Disseminated Cryptococcosis Revealing an HIV Infection: A Case Report.

Cryptococcosis is a common fungal infection regarded as a disease of immunocompromised patients with high mortality. Cryptococcosis is usually observed in the central nervous system and lungs. However, other organs may be involved such as skin, soft tissue, and bones. Disseminated cryptococcosis is defined as fungemia or the involvement of two distinct sites. Here, we report the case of a 31-year-old female patient with disseminated cryptococcosis with neuro-meningeal and pulmonary involvement revealing a human immunodeficiency virus (HIV) infection. Chest computed tomography scan showed a right apical excavated lesion, pulmonary nodules, and mediastinal lymphadenopathy. Concerning biological tests, hemoculture, sputum, and cerebrospinal fluid (CSF) culture were positive for Cryptococcus neoformans. The latex agglutination test for cryptococcal polysaccharide antigen was positive in CSF and serum and HIV infection was confirmed by serological testing. The patient did not respond to initial antifungal therapy with amphotericin B and flucytosine. Despite the adaptation of antifungal treatment, the patient died of respiratory distress.

Antinuclear antibodies in children: indirect immunofluorescence patterns, antigen targets and associated diagnoses / Anticorps antinucléaires chez l'enfant : aspects en immunofluorescence indirecte, cibles antigéniques et situations cliniques associées

Antinuclear antibodies tests are of a paramount importance in the diagnosis, classification, prognostic evaluation and management of autoimmune diseases in children. The present study aimed to describe the immuno-clinical profile of antinuclear antibodies tests in a pediatric population in order to guide the clinical practice of biologists and clinicians. Our study enrolled 268 children. Antinuclear antibodies screening was performed using the indirect immunofluorescence assay on HEp-2 cells. Identification of target antigens was conducted using separately or at one timepoint the following techniques: enzyme-linked immunosorbent assay, Immunodot and Chemiluminescence. The average age of patients was 9.6 ± 4.3 years, with a female predominance (sex-ratio = 1.9). Antinuclear antibodies screening was positive in 40.67% of cases. The most frequently observed antinuclear antibodies patterns were speckled (52.3%), homogeneous (13.8%) and mixed homogeneous-speckled (13.8%). Autoantibodies were detected in 4 patients (2.51%) for whom ANA testing using the indirect immunofluorescence assay was negative. Positive antinuclear antibodies specificities were detected in connective tissue diseases (44.03%; n = 48), organ-specific autoimmune diseases (10.09%; n = 11), and in non-autoimmune conditions (inflammatory diseases, infections, hematological diseases, vasculitis and Wilson's disease) (32.08%; n = 35). Our study revealed a high rate of positive antinuclear antibodies tests in the pediatric population, mainly related to autoimmune diseases (54.12%) besides non-autoimmune conditions (32.08%). Therefore, screening and interpretation of antinuclear antibodies testing in children require the consideration of clinical data and a close collaboration between clinicians and biologists.

[Qualitative dysalbuminemia in capillary serum protein electrophoresis: a case series of 70 patients]. / Les dysalbuminémies qualitatives sur électrophorèse capillaire des protéines sériques : à propos de 70 cas.

Capillary serum protein electrophoresis (CPE) is a high-resolution technique. Thus, it is highly sensitive to the detection of qualitatives dysalbuminemia. By the present study, we aim to describe modifications of albumin fraction within the electrophoretogramm and to expose the underlying diseases. Eight thousand and forty-two CPE were studied, among which 70 showed qualitative dysalbuminemia (frequency ≈ 1/100). The average age of the patients is 33 years with a sex ratio (M / F) of 2.33. Quantitatively, the mean ± SD of albuminemia is 18.5 ± 6.8 g/L by turbidimetric assay and 20.8 ± 7.0 g/L by electrophoretic integration. Qualitatively, the albumin region presented different shapes: a simple thickening of the base, a shoulder to the right or to the left of the peak, one or more distinct additional peaks. The electrophoretic quantification of these modifications ranges from 1.8 to 11.2 g/L. The most frequent causal diseases are nephrotic syndrome and cholestatic jaundice.