Purpose: The hepatitis C-Auto-immune hepatitis overlap syndrome is an uncommon condition whose management can be difficult in both diagnosis and treatment.
Patients et méthodes: 62 old years women, without particular history Hepatitis C was proven by a positive HCV viral load and the autoimmune hepatitis was proven by characteristic immunological and/or histological features.Liver function tests was prescribed. Search for hepatitis B and C viral markers was performed by chimiluminescence, the viral load of the virus VHC was performed by molecular biology. The nuclear anti body were detected by indirect immunofluorescence on hep cells 20-10.Solubles antigens was performed by dot blot
Résults: Laboratory studies showed a lever transaminase ALAT at 220 UI /l, ASAT at 231 UI /l, hypergammaglobulineamia at 30g/l, HVC seropositive, high viral load at 6.19 106 UI/ml. The nuclear antibody showed cytoplasmic fluorescence, Anti DNA were negative, liver biobsy showed lymphocytic infiltrates and steatosis
Conclusion: This case illustrates diagnostic and therapeutic difficulties of hepatitis C–AIH overlap syndromes, this study highlights the deciding contribution of the initial histological findings in the diagnosis of such a HCV/autoimmune hepatitis overlap syndrome.
Introduction: Carbapenemase is a bactericidal antibiotic. They are first line treatments for severe infections, especially those caused by Gram negative Multidrug Resistant Bacteria (BMRs), such as spectrum extended spectrum beta lactamase Enterbacteriaceae, several phenotypic techniques have been proposed for the rapid detection of OPCs. In this work we will establish a comparaison of the performances of the two phenotypic methods of detection of carbapenemases: the Modified Hodge test and EUCAST algorithm.
Results: A total of 18 enterobacterial strains were identified. The iodentification by the Api 10S gallery showed: a predominance of Klebsiella pneumoniae with a rate of 48%, followed by Enterbacter cloacae with a rate of 30%. The detection of carbapenemase production in the 18 enterobacterial strains was first performed by the Modified Hodge test, It revealed 83%. positivity and 17% negativity, the screening algorithm applied to 18 islates of the collected EPCs, showed a pourcentage of positivity of 78% which is more significant than the percentage of negativity 22%. The PCR reaction in final time allowed us to detect 15/18 strains of enterobacteriaceae producing genes encoding carbapenemases and therefore a percentage of positivity of 83,34%. This percentage of positivity with the use of real-time PCR 88,89%, detecting an increased strain of EPC more.
Conclusion: At the end of our work, the screening algorithm proposed by EUCAST is the detection of EPCs dating from a good sensitivity and specificity according to the recommandations of learned societies.