BackgroundThe development of Primary Biliary Cirrhosis (PBC) during the course of Systemic Lupus Erythematosus (SLE) is extremely rare. We report the case of a geriatric woman who was diagnosed with SLE at 69 years of age then with primary biliary cirrhosis one year later.Case presentationA 70-years-old woman, who had been diagnosed with SLE at 69 years, was admitted for further examination of liver dysfunction. PBC was confirmed based on elevated serum levels of transaminase, high levels of antimitochondrial antibodies and following a liver biopsy. The oral administration of ursodeoxycholic acid stabilized the liver dysfunction.ConclusionWe described an original case report of elderly patient with coexisting PBC and SLE. To date, according to the best of our knowledge, there have been few case reports of SLE/PBC co-occurrence. The aetiology of this complex remains unknown, autoimmune mechanisms, environmental and genetic factors are considered important in the susceptibility to both diseases. Osteopontin might play an important role.

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Although gastresophageal reflux disease (GERD) is highly prevalent in Western countries, we have very little data about it in African countries. The aim of the study is to determine the prevalence and severity of GERD symptoms among Tunisian subjects and report its characteristics, consultation rate, management modes, as well as patients' satisfaction. Five hundred subjects living in Tunisia were interviewed face to face. The study was conducted at seven centers of primary care at Monastir's department by six interviewer doctors. The questionnaire consisted of 30 questions relating to subject attributes, lifestyle factors, medical history, reflux-related symptom characteristics, consultation behavior, previous treatments for GERD, and description of the last episode. Symptoms were defined as 'frequent' if they occurred at least weekly and 'occasional' if they occurred less frequently during the last year. The mean age was 42.3 ± 17.3 years and 75.6% were females. Over the previous year, 60% of the respondents reported suffering any GERD symptom. The prevalence of frequent GERD is 24%. Female gender (odds ratio [OR]: 1.97[1.15-3.37]) and body mass index ≥ 25 (OR: 1.54[1.042-2.29]) were associated with increased risk of GERD symptom. Only 22.3%, sought medical advice about GERD symptoms in the last year. In the univariate and multivariate analysis, work status, frequency and intensity of symptoms, duration of symptom, and association of atypical symptoms were associated with a higher frequency of medical consultation for GERD symptoms. Among the subjects complaining about heartburn, 34% took medications. GERD symptoms are common among Tunisian subjects. Few heartburn sufferers seek medical attention, and most do not take medications for symptomatic control.

Ciprofloxacin-containing sequential therapy is more effective and equally safe compared to a clarithromycin-containing sequential therapy.

L'hémorragie digestive haute demeure une cause fréquente d'hospitalisation, de morbidité et de mortalité. Les études épidémiologiques sont limitées dans notre pays. But : Déterminer les causes et l'évolution des patients ayant une hémorragie digestive haute, colligés au CHU de Monastir. Matériels et méthodes : Les dossiers de 874 patients qui ont subi une endoscopie digestive haute pour hémorragie digestive pendant une durée de dix ans (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) ont été rétro-spectivement analysés. Résultats : Les hémorragies digestives hautes ont représenté 5,3 % de l'ensemble des endoscopies digestives hautes. On avait noté une nette prédominance masculine (63,1 %), avec un âge moyen de 54 ± 12 ans. L'origine de saignement a été détectée dans 90 % des cas. La précision diagnostique était plus grande quand l'endoscopie est pratiquée dans les 24 premières heures suivant l'apparition de l'hémorragie, et en présence de l'hématémèse. L'ulcère gastroduodénal est la cause la plus fréquente de l'hémorragie digestive haute (50,5 %), suivi des gastroduodénites hémorragiques (24 %). La prévalence de l'hémorragie digestive par rupture des varices oesogastriques était de 9,49 %. Le traitement endoscopique a été utilisé dans 103 cas (11,7 %). Une intervention chirurgicale a été effectuée chez 51 patients (5,83 %), incluant 9,9 % des patients ayant un ulcère hémor-ragique. Trente-six patients étaient décédés (4,1 %). Conclusion : L'ulcère hémorragique est la cause la plus fré-quente d'hémorragie digestive dans notre pays. La mortalité était élevée dans le groupe des patients ayant saigné par rupture des varices oesogastriques. La plupart des cas d'hémor-ragie digestive haute peuvent être traités par hémostase endoscopique, quand l'endoscopie diagnostique établit la source. Mots clésHémorragie digestive haute · Ulcère gastroduodénal · Gastroduodénite hémorragique · Endoscopie Abstract Background: Acute upper gastrointestinal bleeding (UGIB) continues to be a common cause of hospital admission and morbidity and mortality. Epidemiological studies are still limited in our country. Aim and objectives: The aim of this study is to determine the causes and outcome of patients with UGIB presenting at the teaching hospital of Monastir. Materials and methods: The study was carried out at the teaching hospital of Monastir. The records of 874 patients who underwent endoscopy for UGIB over a period of 10 years (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) were retrospectively analysed. Results: The acute UGIB represented 5.3% of all high digestive endoscopy. Male predominance (63.1%) was noted with an average age of 54 ± 12 years. A bleeding site could be detected in 75.6% of the patients. Diagnostic accuracy was greater within the first 24 hours of the bleeding onset and in the presence of hematemesis. Peptic ulcer was the main cause of UGIB (50.5%) followed by erosive mucosal disease (24%). The prevalence of variceal bleeding was 9.49%. Endoscopic treatment was used in 103 case...

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While it is well recognized that the combination of amoxicillin and clavulanic acid has been associated with hepatic adverse events, there are only a few reports about amoxicillin alone causing hepatic toxicity. We describe a 34-year-old woman who developed severe cholestatic hepatitis following amoxicillin treatment.