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Introduction: Neurological disorders associated with hepatitis C is most often related to mixed cryoglobulinemia. The aim of this study is to show the severity of neurological disorders during hepatitis C infection. Observation: Mrs. S A, 60 years old, who had been in purpuric rash for six months, associated with physical and psychic asthenia and weight loss at 16 kg in 8 months. The evolution was marked by an alteration of the neurological state of the patient with an installation of motor deficit affecting the 04 limbs, abolition of the osteotendinous reflexes, and a hypoesthesia of the upper and lower limbs. The electromyogram (EMG) showed a sensorimotor polyradiculoneuropathy, and the etiological diagnosis was in favor of a peripheral neuropathy secondary to a cryoglobulinemia, related to hepatitis C. In addition, the patient presented after a few days of headaches, a sharp drop in visual acuity and high blood pressure, this is complicated by two episodes of convulsive seizures. A cranial CT scan is performed in an emergency without abnormalities, with no sign in relation to thrombophlebitis after injection of contrast agent. The diagnosis retained is a central neurological disease secondary to infection with the virus c associated with peripheral neurological disease. Conclusion: Neurological disorders associated with hepatitis C are rare but poor prognosis threatening the functional and vital prognosis of patients.

Introduction: Cancer of the pancreas is one of the most aggressive solid tumors often discovered at a locally advanced or metastatic. Adenocarcinoma is the most common histological type. The aim of our study was to analyze the profile of pancreatic cancer by the various imaging techniques. Materials and methods: Descriptive retrospective study over a period of 7 years including all patients who were followed for pancreatic cancer. The epidemiological data, clinical, morphological and treatment were collected, all the patients were hospitalized. The therapeutic decision was taken after a multidisciplinary meeting between the different specialists in the Department of Gastroenterology and liver diseases, medicine C, ibn sina hospital, Rabat, Morocco. Results: Over a period of 7 years, 67 patients were collected. These 37 men and 30 women with a sex ratio of 1.23. The average age was 60 years (26-93 ans). 37% of patient’s had a history of diabetes. Clinically 43% of patients had cholestatic jaundice, 28% had abdominal pain. Clinical examination revealed an abdominal mass in 23% of cases. Abdominal ultrasound showed dilatation of the biliary tract in 67% of cases, the abdominal scanner allowed the diagnosis of pancreatic cancer in 88% of cases. The tumor site was cephalic in 67% of cases, corporeal in 7% of cases and caudal in 25% of cases. Magnetic resonance imaging (MRI) was reported in 11% of patients for suspected intra-ductal papillary mucinous neoplasms (IPMNs) or as a complement to the diagnosis. Echoendoscopy was performed in 11% of the patients as part of the locoregional extension. The average size of the tumor was 48 mm. CA19-9 was only dosed in 26 patients. It was positively positive in 65% of patients and normal in 35% of patients. Histologically, 83% had adenocarcinoma, 3% had lymphoma, 3% had neuroendocrine tumors, and 5% had degenerated IPMNs. Cancer was resectable in 9 patients (13%). The main operative contraindications were vascular and lymph node invasion in 6 patients (8%) and pulmonary or peritoneal liver metastases in 53 patients (80%). For patients with non-resectable cancer, palliative treatment was indicated either by surgical biliary drainage in 4% patients or by endoscopic insertion of biliary prosthesis in 14% of cases or by external biliary drainage in 4% of cases. Chemotherapy was indicated in 78% of patients. Therapeutic abstention was indicated in 10 patients. Conclusion: In our study 82% of pancreatic cancers were diagnosed in the metastatic stage and 10% in locally advanced stage. The only curative treatment currently exists is surgery that has been achieved only in 8% of our patients.

Introduction: Celiac disease is an autoimmune enteropathy induced by the ingestion of gluten (wheat, barley, rye). The classical form has become a minority. Currently, the most frequent forms of presentation are extraintestinal with various manifestations, among others, reproductive disorders. The aim of our study is to assess the frequency of these disorders in celiac disease and their evolution under gluten-free diet. Materials and methods: Descriptive retrospective study of 173 patients with celiac disease followed in the department of diseases of the digestive tract "Medecine C" of the Ibn Sina Hospital in Rabat, over a period of 18 years. Result: In 173 patients with celiac disease, 58 patients (28.9%) had reproductive disorders. There are 53 women and 5 men. The average age was 25-32 years. The diagnosis of celiac disease is based on histology and serology. The reproductive problems were never isolated but always associated with other digestive or extra-intestinal signs at the time of diagnosis of celiac disease. These disorders are represented by: delayed puberty in 11 cases (19%), secondary amenorrhea in 13 cases (22.4%), irregular menstrual in 12 cases (20.6%), absence of development of secondary sex characteristics in 8 cases (12.5%), spontaneous abortions in 7 cases (10.9%), menometrorrhagia in 4 cases (13.8%), primary sterility in 5 cases (8.6%), early menopause in 6 cases (10.3%), premature delivery in 3 cases (5%), primary amenorrhea in 2 cases (3.4%) and intrauterine fetal death in one case (1.7%). All our patients have had a gluten-free diet. 15 patients lost to follow-up, two patients died and 12 patients undergoing follow-up. The remaining 29 patients, the evolution of reproductive disorders under gluten-free diet was favourable in 26 cases (90%), with the normalization of cycles in 15 cases, resumption of cycles in 6 cases, development of secondary sex characteristics in 2 cases, fertility resumption in one case, initiation of cycles after primary amenorrhea in one case and delivery of a new-born at term after premature deliveries in one case. The evolution was unfavourable in 3 cases with the notion of miscarriage 4 years after the start of the gluten-free diet in one patient and the absence of cycle resumption in two cases. Conclusion: The reproductive disorders associated with celiac disease are frequent and varied. In our study, these disorders responded very well under a gluten-free diet, conducted in 90% of cases. These disorders are thus reversible under this diet.