[Sarcoidosis of the thyroid: A case report]. / La sarcoïdose thyroïdienne: à propos d'un cas.

OBJECTIVE: To present a case of thyroid sarcoidosis revealed by a multinodular goiter and cervical and mediastinal adenopathies. METHODS: We summarize the clinical presentation of a thyroid sarcoidosis. A review of literature regarding this topic is also presented. RESULTS: A 48-year-old woman presented dysphagia without dyspnea. Clinical and radiological explorations find a multinodular goiter with cervical and mediastinal adenopathies. The symptomatic side of the goiter and the association with adenopathies justify the surgery. Total thyroidectomy and mediastinal lymphadenectomy are processed. Histopathological examination of the thyroid reveal a goiter without malignity, a vesicular nodule, and non necrotizing granulomas consistent with sarcoidosis, as in the adenopathy. CONCLUSION: The interest here, is the difficulty to make the diagnostic without histopathology, between a thyroid cancer with lymphadenopathies and extrapulmonary sarcoidosis (involving thyroid and adenopathies).

[Long-term fever after gastric banding]. / Fièvre au long cours et anneau gastrique.

We report a 65-year-old male, suffering from aspiration pneumonia after gastric banding revealed by intermittent fever inducing a delayed diagnosis. Several early and later pulmonary complications following laparoscopic gastric banding have been reported. Removal or deflation of the band should be considered in unexplained persistent fever to avoid more severe complications such as respiratory distress.

[A severe side effect of antitubercular therapy: pyrazinamide induced thrombocytopenia]. / Un effet indésirable grave du traitement antituberculeux: la thrombopénie au pyrazinamide.

The haematological side effects of antitubercular drugs are not well known. We report the observation of a patient who received Rifater for the treatment of pulmonary tuberculosis. After one month of treatment, he developed an acute pulmonary infection, with neutropenia (1218/microl) and thrombocytopenia (109,000/microl), requiring suspension of his antitubercular drugs. After the reintroduction of he again developed thrombocytopenia (6,000/microl) associated with bleeding and required treatment with intravenous immunoglobulin. The introduction of a combination of moxifloxacin, isoniazid, pyrazinamide, and ethambutol was followed by a new relapse of the thrombocytopenia. Responsibility of pyrazinamide was then suspected and later confirmed by the evolution of platelet levels after stopping and reintroducing this antibiotic. This is the third reported case of pyrazinamide induced thrombocytopenia, whose frequency is probably underestimated because of the use of compound treatment.