La myasthénie auto-immune de l’adulte lors d’une consultation décentralisée de neurologie au centre hospitalier national de Pikine dans la banlieue de Dakar-Sénégal

Fall, Maouly; Fall, Aicha Awbeck; Leye, Abdoulaye; Ndiaye, Moustapha; Diop, T. M.

doi:10.1016/j.neurol.2015.01.337

Cited by 5 publications

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“…In our study, we identified 14 cases in 4 years and 10 months between March 2012 and January 2017. We found a female predominance with a ratio F/M 1.3, a predominance in young adults (<50 years), and only two cases each of late MG and juvenile MG (<15 years) were recorded, which is in line with data from the literature [12][13][14][15][16][17][18][19][20]. Sex hormones appear to play a central role and some studies involve estrogens as the main mediator of the disease [21,22].…”

Section: Discussionsupporting

confidence: 86%

“…In one series, this association was found in 10.5% of MG with AchR antibodies [36]. Thymic abnormalities (thymic hyperplasia or thymoma) were detected in 71.4% of our patients, thymic hyperplasia in 42.8% and thymoma in 28.6 %, whereas data from the literature indicate the prevalence of thymic abnormalities in MG at about 75% [15,17,24], ie 10-15% for thymoma and 65% for thymic hyperplasia [37,38]. Thus, the prevalence of 28.6% of thymoma in our serie is much higher than in the literature and of Nouvel et al results (16.7%) in France, near Barbaud et al (28%) in France, but lower than El Mahdi et al in Morocco (33%) and Fall et al in Senegal (40%).…”

Section: Discussionmentioning

confidence: 60%

“…Sex hormones appear to play a central role and some studies involve estrogens as the main mediator of the disease [21,22]. At the beginning, MG is influenced by sex and age in a bimodal way: in women under 40, women predominate, but in the fifth decade cases are equally divided between men and women, and after 50 years, new cases are slightly more frequent in men [7,[16][17][18]22,23]. This characteristic has also been observed in our patients.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the prevalence of 28.6% of thymoma in our serie is much higher than in the literature and of Nouvel et al results (16.7%) in France, near Barbaud et al (28%) in France, but lower than El Mahdi et al in Morocco (33%) and Fall et al in Senegal (40%). This observation leads us to hypothesize a possible higher prevalence of thymoma in myasthenic patients in Africa [15,17,19,24]. However, a study in South Africa found no significant racial differences in the prevalence of MG, seropositive, seronegative or associated with a thymoma [9].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, Fall [17], El Mahdi [15], and Nouvel [19] had superior results with 80%, 89% and 70% of myasthenia with AchR antibodies. In the literature, the prevalence of AchR antibodies varies from 75% to 90% for general MG, and from 50% to 60% for ocular MG [27,28].…”

Section: Discussionmentioning

confidence: 99%

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Myasthenia gravis at Ouagadougou (Burkina Faso): about 14 cases

Labodi¹,

Kadari²,

A³

et al. 2017

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Myasthenia gravis at Ouagadougou (Burkina Faso): about 14 cases

Labodi¹,

Kadari²,

A³

et al. 2017

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Evolution clinique de la myasthénie auto-immune en neurologie à Antananarivo, Madagascar

et al. 2020

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Introduction la myasthénie auto-immune est une maladie rare, agissant au niveau de la jonction neuromusculaire. Elle peut engager le pronostic vital surtout lors d´une atteinte respiratoire. La rémission complète est possible sous traitement. Nos objectifs étaient de décrire l'évolution clinique sous traitement de nos patients myasthénique pour améliorer ultérieurement notre prise en charge et pour obtenir une première base de données malgaches. Méthodes une étude rétrospective descriptive fut menée au sein du Service de Neurologie de l´Hôpital Universitaire Befelatanana entre janvier 2010 et décembre 2017, incluant tout patient diagnostiqué comme myasthénie auto-immune après un test à la prostigmine positif. Résultats vingt-cinq patients (0,42%) sur 5814 hospitalisés étaient inclus. Seule l´évolution de 16 patients était connue (64%) dont 14 étaient sous traitement médical et 3 d´entre eux avaient une thymectomie. La durée moyenne de suivi était de 24 mois. Parmi les patients traités, 8 s´étaient améliorés, 2 étaient décédés. Chez les patients thymectomisés, 2 s´étaient améliorés, 1 était décédé. Conclusion la myasthénie reste une pathologie rare, grave, mais l´amélioration sous traitement est possible même en absence d´un plateau technique adéquat pour sa prise en charge à Madagascar. En ce moment, un projet avec l´association des patients myasthéniques à Madagascar est en cours pour pouvoir bénéficier des appareils respiratoires utiles surtout lors des crises myasthéniques.

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Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

et al. 2022

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The direct impact and sequelae of infections in children and adults result in significant morbidity and mortality especially when they involve the central (CNS) or peripheral nervous system (PNS). The historical understanding of the pathophysiology has been mostly focused on the direct impact of the various pathogens through neural tissue invasion. However, with the better understanding of neuroimmunology, there is a rapidly growing realization of the contribution of the innate and adaptive host immune responses in the pathogenesis of many CNS and PNS diseases.The balance between the protective and pathologic sequelae of immunity is fragile and can easily be tipped towards harm for the host. The matter of immune privilege and surveillance of the CNS/PNS compartments and the role of the blood-brain barrier (BBB) and blood nerve barrier (BNB) makes this even more complex. Our understanding of the pathogenesis of many post-infectious manifestations of various microbial agents remains elusive, especially in the diverse African setting. Our exploration and better understanding of the neuroimmunology of some of the infectious diseases that we encounter in the continent will go a long way into helping us to improve their management and therefore lessen the burden.Africa is diverse and uniquely poised because of the mix of the classic, well described, autoimmune disease entities and the specifically “tropical” conditions. This review explores the current understanding of some of the para- and post-infectious autoimmune manifestations of CNS and PNS diseases in the African context. We highlight the clinical presentations, diagnosis and treatment of these neurological disorders and underscore the knowledge gaps and perspectives for future research using disease models of conditions that we see in the continent, some of which are not uniquely African and, where relevant, include discussion of the proposed mechanisms underlying pathogen-induced autoimmunity. This review covers the following conditions as models and highlight those in which a relationship with COVID-19 infection has been reported: a) Acute Necrotizing Encephalopathy; b) Measles-associated encephalopathies; c) Human Immunodeficiency Virus (HIV) neuroimmune disorders, and particularly the difficulties associated with classical post-infectious autoimmune disorders such as the Guillain-Barré syndrome in the context of HIV and other infections. Finally, we describe NMDA-R encephalitis, which can be post-HSV encephalitis, summarise other antibody-mediated CNS diseases and describe myasthenia gravis as the classic antibody-mediated disease but with special features in Africa.

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La myasthénie auto-immune de l’adulte lors d’une consultation décentralisée de neurologie au centre hospitalier national de Pikine dans la banlieue de Dakar-Sénégal

Cited by 5 publications

References 0 publications

Myasthenia gravis at Ouagadougou (Burkina Faso): about 14 cases

Myasthenia gravis at Ouagadougou (Burkina Faso): about 14 cases

Evolution clinique de la myasthénie auto-immune en neurologie à Antananarivo, Madagascar

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

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