IgG4 disease is an immune-mediated disorder characterized by fibroinflammatory masses that can infiltrate multiple organ systems. Renal involvement is considered one of the key features of this disease. Report 02 case...IgG4 disease is an immune-mediated disorder characterized by fibroinflammatory masses that can infiltrate multiple organ systems. Renal involvement is considered one of the key features of this disease. Report 02 cases of IgG4 disease with renal manifestations revealing the disease such as extramembranous glomerulonephritis and tubulointerstitial nephritis rich in polytypic IgG4+ plasma cells. Associated renal parenchymal lesions concomitant with multiple organ involvement should help improve early recognition of IgG4-RKD disease (IgG4-RKD). In our case series, prednisone was the treatment of choice;the use of rituximab in extramembranous glomerulonephritis had resulted in remission of the disease.展开更多
Background： Ee （Eosinophilic esophagitis） is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. Its pathophysiology mimics that of allergic esophagitis, and evo...Background： Ee （Eosinophilic esophagitis） is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. Its pathophysiology mimics that of allergic esophagitis, and evolves clinically as a chronic disease with periods of exacerbation. Symptoms and endoscopic findings are usually non-specific and similar to those of other esophageal illnesses. The mainstay of treatment of Ee is with corticosteroids and/or specific diets, which have been shown to cause symptom remission and histological improvement. Aim： The objective of this study was to demonstrate the efficacy of a novel and promising treatment protocol for Ee. Materials and methods： We prospectively evaluated 24 patients with Ee over two years. Patients were treated with a single intramuscular injection of betamethasone sodium phosphate associated with betamethasone dipropionate and a PPI （proton pump inhibitor） （rabeprazole 20 mg PO）. After 4 weeks of treatment, patients underwent endoscopy and biopsy. We evaluated patients＇ clinical response as well as the results of endoscopic and histological examinations. Results： After 4 weeks of treatment, all patients （100%） are reported significant clinical improvement, which was corroborated by the findings on endoscopy and histology. There were no complications or adverse reactions. Conclusions： In this cohort of patients with eosinophilic esophagitis, treatment with a single intramuscular dose of corticosteroids led to complete remission of symptoms and improvement in endoscopic and histological findings.展开更多
<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">First described in 1908, TAK has now been recognized as a non...<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">First described in 1908, TAK has now been recognized as a non-specific inflammatory disease of unknown etiology, predominantly affecting young females. Sometimes, it progresses into relatively rare and potentially fatal scenarios such heart failure.</span><b><span style="font-family:Verdana;"> Case Presentation: </span></b><span style="font-family:Verdana;">Here, we present the case of a 50-year sub-saharan</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">female suffering from acute heart failure related to TAK.</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">Despite constitutional symptoms (fever, malaise, weight loss) and more characteristic features such claudication of lower extremities, carotydinia, and pulseless syndrome, diagnosis of TAK was delayed since main presentation was heart failure.</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">Immunosuppressive and anticoagulant therapies have induced improvement in cardiac manifestations.</span><b><span style="font-family:Verdana;"> Conclusion: </span></b><span style="font-family:Verdana;">Early diagnosis and proper treatment can protect the patient from dangerous complications such heart failure.</span></span>展开更多
Introduction: GBS is a rare condition in children. The risk factors for GBS are present in Africa;however, the majority of studies reported are case series. The objective of our work was to evaluate the epidemiologica...Introduction: GBS is a rare condition in children. The risk factors for GBS are present in Africa;however, the majority of studies reported are case series. The objective of our work was to evaluate the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of GBS cases. Material and Method: This was a prospective longitudinal study, lasting 24 months between November 2019 and November 2021. All patients aged 2 - 18 years diagnosed with GBS according to the Brighton criteria (level 2) were included in our study. Patients with incomplete or unexploitable records were excluded. Results: Over a 24-month period, 16 cases of GBS were collected. These included 12 boys (75%) and 4 girls (25%). The demyelinating form (ADIP) was found in 9 children (43.75%) and the axonal form in 7 patients (37.5%), 5 of whom had pure motor involvement (AMAN) and 2 with sensory-motor involvement (AMSAN). Corticosteroid therapy was more effective in treating pain and in demyelinating forms. Three deaths were noted and all had AMAN. Conclusion: GBS poses a management problem in our context of a country with limited resources. Corticosteroid therapy has been shown to be effective in the treatment of pain and demyelinating forms of the disease and should be considered for use in GBS.展开更多
