[Disseminated tuberculosis following infliximab therapy for Crohn disease: a case report]. / Tuberculose disséminée survenant après traitement de la maladie de Crohn par infliximab: à propos d'un cas.

UNLABELLED: Anti-tumor necrosis factor (TNF) therapy has been the major advance in the treatment of inflammatory bowel disease, especially Crohn's disease. But there is a higher risk of infections, especially tuberculosis (TB), in patients treated with anti-TNFα. The authors report a case of disseminated tuberculosis with the following features: pulmonary tuberculosis, left supra clavicular cervical and meditational lymphadenopathy, bilateral pleural effusion, peritoneal and splenic involvement. This disseminated tuberculosis was observed in a 39-year-old woman who was treated by infliximab for refractory Crohn's disease. The evolution with antituberculosis drugs was fatal, the death of the patient was due to hepatic encephalitis. CONCLUSION: The physicians should always be aware in the use of TNF-alpha blockers according to guidelines. Its recommended to realize a complete pretherapeutic assessment and it is necessary to follow-up the patients to detect possible reactivation of latent tuberculosis.

[Digital ulcers revealing lung carcinoma]. / Ulcérations digitales révélant un carcinome bronchique.

Digital ulcers usually reflect focal ischemia due to a microangiopathy, its causes are diverse. In women, it first suggests a connective tissue disease whereas in men, a diffuse arteriopathy. Acral ischemia till necrosis is a rare form of a paraneoplasia. We report about a man with a metastatic lung cancer revealed by digital ulcers. In front of digital necrosis, haemopathy or cancer must be searched in the absence of iatrogenic cause, occupational diseases, atherosclerosis or systemic disease.