Acute liver failure is frequent during heat stroke.

Acute liver failure (ALF) is relatively frequent during heat stroke (HS). This risk must be emphasized, because its incidence is higher than is usually thought. In a recent study by Weigand et al, two cases were reported in which liver failure was the leading symptom. We have confirmed their conclusion in a study of 25 cases of HS with ALF, compared with 25 other cases without ALF. Moreover, we observed that hypophosphatemia on admission could predict occurrence of ALF during HS. As for clinical and other biological parameters, phosphatemia should be monitored for at least 3 d in all cases of HS, even when it is thought to be mild.

[Granulomatous gastritis. Apropos of 2 cases]. / Gastrite granulomateuse. A propos de deux cas.

We report two cases of granulomatous gastritis, one unexplained, one in the setting of Crohn's disease. Granulomatous gastritis is an uncommon entity. An etiopathogenetic diagnosis can be reached only by combining the morphological examination with clinical and laboratory investigations. Isolated granulomatous gastritis is a diagnosis of exclusion, distinct from Crohn's disease, sarcoidosis, infections, foreign bodies, malignancy or vasculitis.

[Cardiac manifestations in leptospirosis. Apropos of 15 cases observed in New Caledonia]. / Manifestations cardiaques au cours des leptospiroses. A propos de 15 cas observés en Nouvelle-Calédonie.

The authors report the cardiovascular manifestations observed in 15 cases of severe leptospirosis in New Caledonia. Cardiovascular collapse is frequent. Electrocardiographic alterations consist mainly of arrhythmia secondary to atrial fibrillation and repolarisation disorders. A picture of pseudo-pericarditis has also been observed. These cardiac manifestations represent a factor of gravity when associated with multi-visceral manifestations which control the prognosis.

[Horton's disease in the course of chronic hepatitis C]. / Maladie de Horton au cours d'une hépatite C chronique.

BACKGROUND: Vascularitis is a well-known extrahepatic manifestation of chronic hepatitis C. Mixed cryoglobulinemia is the most common form. To our knowledge, the present case is the first report associating chronic hepatitis C and temporal arteritis. CASE REPORT: A 56-year-old man with chronic hepatitis C in the precirrhogenic phase presented with fever and weight loss. The patient complained of pain of the scapular and pelvic girdles and headache and physical examination revealed claudication of the jaw and abolition of the upper limb pulses. Biopsy of the temporal artery confirmed the diagnosis of Horton's disease. The patient also had bilateral stenosis of the sub-clavian arteries. DISCUSSION: This observation of Horton's disease involving large vessels in a patient with chronic hepatitis C suggests that an infectious factor might trigger vascularitis.

[Medical aspects of hepatic amebiasis in Yaoundé (apropos of 23 cases)]. / Aspects médicaux de l'amibiase hépatique à Yaoundé (a propos de 23 cas).

The authors report a short but homogenous group of 23 cases (15 men and 8 women) of hepatic amebiasis in Yaoundé (Cameroun), all of them confirmed by immunology. They state 2 isolated fevers, 4 jaundices. Nearly all cases were treated by tinidazole with very fast and evident success. One patient was operated and died. The great interest of immunology is underlined for the diagnosis and we wish its generalization, particularly in tropical countries.

[Tumor-like focal nodular hyperplasia. Apropos of 3 cases observed at the Dakar Central Hospital from 1986 to 1989]. / Hyperplasie nodulaire focale à forme tumorale. A propos de 3 cas observés à l'Hôpital Principal de Dakar de 1986 à 1989.

Authors report three observations of Focal Nodular Hyperplasia, Tumor-like on two: senegalese female patients, 16 years and 37 years old, and a young senegalese man, 24 Years old. The mean age is about 25.5 years and oestro progestative intake has bean noted once. Diagnosis of Focal Nodular Hyperplasia was difficult and has been done twice after surgical intervention for chronic cholecystitis and blood peritonitis. The only complication reported, has been a rupture of nodular, causing the death of a patient. This benign tumor that never degenerates, does not need any particular treatment unless a stopping of oral contraception.

[Human leptospirosis in New Caledonia and dependencies. Apropos of 57 cases observed between 1 June 1983 and 31 May 1985]. / La leptospirose humaine en Nouvelle-Calédonie et Dépendances. A propos de 57 cas observés en 2 ans, du 1er juin 1983 au 31 mai 1985.

57 cases of leptospirosis were diagnosed in New Caledonia (South Pacific French Territory) between June 1983 and May 1985. 25% cases are severe infections; thrombopenia and renal failure are frequently observed. Leptospires are found in blood or spinal or urine culture confirmed by haemagglutination tests on microplates (Martin et Petit). Epidemiological studies are being performed during 1985-1986 to devise preventive measures adapted to the territory.