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[Limb lymphedema as a first manifestation of primary intestinal lymphangiectasia (Waldmann's disease)].

Primary intestinal lymphangiectasia (Waldmann's disease) is characterized by protein-losing enteropathy occurring more frequently in childhood. Chronic diarrhea and diffuse edema are the main clinical manifestations. Peripheral lymphedema may also be associated. Lymphedema is usually present at the time of diagnosis or appears later in the course of the disease. We report the observation of a 31-year-old man suffering from an upper, lower limb and genital lymphedema many years before diagnosis of primary intestinal lymphangiectasia was established. Lower limb lymphoscintigraphy confirmed lymphedema and duodenal biopsies lymphangiectasia. Hypoproteinemia, lymphopenia and hypogammaglobulinemia were also noted. Treatment of lymphedema included low stretch bandaging and elastic stocking. No dietary management with a low-fat diet was added. Search for primary intestinal lymphangiectasia with biological parameters would be useful when primary lymphedema is present. Especially since primary intestinal lymphangiectasia may be complicated by occurrence of B cell lymphoma.

Adult↗

[Intestinal parasitic diseases and environment in Sahelo-Sudanese towns: the case of Pikine (Senegal)].

A survey carried out in Pikine (Senegal) on a sample of 5 groups of children drawn from ecologically representative sections of the town confirms the high prevalence in urban areas of Africa of intestinal infection, especially A. lumbricoides (35.6%), T. trichiura (35.4%), and Giardia (43.7%). The prevalence of A. lumbricoides (35.6%), T. trichiura (35.4%), and Giardia (43.7%). The prevalence of A. lumbricoides and T. trichiura are appreciably higher in the oldest sectors of the town or in those with a better sanitary standard: up to 47.7% for Ascaris and 46% for Trichuris. The use of X2 tests and log-linear analysis demonstrates a significant association between Ascaris and Trichuris. The highest prevalence for Giardia (56.8%) were to be found on the outskirts of the town, where the lowest prevalence of Ascaris (21.7%) and Trichuris (22.9%) were noted; moreover, age-based prevalence for the three parasites vary from one ecological area to another. The relationship between the urbanization process, the variation in environmental factors and intestinal parasitic infection, and the operational implications arising from this geographically-based approach are discussed.

Animals↗

Adult celiac disease (celiac sprue), pernicious anemia and IgA deficiency. Case report and review of the relationships between vitamin B12 deficiency, small intestinal mucosal disease and immunoglobulin deficiency.

A 24-year-old man with addisonian pernicious anemia, adult celiac disease and selective IgA deficiency is presented to emphasize the differential diagnosis of vitamin B12 deficient megaloblastic anemia in association with small intestinal mucosal abnormalities and the relationships between immunoglobulin deficiency, pernicious anemia, and adult celiac disease.

Adult↗

Joint inflammations as complications in intestinal inflammations.

Ulcerative colitis and regional ileitis may be accompanied by articular involvement as extraintestinal complications, and were observed in 11 and 4 patients respectively. The temporal connection between the intestinal diseases and the appearance of subsidence of these complications in the majority of the cases suggest an etiologic relationship, regardless of the fact that the etiology of the intestinal diseases has not yet been elucidated. The clinical picture and course as well as the laboratory findings indicate that the joint involvement in question differs from rheumatoid arthritis.

Adolescent↗