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N Hajjaj-Hassouni

Publications and source records attributed to N Hajjaj-Hassouni.

At least 19 recordsLinked to original sources
PubMed2006

[Complete auriculoventricular block during chloroquine treatment].

INTRODUCTION: The cardiac toxicity of antimalarial agents is rare, it includes conduction disorders which can be complicated by third atrioventricular block and hypertrophic cardiomyopathy. We report two observations of patients who presented a complete heart block after several years of treatment by chloroquine. CASE REPORT: Two patients followed for rheumatoid polyarthritis, treated by antimalarial agents for average 12 years and corticotherapy, presented a syncopal complete heart block which required an implantation of a pace maker. After having eliminated all the other underlying causes for complete heart block, the antimalarial agents were accused and were stopped. The clinical evolution after interruption of the treatment was favorable. CONCLUSION: Our observations illustrate rare cardiac side effects observed in our two patients after long-term treatment by antimalarial agents. The diagnosis of antimalarial agents responsibility was retained on clinical and biological arguments after having eliminated the other causes. The insidious character of these complications imposes vigilance during the use of long-term treatment by antimalarial agents.

Adult↗
PubMed2006

An extensive vertebral hydatidosis revealed by a lumbosciatica.

The vertebral hydatidosis is uncommon. It causes problems in diagnosis and in management. A case of an extensive vertebral hydatidosis with few symptoms is reported. A 21-year-old man has consulted for recurrent lumbosciatica that has been evolving for 1 year. Clinical exam was normal. Plain radiographic films disclosed a lytic lesion throughout the bodies of L4 and L5 and calcifications thrown on the liver area. The computed tomography (CT) and the magnetic resonance (MR) images revealed multicystic bony lesions involving the lumbar spine with extension into the spinal canal. Abdominal ultrasound showed also cyst lesions in the right kidney and in the liver. The diagnosis of vertebral and abdominal (liver and kidney) hydatidosis was retained. Four sets of 4-week albendazole cures were given with a 2-week interval in between. Our case of extended vertebral hydatidosis with few symptoms confirms the clinical latency and diagnosis difficulties usually encountered in this disease. This often leads to a late diagnosis of the stage of spinal cord compression. Radiological diagnosis and determination of extension of the hydatid cyst are usually provided by CT and MRI. Vertebral hydatidosis should be evoked in lumbosciatica especially in endemic regions.

Adult↗
PubMed2006

[Leukemia revealed by polyarthritis].

INTRODUCTION: Ostéoarticular manifestation whose reveal leukaemia in 4% of the cases, regress completely with haematological remission. EXEGESIS: We report two observations of leukaemia revealed by polyarthritis. A 22-year-old woman has presented a polyarthritis 8 months before de diagnosis of acute leukaemia. A 34 years old men, has presented one month before admission an acute polyarthritis revealing chronic myeloid leukaemia. CONCLUSION: Polyarthritis may reveal an acute or chronic leukaemia. Systematic blood analysis can make a difference in diagnosis of recent polyarthritis.

Adult↗
PubMed2005

[Bilateral uveitis in relapsing polychondritis. A case report].

We report a rare ocular manifestation of relapsing polychondritis. A 28-year-old woman presented with a 5-year history of relapsing polychondritis with chondritis of the nose, ears and tracheobronchial system. The ocular symptoms were bilateral uveitis with macular involvement and papillaedema. Ocular manifestations of relapsing polychondritis occur in 60% of patients. Uveitis is a rare symptom, sometimes severe, which can lead to blindness. This case report with a literature review sheds light on the features of this disease.

Adult↗
PubMed2005

[Value of the radiographic criteria "fingers and toes" in the early diagnosis of psoriatic arthritis].

PURPOSE: To assess the value of Fournie's radiological criteria "fingers and toes" in the early diagnosis of psoriatic arthritis. MATERIALS AND METHODS: 47 patients with psoriatic arthritis were studied retrospectively. Clinical and radiological features at the hands and fingers were assessed. Radiographic analysis was performed using Fournie's criteria. RESULTS: Of 47 patients studied, 25 patients developed hand and finger involvement. Asymmetrical joint distribution was observed in 76% of cases. Distal interphalangeal arthritis was noted in 60% of cases. Nail lesions were present in 11 cases and dactylitis in 3 cases. Eight patients had erosions of the distal interphalangeal joints. Osteolysis with pencil-in-cup deformity was noted in 3 cases. Ankylosis of interphalangeal joints was found in 7 cases and acro-osteolysis in 3 cases. CONCLUSION: Psoriatic arthritis frequently affects the small joints of the hands and fingers. Asymmetrical and distal interphalangeal joint involvement are a characteristic feature of this arthropathy. Some radiological lesions are suggestive and contribute to the early diagnosis of psoriatic arthritis.

