Although most individuals with sickle cell disease (SCD) live in sub‐Saharan Africa, the natural ... more Although most individuals with sickle cell disease (SCD) live in sub‐Saharan Africa, the natural history of the disease on this continent remains largely unknown. Intravascular haemolysis results in activation of circulating blood cells and release of microparticles (MPs) that exert pro‐inflammatory effects and contribute to vascular damage. We designed a case‐control study nested in the CADRE cohort (Coeur‐Artère‐DRÉpanocytose, clinical trials.gov identifier NCTO3114137) and based on extreme phenotypes, to analyse blood cell‐derived MPs in 232 adult SS patients at steady state in Bamako and Dakar. Thirty‐six healthy adult controls matched by age and sex were recruited in Bamako. The MPs concentrations were higher in SS patients compared to AA controls with a predominance of erythrocyte‐ and reticulocyte‐derived MPs. These erythroid‐derived MPs were significantly lower in patients with retinopathy (P = 0·022). Reticulocyte‐derived MPs were significantly negatively and positively associated with a history of priapism (P = 0·020) and leg ulcers (P = 0·041) respectively. We describe for the first time the comparative patterns of plasma MPs in healthy subjects and
In many sub‐Saharan countries, haemophilia exists in an environment of poor knowledge and poor ac... more In many sub‐Saharan countries, haemophilia exists in an environment of poor knowledge and poor access to treatment. To improve the quality of life of Persons with Haemophilia (PWH), understanding their unmet needs and the socio‐cultural realities is essential.
Introduction/ Background : Chronic lymphocytic leukemia (CLL) is a heterogeneous disease which ca... more Introduction/ Background : Chronic lymphocytic leukemia (CLL) is a heterogeneous disease which can present as an aggressive and life threatening leukemia or as an indolent form that will not require treatment for decades. This heterogeneity has important consequences which will impact on clinical approaches, treatment strategies, and survival times from diagnosis. Prognostic markers such as expression of specific proteins in or on CLL cells (ie, CD38, 70-kD ζ-associated protein or CD49d), cytogenetic abnormalities (del 13q, del 11q, del 17p and trisomy 12) quantified by FISH and immunoglobulin heavy chain (IgVH) gene mutation have all been very useful. Futhermore, patients with early-stage disease, with biologically aggressive disease and shorter survival times can be distiguished. However, these prognostic tests are expensive and require considerable technical expertise and equipment and thus are not available to many patients with CLL living in developing countries. Therefore less...
Introduction Sickle cell disease (SCD) is not only responsible for acute vaso-occlusive events bu... more Introduction Sickle cell disease (SCD) is not only responsible for acute vaso-occlusive events but also for chronic vasculopathy that affects many organs including kidneys. Animal studies have suggested that SCD vasculopathy mainly results from chronic hemolysis. However hemolysis markers have not been consistently associated with clinical vascular complications. Moreover, SCD vasculopathy events have been almost exclusively studied in the USA or in Europe, although more than 80% of SCD patients are born and living in sub-Saharan Africa, a very different environment. We have settled the first multinational African SCD cohort to measure the incidence of SCD vascular complications and looked for their predictive factors in sub-Saharan Africa. We present here our first results, focusing on SCD nephropathy with glomerular involvement and urinary loss of albumin. Methods CADRE is an ongoing cohort of SCD patients in five African countries: Cameroon, Gabon, Ivory Coast, Mali, and Senegal....
The prevalence of type 2 diabetes (T2D) is rapidly increasing in Sub-Saharan Africa, where sickle... more The prevalence of type 2 diabetes (T2D) is rapidly increasing in Sub-Saharan Africa, where sickle-cell trait (SCT) is also frequent. Although SCT is generally considered a benign condition, evidence suggests that SCT could exaggerate vascular dysfunction in T2D. However, it remains unclear whether SCT could increase the risk of the development of T2D complications. Therefore, this study was conducted to determine whether T2D complications were more prevalent among Senegalese individuals with SCT and T2D than among those with T2D only. Rates of hypertension, retinopathy, peripheral neuropathy, peripheral artery disease, and impaired renal function as well as arterial stiffness, blood rheology, and concentrations of plasma advanced glycation end products (AGEs) and cytokines were compared between groups of Senegalese individuals with combined SCT and T2D (T2D-SCT) ( = 60), T2D ( = 52), SCT ( = 53), and neither T2D nor SCT (control) ( = 56). Human aortic endothelial cell (HAEC) express...
