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Case Report: Rhupus (The Association of Systemic Lupus Erythematosus and Rheumatoid Arthritis): About 2 Cases

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第2期14卷 84-88页

作者： Omar Boun Khatab diouf Mouhamed Dieng Michel Assane Ndour Matar Ndiaye Nousradine Mourno Tarsa Boundia Djiba Ibrahima Mané Diallo Demba Diedhiou Anna Sarr Maimouna Ndour Mbaye Internal Medicine Departement Abass Ndao Hospital Dakar Senegal

Introduction: The association of systemic lupus erythematosus and rheumatoid arthritis (rhupus) is a rare clinical condition. Throughout the world, 287 cases of Rhupus have been described. We report two new observations of two patients who presented predominantly distal erosive polyarthritis with positive anti-Sm antibodies in one case and SmRNP in the other case. Observations: Case 1: 37 years old patient, with a recent diagnosis of pulmonary tuberculosis. She has since 8 months an inflammatory, bilaterally and symmetrical polyarthralgia without deformation or ankylosing synovitis, associated with malar erythema without other abnormalities. Immunological tests showed: positive Rheumatoid factor at 158 IU/ml, positive Anti-CCP at 550 IU/ml, and positivity of antinuclear at 1/1280 nuclear fluorescence with a strong presence of anti-Sm >8 IU/ml. The diagnosis of rhupus was concluded, without serious visceral involvement. Case 2: A 28-year-old patient, married with 3 children, with bilateral, symmetrical, deforming and chronic polyarthritis affecting large and small joints, which had been evolving for over 5 years without cutaneous abnormality associated. Paraclinical investigations showed: a biological inflammatory syndrome. Immunology was positive, with rheumatoid factors at 78 IU/ml, anti-CCP at 561 IU/ml, antinuclear antibodies at 1/1280 with positive anti-SmRNP and anti-SSA/Ro52, and a positive direct Coombs test. Joint ultrasound revealed tenosynovitis of the extensors and common flexors of the fingers, erosions and synovitis of multiple PPIs. The diagnosis of rhupus was based on the presence of 10 ACR criteria for RA and 8 ACR/EULAR 2019 criteria for SLE. Conclusion: Rheumatoid arthritis is a rare autoimmune disease combining features of both systemic lupus erythematosus and rheumatoid arthritis in the same patient, often sequentially. Despite a growing number of case reports and series, a consensus on the classification of SLE arthritis is still lacking, and di

关键词： Rhumatoïd Arthritis Lupus Rhupus Connective Tissue Disease

Prevalence of Depression and Anxiety in Patients with Autoimmune Disease: A Comparative Study with a Diabetic Population

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Open Journal of Internal Medicine 2024年第2期14卷 159-166页

作者： Michel Assane Ndour Mouhamed Dieng Omar Boun Khatab diouf Léon Birwe Boundia Djiba Ibrahima Mané Diallo Matar Ndiaye Nousradine Mourno Tarsa Djiby Sow Anna Sarr Demba Diedhiou Maimouna Ndour Mbaye Service de Mdecine Interne Centre Hospitalier Abass Ndao Dakar Senegal Service de Mdecine Interne Centre Hospitalier Aristide Le Dantec Dakar Senegal

Introduction: Systemic diseases are a variety of heterogeneous autoimmune and/or autoinflammatory diseases and syndromes usually affecting multiple systems and resulting from immune system dysregulation. We evaluated risk factors for depression and anxiety in an autoimmune disease cohort compared with diabetic patients. Patients and Methods: We conducted an observational, cross-sectional, case-control survey comparing two groups: individuals with connective tissue disease (CTD) and diabetic controls who were followed within three Dakar University hospitals during the period from April to June 2023. Results: The sample comprised 106 participants, of whom 51 (48%) had CTD and 55 (52%) served as diabetic controls. In the CTD group, the majority had lupus (19) and rheumatoid arthritis (23). The CTD patients had a mean age of 41.0 years (SD 16.9), while the diabetic patients had a mean age of 55.9 years (SD 11.7), with a significant difference observed (p Conclusion: Compared to a chronic disease, devastating in Africa and evolving over the long term, autoimmune diseases are more strongly and more frequently associated with anxiety and depression. This is a factor to be taken into account in the holistic management of these patients.