<div style="text-align:justify;"> <strong>Introduction:</strong> <span "="">Prolonged corticosteroid therapy is labeled as the main cause of corticotropic adrenal insuf...<div style="text-align:justify;"> <strong>Introduction:</strong> <span "="">Prolonged corticosteroid therapy is labeled as the main cause of corticotropic adrenal insufficiency. However, the current frequency of this complication remains unknown. The objective of our study was to assess its epidemiologic, diagnostic, therapeutic, and evolutionary aspects of our practice.<b> Methodology: </b>A 60-month retrospective study was performed from May 2014 to April 2020 in the Pikine National Hospital Centre. Data were obtained from the medical records of patients with corticosteroid-induced adrenal insufficiency. Epidemiologic, diagnostic, therapeutic, and evolutionary parameters, and data related to corticotherapy were recorded.<b> </b>Patients with basal plasma cortisol levels <50 ng/ml or a plasma cortisol level less than double of the basal cortisolaemia one H after administration of synachtene 250 were included. <b>Results: </b>Medical records were obtained from nine patients, comprising six women and three men. The mean age of the patients was 48 years. Long-term corticosteroid therapy was used for self-medication in six patients and artificial bleaching in the remaining three patients. Betamethasone was the most commonly used drug in four patients, followed by clobetasol in three patients. Corticotropic insufficiency was revealed as a result of acute decompensation in five patients. All patients presented with a pseudo-cushingoid pattern. Diagnosis of corticotropic adrenal insufficiency was confirmed by measuring basal plasma cortisol levels of <50 ng/ml in seven patients. A standard Synachtene test was performed on two patients. All patients benefited from hydrocortisone supplementation. In the short-term, the outcome was unremarkable for all patients. Medium and long-term progression could be assessed in only three patients. Two patients showed persistent suppression with a 6- and 9-month follow-up. One patient was readmitted after one month due to an adrenal crisis following voluntary discontinuation of hydrocortisone treatment.<b> Conclusion:</b><b> </b>Post-corticosteroid therapy adrenal insufficiency remains a concern in our practice and is favoured by the non-compliance of providing rules by pharmacies and the parallel drug market.</span> </div>展开更多
Introduction: Focal Segmental Glomerulosclerosis (FSGS) corresponds to a clinicopathological syndrome, manifested by generally abundant proteinuria associated with hyaline deposits on part of certain glomeruli and spa...Introduction: Focal Segmental Glomerulosclerosis (FSGS) corresponds to a clinicopathological syndrome, manifested by generally abundant proteinuria associated with hyaline deposits on part of certain glomeruli and sparing other glomeruli, with effacement of the pedicels. The general objective was to determine the prevalence of FSGS, and to give its profiles;epidemiological, clinical, biological, pathological, etiological, therapeutic and evolutionary of FSGS. Materials and Methods: This is a retrospective analytical study over a period of six years extending from January 1, 2010 to December 31, 2015 patients aged 16 or over who were hospitalized or received consultations during the study period for primary or secondary segmental and focal hyalinosis. Patients whose records were incomplete or unusable were not included in the study. Results: We have 16.54% with 158 cases of FSGS out of 6945 patients received and/or hospitalized. Of the 955 kidney biopsies distributed, the incidences of HSF were;10.15%;14.04%;15%;17.64%;20.11%;19.58% respectively in 2010;2011;2012;2013;2014 and 2015, i.e. an annual increase of around 1.25%. Renal-type edemas were found in 93.3%, the first reason for hospitalization. And ninety-six people had impaired kidney function, or 61%. The average of 24-hour proteinuria was 6.4 ± 3.69 g/24 hours. The extremes were 0.37 and 18.50 g/24h. Patients had nephrotic proteinuria in 84.86%. Non-specific FSGS or NOS (Not Other Specificities) was found in 62 cases or 39.24%, collapsing FSGS in 48 cases or 30.40%. FSGS with found causes was associated with fibrosis in 5/35 cases. Collapsing FSGSs followed by NOS FSGSs were the most corticosteroid-resistant. The evolution of the FSGS reveals that every 8 months the proteinuria decreases by half. Conclusion: Segmental and focal hyalinosis requires histological confirmation and the epidemiological, clinico-biological, etiological, therapeutic and evolutionary profiles depend on the histological (pathological) type. Other works on the risk factors for occurrence and the contribution of electron microscopy in the primary and secondary diagnosis of segmental and focal hyalinosis are desired.展开更多
