Guillain-Barré syndrome associated with Puumula Hantavirus infection.

We report the case of a 62-year-old man who developed Guillain-Barré syndrome (GBS) following Hantavirus infection. Only three similar cases have been described in the literature so far. GBS is an autoimmune disease characterized by progressive symmetrical weakness of lower limbs extending to upper limbs and face and low or absent tendon reflexes. Prompt diagnosis is mandatory as GBS is a potentially life threatening disorder and needs timely treatment to ensure fast recovery and fewer complications

vWFpp/Adams 13 ratio is a usefull marker of thrombotic microangiopathy post liver transplant: A pediatric Case report.

Thrombotic microangiopathy (TMA) encompasses a process of microvascular thrombosis, with thrombocytopenia, macroangiopathic hemolytic anemia, and multiple organ failure following ischemia-injury. TMA has a large range of etiologies and clinical presentations. Transplant-associated TMA has only, since recently, been recognized by the scientific community as a full entity. However, only a few pediatric cases have been reported after liver transplant. The diagnosis is often difficult and the treatment controversial. We describe the case of a 5 years-old child diagnosed with TMA based on increased Willebrand Factor pro-peptid (vWFpp)/ADAMTS 13 ratio in the course of a living-related liver transplantation. Tacrolimus immunosuppression was replaced by sirolimus and mycophenolic acid, in combination with administration of fresh frozen plasma (FFP), and this led to recovery of the TMA. We conclude that vWFpp/ADAMTS 13 ratio is a useful marker of liver transplant-associated TMA, and that the disease may be favored by Tacrolimus. Arrest of this drug can lead to recovery