Introduction: in adults, adenomas are the most frequent causes of pituitary tumours. The objective was to characterize its epidemiological and clinical aspects, as well as its therapeutic modalities in Senegal. Method...Introduction: in adults, adenomas are the most frequent causes of pituitary tumours. The objective was to characterize its epidemiological and clinical aspects, as well as its therapeutic modalities in Senegal. Methodology: this was a multicenter, retrospective, descriptive and analytical study carried out from the Senegalese register of pituitary adenomas (2008-2022). Results: 242 patients were collected with an average age of 42.4 ± 13 years and a sex ratio (M/F) of 0.91. The mean consultation time was 19.7 ± 23 months. The circumstances of discovery were pituitary apoplexy (11 cases, 4.54%), tumor syndrome (176 cases, 72.72%), gonadal manifestations (103 cases, 42.56%), dysmorphic syndrome (21 cases, 8.68%), hypercorticism (15 cases, 6.19%). Morphologically, it was a macroadenoma (197 cases, 81.40%), an extensive adenoma (22 cases, 9.10%). The hormonal profile was lactotropic hypersecretion (80 cases, 33.05%), somatotropic (13 cases, 5.39%), corticotropic (14 cases, 5.78%), mixed (9 cases, 3.71%). The factors significantly associated with prolactinoma were young age (p = 0.000), female sex (p = 0.000), long consultation delay (p = 0.000) and microadenoma (p = 0.001). Only arterial hypertension was associated with acromegaly (p = 0.000). We found a significant correlation between Cushing’s disease and microadenomas (p = 0.000). Non-secreting adenomas were significantly associated with advanced age (p = 0.000), long delay in consultation (p = 0.000), male gender (p = 0.000), tumor syndrome (p = 0.001) and macroadenomas (p = 0.000). Pituitary surgery was effective in 173 patients (71.49%) including 166 cases (68.59%) by transphenoidal approach. Postoperative incidents were transient diabetes insipidus in 82 cases (47.39%), cerebrospinal fluid leak (20 cases, 11.56%). Death was observed in 18 patients in the entire series (7.44%). The latter had a tumor syndrome (88.88%), a macroadenoma (83.33%) and had undergone pituitary surgery (72.22%). Conclusion: pituitary pathology has become a reality with clinical and展开更多
Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age...Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age. This study aims to determine the clinical and paraclinical characteristics of connective tissue diseases in the elderly population. Materials and Methods: We conducted a retrospective and descriptive study, from March 2010 to March 2021, in the Internal Medicine Department of Aristide Le Dantec Hospital, including all the medical records of patients followed up for connective tissue disease and whose symptomatology began at an age greater than or equal to 65 years. Epidemiological, clinical, paraclinical, therapeutic and evolutionary data were collected from a pre-established survey form and then processed using SPSS software. Results: Overall, 22 cases were collected out of 275 seen on consultation. They involved 16 women and 6 men, aged between 65 and 85 years with a median of 70 years. The mean duration of the clinical picture was 15.7 months with extremes of 1 and 96 months. The clinical symptoms were joint pain in 21 patients associated with dry eye and mouth syndrome in seven cases and one patient underwent isolated dry eye and mouth syndrome. Joint involvement was deforming in 13 patients. Poor general condition was noted in 20 patients. Biology showed anemia in 14 patients, hyperleukocytosis (2 patients) and thrombocytosis (5 patients). The sedimentation rate (SR) was accelerated in 9 patients and the C-reactive protein (CRP) was positive in 12 patients. Immunology showed a positive Latex test (3 patients/6), Waaler-Rose reaction (8 patients/13), anti-cyclic citrullinated peptides (anti-CCP) antibodies (11 patients/11), anti-nuclear antibodies (2 patients/4). Anti-extractable nuclear antigens (anti-ENA) antibody testing in 4 patients showed positive anti-U1RNP (1 case), anti-SSA and anti-SSB (1 case). Plain X-Rays of the hands, wrists and feet showed destructive lesions in 16 patients. The 展开更多
