Publications (36)10.08 Total impact
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Article: Small insertion (c.869insC) within F13A gene is dominant in Tunisian patients with inherited FXIII deficiency due to ancient founder effect.
Haemophilia 07/2009; 15(5):1176-9. · 2.60 Impact Factor -
Article: Detection of serum hemolysins in autoimmune hemolytic anemia.
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ABSTRACT: Some patients with autoimmune hemolytic anemia (AIHA) have in their sera autohemolysins able to hemolyze RBCs in vitro by activation of complement. We describe three autohemolysins in patients with AIHA and we study clinical correlations. Thirty-two patients with AIHA were explored by immuno-hematological investigations (DAT, elution and serum testing). Three autohemolysins were detected in three patients. All of these autoantibodies were likely IgM and reacted in vitro only with enzyme-treated RBCs. Two warm autohemolysins were detected in patients with warm-type AIHA. The first one was active at neutral pH with low title. The second, having a wide thermal amplitude reacting at 22 degrees C and a title of 16, was acid. The hemolysin detected in patient 3 with cold hemagglutinin disease, was active at 4 and 22 degrees C, at acid pH. The thermal optimum was 4 degrees C and the title 64. It was also detected at 37 degrees C with the same title, but only at neutral pH. Although these autohemolysins were incomplete, hemolyzing in vitro only enzyme-treated RBCs, they were associated for the three patients with severe hemolysis.Transfusion Clinique et Biologique 01/2007; 13(6):341-5. · 0.80 Impact Factor -
Article: [Blood-transmitted viral infections among haemophiliacs in Tunisia].
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ABSTRACT: In this work, we proposed to evaluate prevalences of hepatitis B and C viruses and Parvovirus B19 among 70 Tunisian haemophiliacs treated with clotting factors imported from Europe and/or locally produced cryoprecipitate; among them 6 (8.6%) are known HIV positive patients. HBs antigen, anti-HBc antibodies and anti-Parvovirus B19 antibodies were detected in 7.1%, 52.9% and 91.8%, respectively. HCV prevalence, defined as positive ELISA with positive Immunoblot and/or PCR was 50.0%. Prevalences of these viral infections in haemophiliacs are higher than prevalences detected among general population and in the control group of the study. HCV infection is less frequent in haemophiliacs born after 1985, the year of introduction of the inactivation procedures in the production of coagulation factors concentrates; it decreases more considerably after 1994, date of introduction of systematic screening of HCV among blood donors. In contrast, despite the inactivation of the factors concentrates and the systematic screening of the blood donations against HBs antigen, since 1973, the risk of HBV infection contamination remains high in the Tunisian haemophiliacs. The introduction in 1995 of hepatitis B vaccination in the national schedule of new-born vaccination may resolve in the future the problem of HBV infection in haemophiliacs and in the other categories of the Tunisian population.Transfusion Clinique et Biologique 11/2005; 12(4):301-5. · 0.80 Impact Factor -
Article: [Hairy cell leukemia: report of 8 cases].
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ABSTRACT: Hairy cell leukemia haemopathy is a rare lymphoïd haemopathy type B. 8 cases are reported and diagnosed at Hôpital Aziza Othmana over a period of 20 years between 1979 and 1999, 7 men and one women. The mean age of the patients is 51 years, with externe ages from 42 to 81 years. 4 patients consulted for an infections and, or anaemia syndrome. The disease was revealed due to the presence of an isolated splenomegaly in other cases. At the clinical examination, the spleen is hypertrophied in 7 patients out of 8. Pancytopenia is observed in 50% of the patients. Only one patient has presented a moderated hyperleukocytosis at 11,000/mm3 related to the presence of moving on tricholeukocytes. The myelogramme is pocr. It allowed to mention the diagnosis in 6 cases out of 8. Bone Marrow biopsy revealed a diffuse infiltration by TCL with a reticulinic fibrosis in all patients. 4 patients out of 8 have been splenectomized. Cytopenies have been corrected in all patients. Only one patient has been treated by alpha Interferon for 3 years with a partial hematological response. A relapse was observed once the Interferon was stopped. With the introduction of new drugs such purine analogues. The HCL treatment has been revolutionarized thanks to the improvement of the rate of complete response (from 10% to 80% of CR). If splenectomy is still observed in HCL for splenomegalic and or severe cytopenia, our findings could be improved thanks to new purine analogues.La Tunisie médicale 01/2002; 79(12):681-5. -
Article: [Atypical defibrination syndromes and acute leukemias with a t(9,22) translocation, apropos of 2 cases].
