[Nephrotic syndrom with focal and segmental glomerulosclerosis in Dakar: epidemiological and clinicopathological characteristics (about 134 cases)]. / Le syndrome néphrotique avec hyalinose segmentaire et focale a Dakar: aspects épidémiologiques et anatomocliniques (a propos de 134 cas).

Focal and segmental glomerulosclerosis (FSGS) is common and non-specific patterns of glomerular injury encountered in human renal biopsies. Cortico-resistant nephrotic syndrome is the main manifestation. We report epidemiological, clinical and pathological aspects of FSGS in Dakar. We report the results of a retrospective study about focal segmental glomerulosclerosis (FSGS) identified from 258 kidney biopsies performed in the medical clinic 1 of A. Le Dantec hospital from January 1993 to December 2003. FSG is found in 134 cases (52%), membranous glomerulonephritis in 32 cases (12,4%), minimal change disease in 20 cases (7.7%). Ninety eigths files were exploitable. FSGS has male gender predominance with a sex ratio of 3. Median age of patients is 28 years (15 and 79 years). Symptomatology is dominated by oedema in 86 cases (87,7%), hypertension in 12 cases (12.2%), hematuria in 5 cases (5.1%), nephrotic proteinuria in 65 cases (66,3%) and no nephrotic proteinuria in 33 cases (33.6%), renal failure in 25 cases (25%)and leucocyturia in 18 cases (18%). FSGS involving more than 50% of glomeruli is encountered in 41 cases (42%), severe interstitial fibrosis is associated in 26 cases. Different pathological aspects are: classical FSGS in 88 cases (88.7%), FSGS " collapsing" in 7 cases (7.1%), FSG "tip-lesion" in one case, FSGS associated to membranous glomerulosclerosis in 2 cases and to diabetic glomerulosclerosis in one case. FSGS is primitive in 88 cases (89,8%) and secondary in 10 cases (10.2%). FSGS is the most common primitive glomerulopathy in Dakar. Nephrotic syndrome is the main manifestation of this disease. Collapsing FSGS is not correlated with the HIV Infection.

[Undesirable effects of methothrexate during treatment of rheumatoid arthritis]. / Tolerance du méthotrexate dans le traitement de lapolyarthrite rhumatoïde.

INTRODUCTION: Methotrexate used as antimetabolite since 40 years in cancerology, is curretly pointed out at weak dose in the treatment of rheumatoid arthitis. However, the intervening of undesirable effects is currently the principal factor limiting its use. The main of our study was evaluate the nature and the frequency of undesirable effects during treatement of rhumatoid arthritis by methotrexate in a prospective study in the department of internal medecine of A.L.D hospital. MATERIAL AND METHODS: Fifty patients were included in the study, they were 43 female and 7 male (sex ratio of 0.161).The mean age were 40.8 years, ranging from 18 to 68. The mean last of MTX treatment was 16.58 months, ranging from 1 to 64. RESULTS: Twenty seven patients (54%) had at least one undesirable effect. Undesirable effect appeared early in 74.1%. they were 61.5% when MTX was associated with others drugs versus 27.3% when MTX was used alone. Undesirable effects mostly were digestives (38%), general (30%), mucouscutaneous (8%) and hepatics (2%).for patients undesirable effects had involved. They were responsable of definitive stopping treatment in two cases of pulmonary tuberculosis.

[Current aspects of systemic lupus erythematosus in Dakar. About 74 cases]. / Aspects actuels du lupus erythemateux systemique a Dakar. A propos de 74 observations.

INTRODUCTION: previously reported studies on systemic lupus erythematosus in Senegal were more then ten years old and reported few cases of patients. Our objectives were to update epidemiological, clinical, laboratory and evolutive aspects of systemic lupus erythematosus throughout a study of 74 patients. PATIENTS AND METHODS: we conducted a retrospective study in the internal medicine and the dermatology units of the university teaching hospital Aristide Le Dantec from January 1993 to December 2002. All patients with systemic lupus erythematosus according to the ACR criteria were included. Those who didn't meet ACR criteria were excluded. RESULTS: we included 74 patients; their mean age was 32 years and the sex ratio 0.1 (male to female). At the entry general symptoms were constants, and cutaneous signs were found in 96% of cases, joints signs in 58.1% and renal sign in 56.8%. Haematological and immunologic abnormalities were nearly constant. All the patients received corticosteroids and in 35.71% they had in addition immunosuppressive drugs. Shorts term evolution was satisfactory. At the medium term 27.02% of the patients were lost and 10.81% of them died. CONCLUSION: currents aspects of systemic lupus erythematosus in Dakar are improved by the early diagnosis when the disease is pauci-symptomatic and by the use immunosuppressive drugs in association with corticosteroids.

