Ambre Dethier, Sophie Gatineau-Sailliant, Claire Geurten, Marie-Françoise Dresse
{"title":"[Pediatric refractory acute immune thrombocytopenic purpura secondary to asymptomatic SARS-CoV2].","authors":"Ambre Dethier, Sophie Gatineau-Sailliant, Claire Geurten, Marie-Françoise Dresse","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute immune thrombocytopenic purpura (ITP) has been revealed as an uncommon complication of COVID-19 in children. Severe bleeding may occur but is rarely life threatening. Management is based on the severity of bleeding symptoms and the degree of thrombocytopenia. We report the case of a 7-year-old girl with severe acute ITP secondary to a COVID-19 infection -without any respiratory symptoms. The initial clinical examination showed a large bulging mediodorsal hematoma, purpuric lesions, and posterior pharyngeal hemorrhage. The patient was monitored in a pediatric intensive care unit. Initial medical management consisted of intravenous immunoglobulins and systemic steroids. Despite this treatment, bleeding and thrombocytopenia worsened, and secondary macroscopic haematuria occurred, requiring 6-hourly platelet transfusions and increased steroid doses to obtain sufficient hemostasis. This case presents a rare and severe acute pediatric ITP secondary to asymptomatic SARS-COV2 which was refractory to initial management and opens the discussion to second line therapeutic interventions.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 7-8","pages":"393-398"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claire Paquet, Maxime Jason, Denis Danthine, Frédéric Kridelka
{"title":"[Dysmenorrhea and pelvic pain secondary to an accessory and cavitated uterine mass].","authors":"Claire Paquet, Maxime Jason, Denis Danthine, Frédéric Kridelka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An accessory and cavitated uterine mass (ACUM) is a rare anomaly with an embryological origin of dysfunctionning female gubernaculum. It is an accessory mass internally lined with normal endometrium, separated from the uterine cavity and located near the insertion of the round ligament. ACUM's clinical manifestations are severe dysmenorrhea and/or chronic pelvic pain. It is a relatively unknown condition, which makes its diagnosis complicated and suggests a large differential diagnosis. We report the case of a 31-year-old female presenting with pelvic chronic pain and crippling dysmenorrhea. The initial work-up consists of a magnetic resonance imaging showing an interstitial lesion possibly corresponding to an ACUM. This supposition was then confirmed by histopathology.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 7-8","pages":"431-435"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10345265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Dysphagia lusoria treated by surgery].","authors":"Natacha Mawait, Arnaud Kerzmann, Quentin Desiron, Denis Henroteaux, Laurie Stiennon, Jean Olivier Defraigne","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Aberrant right subclavian artery, also called arteria lusoria, is the most common congenital anomaly of the aortic arch (prevalence 0,5-1.8 %). Patients with trisomy 21 have a higher prevalence (35 %). It takes its origin from the aortic arch after the three others supra-aortic trunks. It may be associated with other cardiovascular anomalies. In more than 80 % of cases, the aberrant artery is positioned behind the oesophagus. It is often asymptomatic. Sometimes it is associated with symptoms after the age of 40 years old, more often among women: dysphagia (dysphagia lusoria), dyspnoea or cough. Diagnosis is made by computed tomography or magnetic resonance imaging. When it is symptomatic, a barium contrast radiography of the oesophagus is indicated. Surgical treatment by transposition of the aberrant vessel is performed only for symptomatic patients. We report the case of a 50-year-old woman with dysphagia lusoria treated by transposition of the aberrant right subclavian artery into the right common carotid through a cervical approach.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 7-8","pages":"411-414"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10345267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Camille Debrus, Doriane Calmes, Christian Von Frenckell, Bernard Duysinx, Didier Cataldo, Jean-Louis Corhay, Renaud Louis, Julien Guiot
{"title":"[Clinically amyopathic dermatomyositis : a rare entity associated with acute and severe interstitial lung disease].","authors":"Camille Debrus, Doriane Calmes, Christian Von Frenckell, Bernard Duysinx, Didier Cataldo, Jean-Louis Corhay, Renaud Louis, Julien Guiot","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dermatomyositis is a rare disease of unknown etiology characterized by a severe inflammatory myopathy associated with a cutaneous syndrome. Dermatomyositis is associated with multisystemic disorders mostly represented by cardiac, pulmonary and articular involvements, which are particularly associated with a bad prognosis. We report a case of a 50-year-old patient suffering from dermatomyositis associated with an interstitial lung disease with a particularly fast and pejorative clinical evolution. The anti-Melanoma Differentiation-Associated gene 5 (anti-MDA5) antibodies are frequently associated with a severe and rapidly progressive lung disease without myositis named «amyopathic dermatomyositis». High blood levels of anti-MDA5 were found in our patient. Despite maximal immunosuppressive treatment and supportive care, he died 3 months after the diagnosis. Patients may present different antibodies that correspond to distinct clinical phenotypes of dermatomyositis. The anti-MDA5 is known to be a marker of clinically amyopathic dermatomyositis (CADM) associated with a rapidly progressive interstitial lung disease. Moreover, blood level of anti-MDA5 antibody predicts the response to treatment and survival in CADM.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 7-8","pages":"441-447"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10345269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Virginie Van Boeckel, Mara Arenas-Sanchez, Marc Legrand, Jean-François Maillart, Alain Postal
