The association between lack of thyroid hormones and cardiac dysfunction has been well described. We report two new cases of patients with dilated cardiomyopathy (DCM), revealing a periphery hypothyroidism and for whom cardiac function significantly improved after L thyroxin substitutive treatment. Our cases highlight the necessity to perform thyroid function testing to investigate the etiology of non ischemic DCM.
The diagnosis of Henoch-Schönlein purpura (HSP) is difficult, especially when abdominal symptoms precede cutaneous lesions.We report three cases of adult HSP revealed by gastrointestinal (GI) involvement.
IntroductionTakayasu arteritis (TA) is a chronic vasculitis of unknown origin, affecting mainly the aorta and its main branches. As a result of the inflammation, stenosis, occlusion or dilatation of the involved vessels may occur and cause a wide range of symptoms. It has been described in association with various auto-immune disorders (mainly inflammatory digestive tract diseases). However, only few cases of TA associated with sarcoidosis have been reported, raising the question of an association by chance.Case reportWe report a case of a 34 year-old woman, with one year history of sarcoidosis, who presented with asymmetric high hypertension revealing inflammatory humeral, axillary and subclavian arteritis related to TA, successfully treated by steroid and immunosuppressive therapy(MethotrexateR).ConclusionTA and sarcoidosis may be related, rising the hypothesis that TA or Takayasu arteritis-like granulomatous vasculitis may be, in fact, a complication of sarcoidosis.
Context:Autoimmune pancreatitis is a particular type of pancreatitis of presumed autoimmune etiology, it is an entity distinct from all others forms of chronic pancreatitis, characterized by clinical, histopathological, radiographic, serologic and therapeutic features. This benign disease resembles pancreatic carcinoma both clinically and radiographically.Case Report:A 27-year-old man presented with obstructive jaundice and evocative image of pancreatic tumor. A pancreaticoduodenectomy (Whipple operation) was performed and pathological examination of the specimen diagnosed AIP. Patient responded well to a course of corticosteroids with resolution of clinical and biological disorders.Conclusion:Accurate and timely diagnosis of autoimmune pancreatitis is particularly important because steroid therapy is effective and pancreatic resection is not necessary.
A 17-year-old female presented to our hospital with fatigue, arthralgia and fever associated with non-granulomatous anterior uveitis in the left eye. Blood tests revealed renal failure and a renal biopsy showed acute tubulointerstitial nephritis. Findings were consistent with tubulointerstitial nephritis and uveitis (TINU) syndrome. The patient received systemic corticosteroids for 2 months as well as dexamethasone and mydriatic drops. Bilateral non-granulomatous anterior uveitis occurred 10 days after prednisone discontinuation, and was treated with topical steroids; however, uveitis recurred several weeks later. Bilateral anterior chamber inflammation was associated with neuroretinitis in the right eye. Extensive posterior synechiae precluded fundus examination of the left eye. The posterior segment manifestations responded to systemic prednisone, which was slowly tapered. The final visual outcome was favorable. TINU syndrome may rarely manifest with neuroretinitis.
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