[Lupus nephritis in Senegal: study of 42 cases]. / La néphropathie lupique au Sénégal: a propos de 42 cas.

INTRODUCTION: Renal involvement determines the prognosis of systemic lupus erythematosus. The aims of this study were to precise clinical, laboratory, therapeutic and evolutive aspects of lupus nephritis in Senegal in order to improve its management. PATIENTS AND METHODS: According to ACR criteria we included all patients presenting a systemic lupus erythematosus followed in internal medicine and in the dermatology services of university teaching hospital Aristide le Dantec of Dakar from January 1993 to December 2002. All the patients who didn't have a lupus nephritis defined by the existence of more than 0.5 g/24 h of proteinuria and or hematuria were excluded. RESULTS: The prevalence of lupus nephritis was 56.75% among 74 patients with systemic lupus erythematosus. Mean age was 29.6 years and sex ratio 0.13 (male to female). There was a nephritic syndrome in 45.23% of the cases and renal insufficiency in 37.71%. Renal biopsy performed in 52.38% of cases showed predominantly WHO classes IV and V. The key treatment was corticotherapy while immunosuppressive were used in 35.71%. The short term evolution was favourable but in the medium term, many patients were lost or followed up irregularly. CONCLUSION: To improve the management and the prognosis of lupus nephritis in Senegal it is necessary to make patients with a systemic lupus erythematosus sensitive to it and to make systematically urine tests aiming the screening for an early diagnosis of lupus nephritis. In addition we should have aggressive policies in order to lower the costs of immunosuppressive therapy and haemodialysis.

[Senegalese case of thromboangeitis obliterans or Buerger's disease]. / Premiere observation Senegalaise de thromboangeite obliterante ou maladie de Buerger.

INTRODUCTION: Thromboangeitis obliterans (TAO) is an inflammatory, non atheromatous arteriopathy of smoking young adults. It is diagnosed on an association of non specific criteria that we discuss throughout this case. CASE REPORT AND DISCUSSION: A forty years old tabagical, Senegalese black man, had peripheral destructive lesions preceded by Raynaud phenomenon. He was admitted in our Internal Medicine department in November 2002. Actually this clinical presentation was evolving since 11 years. At that time, hypo aesthesia and ulceration of the fingers led to successive amputations in the leprology centre. The diagnosis of Hansen disease had been suspected but there were no evidence of mycobacterium. At the admission in our service, biological tests showed a moderated non-specific inflammatory syndrome. Ultra sound Doppler and arteriography showed a peripheral arterial stenosis without atheromatous lesions, in favour of TAO. To meet all the criteria the patient didn't have any thrombotic or systemic disease. The evolution was favourable after tobacco weaning. CONCLUSION: TAO can bring to difficulties of diagnosis by its way of presentation. Physicians should practice a systematic vascular screening in case of distal arteriopathy.

[An incomplete form of pachydermoperiostosis. Diagnosis of finger clubbing]. / Une forme incomplète de pachydermopériostose. Diagnostic d'un hippocratisme digital.

INTRODUCTION: The finger clubbing is most of the time associated with cardiovascular and pulmonary diseases. Pachydermoperiostosis also known as osteodermopathic syndrome, an hereditary disorder, is a rare cause of finger clubbing which might be difficult to diagnose in an incomplete form. EXEGESIS: We report a 36 years old black man presenting over many years polyarthralgias, broadening of fingers and clubbing of the fingers and toes extremities. This was mentioned on other family members. The physical examination was otherwise unremarkable. There were no skin thickening, no psoriasis-like and cardio-pulmonary disease features. These following exams were normal; Hemogram, fibrinogen, C reactive protein, rheumatoïd factor, serum calcium and phosphorus, thyroid hormones, growth hormone, chest X-ray, gastroduodenoscopy, electrocardiogram. The skeletal X-ray documented a widespread bone formation, a sacro-iliac osteosclerosis and interosseous ossifications betwen tibias and fibulas. CONCLUSION: Pachydermoperiostosis diagnosis was set up on 3 out of the 4 Borochowitz criteria. The absence of pachyderma defines this incomplete form. The osteoarticular manifestations lead mainly to differential diagnosis with the secondary hypertrophic osteoarthropathy and chronic inflammatory rheumatisms. The underlying pathogenic mechanism of this disease remains still unclear.

