1999

J Rheumatol 1999 Feb;26 Suppl 55:25
Undergraduate education in rheumatology in Tunisia.
Zakraoui L
University of Tunis, School of Medicine, Hopital Mongi Slim, La Marsa, Tunisia.
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1998

Mediators Inflamm 1998;7(2):111-4
Levels of soluble Fas/APO-1 in patients with Behcet's disease.
Hamzaoui K, Hamzaoui A, Zakraoui L, Chabbou A

Immunohistology Laboratory, Medicine University of Tunis, Tunisia.
The aim of this study was to quantify soluble Fas/APO-1 (sFas/APO-1) protein in the serum of patients with Behcet's disease (BD) in active and inactive stages, compared with patients with systemic lupus erythematosus (SLE) and patients with rheumatoid arthritis (RA). Soluble Fas/APO-1 was quantified using a sandwich enzyme-linked immunosorbent assay. Increased serum sFas/APO-1 levels were observed in active BD, compared with inactive BD, RA patients and SLE patients. Increased serum sFas/APO-1 levels were correlated with the presence of neurologic manifestations or pulmonary involvement in active BD. In conclusion, increased levels of sFas/APO-1 occurred frequently and exclusively in active BD patients. Preliminary evidence suggested that elevated levels of sFas/APO-1 are associated with the clinical stage and clinical manifestations in BD.
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Tunis Med 1998 Dec;76(12):471-4
[Functional and social-professional impact of rheumatoid arthritis in Tunisia].
[Article in French]
Cheour E, Elloumi M, Sahli H, Bouagina E, Meddeb N, Sellami S
Service de rhumatologie, Hopital La Rabta, Tunis.
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Tunis Med 1998 Nov;76(11):397-400
[Epidemiologic-clinical study of rheumatoid polyarthritis in Tunisia].
[Article in French]
Elloumi M, Cheour E, Bouagina E, Sahli H, Elleuch M, Meddeb N, Sellami S
Service de Rhumatologie, Hopital la Rabta Tunis.

1997

Thromb Res 1997 May 1;86(3):197-204
Protein S deficiency and antibodies to protein S in patients with Behcet's disease.
Guermazi S, Hamza M, Dellagi K

Laboratoire d'Hematologie, Institut Pasteur de Tunis, Tunisie.

Thrombosis occurs in 20 to 30% of patients with Behcet's disease (BD). Most of the reported hemostatic abnormalities are related to the inflammatory syndrome. We have assessed the activity of antithrombin III, protein C and protein S (PS), in 30 patients with BD and in 30 healthy controls. Thrombosis antecedents were found in 16 patients. Antithrombin III and protein C were within the normal range, however free PS and PSactivity were significantly decreased in patients as compared to control group. PS deficiency detected in eight patients, was associated to thrombosis in 6 of them. No correlation was found between free PS/total PS ratio and C4bBP levels. Antibodies to PS were screened by ELISA and were present in 6 patients, associated to PS deficiency in 4, and to thrombosis antecedents in 5 cases. PS deficiency was transient in two patients, associated to a persistent antiPS in one of them. These findings suggest that auto-immune acquired PS deficiency may be involved in the pathogenesis of thrombotic events in BD.
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Tunis Med 1997 Feb;75(2):87-91
[Hypothyroidism and muscular toxicity from fenofibrate, report of a case revealed by polymyositis].
[Article in French]
Cherif O, Karma F, Ben Amor G, Kochbati S, Ben Amor B, Rokbani L
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Rev Rhum Engl Ed 1997 Oct;64(10):592-593
Sciatica secondary to an aneurysmal bone cyst treated with in situ calcitonin injections.
Touzi M, Bergaoui N, Ben Hammouda M, Khalfallah B, Gannouni A, el May M

Publication Types:
oLetter
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J Radiol 1997 May;78(5):373-376
[Septic arthritis of posterior lumbar facet joint].
[Article in French]
Ben Hamouda M, Rajhi H, Golli M, Bergaoui N, Chaouch A, Hassine H, Ganouni A

Service de Radiologie, CHU de Monastir, Tunisie.

Septic arthritis of the posterior lumbar joints is extremely rare. The clinical picture of this unusual site of infection can easily lead to confusion with spondylodiscitis which is more common. We report a case of a 50-year-old woman with Staphylococcus aureus septic arthritis of the left L5-S1 lumbar facet joint. CT scan was helpful to establish the diagnosis and to guide the percutaneous needle biopsy.

Publication Types:
oReview oReview of reported cases
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Rev Med Interne 1997;18(10):821-822
[Darier disease and ankylosing spondylitis: a new case].
[Article in French]
Ben Taarit C, Turki S, Fazaa B, Kammoun M, Ben Maiz H

Publication Types:
oLetter
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Rev Chir Orthop Reparatrice Appar Mot 1997;83(3):278-282
[Intramuscular myxoma. Apropos of two cases].
[Article in French]
Kamoun N, Zouari M, Siala M, Karray S, Douik M, Litaiem T, Sliman N

Service de Rhumatologie, Institut National d'Orthopedie M.T. Kassab, Tunis, Tunisle.

The authors report two cases of rare localization of intra muscular myxoma: one in the buttock, and the other in the lumbar area. The first case, a 58 years old woman had a four month history of a mass in the buttock. Computed tomography revealed the presence of a solid tumor. Diagnosis was based on histological examination. After surgical treatment no recurrence was observed after fourteen months. The second case was a 54 years old woman who presented a sciatica with back pain and neurological signs. The symptoms didn't response to medical treatment. Computed tomography showed an enlarged and-cystic lumbar lesion extending to the first sacral hole, with bone erosion of L3 and L4 articular apophysis and spinous process. Needle biopsy and surgical excision of the tumor were performed. Total neurological recovery was observed and no recurrence was observed after three years. The authors reminded the characteristics of this rare and benign soft tissue tumor and specified the place of magnetic resonance imaging (MRI) to establish the diagnosis which was still confirmed by histological examination of an open biopsy. Clinical follow-up revealed exceptional recurrence and no metastasis.
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1996
Rev Med Interne 1996;17(10):860-861
[Association of Cogan's syndrome and rheumatoid arthritis].
[Article in French]
Ben Taarit C, Turki S, Chaabouni L, Moalla M, Ben Maiz H

Publication Types:
Letter
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Rev Rhum Engl Ed 1996 Apr;63(4):255-261
Diversity of opinions on the management of gout in France. A survey of 750 rheumatologists.

Rozenberg S, Lang T, Laatar A, Koeger AC, Orcel P, Bourgerois P

Department of Rheumatology, Pitie Teaching Hospital, Paris.

Gout is a common disease. Although effective treatments are available for gout, there is some disagreement as to how they should be used. To study prescription patterns in gout, we conducted a questionnaire survey among 2520 rheumatologists. Seven hundred and fifty completed questionnaires were returned over a two-month period. Among respondents, 35.4% worked in a private office, 21% in a hospital and 43.6% in both. The most widely prescribed treatments in acute gout attack were colchicine alone (63%), colchicine with a nonsteroidal antiinflammatory drug (NSAID) (31.7%) and NSAID alone (5.2%), with significant variations according to the type of practice. Mean duration of treatment in acute gout was 18 +/- 16.8 days (range, 3-180 days). Mean time interval between the attack and initiation of therapy with a xanthine oxidase inhibitor was 21.6 +/- 17.2 days (range 0-180); here also, significant variations were seen according to the type of practice. Concomitant symptomatic therapy was prescribed in 97.3% of cases, for a mean duration of 54 +/- 55.4 days (range 2-365). Thirty per cent of responders never prescribed uricosuric agents. The estimated rate of occurrence of treatment-induced attacks increased with the reported interval between the attack and initiation of urate-lowering therapy. Our data demonstrate that French rheumatologists have widely diverging views on how to treat gout. Whether a waiting period is needed between an acute attack and initiation of urate-lowering therapy, and how long this period should be, are unsettled issues that deserve to be studied.
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Tunis Med 1996 Nov;74(11):509-511
[The SAPHO syndrome. A Tunisian case].
[Article in French]
Zakraoui L, Laatar A, Haouet Marrakchi H, Zakraoui H, Ben Osmen A

Service de Rhumatologie Hopital Mongi Slim, La Marsa.
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Rev Rhum Engl Ed 1996 Feb;63(2):87-91
Features associated with juvenile onset of spondylarthropathies in north Africa.
Claudepierre P, Gueguen A, Ladjouze A, Hajjaj-Hassouni N, Sellami S, Amor B, Dougados M

Rheumatology Department, Cochin Teaching Hospital, Paris, France.

To determine whether juvenile onset of spondylarthropathy is associated with specific features, a prospective, cross-sectional study comparing juvenile-onset and adult-onset spondylarthropathies was conducted in the Maghreb in 523 patients meeting Amor's criteria or the ESSG's criteria for spondylarthropathy. Demographic data and clinical findings at the time of inclusion and during the first two years of the disease were compared in the 437 patients with onset at 16 years of age or older and in the 86 patients with onset before 16 years of age using a Student's t test or a chi-square test. The risk of hip involvement during the course of the disease was estimated using Kaplan-Meier curves and compared in the two groups using a Cox model. Early in the disease, patients in the juvenile onset group were more likely to have peripheral arthritis (52% vs 39%, p = 0.021) and enthesopathies (55% vs 40%, p = 0.002) and less likely to have axial manifestations (41% vs 62%, p = 0.0001), as compared with the adult-onset group. These differences persisted after a follow-up of 9.2 years. Juvenile-onset disease was associated with a greater likelihood of hip involvement (54 +/- 6% vs 34 +/- 3% after ten years, p = 0.012). The male bias was more marked in the juvenile onset group (85%) than in the adult-onset group (72%) (p = 0.016). These data confirm that demographic characteristics, clinical manifestations, and disease severity differ between juvenile-onset and adult-onset spondylarthropathies.

Publication Types:
oClinical trial oMulticenter study
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Rev Med Interne 1996;17(4):300-304
[Pyomyositis in adults in central Tunisia. Apropos of 10 cases].
[Article in French]
Chekir T, Omezzine Letaief A, Bahri F, Jamel A, Aloui S, Jemni L

Service de rhumatologie, CHU Farhat Hached, Sousse, Tunisie.

