Les ischémies cérébrales chez les jeunes sont différentes par leurs étiologies et leur pronostic. Le profil étiologique en médecine interne est particulier vu le niveau tertiaire de recrutement. L'objet de notre travail est de faire connaître certaines étiologies particulières de cette pathologie chez le sujet jeune. Etude rétrospective des dossiers de jeunes patients au service de médecine interne à Casablanca, sur une période de 2000-2014. Tous les patients ont bénéficié d'une imagerie cérébrale avec des séquences angiographiques, précisant la nature et la topographie de l'AVCI. Un bilan étiologique dicté par la clinique a été mené. Vingt et cinq patients ont été colligés, avec un sex-ratio à 0,73 et un âge moyen de 36±7. Le tabagisme était présent dans 32% des cas, le diabète et l'hypertension artérielle ont été notés dans 8% des cas. Les épisodes d'amnésie et de migraine ont été notés dans 24%. La prise d'oestroprogestatifs et l'antécédent de fausses couches ont été notés dans 12%. Les étiologies étaient dominées par: lupus systémique aigu (32%) associé à un syndrome des antiphospholipides (80%), maladie de Behcet (16%), maladie de Takayasu (12%). En plus de l'antiagrégation, 76% de nos patients ont eu un traitement aux corticoïdes et immuno-suppresseurs. La médecine interne participe à la prise en charge des AVCI, notamment dans le volet étiologique. Les étiologies des ischémies cérébrales du sujet jeune sont multiples, la recherche doit être rigoureuse afin d'identifier des causes particulières, évaluer le risque de récidive et préciser la stratégie thérapeutique.

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Background Behçet's disease is a complex multi-system disorder of unknown aetiology characteristically presenting with recurrent oral ulcers. It is presumed to be a vasculitis and includes involvement of the ocular, cardiovascular, renal, gastrointestinal, pulmonary,vascular, musculoskeletal, and central nervous systems. Objectives It is a study of 1484 cases of Behcet's disease (BD) diagnosed between 1981 and 2013 in an internal medicine department. Even in countries where BD is frequent, some unusual features were unknown, raising diagnostic problems. Methods It is a retrospective study of 1484 cases of Behcet's disease (BD). All patients fulfilled the diagnostic criteria of the International Study Group for BD and the Davatchi criteria (2011). Results Patients aged between 20 and 40 years were mostly affected (73.8%) with male preponderance (70%). All patients had mucocutaneous lesions including oral ulceration (100%), genital ulcers (84%) and positive pathergy test (52%). Eye lesions were frequent (64.5%) and led to blindness in 30% of cases. Joint involvement was seen in 85% of cases with polyarthritis in 104 cases. Deep venous thrombbosis were observed in 17% of cases complicated by pulmonary embolism in 13 cases. Superior vena cava thrombosis was found in 32 cases. Neurological involvement was present in 19% of cases. 3 patients had intracardiac aneurysms with myocardiopathy in one case. Conclusions In this study, unusual features are observed. Polyarthritis and vena cava thrombosis are not rare. Cardiac involvement can be seen in BD. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.6022

Objective Systemic sclerosis (SSc) is a connective tissue disorder characterized by excessive fibrosis of the skin and internal organs, along with microvascular damage, and is often associated with typical autoantibodies. This study aimed to analyze the correlation between specific autoantibody profiles, clinical and paraclinical features in Moroccan patients with SSc. Methods We analyzed the presence of specific autoantibodies in 46 SSc patients using indirect immunofluorescence (IIF) on Hep-2 cells and immunodot. We then correlated the type of autoantibodies with clinical and laboratory manifestations. Results Among our patients, 86.9% were females. The mean age of patients at diagnosis was 50.21 years old, with an average diagnosis delay of 5 years. The main clinical manifestations found were Raynaud’s phenomenon (89.2%), sclerodactyly (84.8%), proximal scleroderma (67.4%), gastrointestinal involvement (50%), and interstitial lung disease (30.4%). According to the specific autoantibody profile, 14 patients were anti-topo I positive (30.4%), 8 were anti-RNP(68kDa/A/C) positive (17.4%) and 6 were anti-RNA polymerase III positive (13%). We found a significant association of Anti-RNAP III with sclerodactyly and pulmonary arterial hypertension (p < 0.05). We also found an association between anti-topo I and interstitial lung disease in 30.4% of patients. There was no significant association between the positivity for the autoantibodies and other diagnosed clinical manifestations. Conclusion Some clinical manifestations of SSc may correlate positively with the presence of specific autoantibodies. Environmental factors, ethnicity, and gene interaction may also influence this correlation. Lay summary What does this mean for patients? Systemic sclerosis (SSc) is a disease that affects the connective tissues, causing excessive skin and internal organs fibrosis and microvascular damage. Specific autoantibodies, which are antibodies that attack the body's tissues, are responsible for amplifying the immune response and targeting cells involved in the development of SSc. This study aimed to investigate the relationship between specific autoantibodies and the clinical and laboratory features of SSc in 46 Moroccan patients. The majority of patients were female, middle-aged, and of Caucasian ethnicity, with a mean age of 50 years, and duration of disease between 1 and 10 years. The most common symptoms were Raynaud’s phenomenon (89.2% of patients), sclerodactyly (84.8%), proximal scleroderma (67.4%), gastrointestinal involvement (50%), arthralgia (41.3%), interstitial lung disease (30.4%), myalgia (24%) and pulmonary arterial hypertension (10.8%). We found a correlation between anti-RNAP III and Sclerodactyly and pulmonary arterial hypertension, while anti-topo I autoantibodies were associated with interstitial lung disease. The study also noted that environmental factors, ethnicity, and genetic interactions may influence the clinical and autoantibody profile in SSc patients.

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