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

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

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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

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Epidemiological Aspects of Cerebrovascular Accidents in the Diabetic:Experience of the Medical Clinic II of the Hospital Center Abass Ndao of Dakar

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Open Journal of Endocrine and Metabolic Diseases 2018年第1期8卷 9-18页

作者： Djiby Sow Demba Diédhiou Ibrahima Mané Diallo Michel Assane ndour Anna Sarr maimouna ndour-mbaye Norou Diop Said Department of Internal Medicine Ⅱ University Hospital Center of Dakar Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Abass Ndao Hospital Center Cheikh Anta Diop University Dakar Sénéga

Introduction: The objective of our study was to describe the socio-demographic characteristics and cardiovascular risk factors (RVFs) of diabetic patients admitted for stroke in a department other than neurology. Methods: Retrospective cross-sectional study over a period of six (6) years (January 2010 and December 2016), performed at the Internal Medicine Department of the Abass Ndao Hospital Center in Dakar. Results: 79 adults with a mean age of 64.67 years, a female predominance (51.89%). The major risk factors found were arterial hypertension in 74.68% of cases, dyslipidemia in 32.35% of cases, smoking in 6.32% of cases. The reasons for consultation were a disorder of consciousness in 27.4% of cases, hemiplegia in 43.3% of cases, headache in 18.98% of cases, vertigo in 8.86% and dysarthria in 10.12% of the cases. Mean systolic blood pressure was 150 mmHg, mean diastolic blood pressure was 86 mmHg. The average blood glucose was 3 g/l. Strokes were associated with left ventricular hypertrophy in 30.55% of cases. Ischemic stroke accounted for 74.68%. The evolution was marked by a death in 20.25% (16) cases. Conclusion: Stroke is a major public health problem. Despite its predominance of women, they (stroke) affected 48.10% of men in our study when we know that in Africa the social activity is based on men. They remain a serious pathology in the diabetic by the high lethality.

关键词： Africa Chronic Complications Diabetes Mortality

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Decentralized Management of Diabetes Mellitus by General Patrician

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Open Journal of Internal Medicine 2017年第2期7卷 25-35页

作者： Demba Diédhiou Djiby Sow Ibrahima Mané Diallo Ahmadou Diouara Michel Alassane ndour maimouna ndour-mbaye Anna Sarr Said Norou Diop Department of Internal Medicine Abass Ndao Hospital Center Cheikh Anta Diop University Dakar Senegal

Introduction: In Senegal, the frequency of diabetes mellitus is estimated at 3.2% and its management by the general patrician (gp) is dissatisfied. The objective was to evaluate the decentralized monitoring of diabetes mellitus and other cardiovascular risk factors by a trained general practician. Patients and methods: It was a retrospective, descriptive study conducted from June 1, 2013 to 31 May, 2015 in Dakar, where included the files of subjects with diabetes mellitus regularly followed. The data collected were epidemiological, diagnostic and therapeutic. Results: It was of 125 diabetics patients with a mean age of 56.4 years old. At the inclusion, their diabetes had a mean duration of 6.3 years and a mean average HbA1c of 10.4%. The complications were a neuropathy in 58 cases (46.4%), an arteritis in 46 cases (36.8%), a nephropathy in 16 cases (12.8%) and a retinopathy in 28 cases (22.4%). Other cardiovascular risk factors were an arterial hypertension in 74 cases (59.2%), smoking in 11 cases (8.8%), kidney disease in 16 cases (12.8%), and LDL-cholesterol > 1.6 g/l in 39 cases (31.2%). In total, 87 patients (69.6%) were at high cardiovascular risk and among them, 81.6% had LDL-cholesterol > 1g/l. At inclusion, anti-diabetic treatment was oral mono-therapy in 53 cases (42.4%), an insulin therapy in 49 cases (39.2%). After 12 month of follow-up, the dual therapy anti-diabetic was increased from 13.6% to 34.4%. The others associated drugs were anti-hypertensives in 72 cases (57.6%), statins in 29 cases (23.2%) and anti-platelet agent in 46 cases (36.8%). Only 31.2% of the patients with nephropathy were under the renin angiotensin system blockers. Statins and the anti-platelet agents were prescribed respectively at 25.2% and 47.1% of the 87 patients at high cardiovascular risk. During follow-up, the target HbA1c Conclusion: our study shows the importance and the interest of a trained general practician for the management of non-communicable diseases. However, it wo

关键词： Diabetes Mellitus Risk Factors Followed Decentralized General Patrician Senegal

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Morbi Infectious Mortality of Diabetics Hospitalized at the Medical Clinic of Abass Ndao Health Center

