Seroprevalence of rubella in pregnant women in Southern Morocco.

Rubella is a generally benign but dangerous viral infection in early pregnancy, due to the teratogenic potential of the virus. Indeed, it causes spontaneous abortions, in-utero fetal death, premature labor and congenital malformations known as congenital rubella syndrome. The purpose of this study is to determine the immune status of rubella in pregnant women in southern Morocco. A prospective, multicentre study was conducted in 2017 for the detection of rubella IgG and IgM antibodies in 380 pregnant women aged 17 to 46 years, using the Architect i1000 chemiluminescent microparticle immunoassay. Eigthy for percent (84.7%) of women were seropositive. Ten percent of multiparous women remained seronegative despite recommendations for vaccination after delivery. Preventive measures against congenital rubella need to be strengthened, and vaccination is needed in non-immunized women. Vaccination awareness campaigns, especially among non-immunized multiparous women, remain essential.

Hemophagocytic lymphohistiocytosis: epidemiological, clinical and biological profile

Background/aim: Hemophagocytic lymphohistiocytosis (HLH) is a clinical, biological, and pathological entity that is rare but has certain morbidity that may be life-threatening. This work aims to establish a focus on the hemophagocytic lymphohistiocytosis and analyze different aspects of diagnosis while emphasizing the biological data. Materials and methods: We report the results of a retrospective study conducted in the hematology department of Avicenna Hospital in Marrakesh. Thirty-one patients with hemophagocytic lymphohistiocytosis were enrolled. Results: The clinical presentation was dominated by fever and deterioration of the general state for almost all our patients. Splenomegaly was objectified in 90% of the patients. Hepatomegaly, lymphadenopathy, and hemorrhagic manifestations were observed in almost 50% of the patients. Biological assessments revealed bi- or pancytopenia in 96% of the patients, and coagulation disorders in 51% of the patients. On the other hand, hyperferritinemia was found in 84% of the patients, and hepatic cytolysis and hypertriglyceridemia in half of the patients. Hemophagocytosis was observed in all bone marrow samples taken from our patients. Concerning the evolution of patients, in 38.5% of the patients, the evolution was favorable with regression of clinical and biological signs. Twenty six percent of the patients had died, mainly from multiple organ failure and disseminated intravascular coagulation. Conclusion: HLH is a diverse condition with many causes and is likely to be under-recognized, which contributes to its high morbidity and mortality. Clinicians need to be able to recognize the signs and symptoms commonly seen in HLH and actively pursue this diagnosis in the cases of undiagnosed febrile illness with multiorgan dysfunction. Early recognition is crucial for any reasonable attempt at curative therapy to be made.

[Epidemiological, clinico-biological, therapeutic and evolutionary aspects of ß-thalassemia in Morocco]. / Aspect épidémiologique, clinico-biologique, thérapeutique et évolutif de la ß-thalassémie au Maroc.

OBJECTIVE: Thalassemias is the consequence of a synthesis imbalance between the α and ß chains of hemoglobin. It's a hereditary haemolytic anemias, which presents a problem of public health because of their frequency and the difficulties of their care. The objective of this work is to study the epidemiological, clinico-biological, therapeutic and evolutionary profile of thalassemic patients in Morocco. METHODS: We're reporting the results of a retrospective multicenter study on all cases of thalassemia taken at the hospitals: Avicenne military hospital in Marrakech, Mohammed VI hospital in Marrakech and the regional center for blood transfusion in Agadir. RESULTS: During this period we collected 81 cases of thalassemias. The average age was 13 years (from 1 month to 60 years) with a sex ratio (M/F) of 0.8. The reason for consultation was anemia in 43% of cases. The electrophoresis of hemoglobin has shown a predominance of the ß-thalassemia minor form. On the evolutionary level, iron overload and endocrine complications were the most frequent. CONCLUSION: The development of a prevention program based mainly on health education, the reduction of consanguineous marriages and genetic counseling, are probably the main ways of combating the emergence of new thalassemic cases.

IgD-λ multiple myeloma with excessive excretion of free light chains: a diagnostic trap in the identification of monoclonal gammopathies.

Immunoglobulin D multiple myeloma (IgD MM) is a rare entity of monoclonal gammopathies. We report the case of a IgD MM, associated with excessive excretion of lambda free light chains (FLL λ) diagnosed and managed at the University Hospital Mohammed VI of Marrakech among an adult hospitalized in the hematology department for bone pain and alteration of the general condition. Indeed, IgD MM is characterized by its clinical severity and poor prognosis. The discretion or absence of a monoclonal peak in the electrophoresis of serum proteins makes detection difficult. The present case demonstrates that IgD MM may be associated with excessive production of CLL and may therefore be erroneously diagnosed as CLL MM. Knowledge of this rare subtype of MM and its epidemiological, clinical and especially biological characteristics is crucial for establishing the correct diagnosis.