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Ocular Manifestations during Rheumatoid Arthritis in Conakry

Open Journal of Ophthalmology 2022年第4期12卷 373-381页

作者： Alpha Ibrahima Balde aly badra kamissoko Fremba Camara Sonassa Diane Emmanuel Yombouno Adel Lelano Mohamed Awada Ophthalmology Department of the Inter-Army Medical and Surgical Centre (CMCIA/BQG) of Camp Samory Touré in Conakry Co-nakry Guinea Rheumatology Department of the National Ignace Deen Hospital CHU of Conakry Conakry Guinea Regional Hospital of Kankan Kankan Guinea

Rheumatoid arthritis (RA) is a systemic inflammatory disease that primarily affects the joints and may also manifest with extra-articular symptoms. Ocular involvement is common in patients with rheumatoid arthritis and may represent the main clinical manifestation of the disease. Aim: To study the epidemiological and therapeutic particularities of ocular manifestations during rheumatoid arthritis in Conakry. Material and Methods: This was a descriptive cross-sectional study of 6 months duration from 1 January to 30 June 2018 on patients with RA. All patients with chronic inflammatory rheumatism in whom the diagnosis of rheumatoid arthritis had been made according to the diagnostic criteria of the American College of Rheumatology (ACR) 2010 and these patients benefited from a complete ophthalmologic examination. Results: We enrolled 22 patients. The mean age was 43.45 ± 16.07 years (range 21 and 79 years). The mean age at onset of symptoms was 39.4 years with a mean time to diagnosis of RA of 3.9 years. Females dominated with 77.27% of cases with a sex ratio of 0.22 M/F. Photophobia (39.29%), xerophthalmia (31.82%), lacrimation and decreased vision 5 cases or 22.73 each, pruritus (9.09%), foreign body sensation and red eye with 2 cases each or 9.09% were the most frequent symptoms. The different ophthalmological diagnoses found were dry eye 19 cases or 86.36%, allergic conjunctivitis 4 cases or 18.18%, ametropia 3 cases or 13.64%, cataract 2 cases or 9.09%, superficial punctate keratitis 2 cases or 9.09% and chronic glaucoma 1 case or 4.55%. The management of dry eye was based on tear substitutes. Cataract cases (9.09%) required surgical intervention while patients with ametropia (13.04%) received optical correction. Cases of allergic conjunctivitis (18.18%) were reported. Conclusion: Good coordination between the ophthalmologist and the rheumatologist is necessary to optimize the management of patients with rheumatoid arthritis.

关键词： Rheumatoid Arthritis Ocular Involvement Conakry

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Osgood Schlatter Disease: Study of 2 Observations in Conakry, Guinea

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第2期14卷 77-83页

作者： Adama Bah Laetitia Cynthia Abandazegoue Andjembe Abdoulaye Barry Mamadou Lamine Diallo Moustapha Niasse aly badra kamissoko Rheumatology Department Ignace Deen Hospital Conakry Conakry Guin&#233e Rheumatology Department CHU Aristide Le Dantec of Dakar Dakar S&#233n&#233gal Department of Rhumatology Sylvanus Olypio University Hospital Lom&#233 Lom&#233 Togo

Introduction: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee, 20 to 30% of young growing athletes suffer from this pathology, described by Osgood and Schlatter in 1903. Objective: To report 2 observations and review the literature. Observation 1: This was a 14-year-old Guinean teenager, Halpoular, living in Conakry, a right-handed footballer who presented with a painful swelling of the right knee that looked mechanical, whose father had HLA B27 positive ankylosing spondylitis. X-ray of the right knee showed fragmentation of the anterior tibial tuberosities, and ossicle with edema of the patellar tendons at stage 4 according to Ehrenbord and Lagergren (1961). Thus, the disease of OSD is retained, He received 120 mg of diclofenac, 20 mg omeprazole for 1 month and the cessation of sports activity, the evolution was favorably marked by the regression of pain. Observation 2: A 16-year-old girl, initials M.L.T, Guinean, residing in Coyah (Republic of Guinea), a handball player, consulted for intense pain (VAS: 8/10) in her knees after a violent shock received when she hit the post. The physical examination found a painful, soft swelling at the anterior tibial tuberosity of the right knee, the rest of the examination was normal. The X-ray of the right knee shows fragmentation of the anterior tibial tuberosity, and ossicle with edema of the patellar tendon at stage 4 according to Ehrenbord and Lagergren 1961, thus the OSD disease is retained, the treatment instituted was 120 mg of diclofenac, the cessation of sports activity which gives a good evolution (EVA at 2/10). Conclusion: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee in young growing athletes, resolving at rest.