Introduction: Dermatomyositis is a rare pathology with severe prognosis. Its prevalence varies from one part of the earth to another and its clinical aspects are multiple. In Western countries, they have been the subj...Introduction: Dermatomyositis is a rare pathology with severe prognosis. Its prevalence varies from one part of the earth to another and its clinical aspects are multiple. In Western countries, they have been the subject of several studies. However few studies have been devoted to this disease in sub-Saharan Africa. We initiated this work to contribute to a better knowledge of dermatomyositis in our work context. Material and Methods: This is a retrospective, descriptive and analytical study carried out in the Dermatology Department of the University Hospital Center of Treichville from January 2006 to December 2015. All Patients with dermatomyositis have been taken into account in the study. Results: The hospital prevalence of dermatomyositis in our work was 1.38%. The age of our patients ranged from 11 to 79 years with an average of 41 years. The sex ratio was 0.48. The delay before the first consultation ranged from 1 week to 1 year 9 months with an average of 5 months. Cutaneous manifestations were the first signs observed including post-in-flammatory hyperpigmentation and erythro-eodema. Muscular manifestations were dominated by muscular pain (81.08%). muscular enzymes were consistently elevated in biological examinations. The duration of hospitalization was 3 weeks in average. Oral corticotherapy (94.59%) was the most used therapy. A clinical improvement was observed on average 4 months after treatment. The death rate was 16.22%. Conclusion: Dermatomyositis is infrequent in Côte d’Ivoire. It involves mostly young woman. The cutaneous manifestations are often the first signs observed, hence the importance of the dermatologist in its screening and early management.展开更多
文摘IgG4 disease is an immune-mediated disorder characterized by fibroinflammatory masses that can infiltrate multiple organ systems. Renal involvement is considered one of the key features of this disease. Report 02 cases of IgG4 disease with renal manifestations revealing the disease such as extramembranous glomerulonephritis and tubulointerstitial nephritis rich in polytypic IgG4+ plasma cells. Associated renal parenchymal lesions concomitant with multiple organ involvement should help improve early recognition of IgG4-RKD disease (IgG4-RKD). In our case series, prednisone was the treatment of choice;the use of rituximab in extramembranous glomerulonephritis had resulted in remission of the disease.
文摘Background： Ee （Eosinophilic esophagitis） is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. Its pathophysiology mimics that of allergic esophagitis, and evolves clinically as a chronic disease with periods of exacerbation. Symptoms and endoscopic findings are usually non-specific and similar to those of other esophageal illnesses. The mainstay of treatment of Ee is with corticosteroids and/or specific diets, which have been shown to cause symptom remission and histological improvement. Aim： The objective of this study was to demonstrate the efficacy of a novel and promising treatment protocol for Ee. Materials and methods： We prospectively evaluated 24 patients with Ee over two years. Patients were treated with a single intramuscular injection of betamethasone sodium phosphate associated with betamethasone dipropionate and a PPI （proton pump inhibitor） （rabeprazole 20 mg PO）. After 4 weeks of treatment, patients underwent endoscopy and biopsy. We evaluated patients＇ clinical response as well as the results of endoscopic and histological examinations. Results： After 4 weeks of treatment, all patients （100%） are reported significant clinical improvement, which was corroborated by the findings on endoscopy and histology. There were no complications or adverse reactions. Conclusions： In this cohort of patients with eosinophilic esophagitis, treatment with a single intramuscular dose of corticosteroids led to complete remission of symptoms and improvement in endoscopic and histological findings.
