[Cerebral salt wasting syndrome in bacterial meningitis]. / Syndrome de perte de sel d'origine cérébrale avec hyponatrémie au cours d'une méningite bactérienne.

Subarachnoid hemorrhage is the most common cause of cerebral salt wasting syndrome. There are few reports of this condition in infectious meningitis. We describe a patient with hyponatremia and bacterial meningitis. Hyponatremia rapidly improved after administration of sodium chloride. The purpose of this report is to alert clinicians to the fact that hyponatremic patients with central nervous system disease do not necessarily have a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), but may have cerebral salt wasting syndrome. By contrast with SIADH, the treatment requires saline administration.

[Conjugal progressive systemic sclerosis]. / Sclérodermie conjugale.

INTRODUCTION: Familial occurrence of progressive systemic sclerosis is unusual. The occurrence of conjugal scleroderma is exceptional. EXEGESIS: We report here a case of systemic sclerosis in a wife and husband who both developed the onset of illness within a 10-year period. Solvent exposure was noted. CONCLUSION: The etiology of systemic sclerosis remains unknown. Environmental factors may play role in its pathogenesis.

[Sjögren's syndrome with autonomic failure and epilepsy]. / Syndrome de Sjögren avec épilepsie et dysautonomie.

INTRODUCTION: Primary Sjogren syndrome is considered as the most frequent connective tissue disease. Neurological complications may affect the peripheral nervous system and to lesser extent the central nervous system. Autonomic system nervous dysfunction and epilepsy have been rarely reported. EXEGESIS: We present on case of Sjogren's syndrome with epilepsy and autonomic nervous system dysfunction. The epilepsia respond to valproate. CONCLUSION: Autoimmune investigations for Sjogren's syndrome should be initiated in any patient presenting with unexplained neurologic manifestations.

[Association of hereditary hemochromatosis and pernicious anaemia]. / Hémochromatose génétique et anémie de Biermer.

INTRODUCTION: Hereditary hemochromatosis is inherited as an autosomal recessive trait. It is characterized by increased absorption of dietary iron. The association between pernicious anaemia and hereditary hemochromatosis has never been described. EXEGESIS: We report a case of paradoxical association of hereditary hemochromatosis and pernicious anaemia. CONCLUSION: It seems that pernicious anaemia may prevent manifestations of hemochromatosis. We suppose that this protective role is due to atrophic body gastritis with iron malabsorption.

[Cavernous sinus lymphoma mimicking Tolosa-Hunt syndrome]. / Lymphome du sinus caverneux mimant un syndrome de Tolosa-Hunt.

INTRODUCTION: Tolosa-Hunt syndrome is characterized by painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus. Steroid therapy dramatically reverses the symptoms and clinical signs. Because they also may respond to steroids, tumors such as lymphoma and meningioma and orbital tumors can make differential diagnosis difficult. EXEGESIS: We report the case of a 78-year-old male patient in whom systemic lymphoma associated with inflammation of the cavernous sinus was uncovered by painful, gradually progressing, ophthalmoplegia mimicking Tolosa-Hunt syndrome. CONCLUSION: When faced with a clinical picture suggestive of the existence of Tolosa-Hunt syndrome clinical workup is mandatory and should lead to diagnosis of exclusion.

[Progressive multifocal leukoencephalopathy an chronic lymphocytic leukemia]. / Leucoencéphalopathie multifocale progressive et leucémie lymphoïde chronique.

INTRODUCTION: Progressive multifocal leukoencephalopathy is a demyelinating disease resulting from an opportunistic infection of the central nervous system by JC papovavirus. It mostly occurs in patients with an underlying immunosuppressive disorder. In the era of acquired immunodeficiency syndrome it is observed with increasing frequency. EXEGESIS: We report the case of a non-HIV-infected patient who presented chronic lymphocytic leukemia with progressive multifocal leukoencephalopathy uncovered by both imaging and the presence of JC virus in the cerebrospinal fluid. CONCLUSION: Due to the lack of specific treatment, the disease is still rapidly progressive and fatal.

[Ischemic cerebral vascular accident and zoster infection]. / Accident vasculaire cérébral ischémique et infection zostérienne.

Herpes zoster is uncommonly followed by cerebral infarction. The pathophysiological mechanism remains uncertain. Outcome is favorable after early specific treatment. We report the case of a 70-year-old woman who developed right hemiparesis with aphasia 15 days after thoracic herpes zoster. The herpes zoster induced cerebral vasculitis was hypothesized as no other etiology could be identified after detailed assessment of the cerebral infarction including brain MRI and cerebrospinal fluid study, and as the clinical course responded to antiviral therapy.

Rheumatoid arthritis and multiple sclerosis in the same patient. Two case-reports.

We report on two new patients with both rheumatoid arthritis and multiple sclerosis. In one patient, the first manifestations of multiple sclerosis occurred eight years after onset of seronegative rheumatoid arthritis without extraarticular manifestations. The other patient had a 20-year history of multiple sclerosis when she developed seropositive, nodular rheumatoid arthritis. Neither patient had evidence of systemic lupus erythematosus. A lip biopsy was done in one patient, with normal results; the other patient was free of clinical symptoms of sicca syndrome and had a negative Schirmer's test. The paucity of similar cases in the literature is surprising since multiple sclerosis and rheumatoid arthritis are both autoimmune diseases and share many pathophysiologic and etiologic features. Although chance alone may explain the occurrence of both conditions in the same patient, the existence of shared etiologic factors should in theory increase the likelihood of the association.