[Multicentric reticulohistiocytosis with a 20-year follow-up ]. / Evolution sur 20 ans d'une réticulohistiocytose multicentrique.

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.

[Treatment of rheumatoid polyarthritis with methotrexate in Dakar: efficacy, tolerance and cost]. / Traitement de la polyarthrite rhumatoïde par le méthotrexate à Dakar: efficacité, tolérance et coût.

Methotrexate (MTX), which has been used for years in cancer treatment, is now being proposed as a first-line treatment for rheumatoid arthritis (RA), despite its potential side effects. The aim of this study was to investigate the short-term efficacy, safety and relative cost of low-dose MTX for the treatment of RA. We carried out an open, nonrandomized trial in which patients received a 7 mg injection of MTX once per week, with clinical and biological follow up. A single physician performed the weekly assessments, which involved evaluation of the duration of morning stiffness, the number of night awakenings, the number of painful and swollen joints and Ritchie's index. Blood cell count and erythrocyte sedimentation rate were determined monthly. Twelve RA patients were enrolled in the trial, over a mean treatment period of 356 +/- 175 days. A significant improvement was observed in all variables except the number of swollen joints. Ritchie's index decreased from a mean of 31.8 +/- 11.85 to 6.5 +/- 8.98 (p<1.6 x 10- 4). Minor adverse reactions were observed but none indicated treatment withdrawal: 6 cases of nausea, 2 of a moderate increase in transaminase activity, 1 of bronchitis, in which the responsibility of MTX was not definitely established and 3 cases in which hemoglobin levels decreased. The monthly cost of the treatment, including the drug itself and laboratory tests, is lower than that of gold salt injection. Three issues of key importance in our region were investigated in this study: 1) the possible desire to become pregnant of female patients undergoing MTX treatment. In addition, some of the young and unmarried patients did not understand or appreciate the contraceptive effects of the treatment; 2) poor compliance with the treatment due to limited financial resources. Many patients did not regularly attend for their follow-up appointments and many stopped taking the medication. One third of the patients were lost to follow-up during this study; 3) the prevalence of chronic hepatitis, which may limit the use of MTX in our region. Serological tests should be performed before the treatment is started and a liver biopsy is recommended for patients with chronic hepatitis B or C.

[Etiologies of chronic renal insufficiency in a adult internal medicine service in Dakar]. / Etiologies des insuffisances rénales chroniques dans un service de Médecine Interne pour adulte à Dakar.

Chronic renal failure (CRF) sets public health problems both as its prevalence and its morbidity. The treatment is costly, that's why developing countries must engage in preventive strategies. In this view, a retrospective study was led in Le Dantec Hospital from January 1st, 1998 to December 31st 1993. As a preliminary to a countrywide survey, it is necessary to find out the causes of CRF clarify the causes of CRF in a hospital setting and sketch out a preventive strategy. The patients included in this study were those with CRF. The diagnosis of CRF were based on medical history data, anemia, but mainly biological and ultrasound imaging: creatininima more than 18 mg/l, and/or creatinine clearance less than 80 ml/mn, whose diagnosis was little sized kidney. Of the 5276 in patients, 384 had CRF representing 7% of sample. Only 261 cases were retained broken down into 119 females and 142 males (sex-ratio: 1.19). Age span ranges from 15 to 88 years with a mean of 44 years. Etiologies were dominated by unknown causes, 89 cases (34.23%). Nephroangiosclerosis was the most common known cause, 65 cases (25%) followed by diabetes nephropathy with 54 cases (20.69%) and chronic glomerulonephretic representing 41 cases (15.76%). Other causes were identified in various proportions: cortical necrosis (4 casesà, hereditary nephropathies (2 cases), interstitial nephropathy (1 case), nephroponophteois, kidney polykystosis, prostate adenoma and bilharziosis were all found in one case each. This study pointed out to a need for a nation-wide survey to define the aetiologies of CRF. The study also showed that an early diagnosis and adequate treatment of high blood pressure, diabetes and GNC should certainly constitute the principal axes of investigation for prevention.

[Secondary hyperparathyroidism of chronic hemodialysis]. / Hyperparathyroïdie secondaire chez les hémodialyses chroniques a Dakar.

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.

