S. De Breucker

INEFFICACY OF INTRAVENOUS IMMUNOGLOBULINS AND INFLIXIMAB IN DEGOS’ DISEASE

Abstract We report the case of a 60-year-old man who presented with sudden visual loss, a history of postprandial abdominal pain, malabsorption, and skin lesions typical of systemic Degos’ disease. Despite anti-aggregants and prednisone the patient’s status did not improve. On the basis of the hypothetical dysimmune origin of this disease, we attempted treatment with intravenous immunoglobulins, without success. We then administered infliximab (Remicade®), but 2 months after the third injection the patient developed mesenteric infarction and died. We therefore believe that both intravenous immunoglobulins and antiTNFa are ineffective for the treatment of Degos’ disease.

Chronic urticaria in a middle-aged woman.

Abstract We report the case of a 56-year-old female who suffers from chronic urticaria and digestive symptoms, suggesting parasitic infection. Neither repetitive ova and parasite examinations in stools, nor duodenal aspiration examination reveals any parasite. The patient is treated by tinidazole, but the symptoms reappear ten days later. An additive ELISA test on stool remains positive for Giardia Lamblia; the patient receives once more tinidazole and symptoms totally disappear. This case report illustrates that the association between urticaria and digestive symptoms should guide the clinician to the diagnosis of Giardia Lamblia infection, and it shows the importance of a rapid and highly sensitive diagnostic test for giardiasis, like the ELISA test.