{"title":"[Caecum hernia of foramen of Winslow].","authors":"Virginie Van Boeckel, Mara Arenas-Sanchez, Marc Legrand, Jean-François Maillart, Alain Postal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Winslow's foramen hernia, or Blandin's hernia, is a rare internal hernia with a non-specific clinical presentation and its diagnosis may be difficult. The hernia occurs across the omental hiatus, bounded by the inferior vena cava posteriorly and the portal triad anteriorly. CT imaging provides several diagnostic clues in this condition. Prompt surgical management allows reduction before complications arise. We present a case of caecal internal herniation through Winslow's foramen in a patient who underwent gastrojejunal bypass about ten years ago. Laparoscopy with reduction of the caecal bascule and closure of the foramen is performed successfully.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 7-8","pages":"423-426"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10345270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A history of childhood obesity acts as a barrier to the recovery from mental anorexia in adolescence ?]","authors":"Charlotte Trevisani, Gaëlle Orban, Alain Malchair","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>High rates of obesity, unhealthy eating behaviors, and eating disorders among children and adolescents have a very negative impact on their physical and mental health. The role of pediatricians and general practitioners is central in terms of prevention and screening. When a referral to a specialist is necessary, it is important to consider the bidirectional relationship between eating disorders and mental health problems. A history of obesity in a patient with mental anorexia leads to the need for specific management, particularly in relation to the concept of Weight Suppression (WS).</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 7-8","pages":"456-460"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10326943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Dyspnea «sine materia»].","authors":"Renaud Louis, Gilles Louis, Nicolas Bougard, Sébastien Louis, Stéphanie Ziant, Benoît Pétré, Florence Schleich, Thierry Bury, Muriel Delvaux","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dyspnea is a symptom of respiratory discomfort commonly encountered in clinical practice which, in most of the cases, relates to a cardiopulmonary or a metabolic disorder. Its genesis is complex and results from numerous interactions within cortical and limbic brain areas following intero- and nociceptive stimuli. The term dyspnea «sine materia» points to a state where no clear underlying cardiopulmonary or metabolic pathology has been identified and we include here the hyperventilation syndrome and the physical deconditioning. Treatment of dyspnea «sine materia» is based on behavioural psychotherapy and on reathtletisation programme in case of physical deconditioning.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 5-6","pages":"351-355"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9676560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Reactive hypoglycaemia, a frequently mentioned functional disorder, yet overestimated in clinical practice].","authors":"André Scheen, Nicolas Paquot, Pierre Lefèbvre","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Malaises are often attributed to hypoglycaemia in nondiabetic people who don't have any other serious medical problem. Reactive hypoglycaemia, the most frequent one, may be considered as a functional disorder. However, its diagnosis is often overused, because not really demonstrated in most instances. The diagnosis of hypoglycaemia should be structured, based upon the Whipple triad. First, the medical interrogatory must search for adrenergic and neuroglucopenic symptoms that suggest hypoglycaemia. Second, if the malaise is due to a hypoglycaemia, it should resume rapidly after the administration of sugar. Third, hypoglycaemia must be confirmed by a measurement of a low glucose level at the time of a malaise. The latter approach is facilitated by the use of home blood monitoring, a strategy that is now preferred to the use of an oral glucose tolerance test, a non-physiological test far from real-life conditions. When the diagnosis is made based upon this triad, the medical interview should precise the severity of the symptoms and focus on the chronology of the malaises, typically 2-3 hours after a sugar-enriched meal in case of a reactive hypoglycaemia. Therapeutic approach of this functional disorder mostly relies on dietary advices.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 5-6","pages":"363-368"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9676561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Géraldine Brichant, Pierre Carvelli, Alice Moïse, Michelle Nisolle, Béatrice Panariello, Laetitia Rousseau
{"title":"[La dyspareunie féminine, not a simple functional disorder !]","authors":"Géraldine Brichant, Pierre Carvelli, Alice Moïse, Michelle Nisolle, Béatrice Panariello, Laetitia Rousseau","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dyspareunia is defined as pain during sexual intercourse. It will be qualified as superficial if it occurs during the vaginal penetration and as deep when it appears in the lower abdomen or further in the vagina. It concerns between 10 and 28 % of women during their lifetime and will have a significant impact on their quality of life. Multidisciplinary care will allow an accurate diagnosis and optimal treatment. The collaboration between general practitioner, gynecologist, physiotherapist and psychologist is mandatory in order to improve the quality of life of patients.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 5-6","pages":"381-387"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10059519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Verjans, Manon Dewandre, Véronique Keppenne, Julie Leruth, David Waltregny
{"title":"[The overactive bladder syndrome].","authors":"Thomas Verjans, Manon Dewandre, Véronique Keppenne, Julie Leruth, David Waltregny","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The overactive bladder (OAB) syndrome is defined as urinary urgency, usually with urinary frequency and nocturia, with or without urgency urinary incontinence. It significantly impacts patients' quality of life and represents a significant public health issue. Treatment options include conservative and hygienic measures, pharmacological treatments and surgery.</p>","PeriodicalId":21414,"journal":{"name":"Revue medicale de Liege","volume":"78 5-6","pages":"376-380"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9684304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}