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Introduction: Thrombotic thrombocytopenic purpura (TTP) is a rare but potentially fatal hematological disorder that requires urgent treatment. Once the diagnosis has been made, plasma exchange (PE) must be started immediately and until a response is obtained., Aim: Evaluate PE in terms of responses and complications in the treatment of TTP., Methods: This was a monocentric, descriptive, retrospective study including patients in whom TTP was diagnosed and treated with plasmapheresis in the clinical hematology department at Aziza Othmana Hospital, between January 2010 and December 2020., Results: Our study included 26 patients. PE was initiated within a median of 1 day. The rhythm of exchanges was daily in 22 patients. Twenty PE-related complications were noted, hypocalcemia being the most frequent (30%). CR was achieved in 15 patients after PE alone. Nine patients were refractory, and six received 2nd-line treatment, with CR achieved in five patients. Relapse was noted in six patients (40%). They were treated by PE and only one patient received rituximab. Four patients had a response. The overall response rate was 69% and overall mortality was 30%. OS at 2 years was 68,3% and RFS was 84,4%. Factors associated with the achievement of CR were the fall in LDH at D5 of treatment (p=0,027,OR=0,59 ;IC 95%[0,32-1,08]) and the daily rhythm of PE (p=0,005, OR=0,35; IC 95%[0,14-0,91])., Conclusion: Our results were comparable to those of the literature, but the rate of refractory disease was higher. Rituximab may enhance our results.

The Assure approach (improvement of emergency care) is a project designed to improve emergency care for the 63,000 residents of homes for the dependent elderly (Ehpad) in the Ile-de-France region. By reinforcing the skills of caregivers in emergency situations and facilitating collaboration between care providers, the Assure approach is mobilizing, alongside all the Ehpad in the Ile-de-France region over a period of two years, the emergency medical assistance services, emergency physicians, mobile geriatric teams and nursing and care assistant training institutes., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Introduction: Retinal vein occlusion is usually encountered in the elderly and is often associated with systemic vascular disease. It is rarer in young subjects and requires a serious etiological search to best adapt the treatment., Observation: We report the case of a central retinal vein occlusion (CRVO) in a 26-year-old patient who had no pathological history, discovered at a sudden decline of vision in the right eye, reduced to light perception. Fundus examination and retinal angiography showed an edematous CRVO. Radiologic imaging revealed a narrowing of the right carotid canal, probably congenital, and a reduction in the size of the right common carotid artery and internal carotid artery. Progression was favorable without treatment, and visual acuity improved to 8/10., Conclusion: The etiological investigation in retinal vein occlusion in young people must be exhaustive. The visual prognosis is variable and may depend on the etiology., (Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.)

Aims: To study the immunohistochemical expression of HHV8 in Kaposi's lesions and in other vascular lesions and to determine the utility of this technique in differentiating between Kaposi's disease (KD) and other vascular lesions., Methods: Fixed, paraffin-embedded tissue sections from 25 cases of KD, 9 cases of hemangioma, 2 cases of angiolymphoid hyperplasia with eosinophilia and 9 cases of angiosarcoma were examined immunohistochemically using the monoclonal antibody monoclonal LNA 53 (ABI). Strong, nuclear and granular staining in at least a cell was considered as a positive result., Results: Sixteen cases of KD showed positive staining, whereas all cases of hemangioma, angiolymphoid hyperplasia with eosinophilia and angiosarcoma were negative for this antigen, Conclusion: Immunohistochemical detection of the human herpesvirus-8 latent nuclear antigen-1 is a useful for differentiating between KD and other vascular lesions.