关键词： Connective Tissue Disease Lupus Rhumatoid Arthritis Diabetes Depression Anxiety Disability

Profile of Extra-Pulmonary Tuberculosis in Internal Medicine

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Open Journal of Internal Medicine 2024年第1期14卷 64-73页

作者： Mouhamed Dieng Djiby Sow Demba Diédhiou Michel Assane Ndour Boundia Djiba Mouhamed Almahy Niang Matar Ndiaye Oumar Boun Khattab diouf Fatou Kiné Gadji Anna Sar Maïmouna Ndour Mbaye Clinique Médicale II H&ocircpital Aristide Abass Ndao Université Cheikh Anta Diop Dakar Sénégal

Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the epidemiological, clinical, paraclinical and evolutionary aspects of extra pulmonary tuberculosis (EPT) at the Abass Ndao Hospital Center. Patients and Methods: This was a descriptive cross-sectional study conducted over a period of 11 years (January 1, 2010 to December 30, 2021). All patients with extrapulmonary tuberculosis hospitalized in the department of internal medicine during the recruitment period were included. Results: Fifty-two (52) patients were collected. The year 2019 recorded the most cases 23.08% (n = 20). The mean age of the patients was 40.56 ± 18.24 years. The age group 20 - 34 years 42.31% (n = 22) was the most represented. Females were in the majority 61.54% (n = 32) with a sex ratio (M/F) was 0.63. Housewives were in the majority 40.38% (n = 21). 60.87% of the cases (n = 14) came from a health facility. 38.46% of the cases had been infected. 21.74% (n = 9) were smokers. The reasons for consultation were dominated by fever (67.44%), AEG (62.79%) and cough (41.86%). Eighteen patients (40.91%) had fever. The mean time to consultation was 77.37 ± 90.3 days with extremes of 3 and 365 days. The median was 45 days. More than half of the patients 61.90% (n = 26) had anemia. Positive retroviral serology was noted in 21.43% of cases. All patients had a CRP greater than 6. More than half of the patients 51.92% (n = 27) had multifocal tuberculosis. The peritoneum 44.23% (n = 23) was the main organ affected. The average hospital stay was 9.8 ± 4.9 days with extremes of 1 and 19 days. All patients had received the protocol in force at the national level. Death was noted in 4 patients (9.52%). Conclusion: EPT is characterized in our context by a notorious diagnostic difficulty due to the multiplicity of clinical presentations, the complexity of

关键词： Extrapulmonary Tuberculosis Epidemiology Diagnosis Senegal

COVID-19/Tuberculosis Co-Infection at the Epidemic Treatment Center (ETC) of Saint-Louis (Senegal): About 9 Cases

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Advances in Infectious Diseases 2024年第1期14卷 56-66页

作者： Alassane Dièye Moustapha Diedhiou Papa Latyr Junior diouf Mba Bambo Diakhaby Demba Makalou Samba Niang Diatou Dia-Gueye Amadou Diop Dia Ibrahima Louis Martin Dieng Seynabou Lô Ndéye Méry Dia-Badiane Health Sciences Training and Research Unit Gaston Berger University Saint-Louis Senegal Department of Medicine Saint-Louis Regional Hospital Saint-Louis Senegal Infectious and Tropical Diseases Clinic of Fann Dakar Senegal

Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert? MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.

关键词： COVID-19 Tuberculosis Saint-Louis Senegal

Profile of SARS-CoV-2 Infected Patients Hospitalized at the Epidemic Treatment Center (ETC) in Saint-Louis, Senegal during the First Two Waves

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Advances in Infectious Diseases 2024年第2期14卷 322-337页

作者： Alassane Dièye Papa Latyr Junior diouf Bourama Diémé Moustapha Diedhiou Diatou Dia-Gueye Amadou Diop Dia Samba Niang Ibrahima Louis Martin Dieng Ameth Dieng Seynabou Lô Ndéye Méry Dia-Badiane Health Sciences Training and Research Unit Gaston Berger University Saint-Louis Senegal Emergency Department of Regional Hospital Center Saint-Louis Senegal Department of Infectious and Tropical Diseases of Fann Dakar Senegal

Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives: The aim of this study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolution profile of patients infected with SARS-CoV-2 hospitalized at the CTE of Saint-Louis (Senegal) during the first two waves. Patients and Methods: We conducted a retrospective, cross-sectional, descriptive, and analytical study that included all patients hospitalized at the ETC of Saint-Louis (Senegal) with SARS-CoV-2 infection from March 2020 to April 2021. Results: A total of 358 cases were collected, 256 (71.5%) during the first wave and 102 (28.5%) during the second wave. The mean age was 49.5 years (19.5). There was a male predominance (58.4%), with a sex ratio of 1.4. Hypertension was the main comorbidity, with 87 cases (24.3%). The most common functional signs were cough in 194 cases (54.2%), dyspnea in 143 cases (40%) and ageusia in 134 cases (37.4%). Thoracic CT scans were performed on 20 patients (5.6%), with severe involvement (50% - 75%) observed in 50% of cases. Hydroxychloroquine-azithromycin was prescribed to 351 patients (98%). Overall, 338 (94.4%) recovered and 17 (4.7%) died. In multivariate analysis, factors associated with death were male sex [OR = 2.645;95% CI: 1.530 - 4.785;p = 0.011], age 60 years [OR = 1.039;95% CI: 0.564 - 1.914;p = 0.002], the presence of comorbidities [OR = 2.171;95% CI: 0.564 - 3.429;p = 0.033], SpO2 (ambient air) 95% [OR = 2.061;95% CI: 0.616 - 3.827;p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 0.635;95% CI: 0.316 - 1.275;p = 0.001], severe form [OR = 1.664;95% CI: 0.298 - 2.478;p = 0.016], occurrence of complications [OR = 0.521;95% CI: 0.287 - 0.944;p = 0.032], high creatinine levels [OR = 2.061;95% CI: 1.616 - 3.827;p = 0.026], and lymphopenia [OR = 0.485;95% CI: 0.370 - 0.636;p = 0.0

关键词： SARS-CoV-2 Saint-Louis Senegal

Short, Medium, and Long-Term Stroke Mortality in Libreville and Associated Factors

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Neuroscience & Medicine 2024年第1期15卷 39-50页

作者： Grass Aurelle Mambila Matsalou Jennifer Nyangui Mapaga Pupchen M. Gnigone Minka’a Pagbe Michael Chermine Mboumba Mboumba Christian Allognon Mahutondji Aissata Ibrahima Camara Annick A. Nsounda Nelly diouf Mbourou Michel-Arnaud Saphou-Damon Elsa Ayo Bivigou Philomene Kouna Ndouongo Neurology Department University Hospital of Libreville Libreville Gabon Cardiology Department University Hospitalof Libreville Libreville Gabon

Strokes are common around the world and especially in sub-Saharan Africa. They are responsible for severe sequelae and the majority of deaths. In Gabon, no study on stroke mortality has been conducted. Objective: To determine short, medium, long-term mortality and factors associated with long-term stroke mortality. Method: Our study took place in the Neurology Department of the University Hospital Center of Libreville (UHCL). It was a historical cohort study with descriptive and analytical purposes covering the period from June 1 to August 31, 2018 and taking into account hospitalized patients from January 1, 2013 to December 31, 2017. We conducted a comprehensive systematic recruitment of patients with stroke, 18 years old and more, and had been agreed to give information. We included all patients meeting the inclusion criteria. The data was gathered using Epi-Info 7 software. The CHI-2 test was used for the comparison of frequencies and the Student’s test, for comparison of means. Multivariate analysis with logistic regression allowed us to look for factors associated with long-term mortality. A result was statistically significant for a p 0.05 value. Results: At 3 months, 28 patients (18.1%) died, at 6 months thirty-one patients or 20.1% died. At 5 years old, fifty-three patients or 34.4% had died. The factors associated with long-term mortality, if the lost of sight were all alive were tobacco (p = 0.01) and stroke (p = 0.008). If all those who were lost to sight had died, no factor was associated with 5-year mortality. Conclusion: Stroke mortality must not be taken for granted, it can be underestimated because of the large number of lost sight. Measures must be put in place to strengthen post-stroke monitoring. .

关键词： Stroke Mortality Associated Factors Libreville

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

Contribution of Bone Scintigraphy in the Diagnosis of a Case of SAPHO in the Nuclear Medicine Department of Idrissa Pouye General Hospital (Dakar, Senegal)

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Open Journal of Medical Imaging 2024年第1期14卷 1-9页

作者： El Hadji Amadou Lamine Bathily Kalidou Gueye Serigne Moussa Badiane Mamoudou Salif Djigo Gora Thiaw Ousseynou Diop Olatounde Herbert Fachinan Papa Mady Sy Alfonse Rodrigue Djiboune Kokou Fofo Toussaint Adambounou Louis Augustin Diaga diouf Boucar Ndong Gora Mbaye Omar Ndoye Mounibé Diarra Mamadou Mbodj Nuclear Medicine Department Idrissa Pouye General Hospital (HOGIP) Dakar Senegal Biophysical Laboratory FMPO Cheikh Anta Diop University (UCAD) Dakar Senegal Biophysical Laboratory UFR2S Gaston Berger University (UGB) Saint-Louis Senegal Nuclear Medicine Department Hospital Dalal Jamm Dakar Senegal Laboratory of Physical and Pharmaceutical Biophysics FMPO Cheikh Anta Diop University Dakar Senegal Biophysical Laboratory University of Lome Lome Togo

