[Peripheral and bone marrow plasmacytosis in dengue fever: report of a case]. / Plasmocytose sanguine et médullaire au cours de la dengue : une observation.

We report a case of dengue fever with plasma cells in the blood (3980 per cubic millimeter) and bone marrow (30%) in a 55-year-old woman hospitalized for fever, arthralgias and thrombocytopenia (66,000 per cubic millimeter) on returning from the West Indies. Serological testing confirmed the diagnosis. Plasmacytosis is rare in dengue fever and its frequency and correlation with the different forms of the disease remain to be determined.

[Extramedullary blastic transformation revealed by a prolonged fever during the course of a 5q- syndrome]. / Fièvre prolongée au cours d'un syndrome 5q- révélant une transformation blastique extramédullaire.

INTRODUCTION: Fever during a myelodysplastic syndrome can be due to infectious complications, systemic disease or acute transformation with clonal evolution. CASE REPORT: A 51-year-old woman, with a 5q- syndrome and neutropenia, presented with a several week fever duration. Infectious work-up was negative and therapy with antibiotics had no influence on the clinical course. Neither bone marrow nor blood blasts were detected, but liver biopsy demonstrated significant blast infiltration compatible with the diagnosis of acute myeloid leukaemia (AML). CONCLUSION: The absence of blasts in blood or bone marrow does not exclude the malignant transformation of a myelodysplastic syndrome to AML. Tissue biopsy may be necessary to confirm the leukaemic progression.

[Severe hepatitis in a patient with adult-onset Still's disease treated with anakinra]. / Hépatite aiguë médicamenteuse à l'anakinra chez une patiente traitée pour une maladie de Still de l'adulte.

INTRODUCTION: Adult-onset Still's disease is characterized by non-specific polymorphic features. The efficacy of anakinra, an IL-1 receptor antagonist, has been shown in several studies. This medication is well-tolerated, and only one case of severe hepatitis has been previously reported. CASE REPORT: A 22-year-old woman presented with fever, rash, arthritis, and pericarditis, associated with systemic inflammatory response syndrome and elevated ferritin serum level with low glycosylated ferritin. Adult-onset Still's disease was diagnosed, but treatment with steroids did not achieve remission. The patient was then treated with anakinra, which resulted in spectacular improvement, but 3 weeks after the initiation of the treatment she experienced severe hepatitis that resolved after the discontinuation of anakinra. CONCLUSION: Hepatitis is a rare side effect of anakinra and the monitoring of liver tests should be recommended during anakinra therapy.