Introduction: Autoimmune polyendocrinopathies (AP) represent a group of rare concomitant pathologies, making them underdiagnosed. The objective was to study their profile at the Medical Clinic II of the Abass Ndao Hos...Introduction: Autoimmune polyendocrinopathies (AP) represent a group of rare concomitant pathologies, making them underdiagnosed. The objective was to study their profile at the Medical Clinic II of the Abass Ndao Hospital. Patients and Methods: This was an observational, descriptive and analytical study, lasting 24 months, from January 1, 2020 to December 31, 2022. We assessed the epidemiological, clinical and paraclinical characteristics of the patients and classified the APs found. Results: We included 40 patients divided into type III (38 cases) and IV (2 cases). A female predominance was noted with a sex ratio of 0.21. The mean age was 38.6 years. A family history of component diseases of autoimmune polyendocrine syndrome (APS) was found in 62.5%. Goiter (80%) was the main clinical sign present. All 38 patients with ISAP-3 had autoimmune thyroiditis, including 29 cases of Graves’ disease (72.5%) and 9 cases of Hashimoto’s thyroiditis (22.5%). They were associated with either type 1 diabetes (57.9%), Biermer’s disease (21.1%), vitiligo + alopecia (18.4%), lupus (2.6%). The 2 patients with AP-4 had Biermer’s disease associated with either Addison’s disease or type 1 diabetes. Management depended on the pathologies present and their possible complications. The immunological phenomena were also controlled. Conclusion: This series is globally similar to the literature. The polymorphous character of the clinical pictures requires a better collaboration between specialists leading to a clinical and holistic synthesis.展开更多
Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the...Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the epidemiological, clinical, paraclinical and evolutionary aspects of extra pulmonary tuberculosis (EPT) at the Abass Ndao Hospital Center. Patients and Methods: This was a descriptive cross-sectional study conducted over a period of 11 years (January 1, 2010 to December 30, 2021). All patients with extrapulmonary tuberculosis hospitalized in the department of internal medicine during the recruitment period were included. Results: Fifty-two (52) patients were collected. The year 2019 recorded the most cases 23.08% (n = 20). The mean age of the patients was 40.56 ± 18.24 years. The age group 20 - 34 years 42.31% (n = 22) was the most represented. Females were in the majority 61.54% (n = 32) with a sex ratio (M/F) was 0.63. Housewives were in the majority 40.38% (n = 21). 60.87% of the cases (n = 14) came from a health facility. 38.46% of the cases had been infected. 21.74% (n = 9) were smokers. The reasons for consultation were dominated by fever (67.44%), AEG (62.79%) and cough (41.86%). Eighteen patients (40.91%) had fever. The mean time to consultation was 77.37 ± 90.3 days with extremes of 3 and 365 days. The median was 45 days. More than half of the patients 61.90% (n = 26) had anemia. Positive retroviral serology was noted in 21.43% of cases. All patients had a CRP greater than 6. More than half of the patients 51.92% (n = 27) had multifocal tuberculosis. The peritoneum 44.23% (n = 23) was the main organ affected. The average hospital stay was 9.8 ± 4.9 days with extremes of 1 and 19 days. All patients had received the protocol in force at the national level. Death was noted in 4 patients (9.52%). Conclusion: EPT is characterized in our context by a notorious diagnostic difficulty due to the multiplicity of clinical presentations, the complexity of explorations, and the problems of differential diagnosis notably with other granulomatosis, systemic lupus and cancers. This difficulty is reflected in the low rate of diagnosis with a paraclinical argument of certainty and in the long diagnostic delays.展开更多
Introduction: Female hyperandrogenism is essentially manifested by hirsutism. It is present in Senegal but not yet elucidated for lack of data. This is why we proposed to study the profile of hyperandrogenism in our c...Introduction: Female hyperandrogenism is essentially manifested by hirsutism. It is present in Senegal but not yet elucidated for lack of data. This is why we proposed to study the profile of hyperandrogenism in our context. Patients and Methods: This was an observational, cross-sectional cohort study of 19 patients of reproductive age followed for hyperandrogenism at the Medical Clinic II of Abass Ndao Hospital, from November 1<sup>st</sup>, 2019 to August 31<sup>st</sup>, 2021. Results: Our cohort