Biomedical subjects

S Ndongo

Publications and source records attributed to S Ndongo.

11 recordsLinked to original sources

PubMed2006

[Polyarticular gout in young adults: a curable rheumatic disease].

Juvenile chronic gout in its polyarticular deformative form has rarely been described in medical literature. We report a rare case of destructive polyarticular tophaceous gout in a 31-year-old Senegalese man. He consulted for bilateral asymmetric polyarthritis with deformities of the hands and feet that had been ongoing in recurrent episodes since the age of 18 years in association with tophus. He had received no previous medication. All laboratory investigations were normal except hyperuricemia 104 mg/l. Radiographs of affected joints demonstrated evidence of destructive polyarthritis, i.e., articular narrowing and osteo-condensation of the left great toe. The patient responded favourably to colchicine, allopurinol and diet. Gouty arthropathy must be differentiated from rheumatoid arthritis, psoriasic arthritis and distal chronic osteoarthrosis. In our case, definitive diagnosis of gouty arthropathy was based on chronic polyarthritis associated with tophus, hyperuricemia and therapeutic response to colchicine. Polyarticular gout can be suspected in case of chronic seronegative polyarthritis and diagnosis can be confirmed on the basis of plain radiographs and laboratory investigations showing uricemia. Treatment is effective, well tolerated and inexpensive.

Adult↗

PubMed2004

[Hemophagocytic syndrome complicating adult's seropositive rheumatoid arthritis].

INTRODUCTION: Macrophage activation syndrome (MAS) is a severe complication of chronic rheumatic diseases, particularly juvenile rheumatoid arthritis. However, MAS is rarely described in adult rheumatoid polyarthritis. EXEGESE: We report a case of MAS complicating a seropositive rheumatoid polyarthritis after 20 years of evolution. Pancytopenia with fever, renal failure and hepatic dysfunction revealed the disease that was confirmed by multiple macrophages and monocytes invading the bone marrow specimen. CONCLUSION: Outcome has been spectacular under corticosteroids.

Arthritis, Rheumatoid↗

PubMed2004

[Cutaneous leishmaniasis in hospital area: epidemiological and clinical aspects, about 16 cases].

Cutaneous leishmaniasis, a chronic infectious ulcerative skin disease caused by a protozoan parasite of the genus Leishmania, is transmitted by the bite of sandflies. We report 16 cases of cutaneous leishmaniasis observed in Dakar from 1990 to 2000. The aim of this retrospective study was to determine the epidemiological and clinical features. Their age range was 10 to 78 years (mean 41.12 years). The sex ratio was 3. The most commun presentation was the ulcero-crusted lesions (bouton d'orient) observed in 56.25% of cases. The other clinical presentation are the sporotrichoid lesions (25%), the lupoid lesions observed in 12.5% and the cutaneous diffus leishmaniasis in 12.5%. In all these cases, there were many lesions. On treatment we observed 87.5% of total remission.

Adolescent↗

PubMed2004

[Secondary hyperparathyroidism of chronic hemodialysis].

Secondary hyperparathyroidism is defined as autonomic secretion of parathormon (PTH) whose 1-84 fraction level is up to 60 ng/l. The aim of this study was to determine incidence of secondary hyperparathyroidism on patients undergoing hemodialysis in Le Dantec Hospital of Dakar, and describe its diagnostic and therapeutical aspects. Between 22 patients followed in chronically hemodialysis, 11 patients had effective blood test of parathormon. Seven of them had high level of PTH and the other had normal rate. They were 5 men and 7 women with a mean age of 56 years. The mean duration undergoing hemodialysis was 42 months. Clinical signs were rare and non specific, dominated bony pains and anemia. Ectopic calcifications had been found in 3 cases. Hypocalcemia was present in 5 cases and high level of phosphoremia in all cases. The D3 vitamin was at a normal rate in all cases up to 10 ng/ml. Calcium supplementation with 1.5 to 2.5 g/day was effective associated with rich calcium dietary. This level of calcium supplementation appeared too low even though it must be closely estimated because of the possibility of improving ectopic calcifications. At the opposite, D3 vitamin supplementation seems to be unuseful under tropical areas.

Adult↗

PubMed2004

[Non iatrogenic primary hypothyrodism in adults at Le Dantec Hospital : clinical features, diagnosis and treatment. Review of 19 cases].

