Maladies systémiques en médecine interne « contexte africain »: aspects épidémiologiques et classification

Kane, Baïdy Sy; Ndongo, S.; Ndiaye, Abdoul Aziz; Djiba, Boundia; Niasse, Moustapha; Diack, Ngoné Diaba; Ndao, Awa Cheikh; Fall, Babacar; Gning, S. B.; Pouye, Abdoulaye

doi:10.1016/j.revmed.2016.04.237

Cited by 9 publications

(12 citation statements)

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“…Au cours de la dermatomyosite et de la sclerodermie systémique, l'âge moyen des patients était plus élevé. Il était de 41,8 ans pour la sclérodermie systémique, plus élevé que celui retrouvé par Kane B S (36,54 ans) [18] et de 44 ans pour la dermatomyosite, plus bas dans les études de Badji au Sénégal (38,28) et Iba au Gabon (36 ans) [17,19].…”

Section: Discussionunclassified

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Untitled

2022

Our Dermatol Online

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Introduction:The general objective was to determine the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of connectivitis in the dermatology department of the CHU Aristide Le Dantec. Patients and methods: This was a retrospective and descriptive study conducted in the Dermatology Department of the University Hospital Center (UHC) Aristide Le Dantec (HALD) of Dakar between January 2009 and December 2019. Their diagnoses were retained according to the international criteria validated in the course of connectivites Results: We identified 290 cases of connectivitis. Systemic scleroderma was the most frequent in 34.42% (n=94), followed by systemic lupus in 25.86% (n=75), mixed connectivities in 22,06% (n=64) and dermatomyositis in 19,32% (n=56). Cancer was associated with dermatomyositis in 11 cases and with systemic scleroderma in 3 cases. The mean age of our patients was 38.23 years. The sex ratio was 4.2 and the mean duration of evolution was 25 months. Dermatological manifestations were constant, found in all patients. In systemic lupus, they were dominated by discoid lupus lesions found in 40% and hypochromic spots (86%) in systemic scleroderma. In dermatomyositis, skin lesions were dominated by periorbital erythroedema (66.07%). Joint manifestations were found in 56.89% of cases (n= 165), muscular manifestations in 41.37% of cases (n= 120) and pleuropulmonary manifestations in 31.3% of cases (n=91). Neuropsychiatric manifestations were noted in 5.17% of cases (n=15). All our patients were treated with corticosteroid therapy and 12.06% of them had received immunosuppressive treatment, the most commonly used molecules being methotrexate (3.44%) and cyclophosphamide (8.27%). Hydroxychloroquine was prescribed in 59.31% of patients, while D-penicillamine was prescribed in 42.06% of patients, 100% of whom were treated for systemic scleroderma. The main complications encountered were infectious complications in 83 cases (28.6%). Visceral complications, a type of visceral insufficiency, were noted in 4.13% of cases. Conclusion: Our study demonstrates the frequency of connectivitis in the dermatology department. Its particularity was the predominance of systemic scleroderma over lupus which was classically the first connectivite in dermatology services. The delay in diagnosis noted is correlated with visceral attacks; hence the importance of a better knowledge of these affections for an early management.

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“…La prédominance féminine était plus nette dans le lupus systémique où le sex-ratio femmes/hommes était de 9,7. Ce résultat s'accorde avec les données de la littérature où ce sex-ratio varie entre 6 et 17 [15,18,20,21].…”

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2022

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“…Systemic diseases are a heterogeneous group of diffuse autoimmune and/or autoinflammatory diseases and syndromes, usually involving several systems [1]. They affect about 5% of the world population [2].…”

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Therapeutic Itinerary of Patients Followed for Connectivitis in the Internal Medicine Department of the CNHU-HKM of Cotonou (Benin)

Azon-Kouanou¹,

Agbodande²,

Dansou³

et al. 2021

OJIM

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Introduction: In black Africa, connectivites have been for a long time a source of diagnostic erraticity because of their clinical polymorphism. This study aims to determine the therapeutic itinerary of patients followed for connectivitis in the Internal Medicine Department of the CNHU HKM of Cotonou. Methodology: This is a cross-sectional study that included patients followed for connectivitis in the HKM-Cotonou Internal Medicine Department from January 2010 to October 2018. Results: Out of 3600 patients hospitalized in the study period, 21 had connectivitis, i.e. a hospital frequency of 0.58%. Of the 21 patients collected, 18 met the inclusion criteria. The mean age was 40 (±11) years old and the youngest was of 21 and the oldest 58. The sex ratio was 17.9. The "Fon" ethnic group was the most represented (33.3%) and 15 (83.3%) subjects were Christians. Systemic lupus erythematosus was the most frequent connectivitis (55.6%). The average time of consultation was 38 months. Witchcraft was the most incriminating cause (78%). Ten (55.5%) patients had resorted to self-medication as their first choice of treatment, 5 (27.8%) to traditional medicine treatment and 3 (16.7%) to prayer for healing. The reasons for the first choice of treatment were satisfaction (44.4%), financial problems (27.8%), trivialization of the disease (16.7%), and advice from family and friends (11.1%). The consultation at the CNHU followed a referral from a first contact health structure (61%) or an initiative of the patient (27.8%). Conclusion: Connectivitis

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“…En Afrique, la prévalence de la PR varie selon les régions de 0,1 à 0,9 % (Jean del et al, 2002). Au Sénégal elle serait la première maladie systémique dans les services de médecine interne (Kane et al, 2016). Dans le cas du Niger, les études sont rares mais une précédente publication de 2010 à Niamey rapportait les 8 premiers cas documentés, séropositifs (Adehossi et al, 2010).…”

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Polyarthrite Rhumatoïde en Consultation Rhumatologique à Maradi, Niger

Salissou

Condé

Adamou

et al. 2019

ESJ

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Rheumatoid arthritis (RA) is the most common auto-immune disease. Rarely described in Niger, we reported its epidemiological, clinical, paraclinical, therapeutic, and evolutionary aspects in hospitals environments. In order to analyze these aspects in detail, a prospective study has been realized over a period of one (1) year in the Rheumatology Department of the Regional Hospital Center of Maradi. We have included all RA cases in accordance with the ACR/EULAR classification criteria of 2010. The data was entered and analyzed on SPSS 20.0 software. After collecting and studying 32 AR observations from among 846 rheumatologic consultations, the results have demonstrated different points: the average patient's age is 38,9 years, the delay for the diagnosis was 6 years, and in some cases extraarticular manifestations have been observed. The results show that the inflammatory syndrome was constant and that the treatment remains classic with non-pharmacologic means, analgesics, NSAID (non-steroidal antiinflammatory agent), infiltrations and DMARDs (disease-modifying anti-rheumatic drug). The evolution is positive in all the cases. Thanks to this study it is possible to affirm that rheumatoid arthritis is a reality in Niger and it has been better described. The diagnosis is late, the articular and systemic manifestations are the same as in Caucasians, but the autoimmunity seems less. The disease is very active, altering the quality of life. As for its treatment, conventional background therapy still remains effective.

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Maladies systémiques en médecine interne « contexte africain »: aspects épidémiologiques et classification

Cited by 9 publications

References 2 publications

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Therapeutic Itinerary of Patients Followed for Connectivitis in the Internal Medicine Department of the CNHU-HKM of Cotonou (Benin)

Polyarthrite Rhumatoïde en Consultation Rhumatologique à Maradi, Niger

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