[Seroprevalence of HBsAgs in patients with rheumatoid arthiritis in a hospital setting in Senegal]. / Séroprévalence de l'antigène HBs au cours de la polyarthrite rhumatoïde en milieu hospitalier Sénégalais.

PURPOSE: Rheumatoid arthritis is the most common chronic inflammatory joint disease in adults. In Senegal, where biotherapy is unavailable, treatment of RA relies on a combination of glucocorticoids and disease-modifying antirheumatic drugs (DMARD). Since DMARD, particularly methotrexate, induce hepatotoxicity pretreatment assays of serum transaminase and albumin levels, as well as serological tests for the hepatitis B and C viruses is recommended. Hepatitis B virus (HBV) infection is endemic in Africa, particularly in Senegal. The purpose of this study was to assess the seroprevalence of the HBV surface antigen (HBsAg) for HBV in 258 patients with RA in Senegal as a basis for defining the least hepatotoxic DMARD for these patients and ensuring the most suitable monitoring. METHOD: This retrospective study was based on a review of the medical records of patients examined between January 2005 and December 2009 at the rheumatology outpatient clinic of the Aristide Le Dantec Teaching Hospital in Dakar, Senegal. All patients met the American College of Rheumatology criteria for RA. RESULTS: A total of 258 patients were tested for HBsAg. Tests were positive in 6 for a seroprevalence of 2.3%. All 6 positive patients were women with a mean age of 48.7 years (range, 16-79 years). Transaminase levels were normal in 5 patients. In the remaining patient, ASAT level elevation were twice normal and ALAT was normal. No patients had clinical evidence of liver disease. CONCLUSION: HBsAg seroprevalence in our population of patients with RA was lower than in the general population of Senegal: 2.3% versus 15%-18%. No evidence indicated that HBVinfection produced specific features in patients with RA. Based on these findings, widespread use of methotrexate in optimal dosages appears safe in patients with RA in Senegal. Treatment should be accompanied by careful attention to HBV prevention.

[Systemic vasculitis: study of 27 cases in Senegal]. / Vascularites systémiques: 27 observations au Sénégal.

Studies on vasculitis in black Africa are rare. The purpose of this report is to describe a retrospective study of systemic vasculitis managed in the internal medicine, ORL and cardiolology departments of the Aristide le Dantec University Hospital in Dakar, Senegal from 1995 to 2007. A series of 27 cases involving 7 men and 20 women with a mean age of 49 years was compiled. Primary vasculitis included Horton disease in 3 cases, Wegener disease in 2, Takayasu disease in 1, and Buerger disease in 1. Secondary vasculitis included mixed cryoglobulinemia with Gougerot Sjögren syndrome in 7 cases, primary Goujeröt syndrome in 4, rheumatoid arthritis in 3, nodosa periarteritis with hepatitis B in 2, SHARP syndrome in 1, and polymyositis in 1. The remaining two cases involved abdominal periaortitis including one associated with retrosperitoneal fibrosis and tuberculosis and the other with spondylarthropathy. Corticotherapy in combination with anticoagulants, immunosuppressive therapy, and surgery, when necessary, allowed effective management in 24 cases. The findings of this study show that systemic vasculitis can have numerous etiologies and indicate that secondary forms are the most common. Appropriate care modalities are needed to prevent severe outcome in Senegalese hospitals.

Massilistercora timonensis gen. nov., sp. nov., a new bacterium isolated from the human microbiota.

Massilistercora timonensis gen. nov., sp. nov. strain Marseille-P3756T is a new species of the phylum Firmicutes; it was isolated from the human gut microbiota and has a genome of 2 769 591 bp (51.2% G + C). The closest species based on 16S rRNA sequence was Merdimonas faecis strain BR31 with 95.2 % sequence similarity. Considering phenotypic features and comparative genome studies, we proposed the strain Marseille-P3756T as the type strain of Massilistercora timonensis sp. nov., a new species within the genus Massilistercora.

Description of Clostridium cagae sp. nov., Clostridium rectalis sp. nov. and Hathewaya massiliensis sp. nov., new anaerobic bacteria isolated from human stool samples.