Ten adult patients treated for pyomyositis between 1988 and 1994 in Sousse's university hospital (Tunisia) were retrospectively reviewed. Due to the non specific symptoms, the diagnosis was often delayed (mean = 17 days) and other primary diagnoses were considered, mainly including synovitis. The muscles around hip and thigh were most commonly involved (ten patients), and Staphylococcus aureus was the most common pathogen (nine patients). Ultrasonography was very helpful in the accurate diagnosis of the infection. Incision, drainage, and antibiotic therapy eradicated the infection in all patients. No residual functional limitations and no residual symptoms were noted. Our study showed that pyomyositis is present in central Tunisia and not associated with HIV infection. Clinical features and prognosis are similar to those previously described in the literature.
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1995

Ann Med Interne (Paris) 1995;146(1):46-48
[Localized myositis in Behcet disease].
[Article in French]
Kchir MM, Ben Romdhane K, M'rad S, Zouari R, Hila A

Publication Types:
oLetter oReview oReview of reported cases
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Clin Rheumatol 1995 Mar;14(2):227-228
Secretory component deficiency in Behcet's disease.
Hamza M, Makni S

Publication Types:
oLetter
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Br J Rheumatol 1995 Dec;34(12):1139-1145
Predictive factors of severity of spondyloarthropathy in North Africa.
Claudepierre P, Gueguen A, Ladjouze A, Hajjaj-Hassouni N, Sellami S, Amor B, Dougados M

Hopital Cochin, Paris, France.

Both genetic and environmental factors probably influence the severity of Spondyloarthropathies. Hip involvement, which may be used as a marker of disease severity, is more frequent in spondyloarthropathies developed in North Africa. The objective of this study was determine the predisposing factors of hip involvement in spondyloarthropathy in North Africa. Patients fulfilled the Amor or European Spondyloarthropathy Study Group (ESSG) criteria of spondyloarthropathy. The study was retrospective, cross-sectional, multicentre and carried out in North Africa. The data collected were demographic data, socio-cultural factors and clinical presentation at onset. The risk of hip involvement with regard to disease duration was estimated using Kaplan-Meier's method. The predictive value of each variable with regard to time to hip involvement was evaluated using a uni- and then a multivariate Cox proportional hazard model. Five hundred and eighteen patients were included. The risk of hip involvement was estimated at 39+/-3% after 10 yr disease duration. The factors picked up by the multivariate analysis were: diagnostic delay less than 7 yr, age at onset below 24 yr and a combination of 'lower social class' and 'no refrigerator at home'. This study confirms the high prevalence of hip involvement during the course of spondyloarthropathy in North Africa and suggests a role of environmental factors in its appearance.
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Int Orthop 1995;19(3):190-192
[Bone metastasis for choriocarcinoma].
[Article in French]
Baklouti S, Elleuch MH, Kammoun MH, Sellami S

Service de Rhumatologie, Centre Hospitalier Universitaire Hedi Chaker, Sfax, Tunisie.

Metastasis to bone in the pelvis occurred in a woman with a choriocarcinoma. The diagnosis was made on the basis of high levels of HCG and a bone biopsy. The presence of bone metastases in a young woman requires vigorous systemic search for a primary lesion.
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Rev Rhum Engl Ed 1995 Apr;62(4):295-299
Behcet syndrome with ankylosing spondylitis.
Kallel MH, Bejia I, Fournie B, Fournie A

Department of Rheumatology, Toulouse Purpan Teaching Hospital, France.

Two HLA B27-positive patients with concomitant Behcet syndrome and ankylosing spondylitis are reported. The relevant literature is reviewed and the meaning of this combination discussed.
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1994

J Rheumatol 1994 Dec;21(12):2301-2306
Phenotype and functional profile of T cells expressing gamma delta receptor from patients with active Behcet's disease.
Hamzaoui K, Hamzaoui A, Hentati F, Kahan A, Ayed K, Chabbou A, Ben Hamida M, Hamza M

Immunology Laboratory, Medical School, University of Tunis.

OBJECTIVE. Our aim was to investigate the TCR gamma delta+ subset in Behcet's disease (BD) inflammatory sites, which better reflects changes associated with the pathologic process than peripheral blood. METHODS. Forty-five patients with active BD, 10 patients with recurrent aphthous ulcers, 12 patients with rheumatoid arthritis, 5 patients with noninflammatory neurologic diseases and 15 healthy individuals were studied. Three monoclonal antibodies TCR delta 1, BB3, and A13 were used to assess the percentage of TCR gamma delta+ in peripheral blood mononuclear cells (PBMC), in bronchoalveolar lavage and cerebrospinal fluid (CSF). CD11a/CD18 was used to study adhesion molecules. TCR gamma delta+ cells isolated by immunomagnetic separation were tested for cytolytic activity against K562 target cells after interleukin 2 stimulation. RESULTS. The PBMC TCR gamma delta BB3+ subset was significantly increased in BD. In BD inflammatory sites, TCR gamma delta+ cells were also present, composed mainly of A13+ cells from these sites also expressed CD11a marker. TCR gamma delta+ cells from inflammatory sites displayed a higher cytotoxic activity than controls, mediated by the A13+ subset. CONCLUSION. The accumulation of cytotoxic TCR gamma delta+ cells at the sites of inflammation suggests their involvement in the local injury process.
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Ann Med Interne (Paris) 1994;145(2):99-102
[Ileal perforation in 3 cases of Behcet disease].
[Article in French]
Hamza M, Eleuch M, Kchir N, Zitouna M

Service de Rhumatologie, Hopital La Rabta, Tunis, Tunisie.

Digestive manifestations are uncommon in Behcet's disease. The authors reported 3 male patients between 20 and 30 years with Behcet's disease who developed surgical abdomen. Emergency surgical intervention found perfored ileal ulceration. Histological study of resection piece showed mainly intestinal angitis with periphlebitis, venous thrombosis and obliterant endarteritis.
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Tunis Med 1994 Dec;72(12):723-725
[Horton's disease and hypothyroidism. A case report].
[Article in French]

Kchir MM, Chekili S, Hajri R, Zouari R, Hila A

Service de Rhumatologie, Hopital Charles Nicolles, Tunis.
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Rev Rhum Ed Fr 1994 Jan;61(1):53-55
[Synovitis caused by plant thorn and chronic polyarthritis. Apropos of a case and review of the literature].
[Article in French]
Kchir MM, Snoussi H, Kochbati S, Zouari R, Zermani R, Ben Jilani S, Hila A

CHU Charles Nicolle, Tunis, Tunisie.

A 54 year old male developed plant thorn synovitis of the knee followed five months later by nonerosive seronegative polyarthritis. The occurrence of chronic inflammatory joint disease shortly after plant thorn synovitis is exceedingly rare. The relationship between the two events remains to be clarified.

Publication Types:
oReview oReview of reported cases
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J Radiol 1994 Apr;75(4):237-240
[Os acromial and rotator cuff syndrome. Apropos of 12 cases and review of the literature].
[Article in French]
Elleuch MH, Baklouti S, Mnif J, Kchaou MS, Sellami S

Service de reeducation, CHU H. Bourguiba, Sfax, Tunisie.

In relation to 12 patients whose complained of pain in the shoulder associated with os acromial, the authors confirmed the rarity of this anomaly of the scapula which predisposes to subacromial impingement and rotator cuff rupture. The diagnosis is radiological. It requires axillary view of the shoulder which precisely shows the os acromial.

Publication Types:
oReview oReview literature
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J Radiol 1994 May;75(5):283-285
[Uncommon etiology of cruralgia].
[Article in French]
Chaabane M, Abid R, Hamza K, Aloulou R, Robbana A, Chaabouni L, Hamza R

Service d'Imagerie Medicale, Hopital Charles-Nicolle, Tunis.

A 58 year old man suffered from low back pain. Physical examination showed asymmetry of the quadriceps and slight motor deficiency of right leg. Plain radiography of the pelvis revealed a large osteophyte, developed anteriorly at the low part of the right sacro iliac joint. CT exam of lumbar spin was normal. But, it confirmed osteophyte of right sacro iliac. Percutaneous injection of a small quantity of xylocaine under CT guidance in the site of the osteophyte behind crural muscle was marked by immediate disappearance of the pain, confirming the site of conflict between the crural nerve and the osteophyte. The patient was treated by injection of corticosteroid at the same location. Recovery was good.
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1993

Rev Rhum Ed Fr 1993 Dec;60(12):925-927
[Proctitis in Behcet disease. Study of 6 cases].
[Article in French]
Hamza M

Hopital la Rabta, Clinique Saint Augustin, Tunis, Tunisie.

Differentiation of Behcet's disease from the cryptogenic enteropathies can raise diagnostic and nosological problems. The segments of the digestive tract most commonly involved in Behcet's disease are the ileum and colon; rectal manifestations are exceedingly rare. We report six Behcet's disease patients who had rectitis with clinical and histological features reminiscent of ulcerative colitis. However the colon was normal. Immunopathological differences between the two diseases have been reported by other investigators.
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Rev Rhum Ed Fr 1993 Jul;60(7-8):546-547
[Rheumatoid factor, subcutaneous nodules and Sjogren's syndrome in rheumatoid polyarthritis in Magreb].
[Article in French]
Hamza M, Bardi R

Publication Types:
oLetter
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Rev Rhum Ed Fr 1993 Apr;60(4):315-316
[Evaluation criteria for uveitis in Behcet's syndrome].
[Article in French]
Hamza M, Ouertani A

Publication Types:
oLetter
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Rev Rhum Ed Fr 1993 Feb;60(2):115-118
[Articular and vertebral tuberculosis].
[Article in French]
Hamza M

Publication Types:
oEditorial oReview oReview, tutorial
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Rev Med Interne 1993;14(8):765-771
[Lupus in children in Tunisia].
[Article in French]
Yalaoui S, Gorgi Y, Meddeb S, Makni S, Lakhoua R, Debbabi A, Ayed K, Ben Maiz H, Hamza M

Laboratoire d'immunologie, faculte de medecine, Tunis, Tunisie.

