AB0768 NEUROLOGICAL MANIFESTATIONS IN GRANULOMATOSIS WITH POLYANGIITIS: ABOUT 11 CASES

Background:Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis, affecting mainly the superior airways, lungs and kidneys. Neurological impairment is frequent, described in 22 to 54% of cases, and rarely inaugurates the disease.Objectives:The objective of our work was to evaluate its prevalence and its different aspects.Methods:A retrospective study including 11 files of GPA patients followed over a period of 10 years in The Internal Medecine Department at Tahar Sfar Hospital Mahdia TUNISIA.Results:Neurological manifestations were reported in 5 patients: a pyramidal syndrome was noted in 3 patients with a normal cerebral MRI, a disabled headache was described in one patient with a normal cerebral MRI. Peripheral neuropathy in 2 cases, and the Electroneuromyogram objectified a mononeuropathy affecting the ulnar nerve, peroneal nerve, and musculocutaneous nerve in one patient and a distal sensitivomotor poly neuropathy in one patient. Cranial nerves damage was noted in two cases, one VII (1 case) and one V (1 case).Conclusion:Our study results, show the importance of timely diagnosis of these neurological manifestations, as their evolution will depend on the early GPA treatment.References:[1]doi: 10.1016/j.autrev.2017.07.007Disclosure of Interests:None declared

7 facts on metoclopramide utility

Nausea and vomiting can be either a symptom, or an adverse reaction to treatment. Metoclopramide is an effective agent that can be used to treat nausea and vomiting due to inhibition effect on dopamine D2 receptor and histamine 5-HT3 receptor, causing accelerated gastric emptying, as well as increased gut motility. It is effective in treatment of nausea and vomiting regardless of cause. Some conditions with evidence (based on randomized clinical trials) of metoclopramide effectiveness include migraine, diabetic gastroparesis, patients after chemo- or radiotherapy, after surgery. Even though there is a risk of serious adverse events (including extra-pyramidal syndrome), metoclopramide can be regarded as safe, assuming appropriate patient selection. It can be used also during pregnancy, as well as in pediatric setting, where long-lasting adverse outcomes are observed extremely rarely.