Papular Cutaneous Amyloidosis Associated with Multiple Myeloma
Al-Raddadi Reem,
Abbaspour Valiollah,
Ndiaye Maodo
Issue:
Volume 5, Issue 2, March 2016
Pages:
16-19
Received:
23 January 2016
Accepted:
24 February 2016
Published:
4 March 2016
Abstract: We report a case of papular cutaneous amyloidosis associated with multiple myeloma in a 52 years old man who presented papular xanthoma like lesions in periorbital areas and scrotum with severe bone pain in thoracic and lumbar spinal column and lower limbs. Cutaneous histopathology revealed the presence of amorphous deposits in papillary dermis surrounded with small lymphoid infiltrates with erythrocyte containing slots. Congo red staining was positive and bone marrow aspiration showed dysplastic plasma cells. Lytic lesions were observed in long bones and skull radiography. 24 hours Proteinuria was 3.69 g / l. A combination of Melphalan and prednisone as treatment could restore renal function without any change in skin lesions after 14 months.
Abstract: We report a case of papular cutaneous amyloidosis associated with multiple myeloma in a 52 years old man who presented papular xanthoma like lesions in periorbital areas and scrotum with severe bone pain in thoracic and lumbar spinal column and lower limbs. Cutaneous histopathology revealed the presence of amorphous deposits in papillary dermis sur...
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Palindromic Rheumatoid Arthritis-An Unorthodox Presentation of Whipple’s Disease
Stephanie Santucci,
Ernest Ellul,
Noel Gatt,
Jonathan Cutajar,
Leigh Joseph Calleja
Issue:
Volume 5, Issue 2, March 2016
Pages:
20-23
Received:
28 February 2016
Accepted:
6 March 2016
Published:
21 March 2016
Abstract: Whipple's disease is a rare infection of the gastrointestinal tract caused by the actinomycete Tropheryma whippelii. It most commonly presents with arthralgia, abdominal pain, diarrhoea and weight loss. Invasion of the bacterium through the gastrointestinal mucosa leads to small intestinal villus blunting and malabsorption. Diagnosis is made by histological examination of small bowel biopsies. We report the case of a 78 year old gentleman who had a two year history of fleeting joint pain and multiple hospital admissions for varying symptoms. He was treated with antibiotics for a chest infection with improvement only to present again after 1 year with anorexia, fatigue, blackish loose stools and epigastric pain. Microscopic examination of duodenal biopsies showed a stunted villous architecture and expansion of the lamina propria by foamy macrophages. These expressed CD68 and cytoplasmic contents were strongly PAS positive, consistent with a diagnosis of Whipple’s disease. He was started on intravenous ceftriaxone and a prolonged course of oral co-trimoxazole (at least 1 year) with marked clinical improvement. In retrospect, the previous year’s admissions might have also been due to Whipple’s disease but since he did not have the full course of the appropriate treatment he relapsed. Whipple's disease is a difficult diagnosis to make because of the variety of clinical symptoms and the long time span between the initial unspecific symptoms (the prodromal stage) and the full-blown clinical picture of the illness (the steady-state stage). It may be misdiagnosed with a non-infectious rheumatic illness and may be fatal if untreated.
Abstract: Whipple's disease is a rare infection of the gastrointestinal tract caused by the actinomycete Tropheryma whippelii. It most commonly presents with arthralgia, abdominal pain, diarrhoea and weight loss. Invasion of the bacterium through the gastrointestinal mucosa leads to small intestinal villus blunting and malabsorption. Diagnosis is made by his...
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Cholesterol and Triglyceride Levels in Patients with Homozygous Sickle Cell Disease at Campus Teaching Hospital of Lomé (Togo)
Padaro Essohana,
Kueviakoe Irenee Messanh Delagnon,
Feteke Lochina,
Magnang Hezouwe,
Mawussi Koffi,
Layibo Yao,
Dovi Eteh Isac,
Segbena Akuete Yvon
Issue:
Volume 5, Issue 2, March 2016
Pages:
24-28
Received:
5 March 2016
Accepted:
11 March 2016
Published:
24 March 2016
Abstract: Determine cholesterol and triglyceride levels in patients with homozygous SS sickle cell during intercritical stage and study the influence of vaso-occlusive crisis on their rates. It was a case - control study during 6 month: one group of 70 homozygous SS sickle cell and a second group of 70 apparently healthy controls with normal hemoglobin AA. The average age of patients with sickle cell is 16, 22 ± 10.44 years (range 1 year and 40 years) against 28, 91 ± 15, 81 years (range 2 years and 66 years) for the controls. There was a male predominance in sickle cell disease (sex ratio = 1.41) while it was 0.94 for the controls. In the group of patients, about cholesterol, 47 (67.14%) had a low rate, 20 (28.57%) normal rate and 3 (4.29%) a high rate. For control, 24 (34.29%) had a low rate, 25 (35.71%) had at normal rate and 21 (30%) high rate. For HDL cholesterol, among sickle cell, 51 (72.86%) had a low rate, 16 (22.86%) a normal rate and 3 (4.28%) a high rate against respectively 43 (61.43%), 22 (31.43%) and 5 (7.14%) for controls. The calculation of the value of LDL cholesterol showed that for sickle cell disease, 68 (97.14%) had a low rate, 2 (2.86%) against a high rate respectively 49 (70%) and 21 (30%) for witnesses. Triglycerides dosing showed that among the sickle, 5 (7.14%) had a low rate, 56 (80%) normal rate and 9 (12, 86%) a high against respectively 5 (7.14%), 57 (81.42%) and 8 (11.42%) for controls. Analytically, total cholesterol and its derivatives was significantly lower in patients compared to controls. But the difference is not significant at triglycerides level between the two groups. During the study period, 19 patients with sickle cell disease (29.14%) had at least one pain crisis. The comparison of the value of different lipid fractions shows that there is no significant difference whether patients had or not crisis during the study period. There was a significant decrease in total cholesterol and its fractions (HDL and LDL) in homozygous SS sickle cell. The vaso-occlusive crisis does not affect these lipid parameters. We recommend to complete this preliminary study by a realization on a larger scale, by identifying lipid peroxidation markers of oxidative stress.
Abstract: Determine cholesterol and triglyceride levels in patients with homozygous SS sickle cell during intercritical stage and study the influence of vaso-occlusive crisis on their rates. It was a case - control study during 6 month: one group of 70 homozygous SS sickle cell and a second group of 70 apparently healthy controls with normal hemoglobin AA. T...
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