Isolated aortic valvular and pulmonary involvement during essential eosinophilia.

Endomyocardial fibrosis is the most classic and the most known complication of prolonged hypereosinophilic syndrome, whatever the cause. In Burkina Faso, this complication is most frequently encountered in idiopathic form of the syndrome. It commonly involves the apex of the ventricles with possible involvement of atrioventricular valves. The clinical picture is that of restrictive cardiomyopathy with poor prognosis. We report the case of a 22-year-old man with atypical cardiac involvement during idiopathic hypereosinophilic syndrome. Echocardiographic examination showed isolated aortic valve involvement. Left and right ventricular function was preserved. The apex of ventricles was free of lesion. Pulmonary CT-scan showed massive bilateral lung involvement. Treatment consisted of strict control of the eosinophilic process and pulmonary management. The patient suddenly died sudden pulmonary distress one month after first being seen.

[Epidemiologic profile of acute intoxications at the Gabriel Touré University Hospital]. / Profil epidemiologique des intoxications aiguës au C.H.U. Gabriel Toure.

PURPOSE: Determine the epidemiology of intoxications in the emergency service medico-surgical. MATERIALS AND METHODS: The stady was retrospective and transversal from January 2002 to December 2006 in the service of medical surgical emergencies of the teaching hospital Gabriel Touré. Where included all patients admitted and presenting with acute poisoning. Chi2 test was used to compare our results and the level of significance set at p <0.05. RESULTS: Over 5 years, 365 cases of intoxication were collected on a total of 10997 admission with a prevalence of 3.32 %. Patients aged of 0-20 years accounted for 46.58% of cases. The female patients were predominant with 62.47 % of cases. Pupils and students predominated with 31.51 %. Antimalarials were found primarily at the base of poisoning with 32.33 % of cases of drug poisoning. The digestive tract was predominant with 97.81%. CONCLUSION: The typical profile of acute poisoning is a young female pupil or student who took a voluntary drug substance.

Cutaneous T cell lymphomas: mycosis fungoides, Sezary syndrome and HTLV-I-associated adult T cell leukemia (ATL) in Mali, West Africa: a clinical, pathological and immunovirological study of 14 cases and a review of the African ATL cases.

Cutaneous T cell lymphomas (CTCL) are rare lymphoproliferative diseases, which are frequently suspected to be of viral origin. As very few data were available concerning cutaneous T cell lymphomas in tropical Africa, we undertook a clinical, histopathological, immunological and viro-molecular study of patients with a clinical diagnosis of cutaneous lymphoma, in Bamako, Mali. While prior to this study, no case of CTCL had been reported in this country, 14 patients (five women, nine men; mean age 58 years) with a diagnosis of cutaneous lymphoma were seen over a period of 30 months (1992-1994) in the only dermatological department in Mali. Clinically, the most frequent pattern was an infiltrated erythrodermia similar to Sezary syndrome. Nodular lesions and/or plaques were rarely observed. All these cutaneous tumors were T cell lymphoproliferations, only one expressing the CD8+ antigen. A comprehensive analysis of all the available data permitted characterization of three cases of adult T cell leukemia/lymphoma (ATL) associated with HTLV-I (one definitive case, of leukemic type, with demonstration of clonal integration of HTLV-I proviral genome and two probable ATL cases), three cases of Sezary syndrome (SS), two cases of mycosis fungoides (MF) and five cases of pleomorphic cutaneous lymphoma. In one case, the differentiation between MF and pleomorphic cutaneous lymphoma could not be established. HTLV-I serological and/or molecular markers were restricted to the three ATL cases. From the unique definitive ATL case, a T cell line was established from culture of peripheral blood mononuclear cells and sequence analysis of the env gene and the U3-LTR region demonstrated that the virus present in this patient belonged to the cosmopolitan subtype A. Thus, we report here the first evidence of HTLV-I infection and associated ATL in Mali. This is the second ATL case described for the whole Sahelian region (one ATL of the lymphoma type was reported previously in a Mauritanian patient). Furthermore, we demonstrate that the main types of CTCL described in Europe and North America are also present in this African area and that the prevalence of these diseases is greatly underestimated in such regions. Furthermore, no association was observed between HTLV-I/II infection and SS, MF or pleomorphic cutaneous lymphoma in Mali in contrast to other studies.