Adult↗
PubMed2004

[Cardiac manifestations of idiopathic hypereosinophilic syndrome].

BACKGROUND: The aim of our study is to describe the more common cardiac manifestations of idiopathic hypereosinophilic syndrome representing the major cause of mortality. MAIN POINTS: Current therapy consists of corticosteroid, hydroxyurea and interferon alpha. Recent publications confirm the activity of imatinib mesylate, a selective tyrosine kinase inhibitor, in patients with idiopathic hypereosinophilic syndrome. In cases with marked valvular compromise or with endomyocardial thrombosis or fibrosis, cardiac surgery can provide substantial benefits. PERSPECTIVES: A better understanding of the pathophysiology of this syndrome could lead to the development of new therapeutic agents.

Heart Diseases↗
PubMed2004

Involvement of the foot in patients with psoriatic arthritis. A review of 26 cases.

OBJECTIVE: To describe the clinical and radiological features of foot involvement in patients with psoriatic arthritis. METHODS: We retrospectively reviewed the medical records of patients admitted between 1972 and 1999 for psoriatic arthritis with involvement of the foot. We included all patients who had peripheral and/or axial, asymmetric, chronic inflammatory joint disease meeting or not Avila's radiological criteria for psoriatic arthritis, with or without other imaging findings suggestive of psoriatic arthritis and with or without psoriasis. RESULTS: Twenty-six patients were included. Inflammatory heel pain was reported by 14 patients, whereas forefoot involvement was found in only seven patients. Sausage toe was present in two patients. None of the patients had Bauer's toe (combining arthritis and psoriatic skin and/or nail changes) or psoriatic onychopachydermoperiostitis of the great toe. Radiological abnormalities were found in 20 patients. Half the patients had calcaneal changes. Osteoperiostitis of the great toe was noted in two patients and mushrooming in five. DISCUSSION: The features of psoriatic arthritis in Morocco seem similar to those in other countries. Hindfoot involvement was present in 53% of patients. Involvement of the forefoot was rarely recorded in the charts, suggesting missed cases because of insufficient attention to the forefoot during the physical examination and availability of anteroposterior radiographs only. Oblique views (Hirtz and Chaumet) should be obtained because they give a clearer image of the distal part of the toes, which is often difficult to analyze on anteroposterior films.

Adult↗
PubMed2004

Behçet's disease in Moroccan children: a report of 12 cases.

We report 12 cases of Behçet's disease (BD) in children. The mean age of symptom onset was 12.4 years. Four patients (33.3%) had a past familial history of BD. Clinical manifestations were: oral aphtosis (n = 12), genital aphtosis (n = 9), ocular involvement (n = 9), neuro-Behçet (n = 6), venous thrombosis (n = 4), articular involvement (n = 3), and entero-Behçet (n = 1). All patients but one were initially treated with steroids; three cases with ocular involvement were treated with chlorambucil; and three other cases of neuro-Behçet were treated with cyclophosphamide. After a mean follow-up of 4 years, four patients with neurological involvement developed steroid-dependence with recurrence of symptoms. Four patients had optic atrophy with blindness.

Adolescent↗
PubMed2003

Cervical spine involvement in ankylosing spondylitis.

Our objective was to study cervical spine involvement in a Moroccan population of ankylosing spondylitis (AS) patients and evaluate correlations with disease symptomatic and structural severity. Patients were prospectively enrolled for a 1-year period. Clinical, biological, and radiological data were collected. The risk of cervical spine involvement was estimated using the Kaplan-Maier method. Sixty-one patients were enrolled: 38 males (62.2%) and 23 females of mean (SD) age 35.1 years [11] (range 17-66). The mean disease duration was 10.6 years [7] (0.5-30). Forty-three patients (70.4%) had a history of neck pain. Radiological involvement was present in 33 cases (54%). The concordance between clinical and radiological involvement was statistically significant (kappa=0.49; P<10(-6)). The risk of cervical spine involvement with regard to disease duration showed that 19.6% of patients had radiological involvement after 5 years, 29.9% after 10 years, 45.1% after 15 years and 70.0% after 20 years. Comparison between patients with and without cervical spine radiological involvement showed no difference in age of onset or sex. There was statistical difference in symptomatic severity parameters (Schöber, chest expansion, BASMI, BASFI, BASDI, BASG) and structural severity parameters (lumbar syndesmophytes score, BASRI). Our study confirms the greater severity of AS in North African countries. Cervical spine involvement increases with age and disease duration in AS and is more frequent in symptomatic and structural severe forms of the disease.