<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Cardiovascular risk is increased in systemic lupus erythematosus. Cardiovascular events are...<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Cardiovascular risk is increased in systemic lupus erythematosus. Cardiovascular events are the first cause of death in lupus after five years duration. Prevention of cardiovascular events need</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> a good evaluation of the risk. In this work, we tried to evaluate the performance of conventional and adjusted form</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> of cardiovascular risk equations to predict high risk in lupus patients, in comparison with carotid ultrasound. <b>Method: </b>We realized a cross-sectional study during the period from 24 August 2017 to 22 November 2018. Consenting patient meeting the 1997 American college of Rheumatology criteria of systemic lupus erythematosus were recruited. The clinical characteristics and the treatment data were informed. Traditional cardiovascular risk factors were also investigated, and the assessment of cardiovascular risk was performed by Framingham and SCORE equations and their modified forms (multiplication by a factor of 1.5). Carotid ultrasound was used to detect atherosclerosis by measuring intima media thickness and search</span><span style="white-space:normal;font-family:;" "="">ing</span><span style="white-space:normal;font-family:;" "=""> for carotid plaques. In last, we compared cardiovascular risk level</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> by equations to results of carotid ultrasound. Statistical analysis and data collection were performed using SPSS 23.0 software. <b>Results:</b> Forty-nine patients with a sex ratio of 0.13 and a mean age of 33.5 (±11.3) years were enrolled. More than half of patients had dyslipidemia. More than 80% of the population were at low cardiovascular risk according to the equat展开更多
Introduction: Haemorrhagic manifestations rarely represent the mode of onset of lupus and are a therapeutical and diagnosis emergency. We report 6 cases of haemorrhagic manifestations disclosing lupus. Patients and me...Introduction: Haemorrhagic manifestations rarely represent the mode of onset of lupus and are a therapeutical and diagnosis emergency. We report 6 cases of haemorrhagic manifestations disclosing lupus. Patients and methods: It’s about a retrospective, descriptive and multicentric study ranged from 1st January 2014 to 5th January 2019. Were included in the study all cases of lupic disease revealed by hemorrhagic disorders, recorded in 3 Internal Medicine Departments in Dakar: DalalJamm, Dantec, Pikine. The diagnosis of lupus was made on the basis of the 1997 modified classification criteria of ACR for SLE. Results: We gathered 6 cases of women affected by lupic disease. The mean age was 32 years old with extremes ranged from 17 to 56 years. According to haemorrhagic disorders, the diagnosis of lupus was automatically made in 5 of the cases and it took 6 months to confirm the last one. Haemorrhagic features were ruled by purpura (3/6 cases) and nose-bleeding associated with gumbleeding (2/6 cases), epistaxis and melena (1/6 case), hypermenorrhea (1/6 case), cerebral haematoma (1/6case). Cutaneous (5/6), articular (4/6), renal (2/6) and serous (2/6) disorders specially represented the other manifestations. Biological findings showed cytopenia with 3 cases of anaemia, 1 case of leucopenia and 6 cases of thrombopenia. The average of the platelet count was at 20,000 cells/mm3 with extremes ranged from 1000 to 35,000 cells/mm<sup>3</sup>. Thrombocytopenia was related to autoimmune thrombocytopenic purpura in 3 cases, to Evans’ syndrome in 2 cases, to macrophage activation syndrome in 1 case. Immunological investigations found the presence of antinuclear antibodies (1/6), anti-dsDNA (2/6) and anti-Sm (4/6). All patients received a bolus of Solumedrol followed by an administration of Prednisone at a dosage of 1.5 mg/kg (3 cases) and 1 mg/kg to the other patients. A transfusion of platelet concentrates was performed for all of them. The evolution was favorable in 4 cases. Two patients died according to a septic and hae展开更多
<strong>Background:</strong> Empty sella turcica corresponds to an arachnocele which may be complete or partial, primary or secondary. The primary form is rarer. Its cause is unknown, but etiological facto...<strong>Background:</strong> Empty sella turcica corresponds to an arachnocele which may be complete or partial, primary or secondary. The primary form is rarer. Its cause is unknown, but etiological factors have been identified. The prevalence of this condition is variable, depending on techniques of diagnosis. It may be detected fortuitously on imaging or in the presence of neurological, ocular or endocrine manifestations. <strong>Aim:</strong> We aim to report a case of empty sella turcica syndrome revealed by adrenal insufficiency in a young African black woman. <strong>Case presentation:</strong> It was an overweight young woman with signs of intracranial hypertension associated with central adrenal insufficiency. The diagnosis of empty sella was confirmed by magnetic resonance imaging. Secondarily, she developed a hypo metabolism syndrome and biology confirmed central hypothyroidism. After correction of the adrenal cortical deficit, the treatment of the thyroid deficit was administered. Evolution was favourable clinically and biologically. <strong>Conclusion:</strong> The empty sella turcica is rare and its revelation by a central adrenal insufficiency is even more. The case we report is a perfect illustration.展开更多