Using culturomics methods, three strains were isolated, identified and characterized following the taxonogenomics concept. Clostridium cagae strain Marseille-P4344T (=CSURP4344), Clostridium rectalis strain Marseille-P4200T (=CSURP4200) and Hathewaya massiliensis strain Marseille-P3545T (=CSURP3545) were isolated from human stool samples. The phylogenetic reconstruction, phenotypic criteria and genomic analyses were carried out and demonstrated that these three bacteria are different from previously known bacterial species with standing in nomenclature and were classified as new members of the Clostridiaceae family.

[Tuberculosis and systemic diseases: study of 8 Senegalese cases]. / Tuberculose et maladies systémiques: Etude de 8 cas sénégalais.

PATIENTS AND METHODS: A retrospective study (2000-2007) of the tuberculosis observations during systemic diseases was conducted in the service of Internal Medicine of hospital Aristide Le Dantec of Dakar. RESULTS: 8 (4 men and 4 women) has been received. The mean age was 54.5 years. The localization of tuberculosis was lung (n=8) with pleurisy (n=2), ganglionic (n=1), vertebral (n=1) and an abscess of the psoas (n=1). The diagnosis of tuberculosis had been carried with the bacteriological analysis of the expectorations (n=7), the histology (n=1). The systemic diseases was: rheumatoid arthritis and Sjögren's syndrome (n=3), primary Sjögren's syndrome (n=4), autoimmune thrombopenia (n=1). The diagnosis of systemic diseases was previous to that of tuberculosis in 7 cases and concomitant in 1 cases. Under chemotherapy and corticosteroid therapy, the evolution was favorable in 6 patients. CONCLUSION: our study confirms the frequently character spread by the tuberculosis in patients affected by systemic diseases. This association enhances diagnostic and therapeutic problems.

[Contribution of coloscopy to diagnosis of rectal bleeding in Dakar (Senegal)]. / Apport de la coloscopie dans le diagnostic des rectorragies à Dakar (Sénégal).

INTRODUCTION: Rectal bleeding is a common reason for seeking medical attention and can lead to diagnosis of serious disease. The purpose of this report is to describe lesions discovered by coloscopy in patients assessed for rectal bleeding in Dakar, Senegal. PATIENTS AND METHODS: This retrospective study was carried out from January 2006 to December 2008 at the Aristide Le Dantec University Medical Center in Dakar. Coloscopy reports involving patients presenting with rectal bleeding were compiled. Age, quality of preparation, use of sedation, and lesions observed were analyzed. RESULTS: A total of 143 patients underwent coloscopy for rectal bleeding. Mean patient age was 51.3 years (range, 2 to 85 years) and the sex ratio was 1.7 (90 men). Preparation was considered as good in 55.5% of cases. Sedatives were used in 57% of cases. Coloscopy findings were normal in 9.8% of cases. The most common lesions were hemorrhoids (53.14%), rectocolitis (17.5%), cancer (11.9%), polyps (11.2%), and diverticulosis (11.2%). Multiple lesions were found in 20 patients (14%). CONCLUSION: Coloscopy for assessment of rectal bleeding in Dakar revealed a range of lesions with hemorrhoids and rectocolitis accounting for most.

Massilicoli timonensis sp. nov., a new bacterium isolated from the human microbiota.

Massilicoli timonensis sp. nov., strain Marseille-P3755T (= CSUR P3755 = DSM 103513) is a new bacterial species from the phylum Firmicutes and the family Clostridiales which was isolated from the human gut microbiota.

Corynebacterium pacaense sp. nov., Alistipes megaguti sp. nov., Alistipes provencensis sp. nov., 3 new bacteria isolated from fresh human stool specimens.

Here we describe the basic characteristics of Corynebacterium pacaense strain Marseille-P2417T (= CSUR P2417), Alistipes megaguti strain Marseille-P5997T (= CSUR P5997) and Alistipes provencensis strain Marseille-P2431T (= CSUR P2431 = DSM 102308). The phenotypic criteria, the 16S ribosomal RNA sequencing and MALDI-TOF MS spectra analysis were used to identify and characterize these new bacteria species, which were isolated from fresh human stool specimens.

Massilimicrobiota timonensis gen. nov., sp. nov., a new bacterium isolated from the human gut microbiota.

