[Reactivation of tuberculosis during dual therapy with pegylated interferon and ribavirin for chronic hepatitis C]. / Réactivation d'une tuberculose sous bithérapie interféron-pégylé et ribavirine pour une hépatite chronique C.

Hepatitis C viral infection can be associated with other infectious diseases including viral and bacterial infections such as tuberculosis. Mycobacterium tuberculosis infection may be latent for many years and revealed during an immunodeficiency state. The responsibility of antiviral treatment in the reactivation of tuberculosis is controversial. We report two cases of tuberculous reactivation during bitherapy with pegylated interferon and ribavirin for chronic hepatitis C. A rapid viral response was obtained in both cases. Tuberculous reactivation occurred at 12 and 13 weeks of antiviral treatment, respectively. Tuberculosis involved urinary tract in one patient and lymph nodes in the other. Antituberculous treatment was given and antiviral treatment maintained. The outcome of tuberculosis was favourable and a sustained viral response was obtained for both patients.

[Gastrointestinal sarcoidosis]. / Sarcoïdose gastro-intestinale.

INTRODUCTION: Sarcoidosis is a granulomatous disorder of unknown cause, characterised by noncaseating granulomas affecting multiple organs. Gastrointestinal tract involvement in sarcoidosis is rare. The stomach, particularly the antrum is the most common extra-hepatic organ to be involved. We report four cases of gastro-intestinal sarcoidosis. METHODS: Retrospective study of a series of four cases. RESULTS: All patients had gastric sarcoidosis. It involved the duodenum, ileum and gall bladder in a patient with a history of an acute pancreatitis probably due to sarcoidosis. This patient presented with obstructive intestinal manifestations, weight loss and exsudative enteropathy. Two patients presented with mild abdominal pain and the last patient was admitted for upper gastrointestinal bleeding. The endoscopy was normal in one case and showed an antral congestion in another case. Gastric ulcers were found in the patient with a history of upper gastro-intestinal bleeding. A pseudo-linitic aspect was noticed in the patient with obstructive manifestations. The duodenum and the ileum were normal. This patient had an antrectomy and was treated with corticosteroids. Surgery evidenced a perforated duodenal ulcer, which was obstructed by the gall bladder. The patient with gastrointestinal bleeding received proton pump inhibitor and corticosteroids. These two patients improved gradually. The two other patients recovered spontaneously. CONCLUSION: The stomach is the most commonly affected organ in gastrointestinal sarcoidosis. Gastric sarcoidosis can mimic a malignant lesion owing to narrowing of the gastric lumen or can be revealed by upper gastrointestinal bleeding. Duodenum, small bowel and colon involvement is uncommon but may be underestimated in the absence of systematic biopsies.

[Extensive portocava thrombosis revealing a primary antiphospholipid syndrome: a case report]. / Thrombose portocave extensive révélant un syndrome primaire des anticorps antiphospholipides: à propos d'un cas.

We report a 20-year-old woman who presented with a massive portal thrombosis that rapidly extended to the superior and inferior vein cava system causing an acute Budd-Chiari syndrome. The investigations concluded to a primary antiphospholipid syndrome without any other prothrombotic factors. The outcome was fatal, 18 months later, despite anticoagulation, with hepatorenal syndrome and severe liver failure.

[Giant retroperitoneal liposarcoma. One case report]. / Liposarcome rétropéritonéal géant. A propos d'un cas.

INTRODUCTION: Retroperitoneal Liposarcoma is a rare and primary malignancy developed from mesenchymal tissue. It's generally unique and shows an only one histologic component. We report a case of multicentric and synchronous liposarcoma (intraperitoneal and retroperitoneal) and with different histologic types. EXEGESES: A 53-year old man presented with abdominal pain, increased abdominal girth and weight loss. Physical examination revealed two abdominal masses. Computed tomography scan showed a very large retroperitoneal mass displacing the left kidney, digestive loops and vessels. The patient underwent surgery. One enormous mass of the left renal lodge measuring 50 cm, a retroduodenal mass measuring 15 cm and a nodule of the coecum were removed. Histological examination of the mass of the left renal lodge revealed mixed type liposarcoma (dedifferentiated and myxoid). Histological examination of the retroduodenal mass and of the nodule of the coecum revealed well-differentiated liposarcoma. CONCLUSION: Pathological, therapeutic and prognostic aspects of abdominal liposarcoma will be reviewed in this article.