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Eosinophilic myocarditis (EM), irrespective of its unique etiology, is marked by varying extents of eosinophil infiltration, frequently accompanied by peripheral eosinophilia.In some instances, the etiology remains undetermined, thus classified as idiopathic hypereosinophilic syndrome. The clinical manifestations are highly variable, ranging from mild or asymptomatic presentations to acute fulminant myocarditis or chronic restrictive cardiomyopathy.We report a case of idiopathic hypereosinophilic syndrome, characterized by eosinophilic myocarditis, alongside axonal and dermatological involvement. During the follow-up period, the patient demonstrated significant clinical and echocardiographic improvement under corticotherapy and heart failure management, including normalization of eosinophil counts.

Background Anti-viral therapy is not routinely recommended for chronic hepatitis B virus (HBV) infection, in patients who have persistently elevated serum HBV DNA level (>2000 IU/mL), normal alanine aminotransferase (ALAT) and without significant liver fibrosis, defining the indeterminate phase. The objective of the study is to identify the factors associated with the progression of liver fibrosis in chronic HBV infected patients in the indeterminate phase. Methods This is cross-sectional study, conducted in Infectious Disease and Hepato-gastroenterology departments of Farhat Hached university hospital, between January 2008 and January 2022. We have included the Ag HBs (+) patients initially not treated, presenting at the time of the initial evaluation: a viral load> 2,000 IU/L for at least six months, normal ALAT ( Results In total, 97 patients were included, with a median age of 32.9± 9.1 years, and a female predominance (sex ratio M/F=0.64). Progression of fibrosis was observed in 16 patients (16.5%) with a mean delay of 70.9±41.1 months. In the univariate analysis, factors associated with progression of fibrosis were the presence of comorbidities (p=0.001), the high initial viral load (p=0.004), the appearance of cytolysis (p=0.001) and the increase in viral load (p=0.002), during follow-up. The AUROC of the initial viral load was 0.664 (95%CI: 0.500-0.820). An intial viral load at 8090 UI/l was associated with the progression of fibrosis with a sensibility of 70.3% and specificity of 63%. Conclusion Factors associated with progression of fibrosis in the indeterminate phase of chronic HBV infection were the presence of comorbidities, and changes of ALAT during follow-up. This leads us to consider extending the therapeutic indications to this group of patients.

This case report presents a complex case of a 65-year-old female with a history of hypertension and a family history of polycystic kidney disease and Fabry disease presented with acute pancreatitis and subsequent renal insufficiency. Despite initial corticosteroid therapy for immuno-allergic nephropathy, the patient’s condition deteriorated with the development of a skin rash, uremic syndrome, and neurological symptoms. A renal biopsy revealed cellular crescents and cytoplasmic vacuolization in podocytes and tubular cells. Genetic testing confirmed a GLA gene mutation, consistent with Fabry disease. While undergoing treatment with cyclophosphamide, the patient experienced severe allergic reactions, ultimately leading to acute respiratory distress syndrome and fatal outcome. Despite the Fabry disease variant being primarily associated with cardiac involvement, renal involvement was evident. This case highlights the rarity of this co-occurrence, the diagnostic challenges, the importance of genetic factors in autoimmune kidney diseases, and the impact of drug allergies on patient management.

Exploiting the beneficial chemical composition of halophytes is increasingly becoming important since these special plants can survive extremely high temperatures and withstand water salinity. Catalytic upgrading of Salicornia Bigelovii (SB) seeds was conducted previously using Ni/H-β zeolite as the catalyst in the temperature range of 200–500 °C for use in jet fuels. In this work, we conduct fast pyrolysis using the higher acidic and intra-crystalline mesoporous Ni/mordenite zeolite and hydrogen gas to explore its deoxygenation capabilities on the bio-oil produced from pyrolysis of SB seeds in the same temperature range. Our objective here was to increase the yield of aromatics as well as produce mainly deoxygenated compounds in the products to be ultimately used as transportation fuels. Various hydrodeoxygenation (HDO) pathways such as dehydration, demethoxylation, decarboxylation and dehydroxylation were explored considering compound classes from different parts of the SB seeds such as cellulose/hemicellulose, lignin and unsaturated fatty acids. The highest potential of the MOR zeolite with Ni active metal for deoxygenation and aromatization was realized at 400 °C, where 0 % oxygenates and the highest yield of 61 % aromatics were obtained among all temperatures used in this work. The performance of Ni/MOR zeolite in terms of the yield of aromatics, poly-substituted benzene derivatives, aliphatics and HDO capability were compared with that of Ni/H-β zeolite that was used in our previous work, and it was seen that mordenite exhibited a higher degree of deoxygenation with increased aromatics production. Gas chromatography-mass spectrometry (GC-MS) was used to identify the different compounds in the pyrolytic bio-oil. Some reaction sequences were also proposed for the formation of these aromatics and verified with evidence from literature. The novelty of our work is that mordenite zeolite combined with Ni active metal has not been previously used in the fast pyrolysis of SB seeds or any other halophyte to explore the deoxygenation ability. The significance of our study is in the production of ‘drop-in’ transportation fuels in a highly sustainable way from halophytes that can aid in mitigating climate change.

Systemic lupus erythematosus (SLE) rarely occurs in men of any age. Late-onset SLE (typically after the age of 50) presents special challenges. We report a case of SLE with renal involvement in a very old man. The patient, who was 82 years old, presented with acute kidney injury and a family history of SLE. He was diagnosed with lupus nephritis based on clinical criteria, although no renal biopsy was performed. After starting corticosteroid therapy, his condition improved markedly, with recovery of renal function and resolution of proteinuria and hematuria. The patient’s case is notable for its advanced age and familial context, with a milder form of lupus compared with his relatives. Despite the absence of severe kidney damage, the patient’s treatment with corticosteroids was effective, reflecting the unique and rare nature of this case.