文摘Introduction: in adults, adenomas are the most frequent causes of pituitary tumours. The objective was to characterize its epidemiological and clinical aspects, as well as its therapeutic modalities in Senegal. Methodology: this was a multicenter, retrospective, descriptive and analytical study carried out from the Senegalese register of pituitary adenomas (2008-2022). Results: 242 patients were collected with an average age of 42.4 ± 13 years and a sex ratio (M/F) of 0.91. The mean consultation time was 19.7 ± 23 months. The circumstances of discovery were pituitary apoplexy (11 cases, 4.54%), tumor syndrome (176 cases, 72.72%), gonadal manifestations (103 cases, 42.56%), dysmorphic syndrome (21 cases, 8.68%), hypercorticism (15 cases, 6.19%). Morphologically, it was a macroadenoma (197 cases, 81.40%), an extensive adenoma (22 cases, 9.10%). The hormonal profile was lactotropic hypersecretion (80 cases, 33.05%), somatotropic (13 cases, 5.39%), corticotropic (14 cases, 5.78%), mixed (9 cases, 3.71%). The factors significantly associated with prolactinoma were young age (p = 0.000), female sex (p = 0.000), long consultation delay (p = 0.000) and microadenoma (p = 0.001). Only arterial hypertension was associated with acromegaly (p = 0.000). We found a significant correlation between Cushing’s disease and microadenomas (p = 0.000). Non-secreting adenomas were significantly associated with advanced age (p = 0.000), long delay in consultation (p = 0.000), male gender (p = 0.000), tumor syndrome (p = 0.001) and macroadenomas (p = 0.000). Pituitary surgery was effective in 173 patients (71.49%) including 166 cases (68.59%) by transphenoidal approach. Postoperative incidents were transient diabetes insipidus in 82 cases (47.39%), cerebrospinal fluid leak (20 cases, 11.56%). Death was observed in 18 patients in the entire series (7.44%). The latter had a tumor syndrome (88.88%), a macroadenoma (83.33%) and had undergone pituitary surgery (72.22%). Conclusion: pituitary pathology has become a reality with clinical and
文摘Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age. This study aims to determine the clinical and paraclinical characteristics of connective tissue diseases in the elderly population. Materials and Methods: We conducted a retrospective and descriptive study, from March 2010 to March 2021, in the Internal Medicine Department of Aristide Le Dantec Hospital, including all the medical records of patients followed up for connective tissue disease and whose symptomatology began at an age greater than or equal to 65 years. Epidemiological, clinical, paraclinical, therapeutic and evolutionary data were collected from a pre-established survey form and then processed using SPSS software. Results: Overall, 22 cases were collected out of 275 seen on consultation. They involved 16 women and 6 men, aged between 65 and 85 years with a median of 70 years. The mean duration of the clinical picture was 15.7 months with extremes of 1 and 96 months. The clinical symptoms were joint pain in 21 patients associated with dry eye and mouth syndrome in seven cases and one patient underwent isolated dry eye and mouth syndrome. Joint involvement was deforming in 13 patients. Poor general condition was noted in 20 patients. Biology showed anemia in 14 patients, hyperleukocytosis (2 patients) and thrombocytosis (5 patients). The sedimentation rate (SR) was accelerated in 9 patients and the C-reactive protein (CRP) was positive in 12 patients. Immunology showed a positive Latex test (3 patients/6), Waaler-Rose reaction (8 patients/13), anti-cyclic citrullinated peptides (anti-CCP) antibodies (11 patients/11), anti-nuclear antibodies (2 patients/4). Anti-extractable nuclear antigens (anti-ENA) antibody testing in 4 patients showed positive anti-U1RNP (1 case), anti-SSA and anti-SSB (1 case). Plain X-Rays of the hands, wrists and feet showed destructive lesions in 16 patients. The
