Osteoid osteoma of the olecranon

We report a case of osteoid osteoma of the olecranon which developed in the greater sigmoid cavity. The patient was a 22-year-old male who complained of arthritic-like symptoms limited to the elbow joint and progressing for three years. Rheumatoid arthritis then tuberculosis were entertained as possible diagnoses. The diagnosis of osteoid osteoma was not established until the disease had progressed for three years and had already become stiff due to epiphyseal remodeling. Resection of the nidus only alleviate pain and joint motion was not improved.     

Palmar-plantar fasciitis and multiple myeloma

Palmar fasciitis and arthritis was reported in association with several neoplasms and in particular with the cancers of the ovary. We report the case of a 37 year old patient who was hospitalized in our service for investigation of sever palmar fasciitis and to whom various investigations allowed to make the diagnosis of a light chains myeloma. Through the study of the various cases of the literature, we remind the various characteristics of this syndrome.     

Sweet's syndrome associated with ovarian carcinoma

Sweet's syndrome is sometimes associated with haematological malignancies and less frequently with solid tumors. We report a new case of association of a Sweet's syndrome with an ovarian carcinoma.     

Cerebellar liponeurocytoma. Case report

The cerebellar liponeurocytoma is a rarely and recently described tumour. It may be distinguished on the basis of neuroimaging findings that demonstrate the areas of fat density. Complete surgical removal with postoperative radiation therapy is recommended. It has a relatively more favourable prognosis. We report the case of a 38-year-old woman without particular pathological antecedent with a few months history of headache and dizziness, aggravated since 2 days by signs of increased intracranial pressure and cerebellar dysfunction. The Computerized Tomography practiced in emergency showed a subtentorial space occupying mass, heterogeneous, exhibiting the attenuation values of fatty tissue, with hydrocephalus upstream. The patient has been operated. The histopathological and immunohistochemical studies concluded to a cerebellar liponeurocytoma.     

Radiation-induced intracerebral cavernous angioma

Recently, there have been several case reports of cavernous angiomas appearing after radiation to the brain, typically in children. The time interval between irradiation and the detection of the cavernous angioma varied from three to nine years and the doses from 24 to 60 grays. We report the appearance of a cavernous malformation in a young girl 3 years after radiation therapy for a brain tumor.     

Genetical,clinical, and functional analysis of a large international cohort of patients with autosomal recessive congenital ichthyosis due to mutations in NIPAL4

Autosomal recessive congenital ichthyosis (ARCI) belongs to a heterogeneous group of disorders of keratinization. To date, 10 genes have been identified to be causative for ARCI. NIPAL4 (Nipa‐Like Domain‐Containing 4) is the second most commonly mutated gene in ARCI. In this study, we present a large cohort of 101 families affected with ARCI carrying mutations in NIPAL4. We identified 16 novel mutations and increase the total number of pathogenic mutations in NIPAL4 to 34. Ultrastructural analysis of biopsies from six patients showed morphological abnormalities consistent with an ARCI EM type III. One patient with a homozygous splice site mutation, which leads to a loss of NIPAL4 mRNA, showed additional ultrastructural aberrations together with a more severe clinical phenotype. Our study gives insights into the frequency of mutations, a potential hot spot for mutations, and genotype–phenotype correlations.     

Prevalence and causal factors of anemia in children in Tunisia

Anemia continue to be prevalent among children under five years despite the improvement of socioeconomic and sanitary indicators. The purpose of the present cross-sectorial study is to assess the etiologic factors responsible for anemia. Knowledge of the relative importance of the different causes should form a basis for intervention strategies to prevent and control anemia. The survey covered 955 children under the age of five years, native of two regions with the highest prevalent of anemia, the Southwest and the District of Tunis. The results showed that 29% of children suffered from anemia. About 70% of them were iron deficient. The fractions of the deficiency in vitamin B12 and in folates were insignificant. Only 3% of children had chronic inflammation associated with (and possibly responsible for) their anemia A little fraction of anemia (approximately 5%) was due to thalassemia or drepanocytosis. Picawasan important causal factor of iron deficiency anemia. The parasites identified instool could not cause anemia.     

Aichi Virus IgG Seroprevalence in Tunisia Parallels Genomic Detection and Clinical Presentation in Children with Gastroenteritis