consisted of women with an average age of 25.3 years, single (73.7%), with a low socioeconomic level (42.1%). A family history of hirsutism was found in 31.6% of cases. The main reasons for consultation were a menstrual cycle disorder in 94.7% of cases, and hirsutism in 78.9% of cases. The latter was post-pubertal (66.7%), with a slow or progressive evolution. The physical examination revealed: hirsutism (100%) with an average modified Ferriman Gallwey score (mFG) of 8.9 ± 5.8, acne (36.8%), hyperseborrhea (57.9%), major signs of virilization (10.5%), acanthosis nigricans (47.4%) and galactorrhea (5.3%). Hormonal explorations revealed an elevation of: testosterone (31.6%), 17-hydroxyprogesterone (5.3%), dihydrotestosterone (31.6%), and prolactin (10.5%). The ovarian morphology was micropolycystic (84.2%). The etiological profile corresponded to polycystic ovarian syndrome or PCOS (68.4%), ovarian hyperthecosis (10.5%), hyperprolactinemia (10.5%), congenital adrenal hyperplasia or CAH (5.3%). Idiopathic hirsutism was found in 5.3% of cases. Conclusion: Female hyperandrogenism is a less frequent reason for consultation in endocrinology. It deserves to be further evaluated in a large-scale study focused on epidemiological, clinico-biological and etiological investigation, in order to assess its prevalence and better define its profile in our context.展开更多
Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutio...Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutionary aspects. Materials and Methods: This was a cross-sectional, descriptive study, conducted over 5 years (from January 01, 2018 to December 31, 2022) at the National Abass Ndao Hospital Center and including all confirmed cases of primary hyperparathyroidism. Results: Twenty-nine patients were included with a female predominance (86.20%) and an average age of 48.10 ± 18.93 years. The discovery of hyperparathyroidism was fortuitous in 79.31% of cases. The main clinical manifestations were osteoarticular (62%) and urinary (34.5%). On average, serum calcium measured was 109.2 ± 7.92 mg/l, corrected serum calcium 111.3 ± 6.25 mg/l, urinary calcium 421.9 ± 96.45 mg/24h and parathormone at 145 ± 159.71 pg/ml. Among the patients, 25 had hypercalcemia (86.2%) and all had 24-hour hypercalciuria. The diagnosis was retained in view of the elevated parathyroid hormone (PTH) values in all patients. Cervical ultrasound objectified a parathyroid adenoma in 27.58% of cases and 12 patients or 46.2% had presented a scintigraphy in favor of a parathyroid adenoma. We found 01 cases of multiple endocrine neoplasia type 2. Bone densitometry performed in 10 patients found osteoporosis in 60% of cases (6 patients) and osteopenia in 40% of cases (4 patients). Surgical treatment was performed in 12 patients (41.4%). The histology of the surgical specimens was in favor of a parathyroid adenoma in all cases. Among the operated patients, the evolution was marked by a cure rate of 100%. Conclusion: The symptomatology of primary hyperparathyroidism remains mainly osteoarticular and urinary. Surgery has proven its effectiveness in our series. We insist on the systematic dosage of calcemia especially in women over 50 years and the promotion of morphological explorations.展开更多
Introduction: In Senegal, there is very little data on prolactinomas despite their negative impact on couples fertility. Patients and methods: This was a multicentre, retrospective, descriptive, analytical study condu...Introduction: In Senegal, there is very little data on prolactinomas despite their negative impact on couples fertility. Patients and methods: This was a multicentre, retrospective, descriptive, analytical study conducted from 1 January 2008 to 31 December 2022 in the neurosurgery departments of the Fann and Principal hospitals and the endocrinology department of the Abass Ndao Hospital. Results: We included 89 patients, representing a prevalence of 36.7% among all cases of pituitary adenoma. The mean age was 35.6 ± 10 years and the sex ratio was 0.34. The mean time to consultation was 27.1 ± 29 months. Clinical symptoms were dominated by gonadotropic disorders represented by galactorrhoea (71 cases, 79.8%), amenorrhoea (61 cases, 68.5%), and infertility in the couple (31 cases, 34.8%). Fifty-seven (58) patients presented with a tumour syndrome (65.2%, including 57 cases of headache (64%), 34 cases of visual disorders (38.2%) and 8 patients with a dysmorphic syndrome (8.9%). Imaging revealed a macroadenoma in 68.5% (61 cases) and extension of the adenoma in 11 patients (12.4%). The hormonal profile was isolated lactotropic hypersecretion (80 cases, 