The authors report 19 cases of non iatrogenic primary hypothyroidism in adults at Le Dantec Hospital of Dakar. Those cases had been found during a period of 6 years and half in the internal medicine service. The aim was to study clinical features, diagnosis and outcome of patients after treatment. The mean age of patients was 42.2 years with a sex-ratio of 0.33 M/F. The diagnosis delay was around 6,1 years. All patients presented clinical signs of hypometabolism: physical asthenia (63.15%), frilosity (26.3%), bradycardia (47.3%), constipation (36.8%). The cutaneomucal syndrom was composed by myxoedema (73.6%), macroglossia (26.3%), raucousness of voice (26.3%), alopecia (57.9%). Muscle weakness was found in 2 cases and genital troubles in 3 cases. Five patients presented goiter and 9 others had spontaneous thyroid atrophy. All patients presented a high level of TSH associated with decreased level of T4. Anemia was found in 7 cases and hypercholesterolemia in 13 cases. Treatment was based on substitutive hormonotherapy with L-Thyroxin (75 to 250 microg/day). Evolution was favorable after 10 month mean duration of processing. More alertness is necessary on behalf of the practitioners in front of any sign suggesting hypometabolism to reduce the diagnostic delay and prevent complete form of hypothyroidism that might be complicated, by cardiac involvement in particular.

Adolescent↗

PubMed2004

[Diagnosis delay of multiple myeloma: report of 22 cases in an internal medicine department of Dakar].

Reported is a retrospective study conducted on in patients with multiple myeloma diagnosed from January 1990 to December 2000 in the departement of Internal Medicine I of Dakar University Hospital. Twenty-two patients were included. The mean age was 55 years (range 29-76). The sex ratio (male to female) was 2.6 (they were 16 males and 6 females). The presenting clinical features were dominated by bone manifestations with diffuse pain (41%) followed by pathologic fractures (22.27%) and lumbar pain (13.6%). At the hospital admission the type of clinical manifestations recorded were related to bone (91% general (60%), neurologic (36%) and infection (36%). The biological exams documented an anemia in 20 cases (91%) and increased serum protein in 13 cases (59%) and hypercalcemia in 11 cases (50%) and renal insufficiency in 6 cases (27%). Immunoelectrophoresis had been performed in 6 cases and revaled 4 cases of IgG and 2 cases of light chain myeloma. On the skeletal radiological exams it has been found lytic bone lesions in 66.6 % of cases. diffuse bone rarefaction (38.88%), pathological fractures (38.88%) and vertebral collapses (18.18%). The bone marrow aspiration showed in 17 cases over 19 a medullary dystrophic plasmocytosis. According to the Salmon and Durie classification 68% of the patients were pointed in stage III. Comparing our results to the series, we figure out our patients younger at the time of the diagnosis and an important diagnosis delay as previously suggested in the African litterature. This is confirmed by the fact that 68% of patients were one Salmon and Durie stage III. the frequency of severe anemia and pathological fractures We invite practitionners to conduct systematic exploration of mild symptoms like lumbar pain.

Adult↗

PubMed2003

[Systemic scleroderma: 92 cases in Dakar].

We performed a retrospective study in order to characterize epidemiological data and signs of systemic scleroderma in Sénégal. All patients with the diagnosis according the ACR's criteria of scleroderma were recruited. We included 92 patients, the mean age was 33 years and sex ratio male to female was 0.19 (15 men and 77 women). There were 8 children in our series (8.9%). The initial complaints were cutaneous manifestations (64%) and Raynaud's syndrome (16.3%). Clinical manifestations at admission were muco-cutaneous (100%), osteo-articular and muscular (59%) and Raynaud's syndrome (57%). Focal hypopigmentation was common (70%). Anti-nuclear antibodies were present in 67.4% of patients. Skin biopsy was contributive in all patients in which it was performed (79 cases). Electrocardiogram was abnormal in 55%, non specific inflammatory syndrome was present in 44% and pulmonary function was abnormal in 52%. Our data suggest that systemic scleroderma is more common in younger people in black population. Disorders of pigmentation are common and Raynaud's syndrome is uncommon.

Adolescent↗

PubMed2003

[Diabetic ketoacidosis at an internal medicine service].