Massilimicrobiota timonensis gen. nov., sp. nov. strain Marseille-P2264 is a new species from Firmicutes phylum isolated from the human gut. Its genome was 2,849,574 bp-long with a 31.8% G+C content. The closest species based on 16S rRNA sequence was Longibaculum muris with 95.6% sequence similarity. Considering phenotypic features, 16S rRNA sequence and comparative genome studies, we proposed Marseille-P2264 as the type strain of Massilimicrobiota timonensis gen. nov., sp. nov.

Corynebacterium urinapleomorphum sp. nov., a new bacterial species isolated from human urine sample.

Corynebacterium urinapleomorphum sp. nov. stain Marseille-P2799T (= CSURP2799; = DSM103272) is a new species from the order Corynebacteriales that was isolated from urine of a 2-month-old child with gastroenteritis.

Corynebacterium bouchesdurhonense sp. nov., and Corynebacterium provencense sp. nov., two new species isolated from obese patients.

Corynebacterium bouchesdurhonense sp. nov. strain Marseille-P2067T (= CSURP2067; = DSM100846) and Corynebacterium provencense sp. nov. strain Marseille-P2161T (= CSURP2161; = DSM101074) are two new species from the order Corynebacteriales that were isolated from obese French individuals.

Genome sequence and description of Bacteroides bouchesdurhonensis sp. nov., a new anaerobic bacterium isolated from the human gut.

Bacteroides bouchesdurhonensis sp. nov., strain Marseille-P2653T (= CSUR; P2653=DSM103120) is a new bacterial species belonging to the Firmicutes phylum in the family Bacteroidaceae that was isolated from the human gut microbiota.

Olsenella timonensis sp. nov., a new bacteria species isolated from the human gut microbiota.

Olsenella timonensis sp. nov., strain Marseille-P2300T (= CSUR P2300; =DSM102072), is a new bacterial species from the phylum Firmicutes in the family Atopobiaceae.This bacteria species was isolated from the human gut microbiota.

Macrophage activation syndrome, a rare complication of primary Sjögren's syndrome: a case report.

BACKGROUND: The association of macrophage activation syndrome and primary Sjögren's syndrome has been rarely reported in the literature. We report the first observation of this association in Africa, south of the Sahara, and we discuss the diagnosis and therapeutic challenge. CASE PRESENTATION: A 26-year-old Mauritanian and Berber woman was followed for primary Sjögren's syndrome. After a voluntary cessation of her usual background treatment, she was admitted to our department for an outbreak of her illness. A clinical examination revealed anemic syndrome, peripheral polyarthritis, coughing rales at both pulmonary bases, and fever at 39.5 °C. On biologic examination, there was bicytopenia with anemia at 5.70 g/dl, lymphopenia at 796/mm3, a biological inflammatory syndrome with a sedimentation rate at 137 mm in the first hour, C-reactive protein at 97 mg/l, hyperferritinemia at 1778 mg/l (9 normal value), and hypergammaglobulinemia at 20.7 g/l of polyclonal appearance. The triglycerides were 1.95 g/l (1.4 normal value) and the lactate dehydrogenase level was 491 IU/l (1.5 normal value). Cytological examination of a medullary puncture revealed an image of hemophagocytosis. An infectious screening was negative. Thoracic computed tomography showed non-specific interstitial lung disease. A diagnosis of macrophage activation syndrome complicating primary Sjögren's syndrome was selected with a probability of 97.2%, according to H-Score. The evolution was favorable under a treatment including etoposide (VP-16). CONCLUSION: Macrophage activation syndrome is a rare entity, rarely reported during primary Sjögren's syndrome. Its spontaneous evolution is invariably fatal. There is no consensus on therapeutic treatment. Etoposide is a therapeutic option especially in forms refractory to corticosteroid therapy.

[Destombes Rosaï Dorfman syndrome: description of one case and diagnostic challenges in the tropical setting]. / Syndrome de Rosaï Dorfman Destombes à propos d'une observation: difficultés diagnostiques en milieu tropical.