文摘<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">First described in 1908, TAK has now been recognized as a non-specific inflammatory disease of unknown etiology, predominantly affecting young females. Sometimes, it progresses into relatively rare and potentially fatal scenarios such heart failure.</span><b><span style="font-family:Verdana;"> Case Presentation: </span></b><span style="font-family:Verdana;">Here, we present the case of a 50-year sub-saharan</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">female suffering from acute heart failure related to TAK.</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">Despite constitutional symptoms (fever, malaise, weight loss) and more characteristic features such claudication of lower extremities, carotydinia, and pulseless syndrome, diagnosis of TAK was delayed since main presentation was heart failure.</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">Immunosuppressive and anticoagulant therapies have induced improvement in cardiac manifestations.</span><b><span style="font-family:Verdana;"> Conclusion: </span></b><span style="font-family:Verdana;">Early diagnosis and proper treatment can protect the patient from dangerous complications such heart failure.</span></span>
文摘Introduction: GBS is a rare condition in children. The risk factors for GBS are present in Africa;however, the majority of studies reported are case series. The objective of our work was to evaluate the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of GBS cases. Material and Method: This was a prospective longitudinal study, lasting 24 months between November 2019 and November 2021. All patients aged 2 - 18 years diagnosed with GBS according to the Brighton criteria (level 2) were included in our study. Patients with incomplete or unexploitable records were excluded. Results: Over a 24-month period, 16 cases of GBS were collected. These included 12 boys (75%) and 4 girls (25%). The demyelinating form (ADIP) was found in 9 children (43.75%) and the axonal form in 7 patients (37.5%), 5 of whom had pure motor involvement (AMAN) and 2 with sensory-motor involvement (AMSAN). Corticosteroid therapy was more effective in treating pain and in demyelinating forms. Three deaths were noted and all had AMAN. Conclusion: GBS poses a management problem in our context of a country with limited resources. Corticosteroid therapy has been shown to be effective in the treatment of pain and demyelinating forms of the disease and should be considered for use in GBS.
文摘<div style="text-align:justify;"> <strong>Introduction:</strong> <span "="">Prolonged corticosteroid therapy is labeled as the main cause of corticotropic adrenal insufficiency. However, the current frequency of this complication remains unknown. The objective of our study was to assess its epidemiologic, diagnostic, therapeutic, and evolutionary aspects of our practice.<b> Methodology: </b>A 60-month retrospective study was performed from May 2014 to April 2020 in the Pikine National Hospital Centre. Data were obtained from the medical records of patients with corticosteroid-induced adrenal insufficiency. Epidemiologic, diagnostic, therapeutic, and evolutionary parameters, and data related to corticotherapy were recorded.<b> </b>Patients with basal plasma cortisol levels <50 ng/ml or a plasma cortisol level less than double of the basal cortisolaemia one H after administration of synachtene 250 were included. <b>Results: </b>Medical records were obtained from nine patients, comprising six women and three men. The mean age of the patients was 48 years. Long-term corticosteroid therapy was used for self-medication in six patients and artificial bleaching in the remaining three patients. Betamethasone was the most commonly used drug in four patients, followed by clobetasol in three patients. Corticotropic insufficiency was revealed as a result of acute decompensation in five patients. All patients presented with a pseudo-cushingoid pattern. Diagnosis of corticotropic adrenal insufficiency was confirmed by measuring basal plasma cortisol levels of <50 ng/ml in seven patients. A standard Synachtene test was performed on two patients. All patients benefited from hydrocortisone supplementation. In the short-term, the outcome was unremarkable for all patients. Medium and long-term progression could be assessed in only three patients. Two patients showed persistent suppression with a 6- and 9-month follow-up. One patient was readmitted after one month due to an adrenal crisis following voluntary discontinuation of hydrocortisone treatment.<b> Conclusion:</b><b> </b>Post-corticosteroid therapy adrenal insufficiency remains a concern in our practice and is favoured by the non-compliance of providing rules by pharmacies and the parallel drug market.</span> </div>