关键词： Osgood Shlatter Disease Young Athlete

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Ankylosing Spondylitis in a West African Hospital

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Open Journal of Rheumatology and Autoimmune Diseases 2023年第1期13卷 8-16页

作者： Abdoulaye Barry Oumar Diouhé Bah Adama Bah Mamadou Lamine Diallo Kaba Condé Samba Frein Condé aly badra kamissoko Rheumatology Department of the National Ignace Deen Hospital in Conakry Conakry Guinea Biomar 24 Medical Laboratory Conakry Guinea

Introduction: Ankylosing spondylitis (AS) is an inflammatory rheumatic disease characterized by predominant axial and peripheral (enthesitis, sacroiliitis) involvement affecting young subjects aged 30 to 40 years, 80% to 98% of cases are associated with HLA-B27. Objective: To determine the epidemiological profile of ankylosing spondylitis in the rheumatology department of the Ignace Deen National Hospital in Conakry (Guinea). Materials and Methods: This was a descriptive cross-sectional study carried out within the said department over a period of 18 months from July 1, 2018 to December 31, 2020, including all patients seen in consultation and/or hospitalized in the department in which the diagnosis of ankylosing spondylitis had been retained according to the modified New York criterion. The parameters studied were sociodemographic, clinical, paraclinical and therapeutic. Result: We collected 73 cases or 4.1% of ankylosing spondylitis out of a total of 1781 patients seen during the study period. The male gender was represented with 54.8% for a sex ratio of 1.2 M/F. The average age of our patients was 32.18 ± 12.44 years with extremes ranging from 17 to 54 years. Axial involvement was present in 89.9% of cases with a lumbar predominance (95.2%), followed by the sacroiliac seat (35.5%), cervical (14.5%) and dorsal at 4.8%. The pain was chronic in 93.2% of cases. The most common drug treatment was taking analgesics and NSAIDs (100%) followed by cortisone infiltration (41.1%), corticosteroids (30%), and physiotherapy (21.9%). Ankylosing spondylitis represents 83% of spondyloarthritis followed by undifferentiated spondyloarthritis (9.1%) and juvenile spondylitis (3.4%) were the most common conditions.

关键词： Ankylosing Spondylitis Rheumatology Ignace Deen Guinea

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Asymptomatic Cardiac Manifestations in Rheumatoid Arthritis in Conakry (Guinea)

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第2期12卷 57-64页

作者： aly badra kamissoko Ibrahima Sory Barry Marina Sanda Cletus Dieuval Houngbegnon Mamadou Lamine Diallo Abdoulaye Barry Mamadou Dadhi Baldé Owonayo Oniankitan Department of Rheumatology Ignace Deen National Hospital Conakry Guinea Department of Cardiology Ignace Deen National Hospital Conakry Guinea Department of Rheumatology Sylvanus Olympio University Hospital Lome Togo

Introduction: Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatic disease. It is a systemic disease with extra-articular manifestations that can be life-threatening. In sub-Saharan Africa, there is little published information on cardiovascular manifestations in RA. Objective: The objective is to determine the asymptomatic cardiac manifestations during rheumatoid arthritis in Conakry. Patients and Methods: This was a cross-sectional study lasting 6 months from January 1, 2020 to June 30, 2020 in the rheumatology and cardiology departments of the Ignace Deen National Hospital. Patients with RA diagnosed according to the 2010 ACR/EULAR criteria, asymptomatic at the cardiovascular level, which had an ECG and echocardiography, were included in the study. Left ventricular diastolic dysfunction was considered in any patient with an E/A ratio 1, an E/E’ ratio > 10, and an LVEF = 50%, assessed by the Simpson biplane method and classified according to Redfield. Epidemiological, clinical and paraclinical data were analyzed using SPSS statistics 21.0 software. Results: Seventeen cases of rheumatoid arthritis (5.9%) were collected. There was a predominance of women with 14 cases (82.4%). The mean age of patients was 48.2 ± 11.9 years. The average duration of RA was 7.2 ± 4.2 years. Cardiovascular risk factors were dominated by overweight and obesity (58.8%) and sedentary lifestyle (35.3%). RA was predominantly high activity (DAS 28 ≥ 5.1) in 82.4% of patients. Anti-CCP antibodies were positive in 76.9% of cases. Fourteen patients (82.4%) had abnormal cardiac results. The electrocardiogram showed left atrial hypertrophy in 29.4% of cases, left ventricular hypertrophy (11.8%) and ventricular extrasystole (11.8%). The cardiac Doppler scan showed diastolic dysfunction of the left ventricle (47.1%) and moderate pericardial effusion in 11.8% of cases. Conclusion: The study found asymptomatic cardiac manifestations of rheumatoid arthritis. They were dominated b

