[The subcutaneous mucormycosis due to Lichtheimia corymbifera: A case report in an immunocompetent child]. / Les mucormycoses sous-cutanées àLichtheimia corymbifera : à propos d'un cas chez un enfant immunocompétent.

Mucormycosis due to Lichtheimia (ex Absidia) corymbifera is a rare fungal infection, occurring most often in an environment of immune deficiency, rarely in an immunocompetent patient. It comes in different clinical forms, frequently misleading, hence the interest of a pathological and mycological examination that allows the diagnosis of certainty. The management of this condition should be introduced early because it affects the functional prognosis of the patient. In this study, the authors report a case of mucormycosis in a 10-year-old child, and with clinical immunocompetent less severe than the cases reported in the literature.

[Renal failure in sarcoidosis]. / L'insuffisance rénale au cours de la sarcoïdose.

Renal sarcoidosis is rare and may lead to renal failure in less than 3% of patients. It may occur as a consequence of calcium metabolism disorders or granulomatous interstitial nephritis. In this retrospective study, we present five patients with renal failure secondary to sarcoidosis diagnosed in our centre on one period of nine years. Patients were three males and two females with a mean age at the time of the diagnosis of 31,6 years. Pulmonary involvement was present in three cases. Renal biopsy revealed granulomatous interstitial nephritis lesions in all patients. Extra-membranous glomerulonephritis was present in one case. In another case, moderate interstitial fibrosis was observed. Corticosteroid therapy using prednisolone 1mg/kg per day was used in all patients. Three patients had methylprednisolone pulse before oral corticosteroid therapy. One patient required several sessions of haemodialysis. All patients were followed up for a mean period of 52,6 months (ranged from 13 to 84 months). All patients improved their renal function with normalization of creatininemia in two of them. Renal involvement in sarcoidosis is probably underestimated. Corticosteroids therapy is efficient and must be introduced early to prevent progression to chronic renal failure.

[Renal amyloidosis: uncommon complication of sickle cell disease]. / L'amylose rénale: une complication inhabituelle de la drépanocytose.

Type AA amyloidosis is a rare complication of sickle cell anemia. The purpose of this report is to describe the case of a 30-year-old man with heterozygous sickle cell disease who was referred to our unit with nephritic syndrome and microscopic hematuria. Light microscopy on a renal biopsy specimen demonstrated AA amyloidosis. After elimination of other causes, it was concluded that amyloidosis was the result of recurrent acute inflammation secondary to sickle cell disease. To our knowledge, this is the fifth that renal amyloidosis as a complication of sickle cell disease has been described in the literature.

[Hepatitis C and diabetes mellitus: effect of diabetes on the course of the liver disease]. / Hépatite virale C et diabète: influence du diabète sur l'évolution de l'hépatopathie.

UNLABELLED: The prevalence of diabetes mellitus is higher in chronic hepatitis C than in hepatitis B, even without cirrhosis. OBJECTIVE: To study the host, specific viral factors associated with diabetes mellitus and the influence of diabetes mellitus on the intensity of steatosis and the severity of fibrosis. MATERIAL AND METHODS: The following data were collected in a cohort of 1249 patients with chronic hepatitis C established between December 1991 and June 2004: age, gender, body mass index (BMI). None of the patients were under treatment for their liver disease. Serum transaminase level and hepatitis C serology with search for viral RNA, viral load and genotype were obtained. The Metavir score, iron overload using the Perls score (0-4) and steatosis class (0-3) were determined on liver biopsies. RESULTS: Mean patient age was 52.5+/-10 years (56% male). Mean BMI was 24.6+/-24 kg/m2. Forty-three patients (17.2%) presented diabetes mellitus. The mean duration of their diabetes was 8.9 years. Genotype 1 predominated (60.4%) and mean viral load was 7.7x10(6) eq.v/ml. Steatosis was present in 69.7% of the diabetic patients versus 17% of the non-diabetic patients. Grade 2 fibrosis (F2) was observed in 32.5% of diabetic patients versus 29% in non-diabetic patients and F3, F4 in 73% of the diabetic patients versus 57% of the non-diabetic patients. Comparison between diabetic and non-diabetic patients demonstrated an absence of statistically significant difference (at 5%) between the groups for gender, viral load and genotype. Diabetic persons were older (58.7 years against 51 years) and liver biopsy revealed steatosis and fibrosis (F3, F4) more often in diabetic patients (69.7% versus 49.5%). CONCLUSION: These findings suggest that steatosis could favor progression of fibrosis in diabetics with chronic hepatitis C.

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): two case reports.

Sinus histiocytosis with massive lymphadenopathy or Destombes-Rosai-Dorfman's syndrome is a rare benign disease of unknown etiology, usually seen in younger patients. The cases reported concerned a 15-month old Caucasian boy and an 8 year old black boy with unilateral cervical enlargement, occasional fever and without any extranodal involvement. Diagnosis was performed by superficial lymph node biopsy. No immunodeficiency was found. The patients received no therapy and a complete spontaneous resolution was seen after a few months in the two cases. The clinical presentation, histologic characteristics, pathogenesis and treatment of the Destombes-Rosai-Dorfman's syndrome are discussed.