Adolescent↗
PubMed2002

[Polyostotic fibrous dyplasia: a case report of a diffuse form with hemimelic predominance].

Fibrous dysplasia is an uncommon condition characterized by the presence of mesenchymatous tissue in bone. There are various risks. We describe the clinical and radiological features observed in a patient with fibrous polyostotic fibrous dysplasia and discuss risks. A 37-year-old man suffered from bone pain and multiple fractures without endocrine disorder since the age of 10 years. At admission in 1998, he presented limb deformities and hyperchromic spots on the thorax. Calciuria was low and alkaline phosphatase was 1274 IU/ml. Endocrine tests were normal. Radiographs showed polyostotic defects in the right hemibody and in the skull. They also showed a right subtrochanteric fissure. CT scan of the face and skull did not demonstrate nerve compression. Histology analysis identified fibrous dysplasia. Vitamin and calcium supplementation and preventive measures were instituted. No deformity led to surgical correction despite the early beginning. Polyostotic fibrous dysplasia is a congenital disease. Radiological aspects are variable. There is a risk of deformities, fractures, osteomalacia (as in our case), neurological compression, and finally a risk of sarcomatous transformation. Recently introduced biphosphonate therapy appears to provide effective pain relief and probably satisfactory prevention of fractures.

Adult↗
PubMed2000

Atlantoaxial tuberculosis: three cases.

Tuberculosis of the craniocervical junction (CCJ) is exceedingly rare but carries a risk of compression of the medulla oblongata and upper spinal cord. Three cases among 63 patients with spinal tuberculosis are reported. Mean age was 51 years (range, 20-69) and mean time to diagnosis was 4.6 months (range, 1-8). Although atlantoaxial dislocation was a consistent feature, none of the patients had neurological deficits. Computed tomography of the CCJ disclosed a suggestive pattern combining osteolysis and an abscess anterior to the spine. The diagnosis was confirmed by microbiological studies in two cases and histology in one. The outcome was favorable after antituberculous therapy, immobilization of the neck, and surgical fusion. Although tuberculosis remains common in developing countries, involvement of the CCJ is rare. Tuberculosis of the CCJ carries a risk of instability and severe neuraxis compression. Consequently, early diagnosis and treatment are of the utmost importance.

Adult↗
PubMed1999

Polyradiculoneuropathy revealing a solitary plasmacytoma of the ilium. A new case-report.

Neurological manifestations are uncommon in myeloma patients, and subacute polyradiculoneuropathy as the inaugural manifestations of solitary plasmacytoma of bone is exceedingly rare. We report the case of a 52-year-old man who was evaluated for a three-month history of flaccid tetraplegia with a gradually ascending onset and for a deterioration in general health. Electromyography findings were consistent with polyradiculoneuropathy. Laboratory tests showed a moderate amount of a monoclonal IgG-lambda antibody. Findings were normal from a radiographic bone survey and a radionuclide bone scan. Computed tomography of the pelvis disclosed a solitary osteolytic lesion in the right iliac crest, which was found upon biopsy to be a malignant plasmacytoma. Radiation therapy and chemotherapy were given. Subacute or chronic polyradiculoneuropathy as the inaugural manifestation of solitary plasmacytoma is exceedingly rare and should be distinguished from the sensorimotor polyneuropathy produced by plasma cell infiltration in some multiple myeloma patients. The polyradiculoneuropathy of solitary plasmacytoma can be likened to the neuropathies seen in some forms of multiple myeloma (sclerotic myeloma and POEMS syndrome). The pathophysiology of these neuropathies remains obscure. The case reported here suggests that patients with unexplained lasting polyradiculoneuropathy should be investigated for a plasma cell proliferation even if they have no serum monoclonal component. Because plasmacytomas are painless, imaging studies are needed for their diagnosis. The management of the neuropathy consists in treatment of the tumor.

Bone Neoplasms↗
PubMed1999

Rigid spine syndrome. Two case-reports.