关键词： Rheumatoid Arthritis Asymptomatic Manifestations Electrocardiography Sub-Saharan Africa Guinea

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Bilateral Cervical Ribs Fusing or Naffziger Syndrome: About an Observation in Guinea and Literature Review

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第4期14卷 157-164页

作者： Adama Bah Fatou Sow Diouck Laetitia Cynthia Abandazegoue Andjembe Moustapha Niasse Birahim Lo Seydina Omar Cissé Mohamed Lamine Keïta aly badra kamissoko Rheumatology Department Ignace Deen National Hospital Conakry Guinea Rheumatology Department Aristide Le Dantec University Hospital Dakar Senegal Medical Department Aristide Le Dantec University Hospital Dakar Senegal Orthopaedic Traumatology Department Aristide Le Dantec University Hospital Dakar Senegal

Thoraco-brachial outlet syndrome (TDSD) or cervical rib brings together all the clinical symptoms (arterial, neurological and/or venous) due to extrinsic, intermittent or permanent compression of the vascular-nervous elements of the root of the upper limb during cervico-thoraco-brachial crossing syndrome. This pathology is relatively common but often overlooked;it affects women more often (between 4/1 and 2/1) and is rare in children. We report the case of a 59-year-old female patient seen in the department for paresthesia and muscular weakness of the upper limbs rated 3/5 on the right and 4/5 on the left progressively evolving over 39 years, electromyography (EMG) showed indicated compression of the brachial plexus and the CT scan confirmed the presence of bilateral cervical ribs fused with the first on the left. She benefited from physiotherapy while awaiting her surgery, and unfortunately, she died of a stroke in the traumatology department. This pathology is the first in our department to be supported by a review of the literature.

关键词： Cervical Ribs Naffziger Syndrome Guinea

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Undifferentiated Arthritis Revealing Cogan’s Disease

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第1期12卷 29-34页

作者： Paul Eloundou aly badra kamissoko Francine Same Bebey Marina Sanda Al Mâmy Aboubakar William Nguekouo Abèni Faouziyath Yaya Mireille Yomba Severin Noumbissi Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Faculty of Medicine University of Ngaoundéré Garoua Cameroon Cite verte District Hospital Yaoundé Cameroon

Background: Cogan’s syndrome is a rare autoimmune vasculitis (less than 300 cases described in the literature) characterized in its typical form by cochleovestibular involvement, interstitial keratitis, and an inflammatory involvement of large vessels. It is frequently accompanied by general signs and cardio-vascular, rheumatologic, and digestive complications. Its management is essentially based on the use of corticosteroids and immunosuppressants. The outcome of the treatment, even if rapid, does not always avoid functional complications. This disease is probably under-diagnosed in Africa. Objective: The objective of this study was to report a case of Cogan syndrome in sub-Saharan Africa. Case report: A 78 year old black African female patient presented with arthritis of the left knee without fever. The examination also revealed a bilateral deafness of rapidly progressive onset. The patient was known to be diabetic and hypertensive, and was regularly monitored. The biology revealed an inflammatory syndrome and an inflammatory joint puncture fluid. Pure tone audiometry confirmed a 77% hearing loss. The ophthalmological examination revealed stromal oedema and hypertensive retinopathy of Kendall stage III. The rheumatological evolution was good under methylprednisolone and methotrexate, but the deafness persisted. The occurrence of a fever on day 12 of treatment required further investigations (blood culture, PCR-Covid 19 test, cytobacteriological examination of sputum, thoracic CT). The evolution was unfavourable with the death of the patient. Conclusion: Cogan’s disease is a rare inflammatory disease. Its diagnosis and management are multidisciplinary. The treatment can be disappointing.