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ABSTRACT: We report two cases of atypical defibrination syndromes in patients with respectively acute monoblastic leukemia (chronic myeloid leukemia initially) and acute lymphoblastic leukemia. Hemostasis studies show low fibrinogen level, elevated D-dimers, decreased alpha 2 antiplasmin and factor V, normal antithrombin III values. Plasminogen is below the normal range in one patient. Soluble complexes, which are an important argument for diagnosis of intravascular coagulation disease, are not detected in both patients. Primary or secondary hyperfibrinolysis seems also excluded since euglobulin clot lysis time was normal. Enzymatic proteolysis of fibrinogen (or fibrin) by the blast cells has been reported by some authors; this mechanism could account for the hemostasis abnormalities observed in these two patients.Pathologie Biologie 05/2001; 49(3):232-6. · 1.53 Impact Factor -
Article: [Long-term survival and prognostic factors in multiple myeloma treated with conventional chemotherapy. Report of 109 cases].
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ABSTRACT: Our study is retrospective. We report the results of conventional chemotherapy ins previosly untreated patients with myeloma. Survival and prognostic factors were analysed in 109 patients diagnosed from 1983 to 1992. The median age was 65 years, 87 patients (80%) were including in the stage III according the Durie Salmon staging system. The median survival time was 27 months and 10 years survival rate is 3.66%. In the univariate analysis, two prognostic variables were retained namely the hemoglobin and creatinine level. The study suggest that conventional therapy is a good treatment for old patients. However, patients younger than 55 years, must benefit from intensive chemotherapy supported by autologous bone marrow, pheripheral blood stem cells, or allogenic bone marrow transplantation. A considerable encrace in duration of remission and survival is possible.La Tunisie médicale 01/2001; 78(12):705-12. -
Article: The clinical impact of early gram-positive bacteremia and the use of vancomycin after allogeneic bone marrow transplantation.
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ABSTRACT: Gram-positive bacteremia (GPB) is an increasing infection after allogeneic bone marrow transplantation (BMT). Our purpose was to identify risk factors for GPB, to evaluate its impact on early mortality and morbidity, and to compare prophylactic with empirical intravenous vancomycin. We studied 89 consecutive BMTs in adult patients. Early GPB occurred in 29% of posttransplantation episodes. T-cell depletion (odds ratio [OR]: 0.18) and vancomycin-prophylaxis (OR: 0.28) reduced the risk of GPB. Mortality at 6 weeks was not significantly different in patients with GPB (15% vs. 9.5%, P = 0.669). GPB was associated with the development of major complications, the use of amphotericin B, and prolonged neutropenia. Vancomycin prophylaxis led to an increased risk of early renal dysfunction (OR: 18.7). GPB contributes to overall morbidity during the early post-BMT episode but has no impact on mortality. Vancomycin prophylaxis is effective to reduce GPB but has a negative effect on renal function.Transplantation 05/2000; 69(7):1511-4. · 4.00 Impact Factor -
Article: [Results of a prospective protocol for the treatment of adult Hodgkin's disease].
