Association of medullary sponge kidney disease and multiple endocrine neoplasia type IIA due to RET gene mutation: is there a causal relationship?
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Adult↗
Biomedical subjects
B Diouf
Publications and source records attributed to B Diouf.
Use of brook char (Salvelinus fontinalis) physiological responses to stress as a teaching exercise.
Fish hematological changes during osmotic and cold stress are used to introduce the physiological reactions of the animal to an acute stress. Brook char (Salvelinus fontinalis) were subjected to 1 h of stress before being anesthetized and having blood taken from their caudal vein. Glucose, hemoglobin, hematocrit, and osmolarity were determined in the blood samples. Analyses showed that glucose concentration tends to increase and hematocrit tends to decrease in stressed fish. Changes in hemoglobin concentration occurred only in cold-stressed fish. A rise in blood glucose concentration is the result of cortisol secreted by the hypothalamic-pituitary-adrenal axis. The glucose produced is used as an osmolyte or energy source to resist or combat the stress. In stressed fish, changes in hematocrit could be the result of the osmoconcentration of the blood plasma, as shown by the increase in osmolarity for the same group. In cold-stressed fish, a decrease in hemoglobin concentration could be the result of hemodilution by body cell water.
Animals↗
Seasonal fluctuation of antibody levels to Plasmodium falciparum parasitized red blood cell-associated antigens in two Senegalese villages with different transmission conditions.
The recombinant R23, PfEB200, and GST-5 antigens derive from conserved antigens associated with the Plasmodium falciparum-infected erythrocyte membrane. They were identified as targets of protective antibodies in the Saimiri sciureus model. We have assessed here the humoral response to these antigens in humans. Cross-sectional surveys were conducted in two Senegalese villages with different levels of endemicity. The prevalence of specific IgG and IgM was similar and influenced by age in both localities. The anti-R23 antibodies decreased after the rainy season, particularly in the children less than ten years old. The anti-PfEB200 response did not show significant seasonal variation. The anti-GST-5 response increased in both the less-than 10-year-old and the greater-than 10-year-old groups after the rainy season in Dielmo, but only in the Ndiop villagers who were more than 10-years-old. Thus, antigen-specific seasonal variations of antibody levels were influenced differently by age in both villages. The isotype distribution was antigen-specific and differed for both seasons.
Adolescent↗
Flow cytometric analysis of IgG reactive to parasitized red blood cell membrane antigens in Plasmodium falciparum-immune individuals.
Antigens exposed at the surface of Plasmodium falciparum parasitized red blood cells (pRBCs) represent potential targets for protective antibodies involved in opsonization and immune phagocytosis of pRBCs. We measured the recognition of parasitized red blood cell membrane associated antigens by IgG in the plasma of clinically immune individuals by flow cytometry and ELISA. The plasmas were selected on the basis of preexisting IgG antibodies to pRBC membrane associated recombinant proteins. In every plasma sample IgG could bind the surface of live pRBCs in flow cytometry. In addition, there was a significant correlation between the level of IgG recognition of live pRBCs and of pRBC membrane ghost proteins or major identified antigens by ELISA. Flow cytometry thus represents a technique suitable to test for the accessibility and potential functionality of IgG antibodies directed to antigens expressed by the surface of pRBCs.
Adolescent↗
[Hepatitis C virus genotypes among chronic hemodialysis patients in Dakar].
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Genotype↗
[Evaluation of acute renal insufficiency in Dakar].