In this study, we have analyzed the clinical and serological features related to 16 Tunisian children in whom diagnosis of systemic lupus erythematosus was made before or at the age of 15. Renal involvement was found in 75% of cases and renal biopsies have mostly revealed severe histologic patterns. All of the patients who have been followed received corticosteroids and in some cases required additional cytotoxic drugs in order to control disease activity. Five children died in a context of a renal failure. This study of childhood lupus in Tunisia confirms that the clinical course of this disease in children is often aggressive.
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Eur J Med 1993 Jun;2(6):373-375
Jaccoud's arthropathy in primary Sjogren's syndrome with benign hypergammaglobulinaemic purpura.
M'Rad S, Ben Miled K, Makni S, Kchir M, Ennafaa M, Harmel A, Hendaoui L, Mzabi S, el Haddad ML, Ben Dridi M

Internal Medicine and the Radiology Service, Hopital Universitaire de La Marsa, Tunisia.
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Ann Gastroenterol Hepatol (Paris) 1993 May;29(3):107-109
[Caroli's disease and Jaccoud's arthropathy].
[Article in French]
Ben Miled-M'Rad K, M'Rad S, Kchir M, Belkhoja C, Bahri B, Hendaoui L, Ben Dridi M

Service de Radiologie, CHU La Marsa, Sidi Daoud, Tunisie.

The authors present a case of left unilobar Caroli's disease in a 83-year-old-woman associated with a Jaccoud's arthropathy of the hands. The role of repeated episodes of cholangitis and genetic tendency is discussed...
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Int Orthop 1993;17(1):54-56
Osteoid osteoma of the acetabulum.
Karray S, Zlitni M, Karray M, Moalla M, Zouari M, Douik M, Sliman N

National Orthopaedic Institute Mohamed Kassab, Tunis-Mannouba, Tunisia.

Osteoid osteoma of the acetabulum can be expected to cause nonspecific symptoms of hip inflammation. In a sixteen year old girl, investigation by routine radiographs and a bone scan suggested a focus of inflammation with a nidus and sclerosis of the acetabulum and overgrowth of the head and neck of the femur. Removal of the lesion by an anterior approach with dislocation of the hip gave excellent results when seen after three years with a normal gait and normal hip motion.

Publication Types:
oReview oReview of reported cases
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J Radiol 1993 Mar;74(3):143-146
[Scapular exostosis complicated by bursitis. Apropos of a case].
[Article in French]
Ben Hamouda M, Allegue M, Bergaoui N, Dahmene J, Korbi S, Moula T, Ganouni A

Service de Radiologie, CHU de Monastir, Tunisie.

We present one case of bursa formation secondary to a scapular osteochondroma. This rare condition can simulate, clinically and radiologically, a sarcomatous transformation. CT scan is helpful to demonstrate the scapular osteochondroma and the adjacent bursa.

Publication Types:
oReview oReview of reported cases
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Rev Med Interne 1993 Mar;14(3):160-162
[Superior caval syndrome in adults in central Tunisia. Apropos of 26 cases].
[Article in French]
Laouani-Kechrid C, Jemni L, Amira F, Chekir T, Jarray M

Service de Medecine Interne et des Maladies Infectieuses, CHU, Sousse, Tunisie.

We report 26 cases of superior vena cava obstruction (SVC) observed in Sousse University Hospital (TUNISIA). The diagnosis was confirmed by CT scan and/or superior vena cava angiography. The underlying disease was revealed by SVC on 76.9% of cases. Malignant underlying disease was noted on 61.53% of cases. Non malignant causes of SVC was Behcet disease (4 cases) and mediastinal fibrosis (5 cases). SVC revealed Behcet disease in the 4 cases.
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Arthritis Rheum 1993 Apr;36(4):490-9

Levels of circulating tumor necrosis factor alpha and interleukin-6 in patients
with rheumatoid arthritis. Relationship to serum levels of hyaluronan and
antigenic keratan sulfate.

Manicourt DH, Triki R, Fukuda K, Devogelaer JP, Nagant de Deuxchaisnes C, Thonar
EJ.

Department of Rheumatology, Saint Luc University Hospital, University of
Louvain, Brussels, Belgium.

OBJECTIVE. To measure serum levels of tumor necrosis factor alpha (TNF alpha)
and interleukin-6 (IL-6) in patients with rheumatoid arthritis (RA) and
age-matched control subjects and to study how these correlate with serum levels
of hyaluronan (HA) and antigenic keratan sulfate (KS) and other biochemical as
well as clinical indicators of disease activity. METHODS. Immunoassays were used
to measure levels of TNF alpha, IL-6, HA, and antigenic KS in the serum of 35
patients with RA and a group of age- and sex-matched control subjects. Clinical
disease activity in the RA group was assessed using the Lansbury index. Drug
intake was recorded and the erythrocyte sedimentation rate, and levels of
fibrinogen, creatinine, bilirubin, alkaline phosphatase, lactate dehydrogenase,
and aminotransferase were measured. RESULTS. Serum levels of TNF alpha, IL-6,
and HA were significantly higher in the RA population than in the control group.
In patients with RA, serum levels of HA correlated positively with serum levels
of TNF alpha and with clinical joint scores, but only weakly with other
laboratory parameters of inflammation. Serum levels of antigenic KS correlated
negatively with levels of circulating TNF alpha, but much more weakly with other
clinical and biochemical parameters of disease activity. CONCLUSION. These in
vivo data support in vitro studies which have shown that TNF alpha is a potent
stimulator of HA synthesis by synovial lining cells. The results strengthen the
contention that serum HA may be a unique marker of synovial involvement and
inflammation, rather than of only inflammation, in RA.

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Rev Rhum Ed Fr 1993 Jan;60(1):37-44

[Aspergillus spondylodiscitis. Apropos of 5 cases].

Cortet B, Deprez X, Triki R, Savage C, Flipo RM, Duquesnoy B, Delcambre B.

Service de Rhumatologie, Centre Andre Verhaeghe, Hopital B., Lille.

Five cases of Aspergillus discitis in male patients are reported. Three patients
had impaired immune responses as a result of immunosuppressive therapy following
a heart transplant (two cases) or hairy cell leukemia (one case). Two patients
had a recent history of mycobacterial infection. All five patients were
hospitalized for severe spinal pain suggestive of an inflammatory disease with
no neurological abnormalities. Erythrocyte sedimentation rate was elevated in
every case. The diagnosis of discitis was suspected on spinal roentgenograms and
established by computed tomography and/or magnetic resonance imaging. In three
patients the spine was the only site of Aspergillus infection (lumbar discitis
in two cases and thoracic discitis in one case). One patient developed
Aspergillus infection of several disks (L1-L2, L2-L3, and L4-L5) after
Aspergillus endocarditis with embolization to the left lower limb. Another
patient developed discitis after an Aspergillus lung infection. In every case,
Aspergillus fumigatus was recovered in cultures of specimens harvested by a
percutaneous needle biopsy of the intervertebral disk. All five patients were
treated by itraconazole which was given as single drug therapy in one case and
in combination with 5-flucytosine and amphotericin B in four cases. Recovery was
achieved in every case after four to six months of this drug therapy. In
contrast to most previously reported cases, none of the five patients reported
herein required surgical treatment. Efficacy of conservative treatment in this
study may be related to the use of itraconazole in every case.

1992

Tunis Med 1992 Jan;70(1):19-24
[Pseudo-phlebitis of the inferior limb].
[Article in French]
M'rad S, Miled KB, Kchir MM, Tougourti N, Ayari M, Hamza M, Moalla M, Rokbani L, Miled M, Ben Dridi M

Service de Medecine Interne, C.H.U. La Marsa, Tunis.
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Clin Exp Rheumatol 1992 Jan;10(1):43-49
Hereditary chondrocalcinosis in a Tunisian family.
Hamza M, Meddeb N, Bardin T
Service de Rhumatologie, Hopital La Rabta, Tunis, Tunisie.

A clinical and radiological survey of 77 members of a Tunisian family with hereditary chondrocalcinosis was performed. Articular chondrocalcinosis was documented by X-rays in 7 living members of 3 generations. No associated or secondary forms of the disease were found. Clinical features of the disease appeared early in life and radiologic involvement was extensive. The mode of inheritance appeared to be autosomal dominant with incomplete penetrance. Electron microscopy study of synovium and cartilage biopsies from one patient demonstrated calcium pyrophosphate dihydrate crystals. HLA typing revealed that all affected subjects bore the haplotype A1 B12 DR3.
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Ann Med Interne (Paris) 1992;143(7):438-441
[Bolus of cyclophosphamide and methylprednisolone in uveitis in Behcet's disease. Preliminary results with the use of new criteria of evaluation].
[Article in French]
Hamza M, Meddeb S, Mili I, Ouertani A

Service de Rhumatologie, Hopital La Rabta, Tunis, Tunisie.

In a prospective open trial, the effect of pulse cyclophosphamide or methylprednisolone in the treatment of Behcet's disease uveitis was studied. The therapeutic effect was evaluated based on two scores: one evolutive, reflecting ocular inflammation and calculated for each eye before and after therapy; and the other, a measure of disease severity, which took into consideration the irreversible damage. Patients who received cyclophosphamide pulse therapy (n = 8) had significantly lower evolutive scores (16.12 +/- 3.95, vs 10.37 +/- 8.53, p < 0.01) than the patients receiving classical methylprednisolone pulse therapy (n = 20), who had no significant changes in their evolutive scores (12.95 +/- 8.55, vs 10.05 +/- 8.56, p > 0.05).
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J Rheumatol 1992 Jun;19(6):913-916
Bronchoalveolar lavage and transbronchial biopsy in spondyloarthropathies.
Kchir MM, Mtimet S, Kochbati S, Zouari R, Ayed M, Gharbi T, Hila A
Service de Rhumatologie, CHU Charles Nicolle, Institut de Pneumo Physiologie de l'Ariana, Tunisie.

