[Synthesis, chemical and toxicological study of a new benzimidazol derivative]

Hydatidosis is a cosmopolitan parasitic disease that remains a real public health problem in highly endemic countries. Surgery is the mainstay treatment, but with significant morbidity and mortality. In addition, contraindications for surgery emphasize the importance of developing effective medications. Currently, albendazole is the main anti-hydatid agent used worldwide. It has proven efficacy but limited bioavailability due to weak absorption. In order to improve the bioavailability of this molecule we synthesized an ester of albendazole, which exhibits a totally modified solubility compared with the princeps compound. This synthesis was achieved with an output of 75%. The structure of the synthetic product was established by IR spectrometry and by proton nuclear magnetic resonance. A careful toxicity study revealed that this product has little toxicity when administered intraperitoneally and orally in mice, with a lethal dose 50 of 2,500 mg/kg per os and 2,250 mg/kg intraperitoneally, values comparable to those of albendazole. This in vitro parasitological study demonstrated that the chemical changes introduced on the albendazole molecule had no effect on its antiparasitic activity.

Myopericarditis in a Patient With Cryoglobulinemic Kidney Disease: A Case Report

Cryoglobulinemic vasculitis is a rare small-vessel vasculitis leading to multi-organ dysfunction, often associated with chronic infections like hepatitis C virus (HCV), and autoimmune disorders. Most cases involve mixed monoclonal or polyclonal immunoglobulins, presenting symptoms such as purpura, arthralgias, and weakness. Severe organ involvement, particularly cardiac, is rare but potentially life-threatening. We report the case of a 48-year-old woman without prior medical history who presented with acute dyspnea, generalized petechial purpura, and signs of global heart failure. Imaging and laboratory findings indicated cardiomegaly, pericardial effusion, and significant nephrotic syndrome with renal failure. The diagnosis of cryoglobulinaemia was confirmed through histology and serology, showing monoclonal IgM with kappa hypergammaglobulinaemia and complement consumption. Treatment included various immunosuppressants, corticosteroids, and rituximab combined with renal replacement therapy. Following the initiation of treatment and proper management of heart failure, the patient's condition significantly improved. Cardiac involvement in cryoglobulinemic vasculitis, though rare, can lead to severe heart failure. This often involves necrotizing vasculitis of the coronary arteries or systemic inflammation damaging the cardiac muscle, as observed here. Cardiac manifestations with immunosuppressive therapy are reversible despite a poor long-term prognosis for patients with cardiac lesions. In conclusion, cryoglobulinemic vasculitis has a grim prognosis due to its multi-organ impact and the severity of the lesions. Early and aggressive treatment is essential to manage life-threatening acute presentations, even before confirming the diagnosis biologically or histologically.