ABSTRACT
Sub-acute combined degeneration (SCD) is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and is a neurological complication due to vitamin B12 deficiency. Revealing forms of SCD without anemia are rare. We report a case of SCD of the spinal cord in a 33-year-old woman without anemia but with a 10-month history of paresthesis and urine imperiosity. Magnetic resonance imaging (MRI) of the spine showed intramedullary hyperintensity seen on T2-weighted images in the posterior column of the cervico-dorsal spinal cord, extending from C1 to D1. A diagnosis of SCD of the spinal cord was considered and confirmed by a low serum cobalamin. The patient was treated with vitamin B12 supplements and showed gradual improvement in her clinical symptoms.
Subject(s)
Magnetic Resonance Imaging , Subacute Combined Degeneration/diagnosis , Subacute Combined Degeneration/etiology , Adult , Female , Humans , Subacute Combined Degeneration/drug therapy , Vitamin B 12/therapeutic use , Vitamin B 12 Deficiency/complications , Vitamin B 12 Deficiency/drug therapyABSTRACT
OBJECTIVES: To describe a case of Behcet's uveitis associated with Kaposi's sarcoma occurring simultaneously in a patient and to review the literature on iatrogenic Kaposi's sarcoma. METHODS: We describe the case of a 44-year-old Moroccan man, who developed a Kaposi's sarcoma 8 months after immunosuppressive therapy for ocular Behçet's disease. He was treated with corticosteroids and cyclophosphamide (Exdoxan, Baxter) pulse for 6 months followed by oral azathioprine (Imurel, Glaxo Smith Kline). Literature searches were performed on iatrogenic Kaposi's sarcoma and other cases of such association and the potential pathogenic mechanisms involved. RESULTS: Iatrogenic Kaposi's sarcoma is widely reported to develop after renal transplantation during immunosuppressive therapy. Less commonly, Kaposi's sarcoma occurs in patients receiving long-term corticosteroids or immunosuppressive therapy for rheumatic diseases. It is considered to be induced by activation of latent human herpes virus 8. To our knowledge, this is the second reported case of iatrogenic Kaposi's sarcoma in a patient with ocular Behçet's disease. Interferon-alpha is of value for patients with both conditions. CONCLUSION: This case report underscores the relationship between environmental and infectious factors, drug-induced immunosuppression, and the development of Kaposi's sarcoma.
Subject(s)
Behcet Syndrome/complications , Sarcoma, Kaposi/complications , Adult , Antiviral Agents/therapeutic use , Behcet Syndrome/drug therapy , Behcet Syndrome/pathology , Cyclophosphamide/adverse effects , Fatal Outcome , Glucocorticoids/adverse effects , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Injections, Intravenous , Interferon-alpha/therapeutic use , Male , Sarcoma, Kaposi/drug therapy , Sarcoma, Kaposi/pathologyABSTRACT
INTRODUCTION: Systemic capillary leak syndrome (SHCI) is a rare disease with poor prognosis, characterized by recurrent episodes of generalized edema and hypotension. EXEGESIS: Two patients a 41 and 34-year-old woman were admitted with a generalized edema and several episode of shock. One patient had muscular edema with compartment syndrome imposing the aponevrotomia of discharge in emergency. The association of elevated hematocrit, decreased albumin serum concentration confirmed the diagnosis of SHCI. Administration of intravenous fluids improved the clinical and biological symptomatology. CONCLUSION: These two new observations are comparable to the published cases. We didn't find dysglobulinemia whose existence is frequented. The treatment of shock requires macromolecules solutions. The preventive treatment remains empiric.