Ketoacidosis as usual inaugural manifestation and the high frequency of infectious precipating events have been reported in our department on 1986. These same aspects were found in other African series. In this retrospective study of 34 patients presenting an ketoacidosis and managed from, July 1st 2001 to December 31st 2001, we have evaluated the precipating events, and analysed the evolution in comparison with our previous study. Age range was 15 to 74 years with a mean of 43.9. Sex ratio was 2.4. Ketoacidosis inaugurated the disease in 41.17% of cases. Diabetic type 2 was the most frequent one, with an evolution mean duration of 8.1 years. The presenting picture of admission was varied. In addition to the disturbance of consciousness, dehydratation and compensatory hyperventilation were common. With 82.3% in our series versus 43.22% in previous one, infection remain the main precipating cause in our internal medicine department and in tropical area. The disease course was favorable under therapy in 32 patients (94.1%) versus 64.32% on 1986. This might be explained by the lack of hypoglycemic episodes in this present series. The average hospitalisation duration was 20 days. This fact point out the importance of diabetic patients education and screening programs.

Adolescent↗

PubMed2003

[Epidemiological and clinical features of the knee osteoarthritis].

The knee osteoarthritis is one of the most common causes of pain affecting elderly people. The main clinical features are pain and fonctional disability. The aim of this prospective study was to determine the epidemiological and clinical features of the knee in our regions. It was conducted from January 1st through June 30st 2002, on patients with gonarthrosis successively remited from the department of medicine, rheumatology out patient clinic. The diagnosis criteria was based on the Kellgreen and Lawrence scheme. The Lequesne functional index have been used to evaluate the patients disability. Fifty patients were included in the study, they were 33 females and 17 male (sex ratio of 0.51). The mean age was 61.96 years, ranging from 45 to 81 years. The aetiologic factors was dominated by a family history of inflammatory joint desease (72%) and the knees physical stress (60%). Constitutional abnormality were found only among women, with 4 cases of valgum, 3 cases of varum and one cases of the patella extrernal abnormality. Obesity appeared to be very common associated condition. Forty three patients got a body mass index greater than 25. The knee pain was unilateral in 52% of cases, mostly on the right knee and was a mechnical type with no particularity. The functional disability was proportional to average disease duration, and was not associated to the patients age.

Aged↗

PubMed2003

[Behçet's disease in Dakar (Senegal): epidemiological and clinical features].

We report epidemiological and clinical characteristics of 17 consecutives patients with Behçet disease during 26 years in Dakar(Sénégal). All the patients were black, with a mean age of 27.5 years (11- 42 years) and the disease was more common between 20 and 30 years. The sex ratio was 2.4 (12 men -5 women). The majority live in cost area (64.7). Clinical features frequencies were as follow muco-cutaneous (94.11%), ocular (58.82%) neurological (47.05%) articular (47.05) psychiatric (41.17%) vascular (35.29%) digestives (11.76%). Epidemiological characteristics of Behçet disease in Sénégal are common however, the important frequency of neuropsychiatrics manifestations is remarkable.

Adolescent↗

PubMed2002

[Multicentric reticulohistiocytosis with a 20-year follow-up ].

INTRODUCTION: Multicentric reticulo-histiocytosis also known as lipoid dermoarthritis is a rare systemic disease leading to a massive osteoarticular destruction and systemic complications. EXEGESIS: This case report is a 44 year old black woman who was first seen with a rheumatoid arthritis clinical presentation associated with the presence of rheumatoïd factor. Five years later the diagnosis has been reconsidered after skin nodules histological examination. After that the patient has been lost from the follow up clinic. After a twenty years evolution she presented a complex clinical picture including: a cutaneous syndrome with a non pruriginous and hyperchromic papulonodular rash on the arms and fore-arms; a very destructive polyarthritis with major handicap; and systemic manifestations like cardiomyopathy with heart failure. The heart failure treatment associated first corticosteroids and secondary chloroquine was successful. CONCLUSION: The rheumatoid factor presence should not avoid to consider the possibility of multicentric reticulohistiocytosis in case of polyarthritis associated with a papulonodular rash. Then skin biopsy must be performed. The severity of osteoarticular and systemic lesions require an early prescription of a treatment for which there is so far no compromise.

Adrenal Cortex Hormones↗