Fourteen patients (12 men, 2 women) with spondyloarthropathies underwent bronchoalveolar lavage (BAL), transbronchial biopsy (TBB) and other respiratory investigations. BAL revealed lymphocytosis and increased nonaltered neutrophil polynuclears in a smoker and an isolated lymphocytosis in one patient with restrictive syndrome and radiographic apical fibrosis. TBB showed interstitial fibrosis in the 2 patients and in 3 others who are all nonsmokers and among whom 2 had a restrictive syndrome. Subclinical alveolitis in spondyloarthropathies is absent. Interstitial fibrosis is not rare and its frequent association in a restrictive syndrome suggests a mechanical origin.
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1992 May;59(5):357-358
[Osteoid osteoma of the olecranon].
[Article in French]
Kchir MM, Kallel MH, Chabane M, Ben Nejma MS, Zouari R, Slimane N, Hamza R, Hila A

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Med Interne 1992 May;13(3):211-214
[Destructive polyarthritis in Behcet's disease. Apropos of a case and review of the literature].
[Article in French]
Kchir MM, Zouari R, Mrad S, Haddad A, Hila A

Service de Rhumatologie, CHU Charles Nicolle, Tunis.

The authors report a case of a 37 years old man with Behcet's disease since 7 years who develops a destructive chronic polyarthritis involving wrists, hands and one knee. The parallel evolution between recurrent orogenital ulceration and arthritis added to the absence of other associated destructive rheumatism permit to link this polyarthritis to Behcet disease. In spite of the few reports, the occurrence of destructive arthritis can't exclude absolutely the diagnosis of this affection.

Publication Types:
oReview oReview of reported cases
------------------------------------------------------------------------
Ann Med Interne (Paris) 1992;143(5):347
[Palindromic rheumatism and Gougerot-Sjogren syndrome].
[Article in French]
Kchir M, Mrad S, Yacoubi J, Kochbati S, Zouari R, Haddad A, Hila A

Publication Types:
oLetter
------------------------------------------------------------------------
Neurochirurgie 1992;38(5):309-314
[Cervicobulbar intramedullary lipoma. Apropos of a case with review of the literature].
[Article in French]
Mrabet A, Zouari R, Mouelhi T, Khouaja F, Ghariani MT, Hila A, Haddad A

Service de Medecine Interne B, Hopital Charles Nicolle, Tunis, Tunisie.

The authors report a case of cervical intramedullary lipoma extending into the bulbomedullary junction. 99 cases of cervical and/or dorsal intramedullary lipomas without spinal dysraphism, reported since 1884, are reviewed. There is poor correlation between lipoma's length and age of onset. Only lipoma extended to all the spinal cord begin in the first years of life. Clinical presentation is in 58% of cases a slowly compressive myelopathy, a syringomyelic syndrome in 9.5% of cases, a Brown Sequard syndrome in 6.5% of cases or atypical clinical features in 26% of patients. Finding of a subcutaneous lipoma at the level of the lesion helps for diagnosis. C.T. scan and magnetic resonance imaging (M.R.I.) precise lipomatous constitution of the tumor, its limits and relations with neighbouring tissues. Surgery is necessary when clinical features are advanced. Surgery indication is debatable when neurological manifestations are poor or absent. Post operative course is generally good and is not related with type of intervention.

Publication Types:
oReview oReview of reported cases
------------------------------------------------------------------------
Presse Med 1992 Jun 13;21(22):1039
[Collagenous colitis with antinuclear antibodies and chronic neutropenia].
[Article in French]
Boussen K, Mabrouk J, Ben Mami N, Moalla M, Ben Abdallah N, Ben Ammar H, Ben Maiz H

Publication Types:
oLetter
------------------------------------------------------------------------
Ann Med Interne (Paris) 1992;143(1):26-29
[Systemic aspects of heart myxoma].
[Article in French]
Boussen K, Moalla M, Turki S, Ayed K, Ben Ayed H, Ben Maiz H
Service de Medecine Interne et de Nephrologie, Hopital Charles-Nicolle, Tunis, Tunisie.

Publication Types:
oReview oReview, multicase
------------------------------------------------------------------------
J Rheumatol 1992 Jun;19(6):872-877
Psoriatic arthritis: clinical response and side effects to methotrexate therapy.
Espinoza LR, Zakraoui L, Espinoza CG, Gutierrez F, Jara LJ, Silveira LH, Cuellar ML, Martinez-Osuna P

Department of Medicine, Louisiana State University School of Medicine, New Orleans.

In the last decade, methotrexate (MTX) has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects. We describe our clinical experience with this drug in psoriatic arthritis (PsA). The study group included 24 men and 16 women, with a mean age of 47 years (16-75), with oligoarticular (13) or polyarticular (27) involvement, with a mean disease duration of 12 years (1-36). Patients received a mean dose of 11.2 mg of MTX orally/week during a mean period of 34 months (6-132). Seven had been previously treated with other second line agents. Thirty-eight patients had an excellent or good response. In them, the erythrocyte sedimentation rate dropped in a mean of 38 mm/h. Only 2 patients had a rather poor response. Two patients discontinued the medication because of side effects: leukopenia in one and stomatitis in the other. Eleven patients presented with liver test abnormalities: 3 mild, 6 moderate and 2 severe. Seven patients had 11 liver biopsies. Except for one, none had evidence of cirrhosis or inflammation. Indeed, no changes were observed in the histopathology in those with repeated biopsies. The case reported as cirrhosis occurred very early in the course of MTX therapy. He continued taking MTX treatment without further deterioration of liver chemistry and/or histology. It is concluded that MTX is an effective and safe agent in PsA. Results also indicate that it is not necessary to perform liver biopsies on a routine basis.

Publication Types:
oClinical trial

Comments:
oComment in: J Rheumatol 1993 Oct;20(10):1804-5
------------------------------------------------------------------------
Int Orthop 1992;16(2):193-195
Chondromyxoid fibroma of the scapula. A case report.
Baklouti S, Elleuch MH, Sellami F, Hadiji N, Triki FE, Sellami S

Rheumatology Service, C.H.U. Sfax, Tunisia.
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1992 Jul;59(7-8):478-481
[Diagnosis of extruded herniated disks].
[Article in French]
Bergaoui N, Ladeb F, Ben Hammouda M, Gannouni A, Essgaier K, Guefrech I, Mourad A, Elmay M

Service de Medecine Interne, Faculte de Medecine de Monastir, Tunisie.

In a patient with disk herniation it is often difficult to establish that the disk is free in the spinal canal. A retrospective medical record study comparing 65 cases of free herniated disk (FHD) confirmed upon surgery and 65 cases of disk protrusion (DP) demonstrated that FHD was more common in young male blue collar workers, especially those who worked in the sitting position. No clinical findings were diagnostic of FHD although the straight-leg raising test was positive at smaller angles than in disk protrusion. In this study, sensitivity and specificity of CT scan for the diagnosis of FHD were 75% and 80%, respectively. CT scan findings suggestive of FHD included a free disk fragment, found in 22.5% of cases, and an acute connecting angle. Saccoradiculography was more sensitive but less specific than CT scan in this study. In FDH, migration was common and ragged hernia contours were seen on the saccoradiculography images.
------------------------------------------------------------------------
Tunis Med 1992 Nov;70(11):551-554
[Castleman's disease-multicentric form. A case report].
[Article in French]
Laouani-Kechrid C, Korbi S, Chekir T, Jemni L

Service de Medecine Interne, Hopital Universitaire f. Hached de Sousse.

Publication Types:
oReview oReview of reported cases
------------------------------------------------------------------------
Tunis Med 1992 Aug;70(8-9):417-421
[Hyperthyroid osteosis: two cases].
[Article in French]
Abid M, Bahloul Z, Rekik N, Kolsi R, Jarraya A

Service de Medecine Interne, Centre Hospitalo Universitaire, Hedi Chaker, Sfax, Tunisie.

Publication Types:
oReview oReview of reported cases
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1992 May;59(5):341-344
[Dermatopolymyositis induced by D-penicillamine in rheumatoid polyarthritis. Apropos of 1 case with review of the literature].
[Article in French]
Kolsi R, Bahloul Z, Hachicha J, Gouiaa R, Jarraya A

Service de Medecine Interne et de Rhumatologie, Hopital Universitaire Hedi Chaker, Sfax, Tunisie.

Treatment of rheumatoid arthritis (RA) with D-penicillamine (DP) is associated with development of dermatopolymyositis (DPM) in 0.2 to 1.2% of cases. A case of DPM which developed after four years DP therapy in a 58-year-old female with RA is reported. The favorable outcome after discontinuation of DP and administration of corticosteroids and the absence of recurrence or malignant disease after 4 years 9 months follow-up demonstrated the causal relationship between DP therapy and development of DPM. An analysis of 34 previously published cases of DP-induced DPM (DP/DPM) showed the following: development of DPM was not influenced by the dosage or duration of DP therapy; reported cases of DP/DPM were clinically identical with primary DPM but had a different outcome, with permanent recovery of DP/DPM occurring 1.5 to 6 months after withdrawal of DP; patients with DP/DPM had immune disorders, including antinuclear antibodies in 14 of 34 patients; the high prevalence of the B18, B35, DR4 haplotype in these patients denotes immunogenetic differences with primary DPM patients (B8-DR3) and DP-induced myasthenia (DR1).

Publication Types:
oReview oReview, multicase

Comments:
oComment in: Rev Rhum Mal Osteoartic 1992 Nov 30;59(11):774
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1992 Apr;59(4):293-294
[Gougerot-Sjogren syndrome associated with dysthyroidism. Development of histological lesions in the salivary glands following treatment for dysthyroidism].
[Article in French]
Abid M, Kolsi R, Rebai T, Bahloul Z, Rekik N, Jarraya A

Publication Types:
oComment oLetter

Comments:
oComment on: Rev Rhum Mal Osteoartic 1990 Nov;57(11):805-8
------------------------------------------------------------------------
Clin Rheumatol 1992 Mar;11(1):109-11

Septic Streptococcus milleri prepatellar bursitis.

Meys E, Michaux L, Lambert M, Triki R, Nagant de Deuxchaisnes C.

Department of Rheumatology, Cliniques Universitaires Saint-Luc, Universite
Catholique de Louvain, Bruxelles, Belgium.

