Effect of long-term proton pump inhibitors on phosphocalcium metabolism and bone mineral density.

Although Proton pump inhibitors (PPIs) are well-tolerated, their long-term use may be associated with decreased bone mass. This is a case-control study including patients treated with PPIs (>1 year) and control subjects who have not received PPIs treatment. A total of 90 patients and 90 matched controls were included.

Multifocal hydatidosis with extensive involvement of the sacrum and the femoral head.

Key Clinical Message: Hydatidosis is a parasitic infection caused by the larval form of "Echinococcus granulosis." Bone localization is rare even in endemic areas. We report an unusual case of an extensive hydatidosis of the right sacrum and femur with muscle involvement.

Biclonal Gammopathies in South Tunisia: Clinical and Biological Characteristics.

Objective: Biclonal gammopathies (BGs) are rare situations characterized by the production of 2 monoclonal proteins. There are no available data on BGs in North Africa. We aimed to estimate the prevalence of BGs in our population and describe their clinical and laboratory features.

Neuropathic arthropathy of the wrist revealing a syringomyelia.

Syringomyelia is uncommonly revealed by a neuropathic arthropathy (Charcot joint) and characterised by its slow progression with late neurological symptoms. In this particular field, neuropathic arthropathies mainly affect the shoulders and the elbows.We report a new case of neuropathic arthropathy of the wrist caused by syringomyelia, because of the rarity of this condition as well as its uncommon location.

Spinal Paget's disease with bilevel cord compression and ischemic non-compressive myelopathy treated with zoledronic acid.

Cord compression and ischemic non-compressive myelopathy are a complication of spinal Paget's disease (SPD). SPD usually touches a single spine level. We report an unusual case with bilevel spinal cord compression and dysfunction which was medically treated due to resolution of the vascular steal syndrome.

Giant retrocrural plasmacytoma as a relapse of multiple myeloma.

The aim of our clinical image is to report an unusual retrocrural plasmacytoma relapsing a multiple myeloma.

Bilateral septic arthritis of the sternoclavicular joint complicating infective endocarditis: a case report.

Background: Septic arthritis is an infectious disease that commonly affects weight-bearing or proximal joints such as the knee and the hip. The sternoclavicular joint is an unusual site of this entity. It usually occurs in patients with diabetes mellitus, intravenous drug abusers, or those with rheumatoid arthritis.

Association of hyperhomocysteinemia with genetic variants in key enzymes of homocysteine metabolism and methotrexate toxicity in rheumatoid arthritis patients.

Objectives: The study investigated the association between plasma homocysteine, folate and vitamin B12 with 5,10 methylenetetrahydrofolate reductase (MTHFR C677T and A1298C), thymidylate synthase (TYMS 2R → 3R) and methionine synthase (MTR A2756G) polymorphisms and methotrexate (MTX) treatment and toxicity in Tunisian Rheumatoid arthritis (RA) patients.

Methods: A total of 185 patients with RA were included. Homocysteine (Hcy) was assessed by fluorescence polarization immunoassay, and folate and vitamin B12 were measured by chemiluminescence immunoassays.

[Solitary bone plasmacytoma: about 3 cases and review of the literature].

Solitary plasmocytomas are rare, accounting for less than 5% of all plasmocytes proliferations. Its diagnosis is based on the presence of localized tumor of monoclonal plasma cells cytologically identical to those of multiple myeloma, in the absence of other signs of a disseminated form. This study aims to carry out a retrospective study of three cases of solitary bone plasmocytomas associated with a detailed review of the literature describing the diagnostic, therapeutic and evolving characteristics of this rare entity.

Genetic Determinants of Methotrexate Toxicity in Tunisian Patients with Rheumatoid Arthritis: A Study of Polymorphisms Involved in the MTX Metabolic Pathway.

Background And Objective: Methotrexate (MTX) is a disease-modifying anti-rheumatic drug used in the treatment of rheumatoid arthritis (RA). It is the first line drug in the treatment of this disease. However, MTX-related adverse drug reactions (ADRs) are seen in 40 % of the patients.

Cerebral rheumatoid vasculitis: a case report.

Introduction: Central nervous system involvement in rheumatoid arthritis is infrequent. The most frequent neurological manifestations of rheumatoid arthritis are peripheral neuropathy and cervical spinal cord compression due to subluxation of the cervical vertebrae. Cerebral rheumatoid vasculitis is an uncommon and serious complication which can be life-threatening.

Hypertrophy of the feet and ankles presenting in primary hypertrophic osteoarthropathy or pachydermoperiostosis: a case report.

Introduction: Pachydermoperiostosis or primary hypertrophic osteoathropathy is a rare genetic disease with autosomal transmission. This disorder, which affects both bones and skin, is characterized by the association of dermatologic changes (pachydermia or thickening of the skin) and rheumatologic manifestations (periostosis and finger clubbing). Here, we report a new observation of pachydermoperiostosis.