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Le syndrome de DiGeorge un déficit immunitaire congénital (par absence ou sous-développement du thymus) 1219

Le syndrome de DiGeorge est un déficit immunitaire congénital dans lequel le thymus est absent ou sous-développé à la naissance, ce qui entraîne des problèmes avec les lymphocytes T, les globules blancs qui aident à identifier et détruire les cellules étrangères ou anormales. D’autres malformations congénitales cardiaques sont également présentes. Les enfants atteints du syndrome de DiGeorge naissent avec plusieurs anomalies, y compris des anomalies cardiaques, des glandes parathyroïdes peu développées ou absentes, un thymus peu développé ou absent et des traits faciaux caractéristiques. Les problèmes liés aux lymphocytes T provoquent des infections récurrentes. Ce trouble est appelé aussi syndrome de microdélétion 22q11 .2 . 1 /Quelles sont les causes de cette maladie La maladie résulte d'une perte (délétion) d'un petit fragment sur le chromosome 22 qui porte des gènes intervenant dans le développement du cœur, du cerveau, du thymus, et de la glande parathyroïde qui régule le taux de calcium dans le sang. Les conséquences de cette anomalie génétique sont très variables. Certaines personnes n'ont quasiment aucun symptôme et le diagnostic est parfois porté à posteriori , suite à la survenue d'un autre cas plus typique dans la famille. 2/ Quels sont les symptômes ? Il existe des déformations au niveau du visage avec une fente palatine à l’origine d’une occlusion incomplète de la cavité buccale lors de l'émission vocale. Les yeux sont généralement très écartés et la mâchoire est petite et en retrait. Sont observés un retard dans l’acquisition de la marche, de la parole et du langage avec une lenteur ou une maladresse dans l'exécution des gestes. Une susceptibilité particulière aux infections est fréquente avec notamment des otites à répétition et des infections pulmonaires. Une malformation cardiaque est présente dans 75 % des cas affectant essentiellement l’aorte. Un abaissement de la concentration de calcium dans le sang peut provoquer des crises de tétanie. 3/ Y a-t-il un traitement À l'heure actuelle, il n’est pas encore possible de remplacer le fragment chromosomique manquant. La prise en charge des troubles du langage repose essentiellement sur l'orthophonie. Une opération chirurgicale est parfois nécessaire. Un traitement antibiotique prolongé est parfois prescrit à visée préventive pour les enfants qui présentent des infections répétées. Une greffe de tissu thymique ou de cellules souches est effectuée en cas d’absence du thymus. DR MOUSSAYER KHADIJA, spécialiste en médecine interne et en gériatrienالدكتورة خديجة موسيار Présidente de l’Alliance Maladies Rares Maroc (AMRM) et de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Vice-présidente du Groupe de l’Auto-Immunité Marocain (GEAIM) POUR EN SAVOIR PLUS : SYMPTÖMES CARACTERISTIQUES (SOURCE MSD MANUEL), SYMPTÖMES CARACTERISTIQUES (SOURCE MSD MANUEL) Le fœtus ne se développe pas normalement et des anomalies affectent souvent les organes suivants : Cœur : Les enfants naissent souvent présentant un trouble cardiaque congénital Glande parathyroïde : L’enfant naît généralement avec des glandes parathyroïdes (qui contribuent à réguler les taux de calcium dans le sang) insuffisamment développées ou inexistantes. Visage : L’enfant présente en général des traits faciaux caractéristiques, tels que des oreilles basses, une petite mâchoire en