UNLABELLED: Rigid spine syndrome is characterized by massive spinal rigidity, usually most marked in the cervical region. Stiffness of the peripheral joints is sometimes present. We report two cases. Patient 1 was a 12-year-old boy diagnosed at three years of age with Duchenne's muscular dystrophy because of delayed onset of walking. Contracture of the Achilles tendons, flexion contracture of the elbows, and loss of motion of the cervical spine were the main findings during the current evaluation. Radiographs of the affected joints were normal. An electrocardiogram showed an incomplete left bundle branch block. Muscle enzyme activities were moderately elevated. A myopathic pattern was seen on the electromyogram. A muscle biopsy showed muscle fiber atrophy with peri- and endomysial fibrosis. Patient 2 was a 39-year-old man with a five-year history of isolated rigidity of the cervical spine thought to be due to a spondylarthropathy. Extension was the only movement possible at the cervical spine. The peripheral joints showed no motion range limitation. Findings were normal from radiographs of the spine and sacroiliac joints, an erythrocyte sedimentation rate determination, an electromyogram, and muscle enzyme activity assays. A muscle biopsy showed muscle fiber atrophy with peri- and endomysial fibrosis. DISCUSSION: Rigid spine syndrome is rare in rheumatological practice and can simulate a number of other muscle and joint diseases. Peri- and endomysial fibrosis may be strongly suggestive, although nonpathognomonic. Involvement of the heart governs the prognosis.

Adult↗
PubMed1999

Erosive polyarthritis in Crohn's disease. Report of a case.

Erosive polyarthritis in Crohn's disease is rare and raises diagnostic and pathophysiological problems. A case with destructive lesions of the shoulders and hips is reported in a 43-year-old woman with a 26-year history of Crohn's disease. Ankylosis of the spine and hips, motion range limitation of the shoulders and wrists, and boutonnière deformity of the third finger of the right hand were present. Tests were negative for rheumatoid factor and the HLA-B27 antigen. Plain radiographs showed a triple rail pattern at the spine; synostosis of the hips; and destructive lesions of the shoulders, wrists, tarsal bones, and third proximal interphalangeal joint of the right hand. Glucocorticoid therapy was effective in suppressing the bowel symptom flares but only partially improved the joint symptoms, whose treatment relied mainly on nonsteroidal antiinflammatory agents and rehabilitation therapy. Erosive arthritis in Crohn's disease is frequently monoarticular, with the hip being the most common target. It can complicate a spondylarthropathy or reveal granulomatous synovitis. Polyarticular forms pose difficult diagnostic and therapeutic challenges and add to the disability caused by the bowel disease. The potential role of genetic factors remains to be studied.

Adult↗
PubMed1998

[Familial sarcoidosis: three case reports].

INTRODUCTION: Familial sarcoidosis is rare. We reviewed 147 cases of sarcoidosis, whatever their localization, diagnosed at Rabat-Salé University Hospital, during a period of 10 years (1983-1993). Among these cases, we report those of three patients with sarcoidosis, in a same family. The observations concern three generations. OBSERVATIONS: Observation 1: the grandmother presented with pulmonary sarcoidosis. Observation 2: the mother presented with sarcoidosis of the skin, joint and lung. Observation 3: the daughter had cutaneous and pulmonary localizations. DISCUSSION: The real frequency of familial sarcoidosis is probably underestimated because of the big number of latent forms. A review of the literature allowed us to find 43 families with sarcoidosis. There is no clinical difference between familial sarcoidosis and usual forms of the disease, as confirmed by our findings. The preponderance of patients of the same sex in the same family, like our mother-daughter filiation is, described by the majority of the authors. This leads to suppose the existence of genetic factors. Neither this theory nor the one suggesting the possibility for etiologic agent that could perhaps affect the same persons in the same family can be currently demonstrated. Any association with an HLA group in the familial cases of sarcoidosis is unlikely. CONCLUSION: The rarity of familial sarcoidosis forms makes very difficult to establish theories regarding the familial predisposition.

Adult↗
PubMed1998

Third-degree atrioventricular block in a patient under chloroquine therapy.

The first case of chronic cardiac toxicity due to an antimalarial agent was reported in 1971 and since then several cases of heart failure, restrictive cardiomyopathy or atrioventricular block have been ascribed to this family of drugs. We report the case of a 43-year-old woman who developed juvenile chronic arthritis at the age of ten, followed in adulthood by sero-positive rheumatoid arthritis. In 1980 she was put under chloroquine sulfate (hydroxychloroquine was not available) in a dose of 200 mg/d (152.66 mg of chloroquine), with 10 mg/day of prednisone. She developed myalgia and increased skin pigmentation, but disregarded recommendations that these symptoms required discontinuation of chloroquine therapy. She was lost to follow-up, but continued the chloroquine therapy of her own accord. In December 1993, she developed a third-degree atrioventricular block with syncopes requiring implantation of a pacemaker. The rare but well-documented myopathy induced by antimalarial agents can produce early severe lesions of the cardiac muscle, which may have a predilection for the interventricular septum, explaining the risk of atrioventricular block. Although histologic studies were not performed in our patient, the clinical evidence of toxicity, absence of underlying heart disease and fairly young age of the patient pointed to chloroquine toxicity. Periodic cardiac investigations including electrocardiography may be warranted in patients under antimalarial therapy.

Adult↗