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.
Common variable immunodeficiency (CVID) is the most frequent primary immunodeficiency and has a reported prevalence of approximately 1:25,000 to 1:50,000. The fact that it is rarely considered as a diagnosis in adults can lead to diagnostic delay, especially in older patients, and to complications such as bronchiectasis and excess mortality. However, practitioners should first exclude common causes of hypogammaglobulinaemia before considering CVID. Here we present a case of CVID revealed by prolonged fever and complicated with granulomatous manifestations and bronchiectasis in an older woman without a history of recurrent infections.
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
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.