Introduction Le CNTS organise une evaluation externe de la qualite (EEQ) lors des missions de sup... more Introduction Le CNTS organise une evaluation externe de la qualite (EEQ) lors des missions de supervision technique des banques de sang. Cette EEQ a pour but d’apprecier les niveaux de performance de depistage du VIH, du VHC, du VHB et de la syphilis dans toutes les banques de sang du pays. Materiels et methodes Entre 2012 et 2016, quatre echantillons des serums ont ete deposes tous les 6 mois dans 18 banques de sang. Il etait demande a chacune de rechercher l’Ag-HBs, les anti-VIH, les anti-VHC et les anti-Treponema pallidum (anti-TP). Les resultats ont ete compares avec ceux obtenus par le CNTS qui utilise un automate de type Architect (Abbott). Resultats Les performances annuelles obtenues par les banques de sang sont pour : – le VIH (90,6 %), le VHB (94,8 %), le VHC (90,2 %) et l’anti-TP (79,4 %) avec un taux de participation de 68,75 % en 2012 ; – le VIH (100 %) ; le VHB (98,2 %) ; le VHC (70,80 %) et l’anti-TP (98,7 %) avec un taux de participation de 77,7 % en 2013 ; – le VIH (100 %), le VHB (100 %), le VHC (91,6 %) et l’anti-TP (89,2 %) avec un taux de participation de 77,7 % en 2014 ; – le VIH (100 %), le VHB (100 %), le VHC (95,31 %), et l’anti-TP (93,75 %) avec un taux de participation de 88,8 % en 2015 ; – le VIH (100 %), le VHB (100 %), le VHC (100 %), et l’anti-TP (93,75 %) avec un taux de participation de 97,91 % en 2016. Conclusion L’evaluation externe de la qualite lors des missions de supervision technique des banques de sang a permis d’harmoniser les pratiques transfusionnelles dans l’ensemble du territoire.
Chronic myeloid leukemia (CML) is an orphan disease in Africa because of the inaccessibility to s... more Chronic myeloid leukemia (CML) is an orphan disease in Africa because of the inaccessibility to specific treatment and the high cost of diagnosis and monitoring patients. The aim of this study was to report CML treatment response in a developing country in the tyrosine kinase inhibitor era. We conducted a longitudinal study of our cohort of CML patients. Socio-demographic, diagnosis, therapeutic, and treatment response parameters were studied. Sokal score, disease phase at diagnosis, delay from diagnosis to treatment, and treatment response were analyzed for their impact on survival. Fifty-five patients with a diagnosis of CML and who received treatment with imatinib for a minimum of 3 months were included in this study. Median follow-up was 170 patient-years. The sex ratio (M/F) was 1.62 and median age at diagnosis was 42 years. At diagnosis, 85.5 % of the patients were in chronic phase (CP), 12.7 % in accelerated phase (AP), and 1.8 % in blast crisis (BC). Sokal risk score distribution was as follows: low risk 29.8 %, intermediate risk 38.3 %, and high risk 31.9 %. Median time from first symptoms to first medical visit was 6.2 months and median time from first medical visit to cytogenetic and or molecular confirmation was 12.4 months. Mean delay time from first medical visit to imatinib initiation was 12.5 months (95 % CI 6.3-18.7). The complete hematologic response (CHR) at 3 months, the major cytogenetic response (MCR) at 12 months, and the major molecular response (MMR) at 24 months were respectively 82.4, 75, and 25 %. The 2-year overall survival rate was 81 %. Advanced phase at the diagnosis, discontinuation of imatinib therapy over 15 % of the time, lack of CHR at 3 months, lack of MCR at 12 months, and progression of the disease during imatinib therapy were associated with a risk of death (p ≤ 0.05). Our data confirm the improved prognosis of CML treated with imatinib in the setting of a developing country. However, response rates are lower than in developed countries, and additional efforts should be made to facilitate early diagnosis and improve access to TKI, treatment compliance, and regular molecular monitoring of patients.
Cahiers D Etudes Et De Recherches Francophones Sante, Jan 27, 2000
Trois observations de cas feminins de maladie de Biermer diagnostiquee en Afrique sont rapportes.... more Trois observations de cas feminins de maladie de Biermer diagnostiquee en Afrique sont rapportes. Les trois malades avaient toutes une anemie macrocytaire avec un medullogramme temoignant d’une megaloblastose. Les manifestations neurologiques du type sclerose combinee de la moelle, le caractere biermerien de ces megaloblastoses et une vitaminotherapie parenterale font l’originalite de ces observations. Cette affection parait insuffisamment diagnostiquee en Afrique au vu des observations rapportees dans les publications.