The osteoarticular affinity of Streptococcus milleri has only recently been
recognized. We report a case of septic prepatellar bursitis caused by this
pathogen. The recent literature concerning osteoarticular involvement by S.
milleri is reviewed.

1991

Clin Rheumatol 1991 Dec;10(4):456
Herpes simplex virus antigens in sera of patients with Behcet's disease.
Hamza M, Slim A

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1991 Jun;58(6):441-447
[Hereditary chondrocalcinosis in Tunisia. Apropos of 3 families].
[Article in French]
Hamza M, Meddeb N, Bardin T, Hajri R, Mahmoudi B, Absia H, Sellami S

Service de Rhumatologie, Hopital la Rabta Tunis, Tunisie.

Hereditary chondrocalcinosis was reported in three Tunisian families. The clinical manifestations appeared early in life and extensive radiologic involvement was apparent. The mode of inheritance seemed to be autosomal with incomplete penetrance. In one family HLA typing revealed that all affected subjects had the haplotype A1 B12 DR3.
------------------------------------------------------------------------
Clin Exp Rheumatol 1991 Mar;9(2):208-209
Acquired and transitory selective IgA deficiency in Behcet's disease.
Hamza M, Ayed K, Makni S

Publication Types:
oLetter
------------------------------------------------------------------------
Clin Exp Rheumatol 1991 Mar;9(2):131-135
Suppressive T cell function of Epstein-Barr virus induced B cell activation in active Behcet's disease.
Hamzaoui K, Kahan A, Hamza M, Ayed K

Immunology Laboratory, Medical School of Tunis, France.

B and T cell function were studied in 10 patients with active Behcet's disease (BD) and in 10 normal subjects. Peripheral B lymphocytes infected with Epstein-Barr virus (EBV) were cultured for 20 days in the presence or absence of autologous T cells. Immunoglobulin M and G secretions into the supernatants were assessed with an enzyme-linked immunosorbent assay. The extent of suppression of EBV-induced B cell activation by autologous T cells was significantly decreased in active BD patients as compared to normal subjects at a T:B ratio of 1:1, whereas the suppression ratio was in the normal range at a T:B ratio of 4:1. The IgM and IgG secretions in purified B cell cultures were significantly higher in active BD patients as compared to control subjects. Thus, an increased B cell function associated with a defective EBV-specific T cell suppressive function could explain at least in part the immunological disorders in BD patients.
------------------------------------------------------------------------
Tunis Med 1991 May;69(5):315-318
[Rheumatic manifestations in human immunodeficiency virus (HIV) infection].
[Article in French]
Kchir MM, Zouari R, Kochbati S, Hila A

Service de rhumatologie, C.H.U. Charles nicolle, Tunis.

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
J Rheumatol 1991 Feb;18(2):283-285
Embolization of cardiac myxomas masquerading as polyarteritis nodosa.
Boussen K, Moalla M, Blondeau P, Ben Ayed H, Lie JT
Department of Medicine, Hopital Charles Nicolle, Tunis, Tunisia.

Cardiac myxomas are rare tumors which can mimic other diseases. We describe a 19-year-old man who presented clinically with polyarteritis nodosa (PAN). Muscle biopsy showed vasculitis, but corticosteroid and immunosuppressive therapy was initially effective. Cardiac myxomas were found by echocardiogram when the disease relapsed and were resected surgically. Segmental arterial aneurysms and stenoses were found on angiography after leg ischemia. We suggest that echocardiography should be performed in all cases of clinically suspected PAN.
------------------------------------------------------------------------
Ann Med Interne (Paris) 1991;142(3):230-232
[Fatal acute pancreatitis in systemic lupus erythematosus].
[Article in French]
Moalla M, Boussen K, Meddeb S, Gorgi Y, Khalfallah T, Hentati F, Ben Ayed H

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1991 May;58(5):401-402
[Osteomalacia and xeroderma pigmentosum].
[Article in French]
Zakraoui L, Gharbi MR, Laatar A

Service de Rhumatologie, Hopital Charles Nicolle, Tunis, Tunisie.
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1991 Dec;58(12):900-901
[Shoulder bursitis in juvenile chronic polyarthritis].
[Article in French]
Baklouti S, Elleuch MH, Fourati H, Abid R, Triki FE, Sellami S

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1991 Mar;58(3):179-181
[Association of cheiroarthropathy and Dupuytren's disease in diabetes mellitus].
[Article in French]
Bergaoui N, Dibej K, el May M

Service Medecine Interne, Section Rhumatologie, CHU, Tunisie.

Prospective study of 280 diabetic adults and 100 control show an association of limited joint mobility (LJM) with Dupuytren's contracture (DC) in 37 diabetic and no one of control case. In 80 diabetic with LJM, DC is found in 46.25 p. cent against 21 p. cent in 200 diabetic without LJM (p less than 0.00003). LJM and DC are significantly related to diabetic retinopathy and neuropathy. Their coexistence in diabetic patients, reported by other authors may be related to diffuse alteration of diabetic connective tissue.
------------------------------------------------------------------------
Presse Med 1991 Nov 16;20(38):1899
[Spinal cord compression by osteoporotic vertebral collapse associated with osteonecrosis].
[Article in French]
Kolsi R, Bletry O, Laraki R, Ziza JM, Godeau P

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1991 Jan;58(1):74-75
[Prevalence of secondary Gougerot-Sjogren syndrome in Northern Africa].
[Article in French]
Touzi M, Ghariani MT, Jaidane A

Publication Types:
oLetter
------------------------------------------------------------------------

1990

Clin Rheumatol 1990 Dec;9(4):498-500
Antibodies to herpes simplex virus in patients with Behcet's disease.
Hamza M, Elleuch M, Slim A, Hamzaoui K, Ayed K
Service de Rhumatologie, Hopital la Rabta, Tunis.
------------------------------------------------------------------------
J Rheumatol 1990 Oct;17(10):1428-1429
Production of TNF-alpha and IL-1 in active Behcet's disease.
Hamzaoui K, Hamza M, Ayed K

Publication Types:
oLetter
------------------------------------------------------------------------
Ann Rheum Dis 1990 Oct;49(10):817
Negative antineutrophil cytoplasmic antibodies in Behcet's disease.
Hamza M, Meyer O

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1990 Oct;57(9):670
[Arthritis and osteomyelitis caused by Salmonella typhimurium in a case of disseminated lupus erythematosus].
[Article in French]
Hamza M, Elleuch M, Meddeb S, Moalla M
------------------------------------------------------------------------
Clin Exp Immunol 1990 Sep;81(3):390-395
Cytotoxic T cells against herpes simplex virus in Behcet's disease.
Hamzaoui K, Kahan A, Ayed K, Hamza M
Immunology Laboratory, Faculty of Medicine, Tunisia.

Lymphocytes from 36 patients with Behcet's disease (20 in remission and 16 in active phase) were stimulated in vitro with herpes simplex virus and then tested for their ability to generate cytotoxic T cell responses to the virus. Significant cytotoxic responses were found. CD4+ and CD8+ subpopulations from the patients in remission generated specific cytotoxic activity against autologous target cells. These observations suggested that CD4+ and CD8+ cytotoxic T cells may have an important host response in herpes virus infection in Behcet's disease.
------------------------------------------------------------------------
J Radiol 1990 Aug;71(8-9):499-503
[Tuberculous spondylitis with syndesmophytes and paraspinal ossification. Two case reports].
[Article in French]
Hamza M, Elleuch M, Meddeb S, Hamza K, Hamza R, Hendaoui L

Service de Rhumatologie, Hopital La Rabta, Tunis.

The authors described 2 patients with spinal tuberculosis. The first one was presented with multiple anterior marginal involvement of vertebral bodies, centrosomatic spondylitis of L3, associated with a syndesmophytic showing spinal ossification. In the second case, spinal tuberculosis involved the vertebral arc of L2 and L4. A paravertebral ossification on both sides of L4 was seen. The nature of these vertebral and paravertebral ossifications was discussed.
------------------------------------------------------------------------
Clin Exp Rheumatol 1990 Jul;8(4):427
Behcet's disease, palmoplantar pustulosis and HLA-B27 treatment with thalidomide.
Hamza M

Publication Types:
oComment oLetter

Comments:
oComment on: Clin Exp Rheumatol 1988 Apr-Jun;6(2):109-12
------------------------------------------------------------------------
Tunis Med 1990 May;68(5):339-343
[Arterial manifestation of Behcet's disease].
[Article in French]
Hamza MO, Louzir B, Hamza M

Service de Medecine Interne, Hopital la Rabta, Tunis.
------------------------------------------------------------------------
Dis Markers 1990 May;8(3):109-112
HLA-antigens in a Tunisian familial chondrocalcinosis.
Hamza M, Ayed K, Bardi R, Gebuhrer L, Betuel H, Bardin T, Plaetke R, Lathrop M

Service de Rhumatologie, Hopital Le Rabta Tunis, Tunisie.

Thirty members of a Tunisian family with hereditary chondrocalcinosis were typed for HLA-A, B, and DR antigens: 7 affected and 23 unaffected subjects in three consecutive generations. The haplotype A1 B12 DR3 was found in all affected subjects and in 8 unaffected members. Chondrocalcinosis in this family may be associated with the haplotype A1 B12 DR3. The mode of transmission was autosomal dominant with incomplete penetrance.
------------------------------------------------------------------------
Tunis Med 1990 Feb;68(2):123-129
[Streptococcal rheumatism in children and adults: a comparative study].
[Article in French]
Zouiten F, Gastli M, Tiouiri H, Ben Chaabane T, Bouzouaia N, Elleuch M, Hamza M, Zribi A
Service des Maladies Infectieuses. Pr. Zribi A, La Rabia, Tunis.
------------------------------------------------------------------------
Ann Radiol (Paris) 1990;33(1):39-43
[Tuberculosis of the posterior vertebral arch. Apropos of 2 cases].
[Article in French]
Hamza M, Elleuch M, Meddeb S, Hendaoui L, Hamza R

Service de Rhumatologie, Hopital de Rabta, Tunis, Tunisie.