89.9%) and mixed in 9 cases (including concomitant secretion of GH in 8 cases and ACTH in 1 case). All patients had initially benefited? from dopaminergic agonist-based medical treatment. Pituitary surgery was effective in 45 patients (50.6%), including 44 cases by transsphenoidal approach. Postoperative incidents included transient diabetes insipidus (77.7%) and cerebrospinal fluid leakage (20%). We noted 7 cases (7.9%) of death presenting with a tumour syndrome (100%), a macro-adenoma (85.7%), having undergone pituitary surgery (42.9%). The factors significantly associated with prolactinoma were young age (p Conclusion: This series also demonstrates the impact of prolactin adenomas on reproductive function. Delayed diagnosis explains the predominance of macroadenomas, which are a source of pre- and post-operative complications.展开更多
<strong>Introduction:</strong> Cirrhosis is a public health problem and the causes are dominated by viral hepatitis and alcoholism. Deaths due to cirrhosis represented 2.4% of deaths worldwide in 2017. The...<strong>Introduction:</strong> Cirrhosis is a public health problem and the causes are dominated by viral hepatitis and alcoholism. Deaths due to cirrhosis represented 2.4% of deaths worldwide in 2017. The aim of this work was to study the diagnostic and prognosis of cirrhosis at the department of internal medicine of the Abass Ndao hospital center. <strong>Patients and Methods:</strong> This is a retrospective, descriptive study, carried out on the basis of patient files followed from May 1, 1999 to February 28, 2018 (19 years) and included all patients for whom the diagnosis of cirrhosis was accepted. The diagnosis of cirrhosis was made on the basis of clinical, biological and ultrasound (portal hypertension, signs of hepatocellular insufficiency, a diffuse heterogeneous aspect, and irregularity of the liver contours). <strong>Results:</strong> 60 patient files were listed with an average age of 46.9 years, a sex ratio of 2.2 and alcoholism in 11.7% of the cases. The reasons for consultation were dominated by an increase in the size of the abdomen (55%), lose weight (50%). On physical examination, it was a hepatomegaly (43.3%) and jaundices (33.3%). Exploration of liver function showed a cholestasis (48%), a cytolysis (58%) and a hepatocellular insufficiency (46.2%). Anemia was found in (24%). The abdominal ultrasound found in all cases a dysmorphic, heterogeneous liver with irregular contours. Hepatic atrophy was found in 20%. Among the 34 patients who underwent upper gastrointestinal endoscopy, they were grade 2 to 3 esophageal varicose vein in 67.6%, an erosive gastropathy in 29.4%. The etiology was viral hepatitis B in 45%, alcoholism in 11.7% and undetermined in 43.3%. A hematemesis complicated the evolution in 16.7%. Carcinomatous degeneration was found in 5% and 16.7% of the patients had died. <strong>Conclusion:</strong> our experience with cirrhosis was marked by advanced forms at the stage of complications. The viral etiology B remains dominant. Prevention will involve early detection and vaccination.展开更多
文摘Introduction: Autoimmune polyendocrinopathies (AP) represent a group of rare concomitant pathologies, making them underdiagnosed. The objective was to study their profile at the Medical Clinic II of the Abass Ndao Hospital. Patients and Methods: This was an observational, descriptive and analytical study, lasting 24 months, from January 1, 2020 to December 31, 2022. We assessed the epidemiological, clinical and paraclinical characteristics of the patients and classified the APs found. Results: We included 40 patients divided into type III (38 cases) and IV (2 cases). A female predominance was noted with a sex ratio of 0.21. The mean age was 38.6 years. A family history of component diseases of autoimmune polyendocrine syndrome (APS) was found in 62.5%. Goiter (80%) was the main clinical sign present. All 38 patients with ISAP-3 had autoimmune thyroiditis, including 29 cases of Graves’ disease (72.5%) and 9 cases of Hashimoto’s thyroiditis (22.5%). They were associated with either type 1 diabetes (57.9%), Biermer’s disease (21.1%), vitiligo + alopecia (18.4%), lupus (2.6%). The 2 patients with AP-4 had Biermer’s disease associated with either Addison’s disease or type 1 diabetes. Management depended on the pathologies present and their possible complications. The immunological phenomena were also controlled. Conclusion: This series is globally similar to the literature. The polymorphous character of the clinical pictures requires a better collaboration between specialists leading to a clinical and holistic synthesis.