关键词： Cogan’s Syndrome Arthritis Non-Syphilitic Interstitial Keratitis Bilateral Deafness

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Sexuality of Women with Rheumatoid Arthritis in a West African Hospital

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Open Journal of Rheumatology and Autoimmune Diseases 2021年第4期11卷 152-159页

作者： aly badra kamissoko Tayo Nadège Raissa Edikou Abdoulaye Barry Marina Sanda Kadé Fofana Lou Nahan Eunice Irie Mamadou Lamine Diallo Owonayo Oniankitan Department of Rheumatology Ignace Deen National Hospital Conakry Guinea Department of Rheumatology Sylvanus Olympio University Hospital Lomé Togo

Background: Rheumatoid arthritis is a chronic autoimmune disease that causes socio-economic, psychological and sexual problems. It imposes limitations on sexual relationships and these issues are still taboo in African society. Objective: The objective is to assess the impact of rheumatoid arthritis (RA) on women’s sexuality at the Ignace Deen National Hospital. Patients and Methods: This was an analytic case-control study of 8 months (from April 6, 2020 to December 11, 2020). All patients followed for rheumatoid arthritis diagnosed according to 2010 ACR/EULAR criteria for RA had been included. Results: One hundred and five women (52 RA patients and 53 controls) were collected. The two groups were comparable in terms of demographic characteristics. Sexual dysfunction was found in 69.2% of cases versus 35.8% of controls. Women with RA had poorer sexual functioning in the categories of desire, arousal, lubrication, orgasm, satisfaction, and pain of the FSFI score compared to healthy women (p = 0.01;p = 0.7;p = 0.3;p = 0.8;p = 0.1;and p = 0.3 respectively). Patients were 4 times more likely to have sexual dysfunction than healthy individuals and this result was statistically significant with a p-value less than 0.05. Conclusion:

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Complications of Corticosteroid Therapy in Rheumatological Practice in Guinea

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第3期14卷 108-117页

作者： aly badra kamissoko Eve Urielle Amenan Ledjou Mamadou Lamine Diallo Abèni Faouzyath Yaya Mohamed Mouhoudhoiri Yasser Aboubacar Sidiki Condé Souleymane Camara Marie Traoré Abdoulaye Barry Moriba Touré Kaba Condé Owonayo Oniankitan Department of Rheumatology Ignace Deen University Hospital Conakry Guinea Department of Rheumatology Cocody University Hospital Abidjan Cte dIvoire Department of Rheumatology Sylvanus Olympio University Hospital Lom Togo

Introduction: Corticosteroid therapy used in rheumatology is effective but can lead to complications. The objective was to describe the complications of corticosteroid therapy in rheumatological practice at Ignace Deen University Hospital (Conakry). Methods: Cross-sectional study from July 1, 2022 to March 31, 2023. All patients who had been diagnosed with a rheumatological disease and who had received corticosteroid therapy were included. Results: Of the 1489 patients suffering from rheumatological diseases, 238 (15.9%) had received corticosteroid therapy. The average age of the patients was 48.5 ± 17.16 years with a female predominance (70.5%). The main indications for corticosteroid therapy were lower back pain due to probable disco-radicular impingement (35.8%) followed by rheumatoid arthritis (21.9%). The predominant method of administration was infiltration (56.9%). The average dosage was 24.2 ± 13.5 mg prednisone equivalent (range: 5 mg and 40 mg). Complications were present in 26 patients (10.9%) such as muscle cramps (3.8%), hypocalcemia (3.4%), edema of the lower limbs (3%), stimulation of appetite and weight gain (3%), high blood pressure (2.5%), hyperglycemia (2.5%). The occurrence of complications was associated with the high dose of corticosteroid (p = 0.014) and long-term use (p = 0.000). Conclusion: Corticosteroid therapy used in 15.9% of consultations in the rheumatology department of Ignace Deen University Hospital led to 10.9% of complications. These complications were related to the dose and duration of corticosteroid therapy.