Spinal tuberculosis involving vertebral arc occurred in two patients. The first case had a single lesion presenting as a pseudo-tumoral feature. The second one had plurifocal tuberculosis peripheral and spinal one. The needle biopsy permitted the diagnosis in the two cases. Computed tomography showed the vertebral arch lesions with details and contiguous corporeal involvement. Clinical and radiological improvement was obtained after medical treatment.
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1990 Jan;57(1):59-61
[Behcet's disease and class II and III antigens of the major histocompatibility complex].
[Article in French]
Hamza M, Ayed K, Bardi R, Gorgi Y, Meddeb N

Service de Rhumatologie, Hopital La Rabta, Tunis.
------------------------------------------------------------------------
Clin Exp Immunol 1990 Jan;79(1):28-34
Natural killer cell activity, interferon-gamma and antibodies to herpes viruses in patients with Behcet's disease.
Hamzaoui K, Ayed K, Slim A, Hamza M, Touraine J
Laboratoire d'Immunologie, Faculte de Medecine de Tunis, Tunisia.

Interferon-gamma (IFN-gamma) titres in 20 patients with active Behcet's disease were examined and compared with those of 20 normal donors. Sera from Behcet's disease patients revealed an IFN-gamma increase but no correlation between IFN level and natural killer (NK) activity. The analysis of lymphocyte subsets by monoclonal antibodies registered an increase of CD8+ T subpopulation and cells co-expressing CD8(+)-Leu7a+ markers. Moreover, a high number of cells expressing CD25+ and HLA-DR+ phenotype has been noted in patients with active Behcet's disease. Serological analysis showed a high level of IgG antibodies to HSV-1. The increase of IFN-gamma titre, the high number of activated T cells and the increasing level of IgG antibodies to HSV-1 are important manifestations during the active stage of Behcet's disease. These findings are discussed in relation to the immunopathogenesis of Behcet's disease.
------------------------------------------------------------------------
Tunis Med 1990 Mar;68(3):199-203
[Rheumatologic manifestations in hypothyroidism].
[Article in French]
Kchir MM, Zouari R, Doghri T, Rokbani L, Mezhoud N, Hila A

Service de Rhumatologie, CHU H. Thameur.
------------------------------------------------------------------------
Tunis Med 1990 Feb;68(2):103-107
[Course and prognosis of primary Gougerot Sjogren syndrome].
[Article in French]
Kooli C, Zakraoui L, Othman MB, Cammoun M, Khalfallah N, Derbel A, Boussen S, Zouari R, Hila A, Haddad A

Service de Medecine Interne B, Hopital Charles Nicolle.
------------------------------------------------------------------------
J Radiol 1990 Aug;71(8-9):467-472
[Osteoarticular amyloidosis in hemodialyzed patients. Report of 4 cases].
[Article in French]
Moalla M, Ben Abdallah T, Kechrid C, el Matri A, Ben Maiz H, Bahri H, Hamza R, Ben Ayed H

Service de Medecine, Hopital Charles-Nicolle, Tunis.

Chronic hemodialysis is sometimes complicated by an osteoarticular amyloidosis, which happens after a middle delay of ten years, it can be expressed by a tunnel carpal syndrome, a shoulder pariarthritis, bony cysts, and erosive spondylarthropathy. The authors reported their experience about four cases, and insisted on some evocatoring radiologic aspects.

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
J Rheumatol 1990 Apr;17(4):570-571
Behcet disease and priapism.
Moalla M, Gabsi M, el Ouakdi M, Zmerli S, Ben Ayed H

Publication Types:
oLetter
------------------------------------------------------------------------
Ann Otolaryngol Chir Cervicofac 1990;107(2):141-143
[Involvement of the cranial nerves disclosing multiple myeloma].
[Article in French]
Ennouri A, Moalla M, Hajri H, Ben Ayed H, Marrekchi H

Service ORL, Hopital Charles Nicolle, Tunisie.

Diseases of cranial nerves are very seldom associated with multiple myeloma. However, their occurrence as a harbinger of multiple myeloma seems to bear a particular significance and is worth mentioning. In the present paper, we discuss two cases in which disorders of cranial nerves heralded Kahler's disease. The patients presented with posterior laterocondylar space and cochleovestibular (otoliquorrhea) syndromes, respectively. We stress the diagnostic problems involved and analyze the pathogenesis of diseases of the nervous system associated with multiple myeloma. Diseases of cranial nerves are seldom associated with multiple myeloma. Nonetheless, the clinical setting and laboratory tests will direct the diagnosis. The same does not hold true when one is confronted with Collet-Sicard's syndrome or cochleovestibular syndrome accompanied by otoliquorrhea.
------------------------------------------------------------------------
J Fr Ophtalmol 1990;13(6-7):365-367
[Intraorbital involvement in multiple myeloma].
[Article in French]
Moalla M, Ben Nejma MS, Boussen K, Makni S, Gabsi M, Maalej M, Ben Ayed H
Service de Medecine interne du Pr H. Ben Ayed, Hopital Charles Nicolle, Tunis.

According to data from the literature, intraorbital involvement in multiple myeloma is rare. Such involvement may result in exophthalmia, itself the first manifestation and presenting feature of myeloma. These lesions can respond remarkably to radiotherapy. The authors present a new case report.

Publication Types:
oReview oReview of reported cases
------------------------------------------------------------------------
Rev Fr Transfus Hemobiol 1990 Jan;33(1):31-38
[Monoclonal gammopathies in Tunisia].
[Article in French]
Makni S, Zouari R, Barbouch MR, Ayed K, Moalla M, Zakraoui L
Laboratoire d'immunologie, Hopital Charles Nicolle, Tunis.

Protein electrophoresis and immunoelectrophoresis carried out on 4805 sera and 93 urine samples from Tunisian patients over 8 years, and a monoclonal protein was detected in 198 cases. The distribution of the monoclonal compounds to the clinical diagnosis was studied. 115 (58%) were classified as multiple myeloma (MK), 34 (17%) as alpha heavy chain disease (MCL a), 34 (17%) as monoclonal gammapathy associated to various diseases (GMOD), 11 (6%) as benign essential monoclonal gammapathies (GMBE), 4 (2%) as Waldenstrom's macroglobulinemia (MW). The relationship between the monoclonal immunoglobulin and the clinical diagnosis, the distribution of the monoclonal compounds according to the heavy chain class and the identification of the light chains were studied. The results obtained are in line with the principal data in literature concerning monoclonal gammapathy. However there is a particularity about monoclonal gammapathy observed in the Tunisian's population studied: Higher percentage of alpha heavy chain diseases, monoclonal IgD and monoclonal light chain. Lower percentage of monoclonal IgM in GMBE or GMOD, as in MW.

Publication Types:
oReview oReview, multicase
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1990 Dec;57(12):906-907
[Rheumatoid polyarthritis associated with palmoplantar keratodermia of Meleda's type].
[Article in French]
Baklouti S, Sellami S, Elleuch MH, Fourati H

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1990 Jun;57(6):495-496
[Rhizomelic pseudopolyarthritis disclosing cancer of the cavum. A case report].
[Article in French]
Bergaoui N

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1990 Nov;57(11):805-808
[Gougerot-Sjogren syndrome associated with dysthyroidism].
[Article in French]
Kolsi R, Abid M, Rebai T, Sellami F, Bahloul Z, Hachicha J, Rekik N, Jarraya A

Service de Medecine Interne et de Rhumatologie, Centre Hospitalier Universitaire, Sfax.

The occurrence of Gougerot-Sjogren syndrome in a context of dysthyroidism is not a chance happening, as is reflected by the 37% rate of incidence. Routine labial biopsy, carried out in 59 cases of primary hypothyroidism due to atrophic thyroiditis, 20 of Basedow's disease and 4 of Hashimoto thyroiditis identified Gougerot-Sjogren syndrome (3-4 Chisholm grade) in 3 of the 59 cases of hypothyroidism i.e. in 5 percent, and in one Basedow case out of 20, i.e. 5 percent. Using Kaplan's criteria, the incidence of Gougerot-Sjogren syndrome rises to 22 percent in hypothyroidism and 30 percent in Basedow's disease. Consequently, the incidence of Gougerot-Sjogren syndrome is higher in Basedow disease than in primary hypothyroidism. Gougerot-Sjogren syndrome is seen particularly in dysthyroidism involving manifest and all-round clinical signs. This association does not seem to result from one disease being caused by the other, but the outcome of the onset of entities to which a genetically determined context predisposes the subject, as is shown by the prevalence of HLA DRW3 and HLA B8 groupings in Gougerot-Sjogren syndrome, in primary hypothyroidism, in Basedow's disease and in Hashimoto's thyroiditis.

Comments:
oComment in: Rev Rhum Mal Osteoartic 1992 Apr;59(4):293-4
------------------------------------------------------------------------
Tunis Med 1990 Feb;68(2):97-101
[Lupus nephropathy observed at an internal medicine service].
[Article in French]
Guiaa R, Hachicha J, Kolsi R, Bahloul Z, Charfeddine K, Jarraya A

Service de Medecine Interne, C.H.U. Hedi Chaker.
------------------------------------------------------------------------
Ann Rheum Dis 1990 Dec;49(12):1025
Pigmented villonodular synovitis.
Houman MH, Meddeb S

Publication Types:
oComment oLetter

Comments:
oComment on: Ann Rheum Dis 1990 Apr;49(4):210-1
------------------------------------------------------------------------
Presse Med 1990 Sep 15;19(29):1371-1372
[Carcinomatous meningitis revealed by rachialgia with stiff neck].
[Article in French]
Touzi M, Liote F, Golenzer-Cywiner C, Hubault A, Haguenau M, Kuntz D

Publication Types:
oLetter

1989

J Rheumatol 1989 Dec;16(12):1612-1613
Behcet's disease and dental treatment.
Hamza M

Publication Types:
oLetter
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Presse Med 1989 Oct 28;18(35):1755
[Diabetes insipidus in a case of Behcet's disease with neurologic manifestations].
[Article in French]
Hamza M, Chamaki S, Boukris R

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1989 Oct;56(10):703-704
[Periodic disease and ankylosing spondylarthritis. Familial association].
[Article in French]
Hamza M, Ayed K, Bardi R, Sellami S

Departement de Medecine, Hopital La Rabta, Tunis, Tunisie.
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J Rheumatol 1989 Aug;16(8):1153-1158
Camptodactyly, polyepiphyseal dysplasia and mixed crystal deposition disease.
Hamza M, Bardin T

Unite de Rhumatologie, CHU La Rabta, Faculte de Medecine de Tunis, Tunisie, France.

