Acute interstitial nephritis (AIN) is a relevant cause of acute renal failure. Drugs are the predominant cause, followed by infections and idiopathic lesions. AIN, as a form of hypersensitivity reaction, is an uncommon manifestation in the setting of human parasitic infections. We report a case of a polyparasitic infection ( Giardia lamblia, Entamoeba coli, and Endolimax nana) resulting in a severe biopsy-proven AIN in a 61-year-old male patient. Despite the antiparasitic treatment followed by corticosteroid therapy, and during the 6-month follow-up period, the patient remained dialysis-dependent, and he developed autoimmune hemolytic anemia. Extensive search for another infection or neoplasia was negative. Immunological tests were also negative. The resulting hypersensitivity reaction to the triple parasite infection would have led to fatal evolution for the kidneys affected by this unusual type of AIN.
Background:Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis, affecting mainly the superior airways, lungs and kidneys. Neurological impairment is frequent, described in 22 to 54% of cases, and rarely inaugurates the disease.Objectives:The objective of our work was to evaluate its prevalence and its different aspects.Methods:A retrospective study including 11 files of GPA patients followed over a period of 10 years in The Internal Medecine Department at Tahar Sfar Hospital Mahdia TUNISIA.Results:Neurological manifestations were reported in 5 patients: a pyramidal syndrome was noted in 3 patients with a normal cerebral MRI, a disabled headache was described in one patient with a normal cerebral MRI. Peripheral neuropathy in 2 cases, and the Electroneuromyogram objectified a mononeuropathy affecting the ulnar nerve, peroneal nerve, and musculocutaneous nerve in one patient and a distal sensitivomotor poly neuropathy in one patient. Cranial nerves damage was noted in two cases, one VII (1 case) and one V (1 case).Conclusion:Our study results, show the importance of timely diagnosis of these neurological manifestations, as their evolution will depend on the early GPA treatment.References:[1]doi: 10.1016/j.autrev.2017.07.007Disclosure of Interests:None declared
Background:Pulmonary artery pseudoaneurysms (PAP) is a serious complication of Behcet’s Disease (BD).Objectives:The aim of this work is to analyze, through 4 observations, the clinical, para-clinical and therapeutic aspects of PAP.Methods:Matériels et méthodes:Retrospective study including 4 cases of PAA among 150 patients who satisfied the criteria of the International Study Group on BD, followed in the Internal Medicine and Radiology Departments at Tahar Sfar Hospital Mahdia TUNISIA.Results:Résultats:Four men, with an average age of 27 years (20-34). PAPs were inaugural, and multiple (>3) in 3 cases and associated with pulmonary embolism in 2 cases. Hemoptysis was the main clinical symptom. All patients were treated with high-dose corticosteroid therapy combined with monthly boluses of cyclophosphamide in addition to colchicine. Two patients had undergone arterial embolization. Surgery was indicated for 2 patients, one of whom died after surgery as a result of massive hemoptysis. The others had a favorable outcome.Conclusion:PAP severity justifies the necessity of early diagnosis and management. The thoracic angio-CT is the imaging of choice for diagnosis. The treatment is based on a corticosteroid therapy and immunosuppressive association with possibly a selective embolization.Disclosure of Interests:None declared
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