Evaluation of anticoagulant therapy management in a teaching hospital in Tunisia: information and education for vitamin k antagonist newly treated patients need to be improved.

Objective: The objective of this study was to assess the level of Vitamin K antagonist (VKA) therapy knowledge among VKA newly treated patients.

Methods: Questionnaire-based interviews were administered in a university hospital to VKA newly treated patients covering both cognitive (i.e.

Gelatinous Transformation of Bone Marrow in a Patient with Anorexia Nervosa: An Uncommon but Reversible Etiology.

BACKGROUND Anorexia nervosa is a relatively frequently encountered eating disorder. Beyond its psychiatric significance, it is associated with multiple hematological features such as cytopenia. It can be related to gelatinous transformation of the bone marrow.

Three scenarios of nasal obstruction revealing sarcoidosis.

The nasal location of sarcoidosis is rare. In this regard, we report three observations of sarcoidosis observed in three women with an average age of 53.6 years, revealed by annoying nasal manifestations.

Efficacy and Safety of Rituximab in the Management of Pediatric Systemic Lupus Erythematosus: A Systematic Review.

Objectives: To evaluate the efficacy and safety of rituximab for treating pediatric systemic lupus erythematosus (pSLE).

Study Design: We performed a systematic review to evaluate the efficacy and safety of rituximab in children with pSLE. Data from studies performed before July 2016 were collected from MEDLINE, the Cochrane Library, Scopus, and the International Rheumatic Disease Abstracts, with no language restrictions.

[Characteristics of deep vein thrombosis in the elderly].

Purpose Of The Study: Deep vein thrombosis is a common condition in geriatric. The identification of risk factors for venous thrombosis in the elderly is important because it allows an appropriate prescription of preventive treatments. The purpose of this study is to identify the etiologic and therapeutic characteristics of deep vein thrombosis of the lower limbs in the elderly.

[Syndrome d'activation macrophagique: une série de 11 cas tunisiens].

Background: Hemophagocytic syndromes are mostly associated with underlying pathology, they can reveal: immunodeficiency, infections, hemopathies, cancers and auto-immune diseases.

Aim: to investigate clinical, biological features, outcome characteristics and underlying pathology of Tunisian patients with hemophagocytic syndromes.

Methods: A retrospective study of patients with hemophagocytic syndromes admitted in an internal medicine department in Tunis over the period 2009-2012.

Deep vein thrombosis and tuberculosis: a causative link?

Pulmonary tuberculosis is very devastating in developing countries and its thrombogenic potential is a disturbing new entity. We report an 18-year-old woman who presented with a first episode of deep vein thrombosis. Pulmonary, hepatic and splenic tuberculosis was diagnosed while looking for secondary causes.

Liver involvement in tuberous sclerosis.

Tuberous sclerosis complex (TSC) is a rare inherited disease that affects many organs and tissues, which explains the diversity of its clinical manifestations. This disease is often diagnosed at an early age when cutaneous angiofibromas, epilepsy and mental retardation are associated. The hepatic involvement in this phakomatosis is an uncommon location.

Orbital metastasis as the inaugural presentation of occult rectal cancer.

Orbital metastasis is uncommon and occurs in 2-3% of patients with cancer. It is rarely the initial manifestation of a systemic malignancy. It usually indicates extensive haematogenous dissemination of a primary cancer and is associated with poor prognosis.

Phalangeal lytic lesion: do not forget osseous sarcoidosis.

Sarcoidosis is a systemic granulomatous disease that most commonly involves the lung and thoracic lymph nodes. However, any organ can be affected. Osseous sarcoidosis has been reported in 3-13% of the cases.

Polymorphisms of Toll-like receptor-4 and CD14 in systemic lupus erythematosus and rheumatoid arthritis.

Background: Toll-like receptor 4 (TLR4) and its co-receptor CD14 play a major role in innate immunity by recognizing PAMPs and signal the activation of adaptive responses. These receptors can recognize endogenous ligands mainly auto-antigens. In addition, TLR4 (Asp299Gly) and CD14 (C/T -159) polymorphisms (SNPs) may modify qualitatively and/or quantitatively their expression.

Isolated caecal tuberculosis mimicking a neoplastic tumour in an immunocompetent woman.

Although tuberculosis is endemic in Tunisia, only a few cases of intestinal disease have been reported. This entity is usually associated with pulmonary tuberculosis. Any part of the gastrointestinal tract may be affected but usually with ileocaecal involvement.

Hypokalemic rhabdomyolysis: an unusual presentation of Sjogren's syndrome.

Hypokalaemic rhabdomyolysis represents a medical emergency requiring rapid diagnosis and appropriate aetiological treatment. Renal tubular acidosis is a common cause of hypokalemia which can be idiopathic or secondary to systemic disorders such as Sjogren's syndrome. It can remain asymptomatic or manifest with metabolic abnormalities including hypokalemia paralysis, hypocalcaemia and hyperchloremic metabolic acidosis.

Osteomalacia as inaugural manifestation of Sjögren syndrome.

Osteomalacia is a relatively common condition, which is frequently underdiagnosed due to lack of clinical suspicion and non-specific symptoms. Osteomalacia can complicate tubulo-interstital nephritis. However, it occurs exceptionally as the first manifestation of Sjögren syndrome with renal involvement.

Sternal tuberculosis in an immunocompetent adult.

Skeletal tuberculosis accounts for 1-3% of patients with mycobacterial infection. Any bone can be a site for tuberculosis, but sternum involvement is quite rare. We report the case of a 37-year-old woman admitted because of chest pain and increased swelling over the anterior chest.

Haemophagocytic syndrome with disseminated intravascular coagulation associated with tuberculosis.

Haemophagocytic syndrome (HPS) is a clinical entity that combines non-specific clinical and biological features. The diagnosis is usually confirmed by a bone marrow examination. HPS may be primary or secondary to a malignancy or to an infectious or autoimmune disease.

[A leukemoid leucocytosis].

Leukemoid reaction is a rare paraneoplastic syndrome. It can occur in association with carcinomas, in particular of the lung, gastric and renal. However, its association with sarcoma is infrequent.