retrait ou des yeux très écartés. Il peut présenter une fente dans le palais (fente palatine). Thymus : Le thymus est nécessaire pour le développement normal des lymphocytes T. Comme cette glande est absente ou insuffisamment développée, le nombre de lymphocytes T est faible, ce qui limite leur capacité de combattre de nombreuses infections.Le pronostic est en général lié à la gravité de l’atteinte cardiaque. DIAGNOSTIC DU SYNDROME Analyses de sang Parfois, examens d’imagerie (tels que radiographies du thorax et échocardiographie) Les médecins suspectent un syndrome de DiGeorge en se basant sur les symptômes et des analyses de sang. TRAITEMENT Il se fonde sur : Suppléments calciques et de vitamine D Parfois une greffe de tissu thymique ou de cellules souches Chez les enfants qui possèdent tout de même quelques lymphocytes T, le système immunitaire peut fonctionner correctement, sans traitement. Les infections qui se développent doivent être rapidement traitées.. Chez les enfants qui n’ont pas de lymphocytes T, ce trouble est mortel à moins de recourir à une greffe de tissu thymiqu BIBLIOGRAPHIE -DiGeorge or 22q11.2 deletion syndrome, https://primaryimmune.org/understanding-primary-immunodeficiency/types-of-pi/digeorge-or-22q112-deletion-syndrome -James Fernandez , MD, PhD, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Traitement du syndrome de Digeorge, Le Manuel MSD, Vérifié/Révisé janv. 2023 https://www.msdmanuals.com/fr/accueil/troubles-immunitaires/d%C3%A9ficits-immunitaires/syndrome-de-digeorge#:~:text=Les%20enfants%20atteints%20du%20syndrome,T%20provoquent%20des%20infections%20r%C3%A9currentes L'Alliance des Maladies Rares aumar L’Alliance a pour missions de faire connaître et reconnaître les maladies rares auprès du public, des professionnels de santé et des pouvoirs publics en informant sur leurs enjeux scientifiques, sanitaires et sociaux, par tous les moyens : presse écrite, télévision, radio, sites internet et réseaux sociaux. Elle a également pour objectifs de contribuer à l’information des médecins en organisant des colloques thématiques sur les maladies rares. Elle œuvre à aider à la création d’associations de malades dédiées à chaque maladie rare et à améliorer l’accès au diagnostic et aux soins des maladies rares par la mise en place de centre de référence et de compétence et par une prise en charge réellement efficaces en inscrivant ces troubles comme des affections de longues durées (ALD) L’Alliance des Maladies Rares (AMRM) a été créée en 2017. Elle s’est inspirée des modèles des pays plus développés, où des associations de malades atteints de maladies rares et des malades dépourvus d’association se sont unis depuis plusieurs années en « Alliance », telles la France avec l’Alliance des Maladies Rares ou la Suisse avec Proraris. L’Alliance se donne par ailleurs pour but de contribuer à la création par les malades eux-mêmes d’associations spécifiques comme elle l’a fait par exemple pour : l’association marocaine des malades d’angioœdèmes (AMMAO) ou l’association pour les personnes atteintes de rachitisme vitamino résistant hypophosphatémique (RVRH-XLH). L’Alliance au Maroc collabore déjà étroitement avec beaucoup d’autres associations œuvrant sur une pathologie particulière comme l’Association de solidarité avec les enfants de la lune Maroc, l’Association Marocaine de Mucoviscidose, l’association des amis des myasthéniques (AAMM), l’association marocaine du syndrome de Rett (AMSR), l’association SOS Pku …
Dr Moussayer khadija

