Secondary hypertrophic osteoarthropathy, or Pierre-Marie Bamberger syndrome, is characterized by the association of digital clubbing, polyarthritis and periostitis affecting the long bones. Most commonly it is a paraneoplastic syndrome associated with lung cancer in 80% of cases. We report the case of a 49-year-old female patient who is actively smoking, one pack per day for 20 years. Seen in consultation for pain and swelling of the hands, elbows, knees, ankles, and feet evolving for about 5 months, associated with a poorly differentiated pulmonary adenocarcinoma. On history, she told us about a weight loss of about 8 kg, no fever, no cough, no family history of inflammatory rheumatism or cancer. Bilateral digital clubbing was noted. The diagnosis was based on imaging and histology. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and chemo-radiotherapy was started.
Objective: Rheumatologic disorders of chronic inflammatory bowel disease (IBD) and reactive arthritis with a digestive origin are part of the spondyloarthritis family. In black Africa, the prevalence of SpA associated with IBD is not clearly established. Thus the objective of our study was to describe the clinical and radiological characteristics of spondyloarthritis associated with IBD. Patients and Method: We carried out a prospective study in the rheumatology department of CHU Ignace Deen between January and December 2019. The diagnosis of SpA was based on clinical and biological arguments in accordance with the criteria of Amor and ASAS. Results: Fifteen observations of spondyloarthritis associated with IBD were collected in patients mean age 52 years with extremes of 32 and 65 years. 9 (53.33%) were female. Ten patients had Crohn's disease (CD) and 5 had ulcerative colitis (UC). The mean number of pushes was 2.5 ± 1.2. The average diagnostic time was 46 months. Sacroiliitis was present in 73.3% of cases and the mean mSASSS score at diagnosis was 32.11/72. In total, corticosteroids were used in 9 (60%) of patients, NSAIDs in 26.6% while DMARDs salazopyrine and methotrexate in 33.3% and 20% of patients, respectively. Conclusion: The MICI and SpA association is undoubtedly underestimated in our regions. Better collaboration between rheumatologists and gastroenterologists could facilitate diagnosis and improve care.
Introduction: Juvenile Idiopathic Arthritis (JIA) is the most common rheumatoid disease in children. In Sub-Saharan Africa, little data is available on the prevalence of JIA. The objective of our study was to determine the frequency and describe the clinical profile of JIA in Guinean children seen at the
Objectif : Déterminer le profil épidémiologique des cas d’arthropathies microcristallines dans le service de rhumatologie du CHU Aristide Le Dantec. Matériel et méthodes : Il s’agit d’une étude rétrospective menée entre janvier 2002 et décembre 2015 dans le service de rhumatologie du CHU Aristide Le Dantec de Dakar. Nous avions inclus tous les dossiers des patients diagnostiqués pour arthropathies microcristallines selon les critères en vigueur. Résultats : Nous avons colligées 150 cas d’arthropathies microcristallines : 106 cas de gouttes, 37 cas de CCA et 7 cas de rhumatisme apatitique. Les cas de goutte étaient observés chez 92 hommes (86,79%) et 14 femmes (13,21%), d’âge moyen de 55,72 ans (extrême entre 31 et 91 ans). Le délai diagnostique était en moyenne de 11,17 ans (extrême entre 3 jours et 40 ans). L’hyperuricémie était constante et était associé à des facteurs de risque métabolique. Les cas de chondrocalcinose articulaire étaient observés chez 31 femmes (83,8%) et 6 hommes (16,2%) d’âge moyen de 69,05 ans (extrême entre 59 et 91 ans). Le délai diagnostic était de 10,46 ans (extrême entre 1 et 26 ans). Les cas de rhumatisme apatitique étaient constitués uniquement de femme jeune dont l’âge moyen était de 32 ans (extrême entre 29 et 34 ans). Conclusion: L’incidence de cette affection semble être en augmentation dans notre étude où elle est dominée, comme en Occident par la goutte. Le diagnostic des arthropathies microcristallines était tardif et sa présentation clinique et radiologique sévère. Cette sévérité est attribuable en partie au retard diagnostic ce qui est similaire aux formes rapportées chez le noir africain.
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