关键词： Corticosteroids Complications Guinea

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Physiotherapy Management of Rheumatic Diseases

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第1期14卷 37-47页

作者： aly badra kamissoko Abdoulaye Barry Mamadou Lamine Diallo Boutros Cosme Nato Abdel Amide Gbadamassi Marie Traore Abèni Faouzyath Yaya Facely Traore Paul Eloundou Sory Diane Matènè Komara Halimatou Barry Moriba Toure Moriba Toure Kaba Conde Owonayo Oniankitan Department of Rheumatology Ignace Deen University Hospital Conakry Guinea Department of Rheumatology Sylvanus Olympio University Hospital Lome Togo Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Introduction: Physiotherapy is an integral part of the non-drug treatment strategy for rheumatological conditions. The evidence for its effects is not formal. The objective was to evaluate the impact of physiotherapy in the management of rheumatological disorders. Methods: 6-month case-control study (December 15, 2021 to June 20, 2022) at Ignace Deen University Hospital (Conakry). Patients with rheumatological disease who received drug therapy and physiotherapy were included in the case group. Age- and sex-matched controls had rheumatological conditions, treated without physiotherapy. The evaluation questionnaires were used: WOMAC (osteoarthritis), EIFEL (low back pain), NDI (neck pain), SPADI (shoulder). Patients with heart failure, respiratory failure and/or skin infection were not included. Results: We collected 773 patients (389 cases and 384 controls) with a mean age of 53.8 years ± 12.2 with female predominance (56.8%). Patients were mainly followed for osteoarthritis (65.2%). Rheumatological conditions managed were knee-based (119;30.6%), lumbar spine (220;56.6%), shoulders (27;6.9%) and cervical spine (23;5.9%). For an average duration of 53.4 ± 12.2 minutes per session, patients had benefited from a median of 19 physiotherapy sessions. After 3 months, the baseline mean VAS of 6/10 improved to 2.2 ± 1.6 for cases and 5.7 ± 1.2 for controls. Functional capacity was improved (WOMAC: 41.8 ± 22.7 vs. 18.3 ± 7.3). The satisfaction of patients treated with physiotherapy was 20 times higher than in controls. Conclusion: Physiotherapy performed in the management of rheumatological conditions significantly reduced pain and improved functional capacity.

关键词： Rheumatological Disease Physiotherapy WOMAC Guinea

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Profile of Autoantibodies and Clinical Symptoms in Guinean Patients with Connective Tissue Diseases

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Open Journal of Immunology 2024年第1期14卷 1-10页

作者： Mariama Sadjo Diallo Doufin Traore Adame Diouf Djiba Kaba Issiaga Diallo Doudou Georges Massar Niang Alimou Camara Oumar Mouctar Diallo Boh Fanta Diane Abdoulaye Barry Ouo-Ouo Yaramon Kolie Moustapha Mbow aly badra kamissoko Djibril Sylla Babacar Mbengue Mohamed Cisse Faculté des Sciences et Techniques de la Santé Université Gamal Abdel Nasser de Conakry Conakry Guinée Laboratoire de Biologie Moléculaire Nestor BANGOURA/Helene LABROUSSE H&#244pital de jour Donka CHU Donka Conakry Guinée Centre d’Excellence Africain Pour la Prévention et le Contrô le des Maladies Transmissibles Conakry Guinée Laboratoire d’Immunologie Université Cheikh Anta Diop Dakar Sénégal Service de Dermatologie-Vénérologie CHU Donka Conakry Guinée Service de Rhumatologie H&#244pital National Ignace Deen Conakry Guinée Service de Médecine Interne CHU Donka Conakry Guinée

Connective tissue diseases (CTDs) are Autoimmune diseases (AIDs) characterized by the appearance of autoantibodies, which are diagnostic markers. Investigations of these autoantibodies play a major role in the management of several autoimmune diseases. The objective of this study was to describe the profile of anti-ENA antibodies according to the clinical symptoms of mixed CTDs in Conakry teaching Hospital. We performed a cross-sectional study during six months. A total of 20 patients was recruited and we measured antibodies using the ELISA technique. The mean age of our patients was 36.5 years, with a predominance of females. Cutaneous and rheumatological signs were the main clinical manifestations. SLP was the most frequent CTDs;the threshold of ENA antibodies positivity was higher in scleroderma with and SLP. Anti-ENA identification reveals the frequency of anti-SSA (83.33%), anti-U1RNP (66.66%) and anti-histone (50%) antibodies. Antinuclear antibodies (ANA) react with various components of the cell nucleus. Their detection is of major interest in the diagnosis of CTDs. Our results highlight the importance of determining the specificity of these antibodies to guide differential diagnosis.

关键词： Autoantibodies Extractible Nuclear Antigen (ENA) Connective Tissue Diseases ELISA

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