Dr Moussayer khadija

Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie en libéral à Casablanca. Présidente de l’Alliance Maladies Rares Maroc (AMRM) et de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Vice-présidente du Groupe de l’Auto-Immunité Marocain (GEAIM)


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John Bolton and His Controversial Op-Ed Against Morocco: Hostility with Troubled Roots... 309

John Bolton, former U.S. National Security Advisor under Donald Trump, has just published an op-ed in the Washington Times, notably favorable to the Polisario thesis and thus to the Algerian position. The text recycles arguments Bolton has already put forward in the past. He notably defends the outdated idea of a self-determination referendum and accuses Morocco of obstructing the implementation of UN resolutions. It should be recalled once again that the referendum proposal, which Morocco had put forward in Nairobi, has been obsolete and abandoned by the Security Council since 2007; as for accusing Morocco of hindering the process, this is simply false in light of the UN resolutions over the past 20 years. Bolton lies, and he knows it. He is accustomed to it. How can one not think that this is clearly an attempt by this forgotten figure of history to regain relevance, a will to manipulate public opinion, but above all an intention to harm by pleasing the enemies of the Kingdom. This position strangely fits, without surprising, into the continuity of the official rhetoric of the Algerian military junta, the main supporter of the Polisario. It is a blatant alignment and rapprochement that raises questions about Bolton’s integrity. Let us just recall that Bolton was abruptly dismissed by Donald Trump in 2019, officially for strategic disagreements, but according to some observers, also due to questionable connections. Regarding the matter concerning the Kingdom, Bolton regularly frequents Algiers and collaborates with well-paid Algerian lobbyists such as David Keene, former NRA president, engaged in defending the Algerian cause in the United States. This closeness fuels suspicions of a relay role for Algerian interests, aiming to influence American policy. Nothing to be proud of for the jubilant military junta. It is used to contradiction and blunt communication turning the slightest detail into a victory. Bolton no longer counts and has no impact. In his rhetoric, Algiers pretends to ignore that the same Bolton supports the use of force against Iran, Algeria’s strategic ally. Iran, which the Algerian president will soon visit... It is also this same Bolton who pushed for the transfer of the U.S. embassy from Tel Aviv to Jerusalem... A strange supporter of the Palestinians to take one of their enemies as a reference. Bolton’s article fits into a morbid continuity. He shamelessly and unashamedly tries to discredit Moroccan policy and its growing influence on the international stage while defending separatism. He ignores the terrorist nature of the Polisario, opposing an entire faction of Republicans with Joe Wilson as spokesperson. The latter is logically pushing for a vote very soon in the U.S. Congress on a law designating the Polisario as a terrorist organization. Paradoxically, Bolton’s desperate offensive comes at a time when Morocco is achieving major diplomatic successes. The Kingdom has recently further strengthened its ties with several African countries, Kenya being the latest example. Thanks to its autonomy plan for the Sahara, widely recognized and supported by the international community, Morocco is reaping success after success. The vote on the latest Security Council resolution on the issue shows that even countries that once voted out of ideological principle against anything favorable to Morocco no longer do so, quite the opposite. Moreover, the closure of the Polisario Front’s office in Damascus illustrates Morocco’s growing influence in the Middle East. Thus, unanimity is almost reached in favor of Morocco at the Arab League today, with the obvious exception of Algeria alone, perfectly isolated, even neutralized and weakened in everyone’s eyes. At heart, Bolton’s op-ed seems intended to soothe the wounds of Algiers and the separatists, who are losing ground to Morocco’s assertion. The autonomy plan proposed by Rabat is increasingly endorsed on the international stage, while the Polisario sees its influence diminish. It is becoming inaudible and has no other escape than to cling to a few fringe extremist demonstrations here and there. This stance therefore appears as a last gasp from a retreating camp. Lacking any real leverage to influence American or global policy, Algiers and the separatists quench their thirst by drinking the words of marginal figures without substance. To better understand this posture, it must be recalled that John Bolton is a controversial figure in American politics, known for his ultra-conservative positions and aggressive foreign policy approach, often described as neoconservative. His dismissal in 2019 was marked by major disagreements with the Trump administration, but also by suspicions of dubious connections with certain foreign circles. Bolton is suspected of involvement in several controversial international operations, including organizing coups d’état, reinforcing the image of a man with brutal methods and strongly marked convictions. In sum, John Bolton’s recent op-ed in the Washington Times illustrates a persistent hostility towards the Kingdom by a fading figure; a pontiff driven by an outdated political vision. The signatory’s stance is disconnected from current geopolitical developments. It once again shows that Algiers, through its parrot media, is ready to cling to any nonsense, provided it fits its outdated narrative. Above all, it highlights the irreversible decline of the Polisario and Morocco’s growing success on the international stage.

Kenya Inaugurates Its Embassy in Rabat: A Major Diplomatic Turning Point Favoring Morocco on Western Sahara 313

