Inventory of the epidemiological situation of leprosy in Haiti (2013-2017) for the Five-Year Plan: A first stage toward the implementation of the international strategy to combat leprosy, 2016-2020.

Leprosy is endemic in Haiti and remains a disease misunderstood by the population. In 2018, the national program to fight tuberculosis and leprosy (PNLTL) produced its first strategic plan against leprosy to implement the international strategy of the World Health Organization (WHO). The objective of this study was to describe the epidemiological situation of leprosy in Haiti, to assess its prevalence and morbidity, and to guide the strategies of the national plan. A retrospective study of all cases of leprosy diagnosed in the three centers providing care for this disease in Haiti reviewed the new cases at these centers from January 2013 through December 2017. In all, 232 new patients were recorded, or 49 new cases a year. Multibacillary leprosy was predominant: 86%, compared with the international mean of 60 %. Children accounted for 14 % of the new cases (7.5 % internationally), a finding that is evidence of active community transmission. Of the new cases in 2017, 8 %, including one child, had grade 2 impairments. Nearly all the leprosy cases - 94 % (218/232) - came from the two districts with treatment centers (West and Artibonite). Efforts must continue to implement the international strategy to fight leprosy to ensure a reduction by 2020 in the rate of grade 2 impairments among new cases and the number of new cases among children.

[Large granular T-cell lymphocytic leukemia disclosed by bilateral uveitis: association with celiac disease]. / Leucémie à grands lymphocytes granuleux T révélée par une uvéite bilatérale: association à une maladie coeliaque.

A 70-year-old woman presented with bilateral anterior uveitis. She was on a gluten-free diet because of a celiac disease which had been diagnosed 3 months before. An anterior chamber aspirate contained a majority of large granular lymphocytes (LGL). The investigation of a chronic neutropenia led to the diagnosis of an otherwise typical T-LGL leukemia. This seems to be the first report of a CD3+ CD4- CD8+ T-LGL leukemia causing anterior uveitis through infiltration of leukemic cells, and the second report of an intriguing association of celiac disease with T-LGL leukemia.

Immunologic thrombocytopenia followed by thrombotic thrombocytopenic purpura in two HIV1 patients.

Two homosexual HIV1-positive male patients with thrombotic thrombopenic purpura (TTP) were found to have past history of immune thrombocytopenia (ITP). The first patient had ITP 10 months prior to TTP and was successfully treated by splenectomy. The second patient had ITP 32 months before TTP. No specific treatment was given for his asymptomatic ITP. Association of HIV infection to TTP seems to be frequent. These two types of purpura have different pathogenic mechanisms but share a common altered immune response to antigenic challenge. The occurrence of ITP and TTP in HIV-positive patients may lead to errors in diagnosis and therapy.