[Solitary plasmocytoma of the rib: a rare tumor not to miss]. / Plasmocytome solitaire à localisation costale: une tumeur rare à ne pas méconnaître.

Solitary plasmocytoma is a rare tumor accounting for 5% of all plasma cell neoplasias. The diagnosis is based on identification of the localized tumor composed of monoclonal plasma cells identical to those observed in multiple myeloma, and absence of the signs in favor of a disseminated form. We report the case of a52-year-old man who presented a growth of the chest wall in the left axillary region. Imaging disclosed a mass of tissue with a large zone of osteolysis of the 6th rib and infiltration of the chest wall. Surgical biopsy for pathology study and immunohistochemistry enabled the diagnosis of costal plasmocytoma. Blood protein immunoelectrophoresis revealed a monoclonal kappa type IgG. Bence-Jones proteinuria was positive. Search for other localizations was negative and the diagnosis of solitary plasmocytoma was retained. Radiotherapy was delivered and the patient has remained in remission at one year. Costal localization is rare for solitary plasmocytoma. The diagnosis is based on imaging findings and pathology. Radiotherapy is the treatment of choice but with the risk of progression with other bone lesions, the development of medullary plasmocytosis and multiple myeloma. Factors predictive of systemic recurrence have not been identified. Regular surveillance is required.

[Anti-citrullinated peptide antibodies: novel markers for rheumatoid polyarthritis]. / Les anticorps anti protéines citrullinées: nouveaux marqueurs de la polyarthrite rhumatoïde.

Rheumatoid arthritis is a multi-factorial autoimmune disease in which patho-physiological mechanisms have been partially elucidated these past few years. These recent advances have led to new and effective treatments that must be started early in the course of the disease. This review focuses on new serological markers, the anti citrullinated peptides antibodies which seem to be useful in early diagnosis and prognosis of rheumatoid arthritis and probably provide new insights in its pathogenesis.

[Antineutrophil cytoplasmic antibodies positivity in a case of idiopathic pulmonary haemosiderosis]. / Positivité des anticorps anti-cytoplasme des polynucléaires neutrophiles au cours d'une hémosidérose pulmonaire idiopathique.

Idiopathic pulmonary haemosiderosis is a rare disease of unknown etiopathogeny which is characterized by hemoptysis due to alveolar haemorrhage. We report the case of a 16 years-old girl with idiopathic pulmonary haemosiderosis, diagnosed through clinical, radiological, cytological and histopathological data. The finding of myeloperoxydase-anti-neutrophil cytoplasmic antibodies (ANCA) positivity led us to suspect an associated vasculitis which was not further demonstrated.

[Detection and significance of cryoglobulins]. / Exploration et signification clinique des cryoglobulines.

Cryoglobulins are immunoglobulins which reversibly precipitate at cold temperatures. They are usually accompanied with polymorphic clinical manifestations and biological abnormalities. Cryoglobulins are associated with various clinical disorders which include autoimmune diseases, lymphoproliferative and infectious disorders. Because of their low concentration, detection and quantitation of cryoglobulins need very rigorous conditions when collecting blood from patients.

[Evaluation of an immunoblotting technique for the detection of anti-SSA and anti-SSB antibodies]. / Evaluation d'une technique d'immunoblot pour la détection des anticorps anti-SSA et des anticorps anti-SSB.

Immunoblotting and ELISA methods are now employed for the detection of anti Ro/SSA and anti La/SSB antibodies sometimes more often than double immunodiffusion or counter-immunoelectrophoresis. We have developed an immunoblotting technique for the detection of anti Ro/SSA and anti-La/SSB antibodies. This assay named IB-Hela, which uses a Hela cell extract, was compared with the double immunodiffusion technique like two other commercial immunoassays (Elisa test from Sanofi-diagnostic Pasteur and Line immunoassay from Innogenetics). This evaluation shows a good agreement especially in the case of Ro/SSA antibodies detection. IB-Hela seems to be useful in the La/SSB detection with a better sensitivity than the double immunodiffusion technique. We conclude that the IB Hela is helpful for the search for anti-Ro/SSA and anti-La/SSB autoantibodies and that it can be used as an alternative method to the classical techniques of immunodiffusion and counter immunoelectrophoresis.

[Anti-ribosomal antibodies during hepatitis C]. / Anticorps anti-ribosomes au cours d'une hépatite C.

We report the case of a young Tunisian woman hospitalised for reasons of general ill health. A immunological check-up revealed autoimmune disturbances and in particular anti-ribosomal P antibodies. We discuss the possible relation of these antibodies to the hepatitis C infection from which the patient was also suffering.

[Detection of hepatitis C virus in the general population of Tunisia]. / Dépistage de l'hépatite virale C dans la population générale en Tunisie.

We searched for antibodies to hepatitis C in a sample of 3079 Tunisians in the suburban area of Tunis. 30 people were positive by ELISA and 22 were confirmed by immunoblotting. This result represents a prevalence of 0.71% which is close to the values reported in European countries of the Mediterranean area.

[Lupus in children in Tunisia]. / Lupus de l'enfant en Tunisie.

In this study, we have analyzed the clinical and serological features related to 16 Tunisian children in whom diagnosis of systemic lupus erythematosus was made before or at the age of 15. Renal involvement was found in 75% of cases and renal biopsies have mostly revealed severe histologic patterns. All of the patients who have been followed received corticosteroids and in some cases required additional cytotoxic drugs in order to control disease activity. Five children died in a context of a renal failure. This study of childhood lupus in Tunisia confirms that the clinical course of this disease in children is often aggressive.

[Characterization and evolution of blood cryoglobulin in visceral leishmaniasis]. / Caractérisation et évolution d'une cryoglobulinémie au cours d'une leishmaniose viscérale.

The evolution of immunological parameters in mediterranean visceral leishmaniasis reveal a type III mixed cryoglobulin with rhumatoid factor activity and antileishmania antibodies. This cryoglobulin follows the clinical signs of the disease and disappear under treatment. The authors insist on the transitory character of this cryoglobulin which is in relation with polyclonal stimulation of the immune system by parasitical infection.