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Open Journal of Endocrine and Metabolic Diseases 2018年第1期8卷 1-8页

作者： Djiby Sow Demba Diédhiou Ibrahima Mané Diallo Michel Assane ndour Mahecor Diouf Marie Ka-Cissé Anna Sarr maimouna ndour-mbaye Clinique Médicale II Centre Hospitalier Abass Ndao (UCAD) Dakar Senegal Medical Clinic of Abass Ndao Health Center Cheikh Anta Diop University Dakar Senegal

Introduction: Diabetes is a public health problem and is exposed to some complications, particularly infectious. The work on this entity remains segmentary in Africa. The objective was to describe the morbi infectious mortality of the diabetics at the Medical Clinic II of Abass Ndao Health Center of Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from 01 January 2016 to 31 December 2016. It covered patients with diabetes hospitalized during the study period. Epidemiological data and infectious diseases were evaluated. Results: During the study period, 346 diabetics have respected the inclusion criteria. These were 165 men (47.68%), a sex ratio of 0.91. The mean age was 56.17 years. The age group of [60 - 69 years] accounted for 31.5% and 95.6% of the patients came from the Dakar region. The average age of diabetes was 10.31. Diabetes had been evolving for less than 5 years in 25.15% of patients and inaugural in 11.46%. About 82.36% of our patients had type 2 diabetes. The acute complications of diabetes were ketoacidosis (51.89%), hyperosmolar hyperglycemia (0.58%), and hypoglycemia (1.45%). The mean infections were the skin and soft tissues (54.91%), urogenital infections (16.18%), respiratory infections (14.45%), malaria (3.46), infections of the skin and soft tissues were dominated by the diabetic foot (41.90%). The 125 non-diabetic patients developed 38 infectious pathologies, the main ones being respiratory infections (24.32%), infections of the skin and soft parts (24.32%). HIV infection was observed in 0.28% of diabetics and 8.10% of non-diabetic patients. 93 patients died (15.70%). Fifty-one of them died of infectious diseases (54.8%), 42 non-infectious diseases (45.16%), and subjects aged over 60 years, representing 72.54%. The means of consultation was 30 days. The highest rates of lethality were diabetes (37.41%), acute gastroenteritis (17.64%), and acute pyelonephritis (12.5%). The lethality rates of in

关键词： Morbimortality Diabetes Infection Senegal

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Epidemiological, Clinical, Paraclinical and Evolutionary Aspects of Urinary Tract Infection in Diabetics Hospitalized at the Department of Medicine of Abass Ndao Hospital from January 01, 2018, to December 31, 2018

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Advances in Infectious Diseases 2022年第2期12卷 203-215页

作者： Ndeye Fatou Ngom Djiby Sow Demba Diedhiou Michel Assane ndour Cheikh Tacko Diop Fulgence Abdou Faye Ousseynou Ka Anna Sarr maimouna ndour mbaye Department of Medicine Faculty of Health and Sustainable Development Alioune Diop University of Bambey Bambey Senegal Faculty of Medicine Cheikh Anta Diop University Dakar Senegal Internal Medicine Department Abass Ndao Hospital Dakar Senegal Department of Community Health Faculty of the Health and Sustainable Development Alioune Diop University of Bambey Bambey Senegal

Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the frequency and etiologies of urinary tract infections in diabetics hospitalized at the department of medicine of Abass Ndao Hospital. Patients and Methods: This work was a cross-sectional, descriptive, and analytical study conducted from January 01, 2018, to December 31, 2018. It focused on hospitalized diabetic patients with urinary tract infection. Epidemiological, clinical, and evolutionary data of UTI were evaluated. Results: One hundred and twenty-eight (128) diabetic patients had a cytobacteriological urine exam (CUE). 44 of who had a positive CUE (34.4%). The age group [60 - 69] years was the most represented (31.8%). Women predominated (61.4%) with a sex ratio (m/f) of 0.63. Abdominal pain was the most frequent reason for consultation, followed by polydipsia. Fever was recorded in 21 patients (47.7%). Type 2 diabetes was found in most patients (70.5%). Glycemia above 2g/l was found in 34 patients (89.5%). Anemia accounted for more than half of the patients with 29 cases (65.9%). Leukocytosis was noted in 28 patients (63.6%) and a positive CRP in 33 patients (75%). An increase in urea-creatinine was noted in 23 cases (52.3%). The results of the CUE revealed Escherichia coli as predominant (43.2%, n = 19), followed by Candida with 22.7% (n = 10). Antibiotic therapy was given to all patients. The mostly used antibiotic in the treatment of UTI was Cefotaxime 27.3% (n = 12). Older age and female gender were associated with the presence of E. coli. Four (4) deaths were recorded (9%). They were all male over the age of 65. Conclusion: UTI in diabetes is an important cause of morbidity and mortality. The development and implementation of a prevention and management program are essential.

