José Halabe-Cherem

Pyoderma Gangrenosum and Extensive Caval Thrombosis Associated with the Antiphospholipid Syndrome A Case Report

Pyoderma gangrenosum is a rare cutaneous disorder frequently associated with systemic diseases. The authors report the case of a 28-year-old man with pyoderma gangrenosum and inferior cava vein syndrome due to thrombosis. The search for pyoderma gangrenosum-associated conditions (gastrointestinal, rheumatic, neoplasic, and infec tious diseases) was negative. A prolonged partial thromboplastin time and a positive test for circulating anticardiolipin antibodies strongly suggested the diagnosis of the antiphos pholipid syndrome. There are reports of at least three other cases of pyoderma gangrenosum associated with the antiphospholipid syndrome. This clinical case adds further evidence to the possible link between these disorders and warrants a search for anticardiolipin antibodies in patients with pyoderma gangrenosum.

Familial Mediterranean fever and primary antiphospholipid syndrome, a rare association : a case report

The authors present the case of a twenty-one-year-old woman with familial Mediter ranean fever who during her first pregnancy developed a primary antiphospholipid syn drome. This is an association not reported previously.

Protease Inhibitor-Associated Hyperglycemia in Mexican Patients with HIV Infection

BACKGROUND The use of protease inhibitors has revolutionized the treatment of HIV infection. These agents are well tolerated, although the Federal Drug Administration (FDA) has warned U.S. doctors that protease inhibitors may precipitate hyperglycemia and diabetes (DM), based on isolated reports from physicians. METHODS Sixty-one patients with HIV infection with criterion of non-DM from the onset of the protease inhibitor therapy participated in the study. Plasma glucose levels were obtained every month during a 6-month period, with a basal determination prior to protease inhibitor therapy. RESULTS All Mexican patients enrolled in this study had the same Hispanic-American ethnic origin. Four patients (6.55%) developed hyperglycemia related with saquinavir. One had family history of DM type II. These patients were controlled with diet. CONCLUSIONS Based on present data, we believe the benefits of these drugs to patients suffering from HIV infection outweigh the various risks of taking protease inhibitors. However, physicians who use these drugs have to be on the alert for hyperglycemia in the Mexican population, while patients should know the warning symptoms of hyperglycemia and diabetes.