Sarcoidosis is a chronic multisystemic granulomatous disease that is triggered by an autoimmune process. Nowadays, this pathology represents a well-recognized but uncommon complication for antiviral treatment in hepatitis C virus (HCV) infection. Herein, we report a remarkable case of 47-year-old woman treated for chronic HCV infection; the patient has developed interferon alfa-induced sarcoidosis involving the central nervous system. The evolution was fatal despite disrupting the antiviral therapy and initiating a high-dose corticotherapy. This complication of interferon alfa treatment was reported in the literature in only one case. Through this case and a review of the literature, we aim to underline the importance of screening for sarcoidosis before and during the follow-up of HCV patients undergoing antiviral therapy.
La survenue d'une grossesse chez une femme présentant une hypertension portale est redoutable, mettant en jeu le pronostic maternofoetal. Nous rapportons cinq cas de patientes, présentant une hypertension portale et une grossesse, colligés à la maternité du centre hospitalier universitaire Hassan-II de Fès sur une période de trois ans. L'étude a concerné les données cliniques, biologiques, les modalités d'accouchement, la morbidité et la mortalité maternofoetale. La splénomégalie était retrouvée chez toutes les patientes, la sérologie de l'hépatite C était positive chez une patiente, des varices oesophagiennes de stade III étaient retrouvées chez une patiente, et on a noté un cas de décès maternel, un cas de mort foetale in utero et un cas d'accouchement prématuré. Ces patientes ont bénéficié d'une prise en charge multidisciplinaire avec une surveillance étroite par la collaboration d'un obstétricien, d'un chirurgien viscéraliste, d'un réanimateur et d'un gastroentérologue.
Mots clés Hypertension portale · Foie · Cirrhose · Grossesse · Varices oesophagiennesAbstract The occurrence of pregnancy in a woman with portal hypertension is of bleak prognosis for both mother and foetus. We report 5 cases of patients who presented with portal hypertension at the maternity unit of the Fez Hassan-II Teaching Hospital, over a period of 3 years. The study included clinical and biological data, delivery patterns, and maternofoetal morbidity and mortality. Splenomegaly was found in all cases, positive hepatitis C serology was found in one case, grade III oesophageal varicose were found in one case, there was one case of maternal mortality, one foetal mortality in utero and one premature birth. The care of these patients involved close supervision by a multidisciplinary team including an obstetrician, a visceral surgeon, a resuscitator and a gastroenterologist.
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