OBJECTIVE It is predicted that Africa will have the greatest increase in the number of patients w... more OBJECTIVE It is predicted that Africa will have the greatest increase in the number of patients with type 2 diabetes mellitus (T2DM) within the next decade. T2DM patients are at risk for cardiovascular disorders. In Sub-Saharan African countries, sickle cell trait (SCT) is frequent. Despite the presence of modest abnormalities in hemorheology and oxidative stress, SCT is generally considered a benign condition. Little is known about vascular function in SCT, although recent studies demonstrated an increased risk of cardiovascular disorders, including venous thromboembolism, stroke, and chronic kidney disease. We hypothesized that SCT could accentuate the vascular dysfunction observed in T2DM. RESEARCH DESIGN AND METHODS The current study, conducted in Senegal, compared vascular function, hemorheological profile, and biomarkers of oxidative stress, inflammation, and nitric oxide metabolism in healthy individuals (CONT), subjects with T2DM or SCT, and patients with both T2DM and SCT (...
Endemic Burkitt’s lymphoma (eBL) is the single most frequent and represents the vast majority of ... more Endemic Burkitt’s lymphoma (eBL) is the single most frequent and represents the vast majority of pediatric lymphomas in sub-Saharan Africa. Pathophysiology of eBL involves latent EBV infection and malaria. Thus far, chemotherapy-based approaches remain the mainstay of the treatment of BL. Despite the major challenges posed to the treatment of BL in high-endemicity and low-income countries, progress has been made, and treatment should be proposed. Current therapy of eBL yields cure rates in the range of 30–50 %, still largely inferior to the 70–90 % achievable in higher-income countries.
Sickle cell anemia exhibits significant variations in clinical presentation in different populati... more Sickle cell anemia exhibits significant variations in clinical presentation in different populations despite the homogeneity of the genetic defect which is involved. Genetic modulation of this disease is known but cannot explain alone such observations. Our objectives were to determine the effects of Hb F level, sociocultural and economic factors on disease severity in Dakar. Sixty homozygous sickle cell patients were followed up between october 1996 and April 1998 during which period the severity of the disease was assessed and a "severity index" was calculated for each patient. The factors which were identified with proved benefit were: Hb F > 15%, a high socioeconomic level, a good understanding of the disease, at least 4 medical visits per year. These results allow us to identify some potential targets to improve preventive and curative care of this disease.
Known since over than seventy years, von willebrand disaese is the most common herediary bleeding... more Known since over than seventy years, von willebrand disaese is the most common herediary bleeding disorder. This condition was first described by Pr. Willebrand in 1926 in a family with (positive) history of excesive bleeding tendency. Von Willebrand desease is characterized by a lifelong tendency toward easy spontaneous mucosal or post operative bleeding. In females, excessive or prolonged menorrhagia could be a sign of von willebrand desease; symptoms that are often misunderstood to be gynecologic rather than hematologic problem. In the present work, we have tried to screen for this anomaly in females with menorrhagia, following a simple anamnestic, clinical and biological protocol. In a seventeen month study, fifty two procreating females with menorrhagia were recruited in the haematology laboratory of Aristide le Dantec hospital with the cooperation of gynecology and obstetric departements of Aristide Le Dantec, Abass Ndao and grand yoff Hospitals. Eight patients were revealed t...
Médecine tropicale : revue du Corps de santé colonial, 2008
Monoclonal gammapathy of undetermined significance (MGUS) has rarely been reported in African lit... more Monoclonal gammapathy of undetermined significance (MGUS) has rarely been reported in African literature. The purpose of this article is to describe 3 cases of MGUS observed in women aged 63, 54, and 44 years in Senegal. All three patients had previously documented autoimmune disease, i.e., auto-immune thrombopenia, multiple auto-immune disease (comprising Sjögren's syndrome, polymyositis and vitiligo), and Sjögren's syndrome. Diagnosis of MGUS was made thanks to routine protein electrophoresis that demonstrated a monoclonal peak in the gammaglobulin area in all patients. Serum protein binding showed the IgG lambda subtype in one case and IgG kappa subtype in two cases. Medullogram findings were unremarkable with nondystrophic plasma cell rates ranging from 1 to 4%. Bisphophonate therapy was undertaken along with the recommended treatments for the associated autoimmune diseases, i.e., prednisone, hydroxychloroquine, and methotrexate. Treatment was successful in all three pat...