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ABSTRACT: To report the results of an adapted protocol of treatment of Hodgkin disease in Tunisian patients. 70 patients (47 males and 23 females, sex-ratio = 2.04) with a mean age of 38.5 years (15 to 75) are enrolled in a therapeutic protocol to the prognostic factors and based on chemotherapy with MOPP/ABV or hybrid associated to radiotherapy. We perform an evaluation of response to chemotherapy after the 4th cycle, after the 6th cycle and then at the end of the protocol. Our population is characterized by the frequency of young patients(34% between 30 and 40 years), histologic types 2 and 3 (45 and 48%) and advanced disease with 60% of stages III and IV. After the 4th cycle, 32 patients(45%) are in complete response and 31(44%) in partial response, while 6 patients(9%) progress under chemotherapy. After 6 cycles, we observe 44 in complete response(72%) including 46% of the bad responders after 4 cycles. At the end of the protocol and on the 58 evaluable patients, 50 remain in complete response(86%). We observe 5 deaths occurred in 3 progressing patients and in 2 patients by infection after chemotherapy. 5-year actuarial and disease-free survival is 60% and 56% and median survival is 83 months. In the univariate analysis, response to chemotherapy represent the unic significant prognostic factor.La Tunisie médicale 01/2000; 77(12):614-20. -
Article: [The 5q(-) syndrome. Report of 2 cases].
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ABSTRACT: A rare and primitive myelodysplastic syndrome 5q(-) is characterised first, by the persistence of the cytogenetic anomaly 5q(-), and second, by its feminine predominance. Among 13 cases of myelodysplastic syndromes, the subject of a substantial and systematic cytogenetic medullar study (1996-1998), this paper is a case study of 2 syndromes 5q(-) diagnosed in two male patients, respectively, aged 41 and 68. The following diagnosis was made on the basis of an aregenerative macrocytic anaemia, a high platelet count, and a megakaryocytic hyperplasia, along with dysmegakaryocytopoiesis. The diagnosis of the 5q(-) syndrome was verified by cytogenetic analysis showing in one of the patients a deletion 5q(-)(q13, q33) and 5q(-)(q14, q34) with trisomy in the second one. Treatment was only limited to a blood transfusion. Subsequently one of the patients developed an advanced case of leukaemia. This paper suggests that a systematic medullar cytogenetic study must be conducted in the case of any refractory anaemia in order to identify the syndrome 5q(-) in individual cases.La Tunisie médicale 12/1999; 77(11):589-92. -
Article: [Destomebes-Rosaï-Dorfman syndrome (apropos of a case)].
La Tunisie médicale 12/1998; 76(11):421-3. -
Article: [Bernard Soulier disease and severe peripheral thrombopenia: apropos of 2 cases].
La Tunisie médicale 12/1996; 74(12):585-7. -
Article: [Pulmonary aspergillosis in the neutropenic patient. Apropos of 4 cases].
La Tunisie médicale 11/1996; 74(11):493-500. -
Article: [Hemoglobinopathies in Nefza: a model of health intervention].
La Tunisie médicale 01/1996; 74(1):33-8. -
Article: [Association of heterozygote drepanocytosis and G6PD deficiency: apropos of a case].
La Tunisie médicale 10/1995; 73(10):415-7. -
Article: [Association of hemoglobin O Arab/ hemoglobin S: 3 cases].
La Tunisie médicale 04/1991; 69(3):171-5. -
Article: First case in Tunisia of PH1 positive chronic myelogenous leukemia in a 3 year old child.
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ABSTRACT: The first case in Tunisia of a 3 year old child with adult type chronic myelogenous leukemia is presented. Diagnosis was based on clinical and biological presentation and detection of Philadelphia (PH1) chromosome. Chronic myelogenous leukemia in children represents 3.8% of all cases of chronic myelogenous leukemia detected in Tunisia between 1970 and 1990. Only one 3.5 year old case was reported without PH1 chromosome.Nouvelle revue française d'hématologie 02/1991; 33(3):275-6. -
Article: [Sickle cell anemia and pregnancy].
La Tunisie médicale 02/1990; 68(1):5-8. -
Article: [A clinical and hematologic profile of the sickle cell syndrome: apropos of 38 cases].
La Tunisie médicale 11/1989; 67(10):613-6. -
Article: [Genetic study of congenital afibrinogenemia: apropos of 7 families].
La Tunisie médicale 06/1989; 67(5):315-9. -
Article: [Thalassemia intermedia: apropos of 14 cases].
La Tunisie médicale 04/1989; 67(3):173-6.