Aichi virus has been described as a novel causative agent of gastroenteritis in humans. In this study, we report the seroprevalence distribution of Aichi virus in Tunisia. A panel of 1,000 sera was screened by applying an enzyme-linked immunosorbent assay for immunoglobulin G specific for Aichi virus. A considerable prevalence (92%) of antibody to Aichi virus was found across all age groups. The specific anti-Aichi virus antibodies increased with age, from a high rate (68.8%) in children under 10 years old to about 100% in persons more than 60 years old. We found a statistically significant increase in levels of antibody to Aichi virus according to the age of patients. Immunoglobulin M antibodies were detected among five children. A high frequency of Aichi virus monoinfections in hospitalized children with severe gastroenteritis was previously observed in Tunisia. Aichi virus causes diarrhea with dehydration, fever, and vomiting. This work is the first to establish a correlation between the high seroprevalence of specific Aichi virus antibodies, clinical presentation, and a high frequency of isolation of Aichi virus by genomic characterization in stools of children suffering from gastroenteritis. Our data show the importance and emerging character of Aichi virus in the viral etiology of pediatric gastroenteritis.Viral gastroenteritis is a common illness that affects humans worldwide. Rotavirus, calicivirus, adenovirus, and astrovirus have been established as the most important etiologic agents in these clinical diseases (4). Nevertheless, for many nonbacterial gastroenteritis cases, no etiological agent is diagnosed, and it has been hypothesized that other, viral agents are involved. Among these, Aichi virus (AiV) was first recognized in 1989 as the likely cause of oyster-associated gastroenteritis in a Japanese patient (15). This virus is a new member of the family Picornaviridae and is classified in a new genus, Kobuvirus (9, 15). The detection of AiV in stool samples collected from nonbacterial-gastroenteritis outbreaks due to oyster consumption was documented in Asia (14, 16, 19) and in Europe (1, 7). Moreover, this virus was recently identified in oysters implicated in a gastroenteritis outbreak in France (6). The detection of AiV strains has also been reported in fecal specimens from children suffering from gastrointestinal symptoms in several studies in Asian countries (8, 17, 20), in Brazil (7), and in France (1). However, a low incidence (0.9 to 3.1%) of AiV strains was observed in all these surveys in sporadic, as well as epidemic, gastroenteritis. On the other hand, several seroprevalence studies of antibodies to AiV have been conducted in Japan (16), Germany (7), and France (5) showing a high level of seroprevalence (80 to 95%) in adults, which supports widespread exposure to AiV, at least during childhood, and proves that the virus is quite prevalent.In Tunisia, we previously reported the epidemiology and genomic characterization of AiV strains circulating in the pediatric Tunisian population over more than 4 years (12). In this previous prospective survey, contrary to the data in the literature, we showed that AiV was the third most frequently detected agent, after rotavirus and norovirus, in children with sporadic gastroenteritis symptoms. In addition, we observed a high incidence of monoinfections and a relatively high frequency of hospitalizations due to AiV infections, indicating the role of AiV as a causative agent of pediatric diarrhea in our country. Moreover, we previously analyzed sewage and shellfish samples for the presence of AiV from January 2003 to April 2007 (unpublished data), and we performed a comparative analysis of environmental AiV strains with those from clinical cases detected in the same period. AiV was the second most frequent pathogen in sewage, after rotavirus, and a correlation between environmental and human strains was observed. These previous data suggest that AiV plays an important role in pediatric gastroenteritis and environmental contamination in Tunisia.Pursuing our research on AiV epidemiology, in this paper, we report the first seroepidemiological survey of antibodies to AiV in the Tunisian population. One thousand randomly chosen sera from Tunisian individuals were analyzed by an enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G (IgG) specific to AiV. We performed a statistical analysis of IgG antibody levels according to age, and we also looked for AiV-specific immunoglobulin M (IgM) antibodies. We combined the serologic results with clinical and virological data in order to better understand the epidemiology and the role of AiV as a pathogenic agent implicated in gastroenteritis.     

Molecular epidemiology of human astrovirus and adenovirus serotypes 40/41 strains related to acute diarrhea in Tunisian children

Human astrovirus (AstV) and adenovirus types 40 and 41 (AdV 40/41) are responsible for epidemic and endemic acute gastroenteritis in children and adults. The present study was designed to evaluate the prevalence and genetic diversity of enteric viruses in children in Tunisia. A total of 788 fecal samples were collected during a 4‐year period in the region of Monastir, from children under 12 years old, hospitalized or presenting in dispensaries with symptoms of acute gastroenteritis. AstV and AdV40/41 were detected by immunoenzymatic methods and confirmed by PCR/RT‐PCR and sequence analysis. Phylogenetic analyses were performed for nucleotide homology with reference strains. AstV and AdV40/41 were characterized as a causative agent in 28 (3.6%) and 18 (2.3%) of the fecal samples, respectively. Phylogenetic analysis showed that the AstVs belonged to the serotypes 3 (n = 4; 14.3%) and 1 (n = 24; 85.7%), and the enteric AdVs to the serotypes 40 (n = 1; 5.6%) and 41 (n = 17; 94.4%). This is the first report that describes the molecular epidemiology of AstV and AdV40/41 in Tunisian children. Their respective detection rate was very low, far below that of rotavirus and norovirus. The genetic diversity among these two viruses is relatively limited and varies depending on the area. J. Med. Virol. 81:1895–1902, 2009. © 2009 Wiley‐Liss, Inc.