Venous thrombosis associated with pernicious anaemia. A report of two cases and review.

Since homocystinuria, an inborn metabolism error is complicated by venous thrombosis in about half of the patients, hyperhomocysteinemia has been suspected of favouring thrombosis. Several case-control studies and even meta-analysis have confirmed a link between venous thrombosis and mild hyperhomocysteinemia. Nevertheless, the proper role of homocysteine remains debated. Hyperhomocysteinemia is induced by vitamin B9 or B12 deficiencies in a vast majority of cases. The authors report on two patients with venous thrombosis revealing pernicious anemia and review nine similar cases found in the world literature. The literature concerning the relationships between homocysteine and venous thrombosis is briefly reviewed.

Cytomegalovirus-induced thrombocytopenia in an immunocompetent adult effectively treated with intravenous immunoglobulin: a case report and review.

The authors report the case of an 80-year-old male patient who presented with colitis and severe thrombocytopenia. The work-up revealed concurrent cytomegalovirus infection. After failure of prednisone, a single infusion of high-dose intravenous immunoglobulin produced a rapid and sustained response. Seventeen cases from the world literature are reviewed. Corticosteroids seem effective in about one third of cases. In those who do not respond, splenectomy is relatively ineffective and more specific anti-CMV treatment with ganciclovir is of unproven efficacy and toxic, in view of the relatively favourable long term outcome the authors recommend intravenous immunoglobulin in cases of severe bleeding or when the platelet level is under 10 x 10(9) l.

Hodgkin's disease variant of Richter's syndrome: complete remission of the both malignancies after 14 years.

Richter's syndrome is defined by the occurrence of high-grade malignant lymphoma in the course of chronic lymphocytic leukemia (CLL). The prognosis is poor with a life expectancy of a few months. We report on the case of a 68-year old male who developed Hodgkin's disease 6 years after the diagnosis of stage A CLL was made. The patient received 3 cycles of combination chemotherapy according to the ABVD regimen, followed by radiotherapy. This treatment resulted in complete apparent remission of the two diseases, which was persistent after a follow-up of 14 years. The Hodgkin's disease variant of Richter's syndrome is exceptional with about 20 reported cases to date. Recent research indicates that lymphoma cells derive from leukemia. The prognosis appears far better than that for the classical non-Hodgkin Richter's syndrome.

MalignancyCase Report: Systemic Sarcoidosis Preceeding Acute Myeloid Leukemia.

The authors report the case of a 59-year-old woman who developed acute myeloid leukemia nine months after the resolution of systemic sarcoidosis treated by corticosteroid therapy. This rare case poses the questions of the physiopathogenic mechanisms, particularly a granulomatous reaction to leukemic antigens or to cytokines or of the role of an infectious agent.

Neurosarcoidosis Associated with Hodgkin's Disease; Malignancy.

Sarcoidosis is a granulomatous disease of undetermined origin. The association of sarcoidosis with malignant lymphoma is a rare but possibly nonfortuitous event. The authors report on the case of a 26-year-old male patient presenting with lymphnode sarcoidosis which evolved into neurosarcoidosis. The evolution was responded to corticosteroid therapy. Thirty-three months after the diagnosis of neurosarcoidosis, the patient presented with cervical Hodgkin's disease which was successfully treated by chemotherapy and radiotherapy. The pathophysiological mechanisms and possible associations are briefly discussed.