Visceral leishmaniasis in 26 HIV-negative adults.

BACKGROUND: Visceral leishmaniasis is a notifiable parasitic disease that had increased in incidence in our region on the past few years. It is common in children. In adults, it occurs more on a background of immunodeficiency, and frequently with incomplete clinical manifestations, making the diagnosis complicated. FINDINGS: The aim of our study is to reveal different features of visceral leishmaniasis in adults, through the analysis of its epidemiological, clinical and biological parameters, in a group of 26 patients. No one was infected with HIV or under immunosuppressive therapy Clinical presentation was generally conservative, but there was few differences in adults compared to children, concerning both the clinical symptoms and the laboratory parameters. Diagnosis was provided by direct examination of bone marrow smears in 24 cases (sensitivity 92%), and anti-leishmanial serology in the others. CONCLUSION: We should think to the diagnosis of VL even if the patient is not known immunocompromised, and even if the clinical is incomplete, to avoid a delay of care which can lead to serious complications.

[Niemann Pick disease A: a case report]. / Maladie de Niemann Pick type A : à propos d'un cas.

The Niemann Pick disease is a rare lysosomal storage disease responsible for numerous cytological abnormalities of blood cells and bone marrow. The diagnosis requires enzymatic dosages, which can be long and difficult. In this context, the detection of inconstant cytologic anomalies in blood and bone marrow smears, allowing a rapid screening, is an important step in the diagnostic approach. We report the case of a 6 year-old child who presents with abdominal distension; medullogram was performed and revealed the presence of vacuolated cells overload. Correlated with clinical and biochemical data, medullogam results confirmed the diagnosis of type A Niemann Pick disease.

[Laboratory diagnostic and prognostic factors: Multiple myeloma in Morocco]. / Éléments du diagnostic biologique et pronostique du myélome multiple : place d'une étude marocaine.

ObjectivesThe purpose of this retrospective study was to clarify the factors for a laboratory diagnosis of multiple myeloma (Kahler's disease) and assess their prognostic value.MethodsThe study of all 10 patients with multiple myeloma seen during 2009 in the department of internal medicine and the haematology laboratory of HASSAN II University Hospital Centre in Fez. Work-ups for all patients included hemograms, sedimentation speed, electrophoresis of serum and urinary proteins, myelograms, creatinemia, calcemia, ß2-microglobulin, LDH and CRP.ResultsIn this series, the average age of the patients was 59 years and the sex ratio 1.3 (men). The laboratory tests showed anemia below 12 g/dl in 80% of the cases, with IgG accounting for 50% of the cases. The median concentration of the monoclonal component was 28 g/l. The prognostic assessments showed an increase in ß2-microglobulins and creatinemia in one case. CRP was elevated in all patients.ConclusionThe results from this study are consistent with those from other series. Protein electrophoresis and myelography results are major diagnostic elements, because they make it possible to rule out a monoclonal gammopathy of undetermined significance, for which treatment differs completely from that for multiple myeloma. ß2-microglobulin and CRP are independent prognostic factors providing important information about survival.