La Revue de médecine interne
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Hemolysis and red cell fragmentation accompanying vitamin B12 deficiency may misdirect the diagnosis. Signs of malabsorption and abnormalities related to folic acid metabolism characterized by discrepancies between folic acid normal serum levels and erythrocytic folic acid levels may also exist. ⋯ An association between hemolysis, malabsorption and folic acid deficiency should lead physicians to search for signs of vitamin B12 deficiency.
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Non-traumatic myositis ossificans circumscripta is a relatively rare, well defined entity. The pathogenic role of ischemia in its development is discussed. ⋯ Results of X rays, computerized tomography, MR imaging and biopsy are reviewed. Histologically, this lesion main feature is peripheral bone maturation within three areas. Mechanisms (traumatic or not) underlying these lesions are unknown. To our knowledge, only one published case would be comparable to ours. Proliferation followed by change in mesenchymal cells leading to heterotopic ossification must be regarded as a consequence of either ischemia or repeated micro-trauma occurring during muscle shortening.
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Case Reports
[An unknown cause of prolonged fever: apropos of 6 cases of chronic aortic dissection].
Aortic arch dissection may be sometimes misdiagnosed due to the lack of mild to moderate chest pain. Definite diagnosis is often made while dissection has already occurred more than 15 days ago, being thereafter considered as chronic. Aortic dissection may then present as a prolonged febrile illness with fever and/or inflammation as main symptoms, with little or no pain. ⋯ Chronic aortic dissection has rarely been reported to cause fever or increased sedimentation rate. Treatment has to be discussed between medical and surgical teams involved in the therapeutical management of these unusual patients.