关键词： Urinary Tract Infection Diabetes Risk Factors Mortality Senegal

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Epidemiological, Clinical and Therapeutic Characteristics of Hypertensive Type 2 Diabetics at the Marc Sankale Center of Dakar

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Open Journal of Endocrine and Metabolic Diseases 2018年第2期8卷 59-69页

作者： Djiby Sow Demba Diédhiou Ibrahima Mané Diallo Amadou Ndiaye Michel Assane ndour Anna Sarr Said Norou Diop maimouna ndour-mbaye Department of Internal Medicine Ⅱ University Hospital Center of Dakar Cheikh Anta Diop University Dakar Senegal Laboratory Analyzes Medical Biology Abass NDAO Hospital in Dakar Dakar Senegal

Introduction: High blood pressure (hypertension) and diabetes mellitus are two major risk factors for cardiovascular disease, which is increasing rapidly in Africa and worldwide. Africa has the highest prevalence rate of hypertension in the world, with 46% of adults over the age of 25 with. Hypertension is common in type 2 diabetes and increases cardiovascular risk. The association of these two pathologies has many particularities in the sub-Saharan subject. The work related to this entity in Africa shows a frequency between 30% and 60%. The objective was to describe the epidemiological, clinical and therapeutic characteristics at the Medical Clinic II of the Abass Ndao Hospital Center in Dakar. Patients Methods: This was a cross-sectional, descriptive and analytical study conducted from 01 December 2016 to 31 January 2017. It focused on patients with cardiothyrosis. Epidemiological data, cardiovascular risk factors, and cardiothoracic characteristics were evaluated. Results: 303 cases were recorded with a prevalence of 42%, an average age of 61.63 years, a sex ratio of 0.22. The age group of [60 - 70] years was the most representative at 36.30%. The BMI (Body Mass Index) average was 27.06 kg/m2. Obesity was 25% and 35% were overweight. Dyslipidemia consisting of an increase in LDL cholesterol > 1 g/l in 79%, a hypercholesterolemia in 57%, a decrease in HDL cholesterol in 13.23% and a hypertriglyceridemia in 28%. Patients with three cardiovascular risk factors accounted for 93.72%. The average fasting glucose level was 2.85 g/l. Hyperglycemia was noted in 65%. The glycosylated hemoglobin is greater than 7% in 47%. The duration of diabetes was less than 5 years in 133 patients or 44%. 70% of patients were treated with oral antidiabetic drugs. Insulin was used in 21.1%. Hypertension was mild in 24.1%, moderate in 23.8% and severe in 14.8%. Hypertension treated with monotherapy was 49%, combination therapy was 43%. Converting enzyme inhibitors (CEI) were used in 44%;20

关键词： Diabetes Hypertension Risk Factors Treatment Senegal

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Hepatic Cirrhosis: Diagnostic and Prognosis in Internal Medicine

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Open Journal of Internal Medicine 2020年第2期10卷 171-180页

作者： Demba Diédhiou Djiby Sow Elhadji Mamadou Moussa Thioye Michel Assane ndour Ibrahima Mané Diallo Fatou Kiné Gadji Anna Sarr maimouna ndour mbaye Department of Internal Medicine II University Hospital Center of Dakar Cheikh Anta Diop University Dakar Sénégal

Introduction: Cirrhosis is a public health problem and the causes are dominated by viral hepatitis and alcoholism. Deaths due to cirrhosis represented 2.4% of deaths worldwide in 2017. The aim of this work was to study the diagnostic and prognosis of cirrhosis at the department of internal medicine of the Abass Ndao hospital center. Patients and Methods: This is a retrospective, descriptive study, carried out on the basis of patient files followed from May 1, 1999 to February 28, 2018 (19 years) and included all patients for whom the diagnosis of cirrhosis was accepted. The diagnosis of cirrhosis was made on the basis of clinical, biological and ultrasound (portal hypertension, signs of hepatocellular insufficiency, a diffuse heterogeneous aspect, and irregularity of the liver contours). Results: 60 patient files were listed with an average age of 46.9 years, a sex ratio of 2.2 and alcoholism in 11.7% of the cases. The reasons for consultation were dominated by an increase in the size of the abdomen (55%), lose weight (50%). On physical examination, it was a hepatomegaly (43.3%) and jaundices (33.3%). Exploration of liver function showed a cholestasis (48%), a cytolysis (58%) and a hepatocellular insufficiency (46.2%). Anemia was found in (24%). The abdominal ultrasound found in all cases a dysmorphic, heterogeneous liver with irregular contours. Hepatic atrophy was found in 20%. Among the 34 patients who underwent upper gastrointestinal endoscopy, they were grade 2 to 3 esophageal varicose vein in 67.6%, an erosive gastropathy in 29.4%. The etiology was viral hepatitis B in 45%, alcoholism in 11.7% and undetermined in 43.3%. A hematemesis complicated the evolution in 16.7%. Carcinomatous degeneration was found in 5% and 16.7% of the patients had died. Conclusion: our experience with cirrhosis was marked by advanced forms at the stage of complications. The viral etiology B remains dominant. Preventi