文摘Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the epidemiological, clinical, paraclinical and evolutionary aspects of extra pulmonary tuberculosis (EPT) at the Abass Ndao Hospital Center. Patients and Methods: This was a descriptive cross-sectional study conducted over a period of 11 years (January 1, 2010 to December 30, 2021). All patients with extrapulmonary tuberculosis hospitalized in the department of internal medicine during the recruitment period were included. Results: Fifty-two (52) patients were collected. The year 2019 recorded the most cases 23.08% (n = 20). The mean age of the patients was 40.56 ± 18.24 years. The age group 20 - 34 years 42.31% (n = 22) was the most represented. Females were in the majority 61.54% (n = 32) with a sex ratio (M/F) was 0.63. Housewives were in the majority 40.38% (n = 21). 60.87% of the cases (n = 14) came from a health facility. 38.46% of the cases had been infected. 21.74% (n = 9) were smokers. The reasons for consultation were dominated by fever (67.44%), AEG (62.79%) and cough (41.86%). Eighteen patients (40.91%) had fever. The mean time to consultation was 77.37 ± 90.3 days with extremes of 3 and 365 days. The median was 45 days. More than half of the patients 61.90% (n = 26) had anemia. Positive retroviral serology was noted in 21.43% of cases. All patients had a CRP greater than 6. More than half of the patients 51.92% (n = 27) had multifocal tuberculosis. The peritoneum 44.23% (n = 23) was the main organ affected. The average hospital stay was 9.8 ± 4.9 days with extremes of 1 and 19 days. All patients had received the protocol in force at the national level. Death was noted in 4 patients (9.52%). Conclusion: EPT is characterized in our context by a notorious diagnostic difficulty due to the multiplicity of clinical presentations, the complexity of explorations, and the problems of differential diagnosis notably with other granulomatosis, systemic lupus and cancers. This difficulty is reflected in the low rate of diagnosis with a paraclinical argument of certainty and in the long diagnostic delays.
文摘Introduction: Female hyperandrogenism is essentially manifested by hirsutism. It is present in Senegal but not yet elucidated for lack of data. This is why we proposed to study the profile of hyperandrogenism in our context. Patients and Methods: This was an observational, cross-sectional cohort study of 19 patients of reproductive age followed for hyperandrogenism at the Medical Clinic II of Abass Ndao Hospital, from November 1<sup>st</sup>, 2019 to August 31<sup>st</sup>, 2021. Results: Our cohort consisted of women with an average age of 25.3 years, single (73.7%), with a low socioeconomic level (42.1%). A family history of hirsutism was found in 31.6% of cases. The main reasons for consultation were a menstrual cycle disorder in 94.7% of cases, and hirsutism in 78.9% of cases. The latter was post-pubertal (66.7%), with a slow or progressive evolution. The physical examination revealed: hirsutism (100%) with an average modified Ferriman Gallwey score (mFG) of 8.9 ± 5.8, acne (36.8%), hyperseborrhea (57.9%), major signs of virilization (10.5%), acanthosis nigricans (47.4%) and galactorrhea (5.3%). Hormonal explorations revealed an elevation of: testosterone (31.6%), 17-hydroxyprogesterone (5.3%), dihydrotestosterone (31.6%), and prolactin (10.5%). The ovarian morphology was micropolycystic (84.2%). The etiological profile corresponded to polycystic ovarian syndrome or PCOS (68.4%), ovarian hyperthecosis (10.5%), hyperprolactinemia (10.5%), congenital adrenal hyperplasia or CAH (5.3%). Idiopathic hirsutism was found in 5.3% of cases. Conclusion: Female hyperandrogenism is a less frequent reason for consultation in endocrinology. It deserves to be further evaluated in a large-scale study focused on epidemiological, clinico-biological and etiological investigation, in order to assess its prevalence and better define its profile in our context.
文摘Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutionary aspects. Materials and Methods: This was a cross-sectional, descriptive study, conducted over 5 years (from January 01, 2018 to December 31, 2022) at the National Abass Ndao Hospital Center and including all confirmed cases of primary hyperparathyroidism. Results: Twenty-nine patients were included with a female predominance (86.20%) and an average age of 48.10 ± 18.93 years. The discovery of hyperparathyroidism was fortuitous in 79.31% of cases. The main clinical manifestations were osteoarticular (62%) and urinary (34.5%). On average, serum calcium measured was 109.2 ± 7.92 mg/l, corrected serum calcium 111.3 ± 6.25 mg/l, urinary calcium 421.9 ± 96.45 mg/24h and parathormone at 145 ± 159.71 pg/ml. Among the patients, 25 had hypercalcemia (86.2%) and all had 24-hour hypercalciuria. The diagnosis was retained in view of the elevated parathyroid hormone (PTH) values in all patients. Cervical ultrasound objectified a parathyroid adenoma in 27.58% of cases and 12 patients or 46.2% had presented a scintigraphy in favor of a parathyroid adenoma. We found 01 cases of multiple endocrine neoplasia type 2. Bone densitometry performed in 10 patients found osteoporosis in 60% of cases (6 patients) and osteopenia in 40% of cases (4 patients). Surgical treatment was performed in 12 patients (41.4%). The histology of the surgical specimens was in favor of a parathyroid adenoma in all cases. Among the operated patients, the evolution was marked by a cure rate of 100%. Conclusion: The symptomatology of primary hyperparathyroidism remains mainly osteoarticular and urinary. Surgery has proven its effectiveness in our series. We insist on the systematic dosage of calcemia especially in women over 50 years and the promotion of morphological explorations.