[Autosomal dominant polycystosis in the hospital milieu in Dakar (Senegal)]. / La polykystose autosomique dominante en milieu hospitalier à Dakar (Sénégal).

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.

[First case of primary IgA glomerulonephritis (Berger's disease) in Senegal]. / Premier cas de glomérulonéphrite primitive a IgA (Maladie de Berger) au Sénégal.

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.

[Nasal carriage of Staphylococcus aureus at a hemodialysis unit in Dakar]. / Etude du portage nasal de Staphylococcus aureus dans une Unité d'Hémodialyse à Dakar.

Infectious diseases are the most common complications of the hemodialysis unit patients. Staphylococcus aureus (SA) is the main cause and is supposed to be lodged in the nostrils. The purpose of this study is to assess the importance of the SA presence in the patients and the medical staff nostrils in a senegaleese hemodialysis unit. In this regard, we performed a six-month prospective study on 12 patients on going hemodialysis (11 males and 1 female) and 7 medical agents (4 nurses, 2 physicians, and 1 nurse assistant). On patients we reported the initial nephropathy, the problems of vascular access, the infectious episodes prior to the study, and the duration of dialysis. Three sample series of nostril swabbing were carried out on patients and medical staff at a rate of one series every other month. Blood culture was systematically carried out on patients, with body temperature higher than 38 degrees C, every two months and. Sensibility to several antibiotics was tested for each stain. We found six cases of clinical nephroangiosclerosis, one Wegener granuloma and five unknown causes. All patients had Brescia Cimino arteriovenous fistula vascular and the mean time underdialysis was 36 months (from 7 to 55). Bacteriologically, 124 nostril specimens were performed, 80 on patients, 44 on medical staff. SA was isolated in 64 specimens (52 %) on patients and 34 specimens (24.4 %) on staff. Strains from forty five patients (70.32 %) were sensitive to methicillin versus 23 stains from staff ( 67.6 %). The difference was not statistically significant. Sensibility profil for other antibiotics was the same for patients and staff. All blood culture were negative. Despite nostril carriage noted on patients and staff, there were no infections during this period. However, the presence of permanent infection sites make it mandatory to be on the alert in order to control some of the behavioral changes of the germs, and to put into place an adequate prevention system.

[Description of a case of Cacchi Ricci disease associated with hyperparathyroidism in the setting of multiple endocrine disease]. / Description d'un cas de maladie de Cacchi Ricci associée àune hyperparathyroidie dans le cadre d'une polyendocrinopathie multiple.

The authors present a case of a 36 years old woman applied to them for a follow up of sponge kidney disease and in whom they discovered a primary hyperparathyroidism. Further investigations discovered a medullary thyroid carcinoma. So this patient present multiple endocrine neoplasia (MEN) type 2A confirmed by microscopic and genetic analysis. This observation enlarged the discussion upon the nature of the relationship between kidney disease and primary hyperparathyroidism. Elsewhere it recommended to check systematically genetic markers of MEN type 2A if there is an association with sponge kidney disease and primary hyperparathyroidism.

[Evaluation of acute renal insufficiency in Dakar]. / Evaluation du traitement de l'insuffisance rénale aiguë à 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.

[Analysis of 115 kidney biopsies performed in Dakar (Senegal)]. / Analyse de 115 biopsies rénales réalisées à Dakar (Sénégal).

Few data are now avalable concerning renal pathology in black African. That is why we under took this study as a contribution to the better knowlege of pathological aspects of kidney disease in Dakar by analysing our 6 years's experience. It was a retrospective study concerning all the patients who underwent renal biopsyfrom January 1993 to December 1998. The samples were studied on light microscopy and immunoflorescence at the nephrology unit of Necker Hospital in Paris. We performed 115 renal biopsies during this period conceming 64 males and 51 females from 5 to 60 years old (mean age 28 years). Nephrotic syndrome represented 67% of the indications, followed by lupus nephritis (13%). We found primary glomerulonephritis in 75% of all cases. Anatomicaly, 54 cases of focal and segmental hyalinosis were found (47% of all biopsies). The other lesions were extra-membranous glomerulonephritis (8,6%), minimal change glomerulonephritis 6%, endo and extra-capillary glomerulonephritis 2,6%, Mesangial glomerulonephrits, extra-capillary glomerunephrotis, IgA nephropaty represented each 1,7%. In 5% of cases the lesions did not permit a precise classification. Focal and segmental hyalinosis is the main primary lesion and lupus nephritis the main secondary one in kidney deseases biopsied in Dakar.

