[Autoimmune chronic active hepatitis: anatomoclinic's study of 50 patients]. / Les Hépatites auto-immunes (HAI) chroniques de l'adulte: étude anatomoclinique d'une série de 50 patients.

PURPOSE: To analyse anatomoclinic and evolutive aspects of autoimmune hepatitis (AIH) through 50 observations collected in two Internal Medicine departments in Algiers from 1998 to 2002 and to make a review of the literature. METHODS: The study is prospective. The diagnosis of autoimmune hepatitis (AIH) is established according to the recommendations of the score of the International Autoimmune Hepatitis Group (1991) or/and hepatitic damage confirmed by histology. RESULTS: Fifty patients were studied: (32 women-18 men) and the mean age was 38 years (17 to 73). Autoimmune extra-hepatitic manifestations were associated in 26%. The AIH type 1 has been noted in 58%. AIH were type 2 in only 6%. In 22% of the cases AIH were sero-negative and the others AIH represented 14% were classed as overlap-syndrome (5 cases of primary biliary cirrhosis and 2 cases of primary sclerosing cholangitis hepatitis overlap syndrome). The first liver biopsy tissue showed strong necrotic-inflammatory activity in 56% and cirrhosis was identified in 19 patients (38%). The treatment (azathioprine and corticosteroid) was prescribed in 37 patients (74%) in active chronic hepatitis or in compensed cirrhosis. FOLLOW-UP: 28% of the patients died (9-36 months) because cirrhosis's complications or because complications of hepatocarcinoma (3 cases). CONCLUSION: The diagnosis of AIH must be established early for each patient with chronic liver disease particularly is those are supposed as a crypto genetic hepatitis. The prognosis is compromised by delayed diagnosis and the mortality in middle following up is high.

Osteoid osteoma and osteoblastoma of the spine in children. Report of 22 cases with brief literature review.

Thirteen cases of osteoid osteoma and nine cases of osteoblastoma are reported. Diagnostic difficulties of osteoblastoma are illustrated by the versatile radiographic appearances of this tumour. The authors stress the importance of nuclear scan and CT in diagnosis and management.

Immunoproliferative small intestinal disease in Algerians. II. Ultrastructural studies in alpha-chain disease.

The plasma cell infiltrate of the small intestine in alpha-chain disease has been studied ultrastructurally in an attempt to determine whether there is a significant nuclear-cytoplasmic asynchrony that could be used as evidence for the neoplastic nature of the disease, even in its early stages. No such asynchrony was identified. In the early stages of the disease, the infiltrate was mainly of slightly immature plasma cells indistinguishable from those of coeliac disease. Later stages were marked by the presence of less differentiated immunoblastic cells arising in the deep mucosa and infiltrating into glands. Multinucleate plasmacytoid cells were thought to be degenerate cells. The significance of these findings is discussed in relation to the nature of alpha-chain disease and immunoproliferative small intestinal disease in general.

Immunoproliferative small intestinal disease in Algerians. I. Light microscopic and immunochemical studies.

Twenty-two cases of immunoproliferative small intestinal disease (IPSID) were studied with an immunoperoxidase technique. Sixteen of these had serologic evidence of alpha heavy chain disease (AHCD) and have a characteristic immunochemical pattern that allows a diagnosis on jejunal biopsy. kappa-light chain was found in a case of AHCD in the benign appearing plasma cell proliferation and in the associated malignant lymphoma suggesting that failure of light chains is not constant in AHCD. Four cases of IPSID showed secretion of polyclonal IgA in the plasma cell infiltrate providing evidence that some cases may be associated with secretion of complete IgA molecules. This polyclonal pattern is suggestive of a reactive process. Two cases of IPSID without evidence of AHCD showed an immunohistochemical pattern characteristic of AHCD and may represent nonsecreting forms of the disease. Alternatively they may be secreting nondetectable amounts of AHCD protein or an abnormal protein not recognized by standard antisera.

[Segmental dilatation of the ileum associated with an omphalocele and a common mesentery. Discussion around 2 cases : chance or morphogenically "related"? (author's transl)]. / Dilatations segmentaires iléales associées à une omphalocèle et à un mésentère commun réflexions à propos de 2 cas : hasard ou "instantané" de morphogénèse pathologique?

Segmental dilatation of the ileum is the subject of this report which concerns two cases. Both cases were associated with omphalocele and intestinal malrotation, an observation already noticed by some authors. Is it still a hazardous coincidence or rather a real opportunity which throws light over the explanation of this malformation?

[Prolonged ovarian pregnancy associated with an intrauterine pregnancy. Apropos of a case]. / Grossesse ovarienne prolongée associée à une grossesse intra-utérine. A propos d'un cas

Case of advanced ovarian pregnancy are exceptional because ovarian pregnancy itself is very rare. The authors describe a case of prolonged ovarian pregnancy with retention of the dead fetus for more than a year and associated with an intra-uterine pregnancy. Usually ovarian pregnancy finishes in rupture which occurs before the end of the first trimester. It is then difficult to make out the intergrity of the organs and in particular of the tube and indeed to recognize them. On the other hand when the mass persists intact with the development of the pregnancy in a retort shape, it is easy to see how confusion is possible and arises between it and an intra-uterine pregnancy. In this case, however, the different anatomical forms are clear and an almost definite diagnosis can be made at the time of operation (the three first criteria of Spiegelbery). The diagnosis of ovarian pregnancy is never made before operation. At the very best one can say, when things happen early, that an extra-uterine pregnancy has ruptured, or in certain particular circumstances like in the case we are reporting lithopedian. The presence of ovarian tissue in the wall of the sac--which is the fourth criterion of Spiegelberg-is easier to recognize in early accidents than in advanced cases of ovarian pregnancy in which the parenchyma of the ovary is compressed, distended and laminated by the increasing development of the fetus and the adnexae. The absence of the placenta being adherent to other organs than the ovary can then be kept as a worthwhile criterion of ovarian pregnancy.