magnetic resonance imaging demonstrates its precise sub-diaphragmatic or supra-diaphragmatic position.