A sporadic case of camptodactyly and arthropathy is described in a 54-year-old man. Polyepiphyseal dysplasia complicated by the so called "chondrodysplastic rheumatism" was a main feature of the arthropathy which included early onset osteoarthritis, calcium pyrophosphate dihydrate and calcium phosphate deposition diseases. We suggest that epiphyseal dysplasia, chondrocalcinosis and mixed crystal deposition disease could be an additional cause of a camptodactyly-arthropathy syndrome.
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Rev Med Interne 1989 Jul;10(4):299-301
[Behcet's disease].
[Article in French]
Hamza M

Service de rhumatologie, hopital La Rabta, Tunis.
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Presse Med 1989 Mar 4;18(9):493-494
[Frequency of articular chondrocalcinosis in 2 ethnic groups].
[Article in French]
Hamza M, Elleuch M, Sellami S, Moalla M, Hamza R

Publication Types:
oLetter
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Clin Rheumatol 1989 Mar;8(1):113-114
Treatment of Behcet's disease with dapsone.
Hamza M, Hamzaoui K, Ayed K

Publication Types:
oLetter
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Rev Med Interne 1989 Jan;10(1):69-72
[Wegener's granulomatosis and pregnancy. A case].
[Article in French]
M'Rad S, Moalla M, Ben Miled K, Falfoul A, Grossin M, Ben Jilani S, Hamza M, Ben Dridi M, Ben Ayed H

Service de medecine interne, CHU La Marsa, Tunisie.

Pregnancy concomitant with Wegener's granulomatosis is extremely rare: so far, only four cases have been published. The authors report a fifth case where the disease appeared during the post-partum period, a situation which has already been noted in two of the published cases. Interruption of a subsequent pregnancy was followed by a flare-up of the disease resulting in the patient's death. This suggests that post-partum and post-abortum are probably instrumental in the onset and deterioration of Wegener's granulomatosis. The two patients previously reported who received immunosuppressants combined with corticosteroids had no flare-up after delivery. It seems permissible to prescribe such a therapeutic combination before and after delivery or abortion, especially since the fear of foetal toxicity from these drugs seems to be exaggerated.

Publication Types:
oReview oReview of reported cases
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Rev Mal Respir 1989;6(6):555-557
[Pneumomediastinum in dermatopolymyositis].
[Article in French]
M'Raihi ML, Dakhlia MS, Chebbi ML, Hamza M, el Gharbi B
Hopital de Pneumologie de l'Ariana, Tunis.

The authors report the occurrence of a pneumomediastinum occurring in a young female aged 25 who had already been under treatment for 3 years for dermatomyositis and who had a pulmonary involvement with fibrosis. This association did not seem fortuitous. The pneumomediastinum would be due to a cystic degeneration of the fibrosis producing "pseudoblebs".
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Tunis Med 1989 Nov;67(11):693-696
[Value of bronchoalveolar lavage in rheumatoid polyarthritis: apropos of 16 cases].
[Article in French]
Kchir MM, M'Timet S, Ben Miled T, Ben Romdhane T, Zouari R, Ayed M, Gharbi T, Hila A
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Tunis Med 1989 Mar;67(3):145-149
[The synoviorthesis].
[Article in French]
Kchir MM, Zouari R, Hila A

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
Tunis Med 1989 Nov;67(11):661-664
[Solitary plasmacytoma of the bone: nosological and therapeutic problems].
[Article in French]
Maalej M, Moalla M

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
Rev Med Interne 1989 Jul;10(4):338-340
[Etiopathogenesis of Behcet's disease].
[Article in French]
Bergaoui N, Mahjoub S, Ben Dhia N, Achour A, Elmay M
Service de medecine interne de l'hopital universitaire de Monastir, Tunisie.

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
Tunis Med 1989 Jun;67(6-7):453-455
[Renal disorder indicative of Wegener's granulomatosis].
[Article in French]
Ben Dhia N, Elmay M, Mustapha R, Fodha M, Achour A, Bergaoui N, Mahjoub S
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Rev Rhum Mal Osteoartic 1989 Apr;56(5):383-388
[Autochthonous Behcet's disease. Apropos of 73 cases].
[Article in French]
Roux H, Richard P, Arrighi A, Bergaoui N

Service de Rhumatologie, Hopital de la Conception, Marseille.

A multicenter study of Behcet's disease in France confirms the male predominance (62 p. cent), the mean age of onset in the 4th decade, the frequent muco-cutaneous, ocular, articular manifestations (94 p. cent), the skin hypersensitivity (68 p. cent). The forms with arthralgia predominate; the knees are especially affected; arthritis has a favorable course; the para-articular forms are infrequent and in 4 cases, are associated with ankylosing spondylarthritis. HLA B5 is found in 47 p. cent of the cases. HLA-B12 in 22 p. cent. HLA-B5 is associated with eye involvement in 62 p. cent of the cases, HLA-B12 is associated with skin involvement in 67 p. cent of the cases. The effectiveness of colchicine and, at a lesser degree, of steroids, is confirmed.

Publication Types:
oClinical trial oMulticenter study
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Ann Med Interne (Paris) 1989;140(5):418-419
[Adrenoleukodystrophy. Apropos of a case].
[Article in French]
Achour A, Ben Dhia N, Mahjoub S, Ladeb MF, Bergaoui N, Dijeb K, Frih A, Elmay M

Publication Types:
oLetter
------------------------------------------------------------------------
Tunis Med 1989 Nov;67(11):731-733
[Myasthenia and Basedow's hyperthyroidism: apropos of a case].
[Article in French]
Abid M, Bahloul Z, Chaabouni M, Hachicha J, Kolsi R, Jarraya A
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Rev Rhum Mal Osteoartic 1989 Mar 15;56(4):339-340
[Spondylodiscitis caused by Fusobacterium nucleatum. Apropos of 1 case].
[Article in French]
Fain O, Bardin T, Cheour I, Legmann F, Felten A, Kuntz D

Clinique de Rhumatologie, Hopital Lariboisiere, Paris.
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1988

Rev Rhum Mal Osteoartic 1988 Dec;55(12):1035-1036
[Swelling of the hands and feet in a case of lepromatous leprosy].
[Article in French]
Hamza M, Msadak M, Eleuch M, Siala M, Chaffi M, Zribi A

Publication Types:
oLetter
------------------------------------------------------------------------
Tunis Med 1988 Nov;66(11):729-732
[Behcet's disease 50 years later].
[Article in French]
Hamza M

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
Dis Markers 1988 Oct;6(4):263-267
Behcet's disease and major histocompatibility complex class II antigens in Tunisians.
Hamza M, Ayed K, Hamzaoui K, Bardi R
Departement de Medecine, Secteur Rhumatologie Faculte de Medecine de Tunis, Hopital La Rabta, Tunisia.

Forty-two Tunisian patients suffering from Behcet's disease (23 with uveitis) were typed for HLA-DR and DQ antigens. There was a significant excess of HLA-DQw3 (p less than 0.01) but also an important deficiency of HLA-DRw6 and DQw1 (p less than 0.01). A substantial increase of HLA-DR2 (p less than 0.01) for those with uveitis, and of HLA-DR4, DR7, for the others has been recorded (p less than 0.01).
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Rev Rhum Mal Osteoartic 1988 Oct;55(10):771-778
[Pathology and physiopathology of Behcet's disease].
[Article in French]
Hamza M
Departement de Medecine-Rhumatologie Hopital La Rabta, Tunis.

The etiology of Behcet's disease, a multisystems disease, is unknown. Epidemiological, clinical and experimental data indicate that genetic factors and other environmental factors of viral or toxic origin, are necessary for the disease to develop. Sex, age of occurence, presence of familial forms, and frequency of the HLA-B5 gene form the immunogenetic support. The geographic distribution, the results of some virologic studies, and the fact that the disease may be reproduced in animals by organo-chlorinated derivatives, form the support of the environmental factor. Study of the interferon gamma system and T lymphocytes sub-populations is in favor of a viral etiology. Hormonal factors may modulate the clinical manifestations of the disease. Circulating immune complexes may be responsible for certain lesions: uveitis, arthritis, erythema nodosa, and central nervous system involvement. The lymphocytes cytotoxic activity and the increased chemotactile activity are supposed to be the physiopathological base of aphtha, papulo-pustulous skin lesions and the pathergic phenomenon.

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
Arthritis Rheum 1988 Jul;31(7):935-936
Report of a patient with camptodactyly, arthropathy, and epiphyseal dysplasia.
Hamza M, Elleuch M, Ferchiou A, Amara A

Publication Types:
oLetter
------------------------------------------------------------------------
Am J Gastroenterol 1988 Jul;83(7):793-794
Intestinal amyloidosis: an unusual complication of Behcet's disease.
Hamza M, Wechsler B, Godeau P, Hamza H, Ayed K

Publication Types:
oLetter
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1988 Jul;55(9):720-721
[Non-secreting, hyposecreting multiple myeloma, simulating cancer of the base of skull].
[Article in French]
Moalla M, Boussen K, Bergaoui N, Hamza MH, Ben Ayed H, Ayed KH, Ferjaoui M

Publication Types:
oLetter
------------------------------------------------------------------------
Tunis Med 1988 Jun;66(6-7):521-526
[Multiple myeloma. Clinical hematological manifestations and anomalies of the hemogram. A retrospective study of 113 cases].
[Article in French]
Ben Abdeladhim A, Aissoaui B, Boussen M, Moalla M, Hamza M, Ben Ayed H, Boussen S, el Hila A, Haddad S
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Ann Rheum Dis 1988 Apr;47(4):350
Behcet's disease and pregnancy.
Hamza M, Elleuch M, Zribi A

Publication Types:
oLetter
------------------------------------------------------------------------
Clin Exp Rheumatol 1988 Apr;6(2):139-140
Pharyngeal stenosis in Behcet's disease.
Hamza M

Department of Medicine, Faculty of Medicine, Tunis, Tunisia.

