[ C a[\MUQK T]X][ MZa\PMUI\W[][ !C=6" Q[ I KPZWVQK

Clinical and radiological liver diseases are uncommon in patients with systemic lupus erythematosus (SLE). We report a 29-year-old female with SLE who presented with right upper quadrant abdominal pain, thrombocytopenia, elevated liver enzymes and multiple hypodense lesions in the liver on a computed tomography (CT) study that mimicked multiple liver abscesses. A liver biopsy showed mild chronic inflammation. Culture results were negative. With steroid therapy the patient improved clinically, the platelet count returned to the normal range and the multiple liver lesions disappeared radiologicaly. This patient represents a rare case of SLE that had hepatic vasculitis mimicking multiple liver abscesses.

BACKGROUND AND OBJECTIVESThere is limited data available on the characteristics of local Saudi patients diagnosed with congestive heart failure (CHF) and on their adherence to guidelines for managing the disease. This study aimed to fill this gap.DESIGN AND SETTINGRetrospective study of patients treated at King Abdulaziz Medical City from 2002–2008.SUBJECTS AND METHODSThe records were reviewed of subjects admitted secondary to heart failure (defined as systolic heart failure [ejection fraction <55%] and/or heart failure with preserved ejection fraction diagnosed either clinically and/or by echocardiogram and/or cardiac catheterization) or who visited the outpatient department for the same complaint.RESULTSOf 392 CHF cases, the mean age was 67.8 (12.8) years and the majority were males (53.1%). Hypertension was the predominant comorbid illness, accounting for 84.9% of cases, followed by diabetes mellitus type 2 and hyperlipidemia. Almost three-fourths (73.7%) of the subjects had mild to severe left ventricular dysfunction, with 68.5% of the cases having right ischemic cardiomyopathy. Spironolactone, exercise and vaccination were the the least least adhered to recommendations (30.0%, 20.5% and 15.2%, respectively).CONCLUSIONSThe study highlights the need for proper education of patients and caregivers to increase compliance to medications. Physicians are also encouraged to undergo continuing medical education and training courses to properly implement current recommendations in the management of heart failure. Further studies are needed on a larger scale in order to formulate an effective management scheme that will address the current challenges faced by both clinicians and CHF patients.

BACKGROUND AND OBJECTIVESStudies about stroke in Saudi Arabia are limited. This retrospective study aims to determine the clinical characteristics of Saudi patients with heart failure (HF) with and without subsequent stroke, and also to find out whether gender differences exist in the presentation of HF patients who had stroke.DESIGN AND SETTINGSRetrospective study done at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, from 2002–2008.PATIENTS AND METHODSA total of 293 patient (151 males, 142 females) charts from 2002–2008 were reviewed at KAMC. These charts were from Saudi patients who were diagnosed with HF, with and without subsequent stroke. Demographics, HF characteristics, stroke risk factors, and metabolic characteristics were noted and analyzed.RESULTSNo difference was observed in HF characteristics and stroke risk factors among HF patients with and without subsequent stroke. In terms of metabolic profile, those who had stroke had significantly higher low-density lipoprotein (LDL)--cholesterol levels as compared to those without (P=.03). Stratification to gender and adjusting for age and risk factors revealed that significantly higher LDL-cholesterol and total cholesterol levels were observed in female stroke patients (P values .02, .028, respectively) and significantly higher blood urea nitrogen levels were observed in male stroke patients (P=.04) as compared to their counterparts who never had a stroke.CONCLUSIONThe gender differences in the metabolic presentation of Saudi HF patients with stroke warrant further clinical investigation. Atherogenic dyslipidemia and renal insufficiency are suggested to be early predictors for stroke and should be closely monitored in Saudi HF patients.