Mois : janvier 2026

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DOI: 10.48087/BJMS.2025.130202

Authors: Nadir BENABDERRAHMANE¹, Mohamed Lyes DJAMA¹, Hayet BACHA¹, Yasmine BAGHDALI², Hind ARZOUR², Hayat KHALFAT³, Charaf Amir ZINE³, Malika BOUCELMA¹

Affiliations: 1- Internal medicine department, Bachir Mentouri Hospital, Algiers, Algeria. 2- Nephrology department, Mustapha Bacha Hospital, Algiers, Algeria. 3- Anatomopathology departement, Mustapha Bacha Hospital, Algiers, Algeria.

Keywords: Polyarteritis nodosa, Hepatitis B, Vasculitis, Plasmapheresis, Antiviral therapy.

Abstract

Polyarteritis nodosa (PAN) is a necrotizing vasculitis affecting medium and small arteries. Its secondary form linked to hepatitis B virus (HBV-PAN) has become rare. This report describes a 49-year-old Algerian woman with HBV-PAN presenting with prolonged fever. She exhibited fever, fatigue, leg edema, rash, elevated inflammatory markers, mild proteinuria, and elevated liver enzymes. Workup revealed acute hepatitis B infection. During admission, she developed sensorimotor polyneuropathy, diffuse abdominal pain, myocarditis with heart failure, and severe hypertension. Renal biopsy confirmed PAN with fibrinoid necrosis of small vessels, fulfilling the ACR 1990 criteria. Treatment included tenofovir, nine plasma exchange sessions, corticosteroid pulses followed by oral prednisone, and rehabilitation. The clinical course improved significantly, with resolution of pain, recovery of neurological function, and stabilization of cardiac and renal function. However, at six-month follow-up, hepatitis B remained chronic, posing an ongoing relapse risk. HBV-associated PAN is now rare but remains a severe condition. It should be suspected in patients presenting with systemic vasculitic symptoms and positive HBV serology. Combined therapy with antivirals, corticosteroids, and plasmapheresis can lead to favorable outcomes.

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DOI: 10.48087/BJMS.2026.130201

Authors: Sarah BOUAMEUR¹, Meriem DADOUCH², Yamina SEFFIH², Amani MEDJAHED²

Affiliations: 1- Département de pharmacie, Faculté de Médecine, Université Oran1. Oran. 2- Département de pharmacie, Faculté de Médecine, Université Djillali Liabes, Sidi Bel-Abbès – Algérie

Keywords: antidiarrheal, citric acid, extemporaneous preparation, loperamide, syrup, tincture.

Abstract

Loperamide hydrochloride is the most commonly indicated molecule for the symptomatic treatment of acute and chronic diarrhea. However, its presentation in solid forms (tablets and capsules) limits its use in children and patients with dysphagia, while the oral solution remains unavailable due to supply shortages and discontinuation of marketing. In response to this situation, a 0.02% loperamide hydrochloride extemporaneous syrup was developed as an alternative to existing formulations. Materials and Methods. Four syrups containing 0.02% loperamide hydrochloride were formulated. Different solubilization media for the active ingredient were investigated: 2% citric acid solution, lemon tincture, distilled water, and glycerol. The simple syrup used as a vehicle was prepared by cold method with sucrose at a concentration of 65% ± 1%. The formulations underwent quality control testing for macroscopic appearance, pH, density, viscosity, and assay content over a 20-day storage period at room temperature and protected from light. Results and Discussion.  Under experimental conditions, the density of the syrups and their loperamide hydrochloride content remained within acceptable limits for 14 days. The pH and macroscopic appearance showed notable changes, with the exception of the syrup containing 2% citric acid solution, which demonstrated relatively satisfactory stability. Conclusion. The formulation of 0.02% loperamide hydrochloride in syrup form is an innovative approach aimed at meeting the specific needs of patients with dysphagia and the pediatric population. The stability of this extemporaneous preparation is adequate for the duration of treatment of an acute episode of non-infectious diarrhea.