Although most individuals with sickle cell disease (SCD) live in sub‐Saharan Africa, the natural ... more Although most individuals with sickle cell disease (SCD) live in sub‐Saharan Africa, the natural history of the disease on this continent remains largely unknown. Intravascular haemolysis results in activation of circulating blood cells and release of microparticles (MPs) that exert pro‐inflammatory effects and contribute to vascular damage. We designed a case‐control study nested in the CADRE cohort (Coeur‐Artère‐DRÉpanocytose, clinical trials.gov identifier NCTO3114137) and based on extreme phenotypes, to analyse blood cell‐derived MPs in 232 adult SS patients at steady state in Bamako and Dakar. Thirty‐six healthy adult controls matched by age and sex were recruited in Bamako. The MPs concentrations were higher in SS patients compared to AA controls with a predominance of erythrocyte‐ and reticulocyte‐derived MPs. These erythroid‐derived MPs were significantly lower in patients with retinopathy (P = 0·022). Reticulocyte‐derived MPs were significantly negatively and positively associated with a history of priapism (P = 0·020) and leg ulcers (P = 0·041) respectively. We describe for the first time the comparative patterns of plasma MPs in healthy subjects and
In many sub‐Saharan countries, haemophilia exists in an environment of poor knowledge and poor ac... more In many sub‐Saharan countries, haemophilia exists in an environment of poor knowledge and poor access to treatment. To improve the quality of life of Persons with Haemophilia (PWH), understanding their unmet needs and the socio‐cultural realities is essential.
Introduction/ Background : Chronic lymphocytic leukemia (CLL) is a heterogeneous disease which ca... more Introduction/ Background : Chronic lymphocytic leukemia (CLL) is a heterogeneous disease which can present as an aggressive and life threatening leukemia or as an indolent form that will not require treatment for decades. This heterogeneity has important consequences which will impact on clinical approaches, treatment strategies, and survival times from diagnosis. Prognostic markers such as expression of specific proteins in or on CLL cells (ie, CD38, 70-kD ζ-associated protein or CD49d), cytogenetic abnormalities (del 13q, del 11q, del 17p and trisomy 12) quantified by FISH and immunoglobulin heavy chain (IgVH) gene mutation have all been very useful. Futhermore, patients with early-stage disease, with biologically aggressive disease and shorter survival times can be distiguished. However, these prognostic tests are expensive and require considerable technical expertise and equipment and thus are not available to many patients with CLL living in developing countries. Therefore less...
Introduction Sickle cell disease (SCD) is not only responsible for acute vaso-occlusive events bu... more Introduction Sickle cell disease (SCD) is not only responsible for acute vaso-occlusive events but also for chronic vasculopathy that affects many organs including kidneys. Animal studies have suggested that SCD vasculopathy mainly results from chronic hemolysis. However hemolysis markers have not been consistently associated with clinical vascular complications. Moreover, SCD vasculopathy events have been almost exclusively studied in the USA or in Europe, although more than 80% of SCD patients are born and living in sub-Saharan Africa, a very different environment. We have settled the first multinational African SCD cohort to measure the incidence of SCD vascular complications and looked for their predictive factors in sub-Saharan Africa. We present here our first results, focusing on SCD nephropathy with glomerular involvement and urinary loss of albumin. Methods CADRE is an ongoing cohort of SCD patients in five African countries: Cameroon, Gabon, Ivory Coast, Mali, and Senegal....
The prevalence of type 2 diabetes (T2D) is rapidly increasing in Sub-Saharan Africa, where sickle... more The prevalence of type 2 diabetes (T2D) is rapidly increasing in Sub-Saharan Africa, where sickle-cell trait (SCT) is also frequent. Although SCT is generally considered a benign condition, evidence suggests that SCT could exaggerate vascular dysfunction in T2D. However, it remains unclear whether SCT could increase the risk of the development of T2D complications. Therefore, this study was conducted to determine whether T2D complications were more prevalent among Senegalese individuals with SCT and T2D than among those with T2D only. Rates of hypertension, retinopathy, peripheral neuropathy, peripheral artery disease, and impaired renal function as well as arterial stiffness, blood rheology, and concentrations of plasma advanced glycation end products (AGEs) and cytokines were compared between groups of Senegalese individuals with combined SCT and T2D (T2D-SCT) ( = 60), T2D ( = 52), SCT ( = 53), and neither T2D nor SCT (control) ( = 56). Human aortic endothelial cell (HAEC) express...