文摘Introduction: In Senegal, there is very little data on prolactinomas despite their negative impact on couples fertility. Patients and methods: This was a multicentre, retrospective, descriptive, analytical study conducted from 1 January 2008 to 31 December 2022 in the neurosurgery departments of the Fann and Principal hospitals and the endocrinology department of the Abass Ndao Hospital. Results: We included 89 patients, representing a prevalence of 36.7% among all cases of pituitary adenoma. The mean age was 35.6 ± 10 years and the sex ratio was 0.34. The mean time to consultation was 27.1 ± 29 months. Clinical symptoms were dominated by gonadotropic disorders represented by galactorrhoea (71 cases, 79.8%), amenorrhoea (61 cases, 68.5%), and infertility in the couple (31 cases, 34.8%). Fifty-seven (58) patients presented with a tumour syndrome (65.2%, including 57 cases of headache (64%), 34 cases of visual disorders (38.2%) and 8 patients with a dysmorphic syndrome (8.9%). Imaging revealed a macroadenoma in 68.5% (61 cases) and extension of the adenoma in 11 patients (12.4%). The hormonal profile was isolated lactotropic hypersecretion (80 cases, 89.9%) and mixed in 9 cases (including concomitant secretion of GH in 8 cases and ACTH in 1 case). All patients had initially benefited? from dopaminergic agonist-based medical treatment. Pituitary surgery was effective in 45 patients (50.6%), including 44 cases by transsphenoidal approach. Postoperative incidents included transient diabetes insipidus (77.7%) and cerebrospinal fluid leakage (20%). We noted 7 cases (7.9%) of death presenting with a tumour syndrome (100%), a macro-adenoma (85.7%), having undergone pituitary surgery (42.9%). The factors significantly associated with prolactinoma were young age (p Conclusion: This series also demonstrates the impact of prolactin adenomas on reproductive function. Delayed diagnosis explains the predominance of macroadenomas, which are a source of pre- and post-operative complications.
文摘<strong>Introduction:</strong> Cirrhosis is a public health problem and the causes are dominated by viral hepatitis and alcoholism. Deaths due to cirrhosis represented 2.4% of deaths worldwide in 2017. The aim of this work was to study the diagnostic and prognosis of cirrhosis at the department of internal medicine of the Abass Ndao hospital center. <strong>Patients and Methods:</strong> This is a retrospective, descriptive study, carried out on the basis of patient files followed from May 1, 1999 to February 28, 2018 (19 years) and included all patients for whom the diagnosis of cirrhosis was accepted. The diagnosis of cirrhosis was made on the basis of clinical, biological and ultrasound (portal hypertension, signs of hepatocellular insufficiency, a diffuse heterogeneous aspect, and irregularity of the liver contours). <strong>Results:</strong> 60 patient files were listed with an average age of 46.9 years, a sex ratio of 2.2 and alcoholism in 11.7% of the cases. The reasons for consultation were dominated by an increase in the size of the abdomen (55%), lose weight (50%). On physical examination, it was a hepatomegaly (43.3%) and jaundices (33.3%). Exploration of liver function showed a cholestasis (48%), a cytolysis (58%) and a hepatocellular insufficiency (46.2%). Anemia was found in (24%). The abdominal ultrasound found in all cases a dysmorphic, heterogeneous liver with irregular contours. Hepatic atrophy was found in 20%. Among the 34 patients who underwent upper gastrointestinal endoscopy, they were grade 2 to 3 esophageal varicose vein in 67.6%, an erosive gastropathy in 29.4%. The etiology was viral hepatitis B in 45%, alcoholism in 11.7% and undetermined in 43.3%. A hematemesis complicated the evolution in 16.7%. Carcinomatous degeneration was found in 5% and 16.7% of the patients had died. <strong>Conclusion:</strong> our experience with cirrhosis was marked by advanced forms at the stage of complications. The viral etiology B remains dominant. Prevention will involve early detection and vaccination.