The acute renal failure (ARF) is a serious complication occurring commonly in gravidic toxemia. The aim of this retrospective study was to evaluate the treatments wed on patients presenting an ARF and hospitalized in the Dakar hemodialysis centers and emergency service of Hospital Principal. These patients should be aged over 15 years at present no history of chronic renal failure. The diagnosis of ARF was based on the presence of a creatinine clearance value < or = 80 ml/mn, a creatinemia > 176.8 mo/l, an azotemia > 9.99 mmol/l. Thirty patients aged form 16 to 56 years were studied, they were 6 males and 24 females. Among them, 22 (73.33%) present anuria, 5 (16.7%) were in oligo anuria, and 3 (10%) had a normal diuresis. An aetiologic treatment was instituted whenever necessary. The other treatments consisted in dietary measures, hydroelectrolytic balance, blood transfusion, diuretic therapy, and hemodialysis. All anuric patients had a diuretic regimen. Ten of them had recovered a diuresis, 16 underwent hemodialysis in a mean time of 4 days. None of latter recovered renal function 5 patients developed Chronic renal failure and 11 died, mainly by infectious complications. Acute renal failure has until now a poor prognosis in our regions because of a certain management delay. This management should include a guide and adequate volume replacement, and eventually diuretic therapy, and dialysis as soon as possible.
Acute Kidney Injury↗
[Hepatic tuberculosis of the pseudotumoral form].
The authors report a case of a 30 years old immunocompetent woman with liver tuberculosis with an unusual pseudotumoral presentation and secondary occurrence of abcedation with cutaneous fistulization. The diagnosis was based on the bacteriological positivity for acido-alcoolo resistant bacillus in pus of the abscess obtained by ponction guided by ultrasonographic examination. The authors emphasize in the differential diagnosis with the other causes of liver abscess (amibiasis and pyogenic microorganisms) and liver carcinoma. They also note the importance of the function guided by ultrasonographic examination permitting histologic and bacte+ériologic study in the diagnosis of this unusual presentation of liver tuberculosis. The patient was treated by antibacillary antibiotics and evacuation function. The prognostic was good with 6 months of follow-up.
Adult↗
[First case of primary IgA glomerulonephritis (Berger's disease) in Senegal].
Berger's disease or IgA glomerulonephritis is the most common glomerular nephropathy in Europe and represent a rare event in blacks. Here, we describe the case of a 43 years old black Senegalese whose disease was discovered while investigating a persistent proteinuria with high blood pressure and chronic renal failure, but without hematuria. We point out the uncommon feature of this clinical presentation and the importance of bad prognostic factors presented by this patient. We obtained a good outcome by means of converting enzyme inhibitors and corticosteroid therapies: regression of renal failure and normalization of blood pressure. The generalization of renal biopsy practice would lead to a better knowledge of the incidence of this disease among Senegalese people. Indeed, renal biopsy is the main tool to diagnose glomerulonephritis and subsequently adapt the therapy aimed at preventing the possible evolution to end stage renal disease.
Adrenal Cortex Hormones↗
[Autosomal dominant polycystosis in the hospital milieu in Dakar (Senegal)].
Autosomial dominant polycystic kidney disease (ADPKD) is an hereditary affection transmitted in a autosal dominant pattern with variable penetrancy. Diagnosis is based upon ultrasound examination and/or familial history. The authors present a 8 years retrospective hospital study in order to precise the epidemiological and clinico-biological aspects of ADPKD in Dakar. So 23 patients were studied. The mean age at the diagnosis was 46 years. They were 9 men and 14 women (sex ratio 0.64). A past history of familial nephropathy was found in 52.2% of cases. The circumstances of diagnosis were dominated by lombar pain (52.2%) and hypertension (17.4%) but at examination, blood pressure was high in 34.8% and represent the main factor of worsening the disease. Enlargement of kidney was found in 47.8% and hepatomegaly in 13% of cases. Anemia was particularly common 56.5%. The most frequent extra renal manifestation was the liver cysts and occurs mainly in women. National prevalence of ADPKD and the specific gene should be precise in further studies.
Adult↗
[Evolutive aspects of systemic lupus erythematosus in Dakar. Apropos of 30 cases].
To determine the characteristics of evolution of systemic lupus erythematosus (SLE), the authors studied 30 cases retrospectively. All were black women aged from 16 to 73 years (with a mean of 30 years) at the time of diagnosis. Dermatological manifestations consisting in discoid lupus or alopecia inaugurated the disease in 12 cases, joint symptoms in 10 cases. Polyarthritis was the most common inaugural manifestation, followed by discoid lupus. Corticosteroids therapy alone or associated to chloroquine or immunosuppressor led to good results; 88% of patients who received treatment had good outcomes in the first 5 months after diagnosis. After this time lapse, 6 cases of complications related to the corticosteroids therapy occurred. After one year, 5 patients presented one or more flare-ups and had to be re-hospitalized; 8 others were lost to the follow-up. The overall mortality rate was 27% (8 cases out of 30). Causes of death were first renal failure (3/8) followed by infectious complications (2/8). The management of SLE could be improved by a close follow-up and providing the patients and their family with adequate information.