Introduction Le CNTS organise une evaluation externe de la qualite (EEQ) lors des missions de sup... more Introduction Le CNTS organise une evaluation externe de la qualite (EEQ) lors des missions de supervision technique des banques de sang. Cette EEQ a pour but d’apprecier les niveaux de performance de depistage du VIH, du VHC, du VHB et de la syphilis dans toutes les banques de sang du pays. Materiels et methodes Entre 2012 et 2016, quatre echantillons des serums ont ete deposes tous les 6 mois dans 18 banques de sang. Il etait demande a chacune de rechercher l’Ag-HBs, les anti-VIH, les anti-VHC et les anti-Treponema pallidum (anti-TP). Les resultats ont ete compares avec ceux obtenus par le CNTS qui utilise un automate de type Architect (Abbott). Resultats Les performances annuelles obtenues par les banques de sang sont pour : – le VIH (90,6 %), le VHB (94,8 %), le VHC (90,2 %) et l’anti-TP (79,4 %) avec un taux de participation de 68,75 % en 2012 ; – le VIH (100 %) ; le VHB (98,2 %) ; le VHC (70,80 %) et l’anti-TP (98,7 %) avec un taux de participation de 77,7 % en 2013 ; – le VIH (100 %), le VHB (100 %), le VHC (91,6 %) et l’anti-TP (89,2 %) avec un taux de participation de 77,7 % en 2014 ; – le VIH (100 %), le VHB (100 %), le VHC (95,31 %), et l’anti-TP (93,75 %) avec un taux de participation de 88,8 % en 2015 ; – le VIH (100 %), le VHB (100 %), le VHC (100 %), et l’anti-TP (93,75 %) avec un taux de participation de 97,91 % en 2016. Conclusion L’evaluation externe de la qualite lors des missions de supervision technique des banques de sang a permis d’harmoniser les pratiques transfusionnelles dans l’ensemble du territoire.
Chronic myeloid leukemia (CML) is an orphan disease in Africa because of the inaccessibility to s... more Chronic myeloid leukemia (CML) is an orphan disease in Africa because of the inaccessibility to specific treatment and the high cost of diagnosis and monitoring patients. The aim of this study was to report CML treatment response in a developing country in the tyrosine kinase inhibitor era. We conducted a longitudinal study of our cohort of CML patients. Socio-demographic, diagnosis, therapeutic, and treatment response parameters were studied. Sokal score, disease phase at diagnosis, delay from diagnosis to treatment, and treatment response were analyzed for their impact on survival. Fifty-five patients with a diagnosis of CML and who received treatment with imatinib for a minimum of 3 months were included in this study. Median follow-up was 170 patient-years. The sex ratio (M/F) was 1.62 and median age at diagnosis was 42 years. At diagnosis, 85.5 % of the patients were in chronic phase (CP), 12.7 % in accelerated phase (AP), and 1.8 % in blast crisis (BC). Sokal risk score distribution was as follows: low risk 29.8 %, intermediate risk 38.3 %, and high risk 31.9 %. Median time from first symptoms to first medical visit was 6.2 months and median time from first medical visit to cytogenetic and or molecular confirmation was 12.4 months. Mean delay time from first medical visit to imatinib initiation was 12.5 months (95 % CI 6.3-18.7). The complete hematologic response (CHR) at 3 months, the major cytogenetic response (MCR) at 12 months, and the major molecular response (MMR) at 24 months were respectively 82.4, 75, and 25 %. The 2-year overall survival rate was 81 %. Advanced phase at the diagnosis, discontinuation of imatinib therapy over 15 % of the time, lack of CHR at 3 months, lack of MCR at 12 months, and progression of the disease during imatinib therapy were associated with a risk of death (p ≤ 0.05). Our data confirm the improved prognosis of CML treated with imatinib in the setting of a developing country. However, response rates are lower than in developed countries, and additional efforts should be made to facilitate early diagnosis and improve access to TKI, treatment compliance, and regular molecular monitoring of patients.
Cahiers D Etudes Et De Recherches Francophones Sante, Jan 27, 2000
Trois observations de cas feminins de maladie de Biermer diagnostiquee en Afrique sont rapportes.... more Trois observations de cas feminins de maladie de Biermer diagnostiquee en Afrique sont rapportes. Les trois malades avaient toutes une anemie macrocytaire avec un medullogramme temoignant d’une megaloblastose. Les manifestations neurologiques du type sclerose combinee de la moelle, le caractere biermerien de ces megaloblastoses et une vitaminotherapie parenterale font l’originalite de ces observations. Cette affection parait insuffisamment diagnostiquee en Afrique au vu des observations rapportees dans les publications.