The official inauguration of Kenya’s embassy in Rabat, conducted by Moroccan Foreign Minister Nasser Bourita and Kenyan Foreign Minister Musalia Mudavadi, marks a historic milestone in bilateral relations between the two countries. This ceremony, coinciding with the 60th anniversary of diplomatic ties between Kenya in East Africa and Morocco in the far west of the continent, symbolizes a significant strengthening of political, economic, and cultural exchanges in pursuit of continental continuity. Most importantly, it signifies Kenya’s strategic repositioning on the sensitive issue of the Moroccan Sahara. For the first time, Kenya has opened an embassy in Morocco, demonstrating Nairobi’s firm commitment to consolidating its relations with Rabat. Even more crucially, Kenya has officially recognized Morocco’s Autonomy Plan as “the only sustainable approach” to resolving the Western Sahara dispute. This represents a radical shift in Kenyan policy, as until recently, Kenya maintained relations with the self-proclaimed Sahrawi Arab Democratic Republic (SADR), supported by Algeria, which is increasingly losing ground internationally. Under President William Ruto’s leadership, this diplomatic shift began taking shape in March 2024 with the appointment of Jessica Muthoni Gakinya as Kenya’s first ambassador to Morocco. Since then, several memorandums of understanding have been signed covering key areas such as housing, urban development, youth, trade, and diplomatic training, significantly strengthening cooperation between the two nations. Kenya’s repositioning on the Sahara issue aligns with a broader global trend of growing support for Morocco’s stance, while the Polisario Front loses international recognition. Over fifty countries have withdrawn recognition of the SADR since the Cold War’s end, and no African country has recognized it since 2011. Recent developments include Syria’s official closure of the Polisario office in Damascus, signaling a strategic distancing from the Algerian-Iranian axis and a clear rejection of support for Sahrawi separatists. This is a major setback for Algeria on the Arab world stage. In Latin America, key countries such as Bolivia, Ecuador, and Panama have also withdrawn recognition of the SADR, adopting neutral or pro-Moroccan sovereignty positions consistent with UN resolutions. This shift is notable given the region’s past role as a haven for separatist propaganda. In Europe, nearly all countries, including France, Spain, Germany, and many EU members, now explicitly support Morocco’s Autonomy Plan as a serious basis for a lasting political solution. Algeria, increasingly powerless, is losing influence and reputation worldwide due to its persistent backing of the Polisario. Despite this international momentum favoring Morocco, Algeria continues to support the Polisario, exemplified by President Abdelmadjid Tebboune’s recent reception of the “new Sahrawi ambassador” Khatri Adouh. While Bourita and Mudavadi forged strong friendship ties, the Algerian-hosted ambassador boasted of supposed “diplomatic victories” for the separatists, ignoring Polisario’s growing isolation. Algeria and its proxy even disregard UN Security Council Resolution 2756 adopted in October 2024, which explicitly recognizes Algeria as a party to the dispute and calls for respect of the ceasefire and a durable political solution, endorsing Morocco’s initiative led by King Mohammed VI. Morocco is capitalizing on this favorable context by multiplying bilateral agreements, notably with strategic African countries like Kenya. The signing of five memorandums of understanding during Mudavadi’s visit reflects a shared vision of enhanced cooperation based on historical, cultural, and economic ties. Africa is thus showing a new face marked by pragmatism and mutual interests. The opening of the Kenyan embassy in Rabat and Nairobi’s official support for Morocco’s territorial integrity represent a major diplomatic victory for the Kingdom. Algeria can no longer ignore this development without risking even greater isolation on the continent and globally. Adding to Algeria’s woes, Ivory Coast recently reiterated its position sidelining the separatist movement and its sponsor. Morocco is consolidating its diplomatic leadership and advancing toward a peaceful and lasting resolution of the artificial Western Sahara conflict. In contrast, the Polisario is increasingly isolated, supported only by a stubborn Algeria and perhaps, for now, South Africa, whose economy and business ties with Morocco are growing. The international community is converging toward greater recognition of Moroccan sovereignty and its Autonomy Plan, supported by two permanent UN Security Council members and many regional economic powers. This irreversible momentum heralds a new era in African diplomacy, with the African Union likely to expel the SADR in the near future, removing a burdensome member that meets no criteria for international organization membership except Algeria’s excessive sponsorship, itself in notable decline. Omar Hilal, Morocco’s representative to the UN, does not hesitate to remind his Algerian counterparts of this anachronistic and untenable situation at every opportunity, making the international community a witness to this increasingly ridiculous stalemate that cannot last.