Adolescent↗
[Tuberculosis among hemodialysis patients in Dakar, apropos of 2 cases].
Hemodialysis permits a long term survival to patients with End Stage Renal Disease (E.S.R.D.). However the patients ongoing hemodialysis presented a immunodeficiency and a important modification of drugs biodisponibility. Tuberculosis is an endemic disease in our countries. Extrapulmonary tuberculosis is reported from these two cases among 13 patients treated in C.H.U.A. Le Dantec hemodialysis center. Clinical symptoms are not specific bacteria is not found. Diagnosis is obtained by a bundle of arguments. Antituberculosis treatment need to be adjusted in this field. Even if Rifampicine can be administrated at normal dose. The others drugs must be adapted on their clearance and the underlying disease. The two patients presented psychiatrical symptoms motivating a reduction of isoniazide dose witch threshold toxicity is lowered by renal failure state. These observations must increase watchfulness on nephrologist of undeveloping countries, confronted with tuberculosis renewed out break.
Adolescent↗
[Nephronophtisis in Senegal: first 3 cases].
Nephronophtisis is a familial tubulo-interstitial nephropathy with an autosomic recessive mode of transmission. To our knowledge, it has not been yet reported in Black Africa. We report here the case of a 17-year old female from Senegal who presented with renal failure related to a chronic interstitial nephritis characterized by polyuria, hypocalcemia, natriuresis of 23 mmol/l and serum creatinine level of 1070 mumol/l. The parents of this patient were first-degree cousins. Among the 6 siblings, 2 other males were found to have a renal disease. Ultrasound examination of the kidneys showed medullary cysts in the 2 affected brothers and the renal biopsy in one case showed tubular atrophy, with thickening of the basal lamina and an interstitial fibrosis without glomerular involvement. Molecular genetic analysis confirmed the diagnosis of nephronophtisis, with a homozygous deletion of the NPH1 region. In order to recognize this disease early in life, one has to look for it in patients with tubulo-interstitial nephritis, polyuria, childhood enuresia especially when it is associated with growth retardation or tetany. This case raises the issue of consanguinity and endogamy which are frequently encountered in Africa. It also extends the geographic and ethnic distribution of nephronophtisis, being the first cases reported Black Africans.
Adolescent↗
[Echocardiographic data from chronic dialysis patients in Dakar].
The authors report the results of a prospective study about echocardiographic parameters of 14 chronic dialyzed patients. Mean age was 44.4 +/- 12 (extremes: 16 and 63). There are 12 men (86%) and 2 women (14%). The main renal disease responsible was nephroangiosclerosis (9 cases, 64.3%). Hypertension is found in all the patients, anemia in 13 (92.8%). The heart, as shown by echocardiography, was concerned in 13 patients (92.8%). The main abnormalities found were: left ventricular hypertrophy (13 cases: 92.8%), left ventricular dysfunction (4 cases: 28.5%), abnormality in left ventricular relaxation (3 cases: 21.4%), pericardial effusion (4 cases: 28.5%).
Adolescent↗
[Specific antibodies against Plasmodium falciparum antigens in immune subjects: I. Comparison of detection/titration methods].
We report a comparative study of specific antibody levels to the blood stages of P. falciparum in individuals living in two different areas with different transmission levels of malaria. We have compared 2 techniques for the detection/titration of antibodies i.e. ELISA and IFI, ELISA being particularly suitable for immuno-epidemiological related studies. A schizont lysate from P. falciparum infected red blood cells from FUP/CB Marburg strain as antigen proved usefullness, as compared with an antigen extracted from a local strain recently adapted to in vitro culture. Using these techniques, high specific antibody responses were found in the villagers' sera and mean levels of antibodies increased with age. Levels of specific IgG were comparable between those two locations, in spite of a ten fold higher level of transmission between the two villages. In contrast, a significantly higher level of IgM in adults living in holoendemic.