OBJECTIVE It is predicted that Africa will have the greatest increase in the number of patients w... more OBJECTIVE It is predicted that Africa will have the greatest increase in the number of patients with type 2 diabetes mellitus (T2DM) within the next decade. T2DM patients are at risk for cardiovascular disorders. In Sub-Saharan African countries, sickle cell trait (SCT) is frequent. Despite the presence of modest abnormalities in hemorheology and oxidative stress, SCT is generally considered a benign condition. Little is known about vascular function in SCT, although recent studies demonstrated an increased risk of cardiovascular disorders, including venous thromboembolism, stroke, and chronic kidney disease. We hypothesized that SCT could accentuate the vascular dysfunction observed in T2DM. RESEARCH DESIGN AND METHODS The current study, conducted in Senegal, compared vascular function, hemorheological profile, and biomarkers of oxidative stress, inflammation, and nitric oxide metabolism in healthy individuals (CONT), subjects with T2DM or SCT, and patients with both T2DM and SCT (...
Endemic Burkitt’s lymphoma (eBL) is the single most frequent and represents the vast majority of ... more Endemic Burkitt’s lymphoma (eBL) is the single most frequent and represents the vast majority of pediatric lymphomas in sub-Saharan Africa. Pathophysiology of eBL involves latent EBV infection and malaria. Thus far, chemotherapy-based approaches remain the mainstay of the treatment of BL. Despite the major challenges posed to the treatment of BL in high-endemicity and low-income countries, progress has been made, and treatment should be proposed. Current therapy of eBL yields cure rates in the range of 30–50 %, still largely inferior to the 70–90 % achievable in higher-income countries.
Sickle cell anemia exhibits significant variations in clinical presentation in different populati... more Sickle cell anemia exhibits significant variations in clinical presentation in different populations despite the homogeneity of the genetic defect which is involved. Genetic modulation of this disease is known but cannot explain alone such observations. Our objectives were to determine the effects of Hb F level, sociocultural and economic factors on disease severity in Dakar. Sixty homozygous sickle cell patients were followed up between october 1996 and April 1998 during which period the severity of the disease was assessed and a "severity index" was calculated for each patient. The factors which were identified with proved benefit were: Hb F > 15%, a high socioeconomic level, a good understanding of the disease, at least 4 medical visits per year. These results allow us to identify some potential targets to improve preventive and curative care of this disease.
Known since over than seventy years, von willebrand disaese is the most common herediary bleeding... more Known since over than seventy years, von willebrand disaese is the most common herediary bleeding disorder. This condition was first described by Pr. Willebrand in 1926 in a family with (positive) history of excesive bleeding tendency. Von Willebrand desease is characterized by a lifelong tendency toward easy spontaneous mucosal or post operative bleeding. In females, excessive or prolonged menorrhagia could be a sign of von willebrand desease; symptoms that are often misunderstood to be gynecologic rather than hematologic problem. In the present work, we have tried to screen for this anomaly in females with menorrhagia, following a simple anamnestic, clinical and biological protocol. In a seventeen month study, fifty two procreating females with menorrhagia were recruited in the haematology laboratory of Aristide le Dantec hospital with the cooperation of gynecology and obstetric departements of Aristide Le Dantec, Abass Ndao and grand yoff Hospitals. Eight patients were revealed t...
Médecine tropicale : revue du Corps de santé colonial, 2008
Monoclonal gammapathy of undetermined significance (MGUS) has rarely been reported in African lit... more Monoclonal gammapathy of undetermined significance (MGUS) has rarely been reported in African literature. The purpose of this article is to describe 3 cases of MGUS observed in women aged 63, 54, and 44 years in Senegal. All three patients had previously documented autoimmune disease, i.e., auto-immune thrombopenia, multiple auto-immune disease (comprising Sjögren's syndrome, polymyositis and vitiligo), and Sjögren's syndrome. Diagnosis of MGUS was made thanks to routine protein electrophoresis that demonstrated a monoclonal peak in the gammaglobulin area in all patients. Serum protein binding showed the IgG lambda subtype in one case and IgG kappa subtype in two cases. Medullogram findings were unremarkable with nondystrophic plasma cell rates ranging from 1 to 4%. Bisphophonate therapy was undertaken along with the recommended treatments for the associated autoimmune diseases, i.e., prednisone, hydroxychloroquine, and methotrexate. Treatment was successful in all three pat...
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