Introduction: The acronym SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) is a syndrome combining osteoarticular and cutaneous manifestations. It occurs mainly between the ages of 30 and 50. Sternocostoclavicular hyperostosis is one of the main distinguishing features. We report a case of SAPHO in Dakar diagnosed by bone scintigraphy. Observation: 28-year-old Senegalese women presented with left shoulder pain and relative functional impotence for over 2 years. Examination revealed right sternoclavicular hyperostosis and left shoulder pain on palpation. Questioning revealed a history of acne and hyperostosis of the right first toe. Bone scintigraphy, performed after injection of 630 MBq of 99mTc-HMDP, revealed: hyperfixation of the bilateral (right++) manubrio-sternal and sternoclavicular junction, producing the classic bull’s horn image;hyperfixation of the left shoulder with an inflammatory appearance;hyperfixation of the sacroiliac joints suggestive of bilateral sacroiliitis;hyperfixation of the right first toe;two mandibular hyper fixations probably related to dental damage. This scintigraphic appearance in one was strongly suggestive of SAPHO syndrome. Conclusion: SAPHO syndrome, related to spondyloarthropathy, associates cutaneous and osteoarticular signs. It is characterized by frequent delays in diagnosis due to poor recognition. Soy is an invaluable diagnostic tool, enabling us to assess the extent of the disease and its evolution.

关键词： SAPHO Bone Scintigraphy Young Woman Senegalese

Iodine 131 Treatment in Graves’ Disease in a West African Country: Preliminary Study about 25 Cases in Senegal

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Open Journal of Biophysics 2024年第1期14卷 56-72页

作者： El Hadji Amadou Lamine Bathily Serigne Moussa Badiane Mamoudou Salif Djigo Gora Thiaw Kalidou Gueye Ousseynou Diop Boucar Ndong Kokou Fofo Toussaint Adambounou Alphonse Rodrigue Djiboune Papa Mady Sy Mamadou Soumbounou Mohamed Chekhma Louis Augustin Diaga diouf Gora Mbaye Omar Ndoye Mounibé Diarra Mamadou Mbodj Nuclear Medicine Department General Hospital of Idrissa Pouye (HOGIP) Dakar Senegal Biophysical Laboratory Cheikh Anta Diop University (UCAD) Dakar Senegal Biophysical Laboratory Gaston Berger University (UGB) Saint-Louis Nuclear Medicine Department Hospital Dalal Jamm Dakar Senegal Biophysical Laboratory University of Lome Lome Togo Laboratory of Physical and Pharmaceutical Biophysics Cheikh Anta Diop University Dakar Senegal

Introduction: Graves’ disease is the most common cause of hyperthyroidism. Its treatment uses synthetic antithyroid drugs but the use of aggressive radical therapy such as surgery or non-aggressive therapy such as iodine-131 is not uncommon. Treatment of Graves’ disease with radioactive iodine or iratherapy is a simple, inexpensive, well-tolerated treatment. It was introduced in Senegal in 2016. We report through this work the preliminary assessment of the only nuclear medicine service in Senegal in the management of Graves’ disease by iodine-131. Patients and Methods: Retrospective study of the first cases of Graves’ disease treated with iratherapy in Senegal. Socio-demographic, clinical, paraclinical, therapeutic and evolutionary aspects were studied. Radiation protection rules have been implemented and contraception has been effective for six months in women of childbearing age. Results: 25 patients were collected with a mean age of 45 years, twenty women (80%), a family goiter in 24% and a psycho-affective context in 64% of cases. Thyrotoxicosis syndrome was associated with goiter in 68% of patients and exophthalmos in 64%. Thyroid ultrasound performed in 20 patients showed vascular goiter in 80% and thyroid scintigraphy in 3 patients, homogeneous and diffuse hyperfixation. TRAK dosed in 8 patients was still positive. All patients had received first-line medical treatment. The average duration of this treatment was more than 18 months in 92%. The empirically used iodine-131 activity averaged 15.35 mCi. Oral corticosteroid therapy was prescribed in 7 patients for the prevention of malignant orbitopathy. No early side effects were noted. The remission rate at 3 months was 52% and at 6 months was 88% to 92%. Conclusion: The effectiveness of radioactive iodine, in particular ablative doses in the treatment of hyperthyroidism, is no longer to be demonstrated. Taking into account our socioeconomic context, iratherapy should be a treatment of choice for hyperthyroidism

关键词： Graves’ Disease Iratherapy Iodine-131 Senegal