Unusual association of cirrhosis and sickle cell anemia revealed by hemolytic anemia: A case report

Hepatobiliary complications of sickle cell disease are rare, cirrhosis remains very exceptional, especially in heterozygous forms of the disease. We report the case of a 19-year-old patient whose etiologic investigation of hemolytic anemia revealed heterozygous sickle cell disease complicated by hepatic cirrhosis. The diagnosis of cirrhosis was made due to the presence of signs of hepato-cellular insufficiency, portal hypertension syndrome and hepatic dysmorphia on imaging. The etiological assessment was negative. The liver biopsy was not performed due to the risk of bleeding. The interest of this observation is to evoke hepato-biliary complications (in particular cirrhosis) in patients with sickle cell anemia, in order to avoid a pejorative evolution burdened with serious complications.

Liver metastasis from an ovarian Yolk-Sac-Tumor: A case report and review of the literature

The endodermal sinus tumor or Yolk sac tumor is a rare ovarian tumor that classically occurs in adolescents and young women, it is a histological type rarely found in clinical practice. We report the case of a 24-year-old woman presenting with an ovarian tumor of the endodermal sinus with hepatic metastasis revealed by a painful abdominal mass in the right hypochondrium associated with a deterioration of the general condition. The blood Alpha-Fetoprotein (AFP) level was 71,300 ng / ml. Abdominal magnetic resonance imaging revealed multiple liver nodules and masses, associated with a magma of secondary lymphadenopathy. The immunohistological study of the hepatic puncture biopsy allowed the diagnosis of a hepatic localization of an ovarian endodermal sinus tumor (Yolk-Sac-Tumor). The tumor was classified stage IV-B of the FIGO 2014 classification, which does not allow a curative approach. Chemotherapy treatment (BEP protocol) was started.

Gastroprotection and mucus stimulation by vitamin D3 in pyloric ligation and Indomethacin-induced gastric ulcers rats models

The effect of vitamin D3 (VD3) on gastric ulcers was investigated by evaluating ulcer index, biochemical aggressive, and protective factors. Rats were divided into 4 groups; untreated indomethacin ulcer, VD3 pre-treated + indomethacin ulcer, untreated pyloric-ligation ulcer and VD3 pre-treated + pyloric-ligation ulcer. Treatment with VD3 (400 IU/kg intramuscular) was done daily for 6 days and an hour before ulcers induction. Four hours post-induction, the blood sample was obtained for the determinations of 1,25-dihydroxy vitamin D (1,25-DHCC), Parathyroid Hormone (PTH), and Calcium (Ca). Laparotomy was performed and the stomach was harvested for gastric acidity, ulcer index, and biochemical evaluations. The data were analyzed using statistical tools and the “student t-test” was performed at p<0.05. VD3 pre-treatmment caused an increase in serum levels of 1,25-DHCC, has no significant effect on PTH and Ca levels but decreased gastric acidity and ulcer index (p<0.05) with protective ratios of 42.11% and 60.00% against indomethacin and pyloric-ligation ulcers respectively. Pretreatment resulted in decreased gastric MDA, increased gastric protein, mucin, and nitric oxide levels. Gastric protection by VD3 was through oxidative stress inhibition and stimulation of mucus and blood flow against indomethacin and pyloric ligation gastric damage.