R. Cevallos

Spectre étiologique des hyperferritinémies

Serum ferritin levels may be increased in many conditions: renal diseases, liver diseases, human immunodeficiency virus infection. The purpose of this study was to assess the aetiological spectrum of high serum ferritin levels in a 1200-bed university hospital, to compare our results with the data already published and to assess a potential association between aetiology and ferritin levels. Patients and methods. – Patients with a serum ferritin level higher than 600 μg/l were retrospectively included between 15 November 2003 and 15 January 2004, and their medical records were reviewed. Results. – Ninety-eight patients (38 women and 60 men; median age: 59,5 years [19–92]) were recruited in departments of hepatology and gastroenterology (22%), haematology (14%) and internal medicine (18%). Diagnosis performed were: non-HIV systemic infections (23,8%), haematological diseases (16,1%), alcoholism (11,2%) and malignancies (9,8%). Dialysed chronic renal failure, liver diseases, haemochromatosis and systemic inflammatory diseases counted for 4.2 to 5.2% of cases. Serum ferritin level lied between 600 and 1000 μg/l for 50 patients, between 1000 and 1500 μg/l for 24, and over 1500 μg/l for 24. There was no significant difference between the three groups as regards the etiological distribution. Discussion. – In our study, chronic renal failure was not a major cause of high ferritin level: this is probably due to the current use of erythropoietin, which has decreased the use of blood transfusions. The two major aetiology of hyperferritinemia were non-HIV infections and malignancies.

Article originalSpectre étiologique des hyperferritinémiesAetiological spectrum of hyperferritinemia

Serum ferritin levels may be increased in many conditions: renal diseases, liver diseases, human immunodeficiency virus infection. The purpose of this study was to assess the aetiological spectrum of high serum ferritin levels in a 1200-bed university hospital, to compare our results with the data already published and to assess a potential association between aetiology and ferritin levels. Patients and methods. – Patients with a serum ferritin level higher than 600 μg/l were retrospectively included between 15 November 2003 and 15 January 2004, and their medical records were reviewed. Results. – Ninety-eight patients (38 women and 60 men; median age: 59,5 years [19–92]) were recruited in departments of hepatology and gastroenterology (22%), haematology (14%) and internal medicine (18%). Diagnosis performed were: non-HIV systemic infections (23,8%), haematological diseases (16,1%), alcoholism (11,2%) and malignancies (9,8%). Dialysed chronic renal failure, liver diseases, haemochromatosis and systemic inflammatory diseases counted for 4.2 to 5.2% of cases. Serum ferritin level lied between 600 and 1000 μg/l for 50 patients, between 1000 and 1500 μg/l for 24, and over 1500 μg/l for 24. There was no significant difference between the three groups as regards the etiological distribution. Discussion. – In our study, chronic renal failure was not a major cause of high ferritin level: this is probably due to the current use of erythropoietin, which has decreased the use of blood transfusions. The two major aetiology of hyperferritinemia were non-HIV infections and malignancies.

Syndrome de Goujerot-Sjögren primitif de forme grave chez le sujet jeune. A propos de deux observations

The authors report two unusual cases of primary Sjogrens syndrome which occured in young north africans patients. The two patients showed a multisystemic disorder, with, in the first case, renal tubular acidosis (associated with nephrocalcinosis), pulmonary involvement and haemotologic features, and in the second case, severe pulmonary fibrosis and cutaneous vasculitis.

Sclérodermie induite par inhalation de crésol. Évolution sous facteur XIII

The authors present the evolution and regression of a systemic sclerosis case associated to a long exposition to phenol and polycyclic hydrocarbons.

Insuffisance surrénale aiguë révélant une hémorragie bilatérale des surrénales : 3 nouveaux cas

We report three cases of adrenal hemorrhage that were confirmed by hormone measurements and computed tomography. Precipitating factors included in two cases heparin therapy and surgery. Despite the availability of computed tomography adrenal hemorrhage mimics many other diseases, and an early diagnosis remains difficult.

Conjonctivite de Parinaud et tularémie : une étiologie rare à ne pas méconnaître

Tularemia oculoglandular is not common. We present a case with purulent conjonctivitis (Parinaud conjonctivitis) and swollen pre-auricular lymph nodes. The transmission was made by contaminated fingers.

À propos de 15 neurolupus

Neuropsychiatric manifestations are described in 15 patients with systemic lupus erythematosus. There was 9 seizures, 5 cerebrovascular accidents, 3 psychosis, 1 chorea, 1 cerebral venous thrombosis, 1 transverse myelopathy, 1 peripheral neuropathy. Abnormalities of cerebrospinal fluid, electroencephalography, computerized tomographic scans and magnetic resonance imaging are described. Anti- phospholipid antibodies (APLA) are found in 10/15, anti-gangliosides in 2/4 patients without APLA.

Anévrysme mycotique et septicémie à Yersinia enterocolitica

Abstract The authors presents the first case of Yersinia enterocolitica septicimia associated to the rupture of a mycotic anevrysm of the popliteal artery in a 70 years old men. This septicemia is uncommon and few cases have been reported in apparently healthy persons.

Diagnostic d'une hyperéosinophilie dans un service de Médecine Interne : à propos de 38 observations

We report 38 cases of eosinophilia ≥ 500/mm3 (mean 3761/mm3). The diagnosis was ; parasitic infections (31,57 %), drugs (15,78 %) necrotizing vasculitis (7,89 %) lymphoma (7,89 %) et hypereosinophilic syndrome (7,89 %). No cause of hypereosinophilia was found in 28,97 % of cases. The diagnostic approach is discussed

Apoplexie hypophysaire : un piège diagnostique. À propos de 12 observations

The authors report twelve cases of pituitary apoplexy. This uncommon condition is characterized by headache, alteration in the level of consciousness, signs of meningeal irritation and usually ocular symtoms, often leading to an incorrect diagnosis ; however, prompt recognition and treatment may be life-saving, and justify the present publication.