Adolescent↗
[Specific antibodies against Plasmodium falciparum antigens in immune subjects: II. Screening of responses against the merozoite major surface antigen (MSP!)].
Specific immune responses to asexual blood stages of P. falciparum antigens (a lysate of parasitized red blood cells and a characterized vaccine candidate i.e. MSP1 p19) were analyzed in plasma samples from immune adult individuals living in three different areas of Senegal, where malaria transmission is different. Most individuals in the three sites had specific IgG and IgM to total P. falciparum antigens, whereas approximately 50% had either IgG or IgM specific to MSP1 p19. Further, no anti-MSP1 p19 IgG2 and IgG4 antibody was noticed in any individual whereas the distribution of anti-MSP1 p19 IgG1 and IgG3 was different upon the epidemiological context. In addition, no relationship was found between antibody responses and in vitro T cell responses against P. falciparum antigens upon those experimental conditions. These data stress on the relatively elevated distribution of specific antibodies to MSP1 p19 in P. falciparum hyperendemic areas and suggest a differential regulation of isotypes depending on individual parasite exposure.
Adolescent↗
[Management of lupus nephritis in Senegal].
Systemic lupus erythematosus is a disease considered as seldom in Senegal. Nevertheless its incidence is increasing these last years. The prognosis is significantly related to the renal involvement, classified into 6 classes by the WHO. The treatment of these different forms is variable, consisting on abstention or symptomatic treatment for the class III (with low activity index), class II, I, and V (without renal failure). In the other hand a vigorous treatment is indicated in the class III, with consistent activity index, class IV and class V with renal failure. The most frequent of these treatment remains the association using corticosteroids and immunosuppressants. Among immunosuppressants, cyclophosphamide and azathioprine are the most commonly used. The case we reported is about a 41 years old woman who presented a class IV lupic nephropathy, with a good outcome after a 18 months corticosteroid and immunosuppressants association treatment. This case leads us to some recommendations. Considering our poor socioeconomical conditions, we suggest to treat all patients presenting proteinuria higher than 2 mg/24h. However it is more judicious to perform renal biopsy on patients with signs evocating renal impairement and to treat the class III, IV and V whatever would be the degree of activity and chronicity indexes. This treatment must associate immunosuppressive drugs and corticosteroids; the modalities and duration depending on clinical presentation, histologic features and evolution.
Amenorrhea↗
[Current aspects of gastric cancer in Senegal. Epidemiological and clinical study of 220 cases (1984-1991)].
220 cases of gastric cancer were selected from Dakar Hospitals during seven years (1984-1991). This retrospective study confirms that gastric cancer is the most common cancer of the Gastro-intestinal tract (48.4%). The sex ratio was 2.7 (M/F) with mean age of 50 years. However, a steady progression of gastric cancer was noticed beginning at 40 years. Despite the introduction of upper gastro-intestinal endoscopy the classical evolved form was the most commonly found (83.2%). The associated lesions known to be premalignant were found in 22.7% of cases. The patients were seen with a long delay after the first symptoms. This is why we have long delays of diagnosis in our centers. 61.7% of them are seen 3 to 12 months after their first symptoms. In 70% of cases, lesions were found on antropyloric region. The most common histological type remain adenocarcinoma (90% of cases). Even though endoscopy has contributed to increase the incidence of gastric cancer, it did not allow to discover early gastric carcinoma.
Adult↗
[A case of joint toxicity from pefloxacin in the treatment of nephrotic syndrome in a child].
In order to improve the nephrotic syndrome management, we tried to treat one patient by pefloxacin. A polytenosynotis was noticed during this treatment and motivated it stopping. Remission of proteinuria was obtained after an eleven days treatment. This case give us the opportunity to discuss the possible toxicity of quinolones on joints and the efficacy of pefloxacin in this disease.
Adolescent↗