Fatal Systemic Vasculitis Associated with Chronic Active Epstein-Barr Virus Infection.

Chronic active Epstein-Barr virus infection is a rare disease with an often fatal outcome. Cardiovascular complications are associated with a poor prognosis. We herein describe the clinical course of an adult patient with Epstein-Barr virus-associated systemic vasculitis complicated by multi-systemic aneurysmal disease. The vascular imaging showed multiple aneurysms involving coronary arteries, abdominal arteries, cerebral arteries, and vertebral arteries. Immunophenotyping analysis of peripheral blood lymphocytes revealed the presence of an increased number of double negative T cells. The patient received multiple lines of immunosuppressive therapy with no response. Unfortunately, he succumbed to a cerebral aneurysm rupture.

Paraneoplastic syndromes revealing ovarian teratoma in young and menopausal women: report of two cases.

Paraneoplastic syndromes are a heterogeneous group of clinical and biological manifestations caused by underling neoplasms. They can reveal ovarian teratoma which express neuroendocrine proteins, or contain mature or immature neural tissue inducing an autoimmune response. The etiological investigation is then crucial to early identification of the tumor in order to optimize the prognosis and to limit neurological sequelae. In case of ovarian teratoma, management is essentially based on surgical resection sometimes associated with immunotherapie. We report two new cases of ovarian teratoma revealed by paraneoplastic syndromes in young and menopausal woman.

[Granulomatous spondylodiscitis: due mainly to tuberculosis but lymphoma cannot be excluded]. / Spondylodiscite granulomateuse: surtout la tuberculose mais ne pas omettre le lymphome.

Lower back pain is due to multiple etiologies that make diagnosis difficult. Primitive spinal lymphoma is rare and its diagnosis often requires ultrasound-guided biopsy. A 30-year old man hospitalized for inflammatory lumbago evolving within the context of an impaired general condition. Phisical examination revealed pain on palpation of the L2-L3 vertebral apophysis without peripheral tumor syndrome. Laboratory tests showed an inflammatory syndrome. Morphological assessment was in favour of a spondylodiscitis. The first biopsy showed granulomatous osteitis.Clinical and radiological worsening during antibacillary treatment led to reconsider the original diagnosis and a second biopsy confirmed the diagnosis of lymphoma. The diagnosis of skeletal tuberculosis in particular spinal tuberculosis requires bacteriological or histological confirmation in order not to overlook a primitive bone lymphoma.

[Peripheral neuropathy during Infliximab therapy: a case study]. / Neuropathie périphérique sous Infliximab: étude d'une observation.

Anti TNF alpha treatments are wide spectrum therapies. Multiple side effects have been reported in recent years, particularly peripheral neuropathies. We report a case of axonal neuropathy occurring three months after starting treatment with Infliximab. Our study focused on a 60-year old female patient treated for therapy-resistant hemorrhagic rectocolitis, requiring treatment with infliximab. Three months later, the patient had sensory axonal neuropathy. Etiologic assessment remained negative and dose reduction was accompanied by an improvement in symptoms. The time between initiation of treatment with Infliximab and the onset of clinical manifestations as well as improvement after dose reduction advocate the responsibility of infliximab in the occurrence of sensory neuropathy. Its management is not standardized and should be discussed case by case.