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Copyright of Cahiers Santé - Médecine Thérapeutique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Factitious Cushing's syndrome is extremely rare. The difficulty of its diagnosis lies in the cross-reaction between synthetic corticosteroids and plasma or urinary cortisol during immunological tests, which can make it difficult to distinguish between the real Cushing's syndrome and its factitious version. We present in this article a case of 33-year-old women, followed for ankylosing spondylitis for which she had received corticosteroid therapy in the past, who presented for a frank physical stigma of Cushing's syndrome, for which she had consulted several times. The biological evaluation found evidence of elevated free cortisol urinary levels contrasting with inhibited plasma cortisol and inhibited ACTH. The dynamic tests carried out were negative. The adrenal imaging was without particularities. Although the patient has always denied taking exogenous corticosteroids, the measurement of urinary free cortisol using liquid chromatography coupled with mass spectrometry who was decisive and showed drug interference during measuring. In this rare case, we expose the difficulties encountered by the clinician on two levels, proving the exogenous origin of glucocorticoid toxicity on the one hand and confronting the patient and their relatives on the other hand. Finally, it is important to consider this differential diagnosis in cases of hypercortisolism, especially when the patient's medical history and the results of investigations are contradictory. [ABSTRACT FROM AUTHOR]

Ocular inflammatory reactions secondary to treatment with bisphosphonates are a rare entity. Their physiopathological mechanism is still poorly understood but seems to be linked to an immunological reaction mediated by some cytokines. Observation: We report the case of a 63-year-old patient followed for severe osteoporosis and treated with zoledronate. The patient presented 6 weeks after the initiation of treatment with a decrease in visual acuity diagnosed as acute anterior uveitis. Conclusion: Acute anterior uveitis is an important entity to be aware of because a good evaluation and rapid management can reduce complications involving the visual prognosis. [ABSTRACT FROM AUTHOR]

Les néoplasies pulmonaires à petites cellules et les tumeurs avec une différenciation neuroendocrinienne sont très fréquemment impliquées dans les syndromes paranéoplasiques. Elles peuvent perturber l'équilibre hydrique de deux manières, qui doivent être reconnues par l'interniste et l'endocrinologue. La plus fréquente est le syndrome de Schwartz-Bartter, qui fait suite à une sécrétion ectopique d'hormone antidiurétique par les cellules néoplasiques. La seconde est le diabète insipide central par le biais d'une destruction massive de l'hypothalamus par dissémination métastatique. Peu de cas sporadiques de diabète insipide central du fait d'une localisation secondaire ont été rapportés. Nous rapportons l'observation clinique d'une présentation inhabituelle de cancer pulmonaire à petites cellules, associé à un syndrome polyuropolydipsique, avec une bonne réponse au traitement. [ABSTRACT FROM AUTHOR]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)