文摘<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Cardiovascular risk is increased in systemic lupus erythematosus. Cardiovascular events are the first cause of death in lupus after five years duration. Prevention of cardiovascular events need</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> a good evaluation of the risk. In this work, we tried to evaluate the performance of conventional and adjusted form</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> of cardiovascular risk equations to predict high risk in lupus patients, in comparison with carotid ultrasound. <b>Method: </b>We realized a cross-sectional study during the period from 24 August 2017 to 22 November 2018. Consenting patient meeting the 1997 American college of Rheumatology criteria of systemic lupus erythematosus were recruited. The clinical characteristics and the treatment data were informed. Traditional cardiovascular risk factors were also investigated, and the assessment of cardiovascular risk was performed by Framingham and SCORE equations and their modified forms (multiplication by a factor of 1.5). Carotid ultrasound was used to detect atherosclerosis by measuring intima media thickness and search</span><span style="white-space:normal;font-family:;" "="">ing</span><span style="white-space:normal;font-family:;" "=""> for carotid plaques. In last, we compared cardiovascular risk level</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> by equations to results of carotid ultrasound. Statistical analysis and data collection were performed using SPSS 23.0 software. <b>Results:</b> Forty-nine patients with a sex ratio of 0.13 and a mean age of 33.5 (±11.3) years were enrolled. More than half of patients had dyslipidemia. More than 80% of the population were at low cardiovascular risk according to the equat
文摘Introduction: Haemorrhagic manifestations rarely represent the mode of onset of lupus and are a therapeutical and diagnosis emergency. We report 6 cases of haemorrhagic manifestations disclosing lupus. Patients and methods: It’s about a retrospective, descriptive and multicentric study ranged from 1st January 2014 to 5th January 2019. Were included in the study all cases of lupic disease revealed by hemorrhagic disorders, recorded in 3 Internal Medicine Departments in Dakar: DalalJamm, Dantec, Pikine. The diagnosis of lupus was made on the basis of the 1997 modified classification criteria of ACR for SLE. Results: We gathered 6 cases of women affected by lupic disease. The mean age was 32 years old with extremes ranged from 17 to 56 years. According to haemorrhagic disorders, the diagnosis of lupus was automatically made in 5 of the cases and it took 6 months to confirm the last one. Haemorrhagic features were ruled by purpura (3/6 cases) and nose-bleeding associated with gumbleeding (2/6 cases), epistaxis and melena (1/6 case), hypermenorrhea (1/6 case), cerebral haematoma (1/6case). Cutaneous (5/6), articular (4/6), renal (2/6) and serous (2/6) disorders specially represented the other manifestations. Biological findings showed cytopenia with 3 cases of anaemia, 1 case of leucopenia and 6 cases of thrombopenia. The average of the platelet count was at 20,000 cells/mm3 with extremes ranged from 1000 to 35,000 cells/mm<sup>3</sup>. Thrombocytopenia was related to autoimmune thrombocytopenic purpura in 3 cases, to Evans’ syndrome in 2 cases, to macrophage activation syndrome in 1 case. Immunological investigations found the presence of antinuclear antibodies (1/6), anti-dsDNA (2/6) and anti-Sm (4/6). All patients received a bolus of Solumedrol followed by an administration of Prednisone at a dosage of 1.5 mg/kg (3 cases) and 1 mg/kg to the other patients. A transfusion of platelet concentrates was performed for all of them. The evolution was favorable in 4 cases. Two patients died according to a septic and hae
文摘<strong>Background:</strong> Empty sella turcica corresponds to an arachnocele which may be complete or partial, primary or secondary. The primary form is rarer. Its cause is unknown, but etiological factors have been identified. The prevalence of this condition is variable, depending on techniques of diagnosis. It may be detected fortuitously on imaging or in the presence of neurological, ocular or endocrine manifestations. <strong>Aim:</strong> We aim to report a case of empty sella turcica syndrome revealed by adrenal insufficiency in a young African black woman. <strong>Case presentation:</strong> It was an overweight young woman with signs of intracranial hypertension associated with central adrenal insufficiency. The diagnosis of empty sella was confirmed by magnetic resonance imaging. Secondarily, she developed a hypo metabolism syndrome and biology confirmed central hypothyroidism. After correction of the adrenal cortical deficit, the treatment of the thyroid deficit was administered. Evolution was favourable clinically and biologically. <strong>Conclusion:</strong> The empty sella turcica is rare and its revelation by a central adrenal insufficiency is even more. The case we report is a perfect illustration.
