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Tuberculosis (TB) is still a major public health concern in Morocco. Although first-line antituberculosis drugs (ATD) are generally considered safe and effective, serious adverse events can occur. In this case report, we describe a female with pulmonary TB who experienced anaphylaxis induced by rifampicin (RFP) and pyrazinamide (PZA) during ATD therapy. Anaphylactic reactions to first-line ATD can occur and may lead to treatment discontinuation and challenges in finding effective alternative treatment options. Healthcare professionals should be aware of the potential of anaphylaxis with the use of these drugs, especially in patients with a history of lupus. Further research is needed to better understand the mechanisms underlying anaphylaxis and develop effective preventive and management strategies. A young female patient with a history of lupus and splenectomy presented with respiratory symptoms and deterioration of general condition. She was diagnosed with pulmonary tuberculosis and received first-line ATD, which caused complications including liver dysfunction and anaphylactic shock. Despite these challenges, the anaphylactic shock was successfully managed; she was put on a combination of levofloxacin, kanamycin, and ethambutol (ETB), as well as a desensitization protocol for isoniazid (INH); the patient was cured.
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Granulomatous mastitis is an inflammatory disease that often affects women with a history of breastfeeding. The pathogenesis is still unclear and several factors have been incriminated, such as trauma, metabolic and hormonal disorders, infections, and autoimmunity. This poses a diagnostic issue, given that there are several different diagnoses, particularly carcinomatous mastitis. We report the case of a 32-year-old woman, with a history of breastfeeding, who presented with inflammatory left breast. The physical examination has objectified a 10/10 cm painless mass and a 3 cm homolateral axillary lymphadenopathy. A sonomammography revealed inflammatory left breast infiltration with multiple collections associated with homolateral axillary lymphadenopathies. A Trucut biopsy was performed, revealing granulomatous mastitis without signs of malignancy. Interferon-gamma measurement and Koch Bacillus (BK) search by polymerase chain reaction (PCR) in the breast collection were all negative. The patient was put on non-specific antibiotics with no response and clinical worsening; therefore, we were obliged to start bacillary treatment. The evolution was marked by a total drought and the disappearance of inflammatory signs within a few weeks. Mammary tuberculosis poses a diagnostic issue given the difficulty to identify the bacteria in the samples. This is why tuberculosis should never be excluded despite negative results, especially in endemic countries.
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Plasmacytomas are a rare spectrum of plasma cell neoplasms that are single localized tumours, lacking the clinical features of plasma cell myeloma with no radiographical evidence of additional plasma cell tumours. Two clinical variants of plasmacytomas can be distinguished: solitary plasmacytoma of bone and extramedullary (or extraosseous) plasmacytoma. The latter is rare, representing 1% of all plasma cell neoplasms, occurring most frequently in the upper airways. Ovarian localization is exceptional, with only a few cases being reported in the literature. We herein report a case of an ovarian extramedullary plasmacytoma occurring in a 56-year-old woman who consulted for abdominal pain and abdominal mass, while highlighting the main histological and immunohistochemical features of this rare malignancy, along with a thorough review of literature gathering all cases of ovarian plasmacytomas reported to date.
Assuntos
Neoplasias Ósseas , Mieloma Múltiplo , Plasmocitoma , Feminino , Humanos , Pessoa de Meia-Idade , Plasmocitoma/diagnóstico , Plasmocitoma/patologia , Mieloma Múltiplo/patologia , RadiografiaRESUMO
The incidence of lymphoma is constantly increasing worldwide. The reasons for this increase are unclear and likely multiple. B cell lymphomas represent the majority of non-Hodgkin lymphomas. Primary orbital localization remains a rare entity to think about in order to avoid missing a therapeutic emergency. In this article, we report the case of a 52-year-old man who has been treated for five years for an inflammatory orbitopathy with steroids, but the worsening of the clinical condition and the installation of exophthalmia led to push investigations and the outcome was a primary orbital lymphoma marginal zone type. The patient was treated by systemic chemotherapy with immunotherapy (RCHOP protocol) with a very good evolution and complete disappearance of the lesion after chemotherapy.
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Focal segmental glomerulosclerosis is a severe renal disease with a complex and unclear pathophysiology. Nephrotic syndrome is the clinical presentation of this renal disease. The recurrence of the disease after renal transplantation and the remission obtained after immune-adsorption treatment illustrate the implication of a circulating factor that requires characterization. Granulomatous inflammation is a tissue reaction caused by several conditions, including neoplastic diseases. In the literature, focal segmental glomerulosclerosis and granulomatous inflammation have both been associated with lymphoma. We report the case of a 56-year-old woman who initially developed focal and segmental glomerulosclerosis. After one year, the granulomatous inflammation was treated as tuberculosis infection and then as sarcoidosis. Finally, after another year, non-specified peripheral T-cell lymphoma was diagnosed.
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Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder due to autoantibodies directed against nuclear and cytoplasmic antigens that may affect several different organs. The association of SLE and acute myeloid leukemia (AML) is rare, the incidence of this combination is not known, but there are few case reports in the literature. We report here the case of a 62-year-old woman, admitted for aetiological diagnosis of weight loss and severe anemic syndrome. The blood count has objectified a pancytopenia with lymphopenia. A thorough assessment was carried out following which a diagnosis of AML associated to SLE was retained. The patient received a low dose of cytarabine due to comorbidities and poor performance status associated with steroids and she died three months after diagnosis with a septic shock.