关键词： Cirrhosis Diagnosis Internal Medicine Senegal

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Correlation between Glomerulopathy and Retinopathy in an African Population of Type 2 Diabetics

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Journal of Diabetes Mellitus 2020年第2期10卷 64-72页

作者： Michel Assane ndour Jean Pierre Diagne Demba Diedhiou Djiby Sow Esperance Ciss Ibrahima Mane Diallo Muriel Diembou El Hadj Fary Ka Papa Amadou Ndiaye Anna Sarr maimouna ndour mbaye Department of Internal Medicine Abass Ndao Hospital Center Dakar Sénégal Department of Ophtalmology Abass Ndao Hospital Center Dakar Sénégal Department of Nephrology Aristide Le DantecHospital Center Dakar Sénégal

Introduction: Diabetic microangiopathies are common, but their time to onset in a diabetic patient varies from subject to subject. The aim of our study was to study the correlation between renal and ophthalmic disorders in patients with type 2 diabetes. Patients and methods: This longitudinal, analytical study took place from March 1, 2018 to March 31, 2019 at the Abass Ndao University Hospital Center. It was studying retinal involvement in diabetic patients with glomerulopathy. Results: Of the 100 cases of diabetic glomerulopathy, they are divided into 70 women and 30 men with an average age of 58.2 years. The average duration of diabetes was 6.1 years and their average glycated hemoglobin (HbA1c) was 8.1%. Only 37% of patients had an HbA1c level below 7%. The other cardiovascular risk factors were high blood pressure (HBP) (39%), dyslipidemia (36%), and obesity (15%). Among these patients, diabetic retinopathy was present in 21% of the cases. Retinopathies were more frequent in the group of patients diagnosed with diabetes for less than 6 years (69%) and in patients with chronic renal disease with slightly reduced glomerular filtration rate (GFR) (34%). Conclusion: Our study allowed us to conclude that during the course of type 2 diabetes, the onset of chronic kidney disease does not systematically imply the presence of diabetic retinopathy. It is thus important to make screenings and assessments of systematic complications.

关键词： Diabetic Retinopathy Diabetic Nephropathy Microangiopathy Daka

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Rosai Dorfman Destombes’s Disease about 5 Cases

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Open Journal of Internal Medicine 2020年第2期10卷 212-222页

作者： Michel Assane ndour Boundia Djiba Baï di Sy Kane Pape Guirane Ndiaye Demba Diedhiou Mouhamed Dieng Barane Thiam Rosa Bampoky Muriel Diembou Atoumane Faye maimouna ndour mbaye Anna Sarr Abdoulaye Pouye Department of Internal Medicine Abass Ndao Hospital Center Dakar Senegal Department of Internal Medicine Aristide Le Dantec Hospital Center Dakar Senegal

Rosai Dorfman’s Disease (RDD) Destombes also called sinus histiocytosis with massive lymphadenopathy is a lymphoproliferative pathology usually benign, of unknown etiology, and of low incidence. It is a rare, but well-defined clinicopathological entity, which predominantly affects children and adolescents without distinction of gender or race. It manifests itself generally by bulky cervical lymphadenopathies, most often bilateral, painless, of benign but persistent evolution and a long-term fever associated with a non-specific biological inflammatory syndrome. Extra lymph node locations are described in association with lymph node involvement or isolation. The definitive diagnosis of Rosai Dorfman’s disease is histological, characterized by histiocytic infiltration with emperipolesis essentially of lymphocytes. The etiopathogenesis of the condition remains unclear, based on infectious and immunological hypotheses without clear evidence. The management is not well codified, it combines depending on the case, surgery;corticosteroids;antimetabolites and interferon alpha. Studies devoted to this condition in tropical Africa are rare. We report the clinical and progressive features of 5 observations of Rosai Dorfman’s disease.

关键词： Rosai Dorfman Histiocytosis Dakar

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