Sanaa Hammi

First line anti-tuberculosis induced hepatotoxicity: incidence and risk factors

In our days, tuberculosis, whet ever its localization, became a curable disease. The cornerstone is a 6 month course of isoniazid, rifampicine and pyrazinamide. All of the three first line antituberculosis drugs may induce hepatic damage which may have negative consequences for treatment outcome. Several risk factors were associated with the development of antituberculosis- drug-induced hepatotoxicity (ATDH). A retrospective study was conducted from July 2014 to March 2015 regarding all therapeutic drug-monitoring requests sent to the Laboratory of Poison Control and Pharmacovigilance Centre of Morocco. 142 patients diagnosed with active tuberculosis were included in study. Plasma peak levels of isoniazid, rifampicin and pyrazinamide were analyzed in plasma samples after 2 to 3 hours of administration of anti-tuberculosis treatment. Logistic regression was used to identify the ATDH risk factors. The incidence of ATDH was found 24.6% (35 patients out of 142). Intergroup differences in the plasma levels were statistically significant for isoniazid (p=0.036). ATDH was found to be associated with combined form of anti-TB drugs (p=0.002, COR=13.1, AOR= 13.5) and plasma concentration of INH superior to 2mg/l (p=0.045, COR=1.3, AOR= 1.4).age, gender, alcohol intake and smoking status were not significantly associated with ATDH. The finding of 24.6% incidence of hepatotoxicity is extremely high. Many factors can be associated with the development of ATDH such as genetic factors, combined forms of treatment and plasma peak levels.

Contribution of Imaging in Diagnosis of Primitive Cyst Hydatid in Unusual Localization: Pleura—A Report of Two Cases

Hydatic disease has always been the most common in countries where large amount of sheep and cattle is raised, but increased travel and immigration have made this condition a serious worldwide public problem. Cyst hydatid may affect all parts of the human body like the heart, the bone marrow, the eye, the brain, the kidney, and the spermatic cord. Humans can become infested by accidentally ingesting the eggs that are passed in the feces from definitive hosts (usually a canid, such as a wolf, fox, or dog). Even in endemic countries, the primitive pleural hydatid cyst is exceptional, and it is very difficult to distinguish from other pleural and parietal cystic masses especially that in majority of cases the immunologic tests are negative. We report two cases of pleural hydatid cyst discovered in two young patients, with a nonspecific clinical presentation. The interest of this paper is to raise the primordial role of imaging in the positive diagnosis of primary pleural hydatid cyst.

Primary Pleuropulmonary Synovial Sarcoma: A Case

Primary pleuropulmonary synovial sarcoma is extremely rare. The diagnosis can only be made after having eliminated an extrapleuropulmonary localization in the past and at the time of diagnosis. Our presentation is about a 40-year-old woman having a cough and dyspnea since three weeks ago; imaging had showed a left pleurisy with pleuropulmonary process. Histological study of the biopsy confirmed the diagnosis of pleuropulmonary synovial sarcoma. PET-SCAN had not identified any extrathoracic localization. This tumor is known for its aggressive nature and high risk of metastasis. Its primitive character is retained following a diagnostic procedure of exclusion. Surgical treatment remains the best therapeutic tool when it is technically feasible; otherwise the prognosis is often unfortunate. In this paper, we report a case of primary pleuropulmonary synovial sarcoma. Through this case, we present a rare disease that is often difficult to diagnose.

A primary intestinal lymphangiectasia hiding the diagnosis of pleural and pericardial tuberculosis: a clinical observation

Primary intestinal lymphangiectasia (Waldmann’s disease) is an exudative enteropathy characterized by lymph leakage into the small bowel lumen leading to hypoalbuminemia, hypogammaglobulinemia and lymphopenia (particularly T-cell). The diagnosis is based on viewing the duodenal lymphangiectasia. A 20 years old female patient, treated for a primary intestinal lymphangiectasia, has consulted for anasarca. Etiological work-up reveals pleural and pericardial tuberculosis. The clinical aggravation of an enteropathy, particularly in adulthood, requires a search for a secondary etiology. Tuberculosis should be sought systematically.

L’arbre qui cachait la forêt: aspergillose sur carcinome bronchique (à propos de deux cas)

Endobronchial aspergilloma and intracavitary pulmonary aspergilloma may clinically and radiologically mimic a bronchial neoplasia, hence the importance of systematically searching for an association. A confirmed association completely changes the prognosis as well as the therapeutic approach. We here report two cases with two different forms of pulmonary aspergilloma associated with bronchial carcinoma.

Tuberculome myocardique: localisation inhabituelle de la tuberculoseà propos d’une nouvelle observation avec une revue de la littérature

We report the case of a 50-year old patient with a left ventricular tumor whose evolution was marked by impaired general condition and fever. This mass was objectified by echocardiography performed to explore a radiological cardiomegaly. The imaging (MRI) appearance was suggestive of an intra-myocardial tuberculoma Based on our observations, we propose a review of the literature on this unusual location of tuberculosis.

Tuberculose multirésistante chez l’enfant: à propos de deux cas

Multidrug-resistant tuberculosis in children is a severe form of tuberculosis, which remains a major health problem especially in developing countries. We report the case of two children treated, during our training, for multidrug-resistant tuberculosis and put on second-line regimen.

New regression equations for predicting peak expiratory flow in Moroccan adults

Objective: To describe Peak Expiratory Flow (PEF) reference equations for healthy Moroccan adults who have never smoked and to compare the predicted values with those derived in other ethnic groups. Methods: Reference equations for PEF were derived in 354 men and 420 women living in Tetouan, Morocco. Ages ranged from 15 to 86 years in women, and from 15 to 87 years in men. PEF tests were done using Spirometer following the recommendations of the ATS/ERS. Results: For both genders, age and height were the only determinants of PEF, witch were best fitted by linear regression. Reference equation for females is PEF= -207,511 -0.721 Age + 3.609 Height. Reference equation for males is PEF= -463,755 -1.093 Age + 5.901 Height. The reference values for PEF in the present study were different from those derived in other ethnic groups. Conclusion: New predicted equations for Peak Expiratory Flow were obtained in a general sample of Moroccan adults. The values calculated using these equations are different from other ethnic groups, which requires the use of these new formulas in Morocco.