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Factor V deficiency is a rare hemostatic disorder. It may present with a diverse spectrum of symptoms due to a variety of mechanisms including development of autoantibodies associated with a number of conditions. We report a first case of factor V deficiency in Tunisian hemodialysis patient due to an autoantibody most likely secondary to antibiotic exposure responsible for an arteriovenous shunt thrombosis rather than bleeding. We discuss here the clinical and biological features of acquired factor V inhibitor and provide a short review of the current literature.

La recherche des anticorps irreguliers (RAI) chez la femme enceinte est fondamentale. Le but etait d’analyser les RAI pour evaluer la prevalence de l’AI antierythrocytaire en milieu obstetrical. L’etude etait retrospective (09/2016-01/2019). Les renseignements cliniques recueillis : Groupe sanguin (GS) ABO RH1, terme gestationnel, antecedents obstetricaux et transfusionnels, injection d’immunoglobulines anti RH1. La RAI etait realisee par coombs indirect (CI) sur carte gel. Deux panels (depistage et identification) ont ete utilises. Le titrage des anticorps immuns etait fait par CI en microfiltration. L’analyse des donnees etait faite par SPSS. Trois milles six-cents soixante RAI (moyenne :1[1–7]) etaient realisees pour 3543 femmes. Quatre cent quatre-vingt six cas etaient documentes. Les GS etaient essentiellement : O (49 %). 71 % etaient RH1 positif. Les RAI etaient realisees au 2e trimestre dans 35 % des cas. 37 % des femmes etaient nullipares. Les antecedents obstetricaux releves etaient avortement (13 %), toxemie gravidique (9 %), mort fœtale in utero (3 %). La transfusion etait notee chez 1 % des femmes. La RAI etait positive dans 35 cas (1 %) identifiant 40 anticorps (Ac) ou associations d’Ac : 15 allo-Ac (anti RH1 :2 cas, anti RH1 + anti RH2 :2 cas, antiRH3 + anti RH4 :2 cas, anti RH3 :1cas, anti RH2 :1 cas, antiMNS 3 :1 cas, anti FY1 :1cas et un anti HTLA :1cas), 22 anti-RH1 passifs, 2 auto-Ac (IgG) et un Ac anti MNS1. Le titre d’anti-RH1variait de 16 a 2048 et celui de l’anti-MNS1 etait de 64. Une transfusion in utero a ete realisee dans 2 cas. L’AI antiRH1est relativement faible, neanmoins l’identification d’autres Ac incite la mise en place d’un calendrier bien definie de surveillance obstetricale en Tunisie.

Von Willebrand's disease (VWD) is the most commonly inherited bleeding disorder. It is characterized by clinical, biological and molecular heterogeneity. In certain types of the disease, diagnosis can be difficult.We report the clinico-biological characteristics of VWD's patients and analyze diagnosis difficulties.33 cases were diagnosed in the laboratoryfrom February to May, 2011. Screening hemostasis included the measuring ofC, VWF: Ag and VWF: RCo. Blood cell count and blood group were performed in all cases.Mean age at diagnosis is 13 years [10 months -43 years]. The sex ratio M/F is 0.5. The patients are classified type 3 VWD in 52% of the cases, type 2 VWD in 30 % of the cases and type 1 VWD in 18 % of the cases. The diagnosis of type 2B VWD suspected in combination of the ratio VWF:RCo / VWF: Ag0,7 and thrombocytopenia in one case. Required tests for positive diagnosis and distinction between the primary categories of VWD are available. Specialized tests will allow a best characterization variants type 2 VWD for a better therapeutic approach.

Immunophenotyping is an essential step in the diagnosis of acute myeloid leukemia. Its prognostic value remains controversial with contradictory results.To assess prognostic impact of the immunophenotyping in AML.Our study is retrospective (October, 2005 - July, 2007) concerning 56 cases of AML (AML3 excluded) of the adult from 18 to 55 years old diagnosed and treated in Tunis Aziza Othmana Hospital. The immunophenotyping was performed by flow cytometry (Beckman Coulter EPICS XL MCL®). We studied clinical and biological characteristic, immunophenotypic expressions, and parameters of the response to the treatment: complete remission (CR), overall survival (OS), relapse free survival (RFS) and relapse in a delay of 1 year and 2 years. SPSS software was used to perform the statistical analysis.The median age of the patients is of 37,7±11.8 years. Sex ratio (M/F) is 1.33. Among individual antigenic expressions, only CD7 is associated to lower CR rates (p=0.044). We did not find any statistically significant association between immunophenotypic expressions and OS nor with relapse or RFS.The impact of immunophenotyping in AML remains controversial because of contradictory results. The research of molecular changes would be an interesting alternative in our context.