Encapsulating peritoneal sclerosis.

Encapsulating peritoneal sclerosis (EPS) is a rare but potentially lethal complication of peritoneal dialysis (PD). Peritoneal tuberculosis is considered an etiologic factor. We report a case of EPS in a 40-year-old man who was switched to hemodialysis because of peritoneal tuberculosis after 2 years of PD. Because of the persistence of gastrointestinal symptoms and cachexia, laparoscopic exploration was performed, which revealed an important thickening of the peritoneal membrane sheathing the intestinal loops. Accordingly, a diagnosis of EPS was made. Anti-tuberculosis treatment associated with a low dose of corticosteroids stabilized the disease.

[Lupus nephropathy in black patients with systemic lupus erythematosus in Senegal: 43 cases]. / Néphropathie lupique chez les sujets génétiquement pigmentés vivant au Sénégal : à propos de quarante-trois cas.

UNLABELLED: This study sought to assess the prevalence of lupus nephropathy and to determine its clinical, histological, therapeutic and outcome profiles. PATIENTS AND METHODS: This retrospective study examined records covering a 10-year period from 1999 to 2009 at the nephrology department of the Aristide Le Dantec University Hospital Center. RESULTS: The records showed 43 patients with systemic lupus erythematosus (SLE), and 72% had lupus nephritis. The patients' mean age was 32.9 years; 40 were women and 3 men, for a sex ratio of 0.075. The lupus nephritis led to discovery of SLE in 27.9%. The mean proteinuria concentration was 2.01 g/dL. Seventeen patients had impaired renal function, and 26 had renal biopsies. It found class II nephritis in 2 patients, class IV in 10, and class V in 12. In addition, fifteen patients received combined corticosteroid + immunosuppressant treatment. Four patients died during the study period, one from SLE activity, two from complications of renal failure, and the fourth from sepsis. CONCLUSION: A larger study would be useful to assess more acurately the prevalence of various classes and severity of lupus nephropathy among blacks living in sub-Saharan Africa.

[Quality of life in hemodialysis patients in Dakar: differences for the tropics?]. / Qualité de vie des patients en hémodialyse à Dakar (Sénégal): quelles particularités pour les personnes vivant en milieu tropical ?

UNLABELLED: In recent years, measuring quality of life (QoL) to quantify the impact of disease on patients' lives has become widespread. We conducted a study to evaluate the QoL of hemodialysis patients in Dakar and to identify factors that influence it. PATIENTS AND METHODS: This cross-sectional study took place from May through July 2008 in two hemodialysis centers in the city of Dakar. It included all patients who had been undergoing dialysis for more than 3 months, were in stable clinical condition with no hospitalization in the previous month and consented to participate. QoL was assessed with the Kidney Disease Quality Of Life Short-Form version 1.2 (KDQoL-SF), which comprises 43 items specific to kidney disease as well as the 36 items of the SF-36. RESULTS: Our study included 60 patients. Their mean age was 50.5 years, and the male/female sex ratio was 0.9. The global mean score (for the SF-36 was 45.7 ± 25.5, 41 ± 24.4 for the physical dimension and 53.6 ± 27.3 for the mental health dimension. The mean global KDQoL score was 55.2 ± 24.0, 44.8 ± 26.1 for the physical dimension, and 54.8 ± 24.4 for the mental health dimension, 60.8 ± 21.3 for the specific dimension of dialysis and 78.4 ± 22.3 for patient satisfaction. The study shows that the QoL of 90% of our patients was impaired by their kidney disease. CONCLUSION: Studies that focus on QoL of dialysis patients are rare in Africa. This one showed an impaired QoL, especially for physical health, among our hemodialysis patients.

Schistosoma hematobium-associated glomerulopathy.

Schistosomiasis is the second most devastating tropical parasitic disease worldwide and is responsible for many urological complications. However, glomerular injury is a rare complication mainly described with Schistosoma mansoni. We report a case of membranoproliferative glomerulonephritis (MPGN) associated with Schistosoma hematobium infection in a young Senegalese boy living in a rural area. Clinical presentation was with steroid-resistant with nephrotic syndrome. Renal biopsy showed type 1 MPGN with the presence of S. hematobium eggs surrounded by a gigantocellular granuloma. Despite therapy with antihelminthic and immunosuppressive drugs, evolution was characterized by progression to end-stage renal disease over 1 year. More efforts should be made on the prevention and early detection of schistosomiasis among at-risk populations.