This report describes a patient with Behcet's disease who developed pharyngeal stenosis. It is suggested that this unusual complication is due to localised myositis.
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Clin Exp Immunol 1988 Jan;71(1):126-131
Natural killer cells in Behcet's disease.
Hamzaoui K, Ayed K, Hamza M, Touraine JL

Laboratoire d'Immunologie, Hopital Charles Nicolle, Tunis, France.

We studied natural killer (NK) cell activity and numbers in the peripheral blood obtained from patients with Behcet's disease (BD) in inactive and convalescent stage, and from healthy controls. Ratios of helper/suppressor cells (OKT4/OKT8) were below 1.0 in patients with active stage and were normal in the convalescent stage of BD. A relative increase of OKT8+ cells and at the same time of Leu 7+ cells was obtained in the active and convalescent BD stages. Double marker analysis revealed that the sub-population of cells expressing both the T8+ and the Leu 7+ antigen (T8+/Leu 7+) was increased in patients with active stage, and normal in the convalescent stage. The frequency of cells reactive with Leu 11 monoclonal antibody (active NK cells) was evaluated in patients with BD. Data from peripheral blood showed an increased sub-population of T8+/Leu 7+ double marker cells, and a decreased Leu 11+ cell sub-population in patients with active BD, but the majority of Leu 7+ cells in patients with convalescent stage lacked OKT8 antigen when investigated in a double marker system. A parallel increase of Leu 11+ cells was observed in the convalescent stage. This phenotypic analysis was carried out with the NK in vitro functional evaluation of cell populations from peripheral blood. NK cell activity in the clinically active stage of BD was significantly lower than that of healthy controls and patients in the convalescent stage. The decrease of peripheral blood NK function in patients with active BD may be related to the presence of immature forms of NK cells and/or to the increased percentage of T8+/Leu 7+ cells.
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Ann Radiol (Paris) 1988;31(7-8):443-445
[Disappearance of a calcification of the sub-quadriceps pouch in a case of chondrocalcinosis].
[Article in French]
Hamza M, Bardin T, Cheour I, Msaddak M, Meddeb N, Chekir T, Hamza R
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J Mal Vasc 1988;13(3):250-256
[Pathogenic concepts, nosological limits and diagnostic criteria of Behcet's disease].
[Article in French]
Hamza M

C.H.U. La Rabta, Tunis, Tunisie.

Behcet's disease, a multi-system disease, raises aetiological and classification problems. Its aetiology is unknown, although several factors have been incriminated in its pathogenesis: immunogenetic, toxic, viral, hormonal,... It overlaps with several groups of diseases: seronegative spondyloarthritis, connective tissue diseases, angiitis, uveomeningitis and aphthosis. Several diagnostic criteria proposed by various authors are discussed.

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
J Mal Vasc 1988;13(3):245-249
[Arterial involvement in Behcet's disease].
[Article in French]
Hamza M, Horchani H, Elleuch M, Hamza K, Chaker C, Fourati M, Hamza R, Zribi A, Ennabli E

C.H.U. La Rabta, Tunis, Tunisie.

Ten cases of Behcet's disease with arterial lesions were observed in a series of 500 patients over a period of 12 years. The majority of patients were male (9/10) aged between 24 and 36 years with a mean of 30 +/- 5 years. The first group (3 cases) presented with thrombosis of the radial and superficial femoral arteries, the second group (4 cases) presented with aneurysm of the subclavian artery, common and external iliac arteries, brachiocephalic trunk and abdominal aorta and the third group (3 cases) had a combination of thrombosis and aneurysm of the pulmonary, external iliac and renal arteries.

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
Tunis Med 1988 Dec;66(12):821-832
[Clinico-biological profile of systemic scleroderma apropos of 25 cases].
[Article in French]
Zakraoui L, Jeridi T, Chekir T, Cheour I, Bouslama K, Hila A, Haddad S
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Tunis Med 1988 Jun;66(6-7):521-526
[Multiple myeloma. Clinical hematological manifestations and anomalies of the hemogram. A retrospective study of 113 cases].
[Article in French]

Ben Abdeladhim A, Aissoaui B, Boussen M, Moalla M, Hamza M, Ben Ayed H, Boussen S, el Hila A, Haddad S
------------------------------------------------------------------------
Tunis Med 1988 Feb;66(2):107-110
[Use of disc-vertebral puncture in the diagnosis of spondylodiscitis--apropos of 17 cases].
[Article in French]

Zakraoui L, Hendaoui L, Chekir T, Tarzi H, Siala M, Hamza R, Hila A, Haddad S
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Tunis Med 1988 Jan;66(1):51-54
[Use of systematic echocardiography during a rheumatic flare-up].
[Article in French]

Cherif O, Hanablia M, Kchir MM, Charrad R, Rokbani L, Mezhoud N
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Rev Rhum Mal Osteoartic 1988 Nov;55(11):949-953
[Multicentric reticulohistiocytosis. A new case with ultrastructural study].
[Article in French]
Moalla M, Abdelkefi M, Jaafoura H, Ben Ayed F, Hachicha A, Lakhoua H, Ben Ayed H

Service de Medecine Interne, Hopital Charles Nicolle, Tunis.
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Tunis Med 1988 Oct;66(10):663-672
[Prognostic factors in multiple myeloma. Critical analysis based on a multicenter study of 53 cases].
[Article in French]
Zakraoui L, Cheour I, Jeridi T, Jellouli N, Bergaoui N, Moalla M, Abdeladhim A, Karoui M, Ben Hamida A, Zouari R, et al

Publication Types:
oClinical trial oMulticenter study oReview oReview of reported cases
------------------------------------------------------------------------
Tunis Med 1988 Nov;66(11):733-742
[Osteoporosis. Etiopathology and therapeutic inferences].
[Article in French]
Zakraoui L, Bouslama K

Publication Types:
oReview oReview, tutorial
------------------------------------------------------------------------
Rev Rhum Mal Osteoartic 1988 Jan;55(1):1-6
[Lupus disease with antinuclear antibodies of the nucleolar type. Apropos of a series of 13 cases].
[Article in French]
Meyer O, Bourgeois P, Zakraoui L, Piette JC, Ziza JM, Bletry O, Kahn MF, Godeau P, Ryckewaert A

Clkinique Rhumatologique, Universite Paris VII, Faculte de Medecine Lariboisiere, Paris.

An exclusive or predominant nucleolar location of antinuclear antibodies is rare in the course of lupus disease: less than 1 p. cent of our patients. Thirteen cases of lupus disease with exclusive or predominant antinucleolar antibodies are analyzed: clinically, the only difference from other lupus diseases is the absence of pleurisy (p less than 0.03) and the frequent thrombopenia (p = 0.05). A proliferative glomerular lesion was found 4 times on renal biopsy. No patient presented any indications of overlapping sign with sclerodermia, polymyositis or Gougerot-Sjogren syndrome which are usually associated to a nuclear fluorescence of nucleolar type. 11 out of 13 patients have natural anti-DNA antibodies, including 9 with a very weak titer. Six patients present cytoplasmic anti-organic antibodies. Four patients have antibodies which precipitates on gelose, identifying nuclear or cytoplasmic antibodies: in 1 instance anti-SS-B et SS-A (Ro), in 1 instance anti-ribosomes associated with anti-ADN, in one instance anti-DNA. No serum contained anti-histones antibodies. The study of the sensitivity of nucleolar antigens to digestion by various enzymes (DNAse, RNAse and trypsin) showed that antinucleolar sera could be placed into three groups: 8/10 recognize a ribonucleic antigen, 1/10 a ribonucleoproteic antigen and 1/10 an antigen resisting to various enzymatic digestions. Therefore, in spite of its rarity, an exclusively nucleolar fluorescence should not rule out the diagnosis of lupus disease.
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1987

Clin Rheumatol 1987 Dec;6(4):608-609
Thalidomide and cell mediated immunity in Behcet's disease.
Hamza M, Hamzaoui K, Ayed K, Eleuch M, Zribi A

Publication Types:
oLetter
------------------------------------------------------------------------
Tunis Med 1987 Oct;65(10):617-622
[Ergotism revealing Horton's disease].
[Article in French]
Zouiten F, Hamza M, Dallagi K, Hajri R, Louzir B, Zitouna M, Miled M
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J Radiol 1987 Oct;68(10):609-614
[Osteoarticular manifestations of sickle cell anemia. Update apropos of a series of 29 cases].
[Article in French]
Moalla M, Baklouti S, Rais H, Hamza R, Hamza MH, Hachicha A, Lakhoua H, Ayed HB

Service de Medecine Interne et Rhumatologie, Hopital Charles Nicolle, Tunis.

In a retrospective study, the authors report 14 cases of osteoarticular manifestations, among 29 patients affected with a sickle cell disease observed at adult age. They insist on their frequency and their interest for diagnosis and prognostic. Effectively, the diagnosis has been revealed on occasion of these manifestations in 9 cases/14. The articular signs are noted in 35%, and the osseous signs in 25% of cases.
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J Rheumatol 1987 Jun;14(3):554-559
Large artery involvement in Behcet's disease.
Hamza M

Ten (2.2%) of 450 patients with Behcet's disease seen over a 10 year period had arterial manifestations. This was demonstrated by occlusion of radial and superficial femoral arteries in 3, aneurysm of subclavian, innominate, common and external iliac arteries and abdominal aorta in 4, both occlusion and aneurysm of pulmonary, external iliac and renal arteries in 3. All patients were male except one. Their ages ranged from 24-36 years with a mean age of 30 +/- 5 years.
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Rev Rhum Mal Osteoartic 1987 May;54(5):438
[Localized myositis in a case of Behcet's disease].
[Article in French]
Hamza M

Publication Types:
oLetter
------------------------------------------------------------------------
Ann Chir 1987;41(7):529-533
[A case of Behcet's disease complicated by venous thrombosis and aneurysm of the innominate artery associated with situs inversus].
[Article in French]
Hamz