M. Jira

Acro-ostéolyse et polyarthrite rhumatoïde (une nouvelle observation et revue de la littérature)

Resumé:Introduction:L’acro-ostéolyse radiologique peut être secondaire à plusieurs affections. On différencie habituellement une forme idiopathique et des formes acquises. Parmi celles-ci, la polyarthrite rhumatoïde (PR) n’a été signalée qu’exceptionnellement.Observation:Nous rapportons le cas d’une patiente de 45 ans. Elle est suivie pour PR déformante et destructrice depuis 13 ans. Les radiographies et l’IRM des avant-pieds ont objectivé une ostéolyse bilatérale avec amputation des deuxièmes phalanges des gros orteils.Conclusion:L’acro-ostéolyse a été décrite dans la PR, soit d’une façon fortuite, soit en présence d’une vascularite, d’une neuropathie ou suite à une extension du processus rhumatoïde de l’articulation interphalangienne distale. Devant l’absence de ces anomalies, notre observation relance le débat sur la relation PR—acro-ostéolyse.Abstract:Introduction:Radiological acro-osteolysis can be secondary to several diseases. Idiopathic and acquired forms are usually differentiated. Among those, rheumatoid polyarthritis (RP) remains rare.Observation:We report the case of a 45 year-old female patient, who has been suffering from deforming destructive RP for 13 years. Radiological examinations and the MRI of the feet showed bilateral osteolysis with amputation of the second phalanges of the big toes.Conclusion:Acro-osteolysis was described in RP, either in a fortuitous way or in the presence of a vasculitis, a neuropathy or following an extension of the rheumatoid process from the distal interphalangeal articulations. In the lack of these abnormalities, through our observation, we discuss the relationship between RP and acro-osteolysis.

Serum vitamin D and vitamin D receptor gene polymorphism in Moroccan patients with systemic lupus erythematosus

Background: Vitamin D plays an important role in the immunomodulation and could be involved in the development of autoimmune diseases such as systemic lupus erythematous (SLE). The study of the polymorphism of the Vitamin D Receptor (VDR) gene may be of interest in explaining the pathophysiology of SLE. Methods: In this study, we aimed to examine the characteristics of VDR gene BsmI polymorphism for the first time in Moroccan patients with SLE and their relationship with clinical manifestations of the disease. We also measured the serum level of 25-hyroxyvitamin D 3 to assess its relation to such polymorphism. Results: The study included 66 SLE patients and 91 healthy controls. Our results showed that there were no differences observed in VDR genotypes and allelic distribution within the two groups. Both groups were in Hardy-Weinberg equilibrium, with no significant P values for the observed and expected genotype frequencies. 25-hyroxyvitamin D3 serum levels were the same in the two groups. Conclusions: Based on the results of the present study. We cannot verify any association between VDR gene BsmI polymorphism and SLE. This polymorphism could not be regarded as a genetic marker of the SLE. A larger study examining BsmI and other VDR gene polymorphisms is needed.