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Biomedical subjects

L Rokbani

Publications and source records attributed to L Rokbani.

At least 19 recordsLinked to original sources

[Pituitary and ovarian mass syndrome in primary hypothyroidism].

INTRODUCTION: Hyperprolactinemia and a pituitary mass syndrome can occur in patient with primary hypoyhroidism. In young women, hypothyroidism can be associated with ovarian cysts. EXEGESIS: We report a case of a 30 year-old women who was treated for an anemia. She had clinical and biological signs of primary hypothyroidism with hyperprolactinemia at the biology. Pituitary MRI showed a pituitary mass. The pelvic ultrasound examination and CT scan showed a right ovarian cyst. The subsequent thyroid hormone replacement was associated with a clinical, a biological and radiological resolution. It was a pituitary and ovarian mass syndrome secondary to primary hypothyroidism. CONCLUSION: The recognition of these associations may eliminate unnecessary surgery and lead to the choice of hormone replacement therapy.

Adult↗

[Estrogen use in systemic lupus erythematosus].

The role of exogenous estrogen in the initiation and maintenance of human systemic lupus erythematosus (SLE) remains very controversial. To review the current literature of the safety of using exogenous estrogens in patients with SLE, a Medline search for articles published between 1970 et 2004 regarding this relationship was performed. Although cohort studies suggest an increase in the incidence of SLE with both oral contraceptives and hormone replacement therapy, recent retrospective studies suggest that the risk of flares is not increased with hormone replacement therapy. Large prospective double blind placebo controlled studies inclusive of all ethnic groups such as the Safety of Estrogen in Lupus Erythematosus National Assessment (SELENA) trial had to provide the basis for definitive recommendations but it had been interrupted after WHI study results.

Contraceptives, Oral, Hormonal↗

[Bilateral retinal vascular occlusion during antiphospholipid antibody syndrome: a case report].

PURPOSE: Antiphospholipid syndrome is defined by the association of at least one clinical event (arterial and/or venous thrombosis, fetal loss) and antiphospholipid antibodies. It can be isolated or associated with systemic lupus disease. The purpose of this case report is to demonstrate that an ocular vascular event can reveal the disease and that its diagnosis is important because this disease generally affects young people and may endanger ocular and vital prognosis. OBSERVATION: We report the case of a 20-year-old female treated for systemic lupus erythematosus for 2 years, who stopped her medical treatment and presented a sudden bilateral loss of vision. Fundus examination and fluorescein angiography revealed severe bilateral retinal vascular occlusion. Antiphospholipid antibody syndrome was confirmed with the presence of anticardiolipin antibodies. With medical treatment, there was initially a small functional improvement and then a general degradation in 3 months, followed by the death of the patient secondary to severe pulmonary emboli. DISCUSSION AND CONCLUSION: Central retinal artery or vein occlusion in a young patient must suggest the diagnosis of antiphospholipid antibody syndrome. The bilateralism of vascular occlusion is considered a severe factor because of its consequence on functional ocular and vital prognosis, where it can sound the alarm to the extension of thrombotic events to other vessels in the body. Antiphospholipid syndrome must be studied in cases of severe retinal vascular occlusion in young patients. Its diagnosis is important because the risk of recurrent thrombotic events may endanger functional and vital prognosis.

Adult↗

[Systemic manifestations of chronic hepatitis C].

It's well known that hepatitis C virus (HCV) related chronic liver disease may be associated with various extra hepatic disorders. These manifestations can revealed the hepatic disease. We review the available data on the conditions and asses their clinical implications: vascular, cutaneous, articular, neurological or renal disorders. There is no correlation between these extra hepatic manifestations and the severity of liver disease. Several recent studies have established a strong link between HCV infection and essential mixed cryoglobulinemia but some other extra hepatic associations are just fortuitous. Others datas are necessary to better analyze these extra hepatic disorders and to offer the beneficial treatment of patients with chronic hepatitis C.

Cryoglobulinemia↗

[Value of magnetic resonance imaging in neuro-lupus: report of 10 cases].

This study shows the contribution of MRI to diagnosis and follow up of the cerebral lesions in neuro-lupus. Ten cases of neuro-lupus have been reported. The affected patients are 7 women and 3 men having an average age of 34 years. For 8 patients, MRI revealed lesions that were not detected using computed tomography. These lesions were high signal zones on T2, scattered with predilection to deep and sub-cortical cerebral white matter. MRI has also shown cortical and sub-cortical cerebral atrophy for 3 cases, cortical and deep infarcts for 2 cases and both atrophy and infarcts in one case. The MRI diagnosis was normal for the two remaining patients. MRI contributes to the diagnosis confirmation and localization of the cerebral lesions and to the follow-up. In spite of MRI sensitivity, the detection of these lesions remains non specific to neuro-lupus. New methods of exploration as the spectroscopy by magnetic resonance and the cerebral scintigraphy with Technetium 99m could be very helpful in diagnosis of cases for which MRI has shown limitations.

Adolescent↗

[Diagnostic imaging in neuro-Behçet's disease. Report of 5 cases].

The authors report five patients with neuro-Behçet's disease. Computed tomography showed low-density lesions with or without mass effect and contrast enhancement. Magnetic resonance imaging revealed scattered areas of high signal intensity on T2-weighted images, and iso or low signal intensity on T1-weighted images with enhancement after gadolinium injection. These lesions affected all the central nervous system structures with predilection to the brain stem, basal brain ganglia, internal capsula, subcortical and deep cerebral white matter. By its availability, computed tomography remains a precious tool for diagnosis and assessment of severity of neurological involvement. Brain magnetic resonance imaging reveals silent lesions on CT, specifies their exact topography, identifies lesional association reminiscent of neuro-Behçet and contributes to the differential diagnosis with multiple sclerosis. CT and MRI permit the follow-up of lesions under treatment and evaluate prognosis.

Adult↗

[Pseudotumor extramedullary hematopoiesis. Report of 3 cases and review of the literature].

We report 3 cases of extramedullary hematopoiesis with a sacrococcygeal, right obturatory hole and paravertebral dorso lumbar locations respectively in 30, 34 and 58 years old patients (two males and woman). A medullary tuberculosis was discovered in one case, a beta thalassemia in the second, and the third was classified as idiopathic. Radiologic picture often permitted to evoke the diagnosis on the aspect of a well limited multilocular tumor especially when there is a paravertebral location as in our third patient. Fine needle punction cytologic examination can permit the diagnosis and avoid surgery, except if complications occur.

Adult↗