文摘Introduction: Focal Segmental Glomerulosclerosis (FSGS) corresponds to a clinicopathological syndrome, manifested by generally abundant proteinuria associated with hyaline deposits on part of certain glomeruli and sparing other glomeruli, with effacement of the pedicels. The general objective was to determine the prevalence of FSGS, and to give its profiles;epidemiological, clinical, biological, pathological, etiological, therapeutic and evolutionary of FSGS. Materials and Methods: This is a retrospective analytical study over a period of six years extending from January 1, 2010 to December 31, 2015 patients aged 16 or over who were hospitalized or received consultations during the study period for primary or secondary segmental and focal hyalinosis. Patients whose records were incomplete or unusable were not included in the study. Results: We have 16.54% with 158 cases of FSGS out of 6945 patients received and/or hospitalized. Of the 955 kidney biopsies distributed, the incidences of HSF were;10.15%;14.04%;15%;17.64%;20.11%;19.58% respectively in 2010;2011;2012;2013;2014 and 2015, i.e. an annual increase of around 1.25%. Renal-type edemas were found in 93.3%, the first reason for hospitalization. And ninety-six people had impaired kidney function, or 61%. The average of 24-hour proteinuria was 6.4 ± 3.69 g/24 hours. The extremes were 0.37 and 18.50 g/24h. Patients had nephrotic proteinuria in 84.86%. Non-specific FSGS or NOS (Not Other Specificities) was found in 62 cases or 39.24%, collapsing FSGS in 48 cases or 30.40%. FSGS with found causes was associated with fibrosis in 5/35 cases. Collapsing FSGSs followed by NOS FSGSs were the most corticosteroid-resistant. The evolution of the FSGS reveals that every 8 months the proteinuria decreases by half. Conclusion: Segmental and focal hyalinosis requires histological confirmation and the epidemiological, clinico-biological, etiological, therapeutic and evolutionary profiles depend on the histological (pathological) type. Other works on the risk factors for occurrence and the contribution of electron microscopy in the primary and secondary diagnosis of segmental and focal hyalinosis are desired.
文摘Introduction: Dermatomyositis is a rare pathology with severe prognosis. Its prevalence varies from one part of the earth to another and its clinical aspects are multiple. In Western countries, they have been the subject of several studies. However few studies have been devoted to this disease in sub-Saharan Africa. We initiated this work to contribute to a better knowledge of dermatomyositis in our work context. Material and Methods: This is a retrospective, descriptive and analytical study carried out in the Dermatology Department of the University Hospital Center of Treichville from January 2006 to December 2015. All Patients with dermatomyositis have been taken into account in the study. Results: The hospital prevalence of dermatomyositis in our work was 1.38%. The age of our patients ranged from 11 to 79 years with an average of 41 years. The sex ratio was 0.48. The delay before the first consultation ranged from 1 week to 1 year 9 months with an average of 5 months. Cutaneous manifestations were the first signs observed including post-in-flammatory hyperpigmentation and erythro-eodema. Muscular manifestations were dominated by muscular pain (81.08%). muscular enzymes were consistently elevated in biological examinations. The duration of hospitalization was 3 weeks in average. Oral corticotherapy (94.59%) was the most used therapy. A clinical improvement was observed on average 4 months after treatment. The death rate was 16.22%. Conclusion: Dermatomyositis is infrequent in Côte d’Ivoire. It involves mostly young woman. The cutaneous manifestations are often the first signs observed, hence the importance of the dermatologist in its screening and early management.