Neoplatonism 373

Neoplatonism is a philosophical and spiritual tradition that arose in the 3rd century CE, deeply rooted in the teachings of Plato but expanded into a comprehensive metaphysical system emphasizing the soul’s journey toward divine union. Far more than an academic commentary on Plato’s dialogues, Neoplatonism offered a mystical framework for understanding the cosmos, the nature of being, and the purpose of human existence. Its influence extended from the pagan late antiquity into Christian, Islamic, and Jewish thought, and it became a cornerstone of the Western esoteric tradition, profoundly shaping Hermeticism, Kabbalah, and Renaissance occult philosophy. The founder of Neoplatonism is traditionally identified as Plotinus (c. 204/5–270 CE), whose teachings were recorded and organized by his student Porphyry in the Enneads. Plotinus developed a tripartite cosmology that remains central to Neoplatonic thought: The One (or the Good): The highest principle, utterly transcendent, beyond being and intellect. It is the source of all existence, perfect, infinite, and indivisible. Nous (Divine Intellect): The first emanation from the One. It contains the realm of ideal Forms or archetypes—eternal truths that shape reality. Psyche (Soul): The World Soul and individual souls emanate from the Nous, descending into the realm of matter. This emanationist cosmology postulates that all reality flows outward from the One in a hierarchical cascade, and that all beings long to return to their source. Unlike creation ex nihilo, Neoplatonic emanation is not a one-time event but a continuous process of unfolding and return, guided by the principle of divine participation—all things contain within themselves a trace of the divine origin. The ultimate goal of the soul in Neoplatonism is henosis, or mystical union with the One. This ascent is achieved not through external rituals alone, but through philosophical contemplation, ethical purification, and inner transformation. As the soul turns away from the distractions of the material world and awakens to its true nature, it ascends through the levels of being, ultimately dissolving into divine simplicity. Plotinus’s successors, including Porphyry, Iamblichus, Proclus, and Damascius, expanded and refined the system. Iamblichus, for example, introduced a more theurgical and ritualistic approach, arguing that philosophical contemplation was insufficient on its own for divine ascent. Instead, he emphasized theurgy—a sacred science of divine operations involving prayers, invocations, and symbolic rites. These practices formed the foundation of later esoteric traditions, particularly the magical worldview of the Hermetic Order of the Golden Dawn and Renaissance Neoplatonic magicians like Marsilio Ficino and Giordano Bruno. Neoplatonism also had a profound influence on Christian mysticism, particularly through thinkers like Pseudo-Dionysius the Areopagite, St. Augustine, and Thomas Aquinas, who adapted Neoplatonic cosmology to Christian theology. In the Islamic world, philosophers such as Al-Farabi, Avicenna (Ibn Sina), and Suhrawardi incorporated Neoplatonic ideas into their metaphysical and mystical systems, contributing to the development of Sufi cosmology. In Jewish thought, Neoplatonism informed early Kabbalistic doctrine, particularly in its conception of divine emanations (sefirot) and the soul’s return to God. In the Renaissance, Neoplatonism was revived as part of a broader cultural rediscovery of classical antiquity. Philosophers such as Ficino and Pico della Mirandola saw it as a key to unlocking the divine potential of the human being and harmonizing philosophy with mysticism. Ficino’s translation of Plotinus and his commentaries on Plato and Dionysius laid the groundwork for a magical humanism, in which the soul, through study and virtue, could ascend the cosmic ladder and participate in the divine intellect. In modern esotericism, Neoplatonic principles continue to underpin key doctrines, including correspondence, hierarchy, and spiritual ascent. The image of the cosmos as a living, divine order—structured, intelligible, and participatory—remains central to Hermeticism, Rosicrucianism, and contemporary metaphysical systems. The idea that the microcosm reflects the macrocosm—that the human soul mirrors the cosmos and can return to its source—echoes through the ages as a core Neoplatonic insight. In conclusion, Neoplatonism is not merely a philosophical system—it is a sacred path, blending metaphysics, mysticism, and ethical discipline into a vision of cosmic unity and human divinization. By tracing all things to the ineffable One and guiding the soul’s ascent through reason, beauty, and inner purification, Neoplatonism continues to offer a profound map of spiritual realization, bridging ancient wisdom and perennial truth.

La Maison de l'Avenir : A dream comes true 381

La Maison de L’Avenir : A Dream Comes True Thirty years ago, on May 30, 1995, Her Royal Highness Princess Lalla Meryem inaugurated « La Maison de L’Avenir ». Built by the Association l’Avenir, this long-dreamed home provides accommodation for families with a child undergoing cancer treatment at the Rabat Children’s Hospital, families who live outside Rabat and cannot afford the expenses associated with treatment and repeated stays in Rabat. This home’ objectives were to enable children with cancer to receive treatment for as long as necessary, to give all patients the same chance of cure, to reduce the number of treatment dropouts, to avoid « the anguish of the night at the hospital” whenever possible, and finally, support parents in difficult times. In June 1991, the Ministry of Housing granted the l’Avenir Association a plot of land in Hay Nahda II, Rabat. The association launched a campaign to raise awareness about the need to welcome parents of hospitalized children, using the slogan : “Help me heal, surrounded by those I love.” Many individuals and organizations, both Moroccan and international, answered this appeal by donating time, money, materials, equipment, and expertise. The result was a welcoming, functional house, a “home away from home” for families with children being treated for cancer or blood diseases at the Children’s Hospital in Rabat. It includes 22 rooms with two to four beds each, for a total of 54 beds. Families can stay there for a small fee, but above all, are asked to keep « their Home » clean and respectable. When a new family arrived, devastated by the shock of diagnosis they have just received at the hospital, they found other families and other children undergoing treatment or returning for a simple check-up. They listened, got informed, learned, and little by little, the hope of keeping their child alive would return. Thirty years later, La Maison de L’Avenir still exists and has helped to reduce the number of treatment and follow up abandonment, soften the medical, social, and psychoaffective conditions of children and their families, and ultimately, contributed to the healing of countless young patients.