Destombes Rosaï Dorfman (DRD) syndrome is form of nonlangerhans cell sinus histiocytosis. The main symptoms are cervical adenopathy, fever and fluctuating hepatosplenomegaly. It can be confused with ganglionary tuberculosis especially in our region where tuberculosis is common. This report describes a case of Destombes Rosaï Dorfman syndrome in a 40-year-old woman from Senegal. The main presenting symptom was the presence of massive tumour-like lesions on the neck with altered general condition and fever. Based on these clinical findings, ganglionary tuberculosis was suspected and presumptive treatment was initiated in the local hospital. However further workup failed to confirm the diagnosis and the patient was transferred to the Internal Medicine Department. Clinical examination in our service revealed the presence of extensive adenopathy in the supraclavicular, axillary, and inguinal regions. Laboratory tests demonstrated a nonspecific inflammatory syndrome. Abdominal ultrasonography depicted extensive mesenteric and para-aortic adenopathy. Chest x-ray showed bilateral and asymmetric mediastinal adenopathy. Medullogram findings were normal. Histology confirmed DRD syndrome. DRD syndrome is rare disease of unknown aetiology. In tropical areas differential diagnosis with ganglionary tuberculosis, lymphoma, and reactive hemophagocytic syndrome can be challenging. Lymph node biopsy should be performed in all patients presenting fever and polyadenopathy.

[Etiologic profile of cervical adenopathology observed in an internal medicine department in Dakar, Senegal. A 66 case series]. / Profil étiologique des adénopathies cervicales en médecine interne: étude de 66 observations à Dakar (Sénégal).

Cervical adenopathy is a frequent reason for hospitalization in the internal medicine department. This finding can be a sign of severe disorder requiring early diagnosis. The purpose of this retrospective study was to describe clinical features and evaluate diagnostic tests especially lymph node biopsy associated with evaluation of patients presenting cervical adenopathies in an internal medicine department in Senegal. Records of a total of 8610 patients treated in the Internal Medicine Department of the Aristide Le Dantec Hospital of Dakar, Senegal over a 68-month period from January 1, 2000 to August 20, 2006 were reviewed. Sixty-six files were included for study. A structured questionnaire was used to collect sociodemographic, clinical and paraclinic data. There were 37 men and 29 women. Average patient age was 34 years (range, 15 to 73 years). The side of the neck was the most frequent location of adenopathy followed by the pericervical arterial circle and anterior cervical area. Thirty-six patients presented superficial adenopathy in other locations including the armpit (39%), groin (32%) and elbow (1.5%). The etiologies underlying cervical adenopathy included classic causes such as tuberculosis that is the main cause in tropical regions and lymphoma that frequently led to macroadenopathy as well as novel causes such as Rosaï Dorfman Destombes syndrome.

[Frequency of hematological and immunological manifestations of lupus in Dakar]. / Frequence des manifestations hematologiques et immunilogiques de la maladie lipique a Dakar.

INTRODUCTION: The systemic erythematosus lupus (SEL) or lupic disease is a systemic auto-immun pathology characterized primarily by the presence of antibodies directed against native antibodies anti-DNA. The discovery circumstances of diagnosis are variable and polymorphic. The hematologic signs and the immunological disorders constitute the diagnosis criteria of the lupic disease. METHODOLOGY: It is a multicentric and retrospective study undertaken study from January 1, 1997 to September 30, 2006. Patients were followed up in the Internal Medicine of Dakar. We have studied the hematological and immunological aspects of the SEL and have evaluated the prevalence of lupic disease. RESULTS: 142 patients with lupic disease were included with 125 women and 17 men; the ratio--sex was 0.13. The mean age was 34 years with extremes of 6 and 72 years. Our patients had hematological and immunological manifestations in 32.4% and 76.8% of the cases. The immunological tests showed the presence of antinuclear antibodies in 97.9% of the cases, native antibody anti-DNA in 45.7% of the cases, the anti-ECT in 8.95% (with the anti-RNP in 78.3 % of the cases, anti-Sm in 56.5% and of anti-SSA in 87% of the cases). Antibodies anti-DNAand anti-ECT were associated the hematologic demonstrations respectively in 92% and 95% of the cases (p 0.08). CONCLUSION: The hematologic and immunoligical signs of lupus disease are frequent and constitute diagnostic criteria of the disease.

[Autoimmune cholangitis or seronegative biliary cirrhosis: report of one case]. / Cholangite auto-immune ou cirrhose biliaire séronégative: une observation chez un homme.

INTRODUCTION: Auto-immune cholangitis appears by a table of cholestatic jaundice without anomalies of the hepatic bile ducts. It is a primitive biliary cirrhosis without antimitochondrial antibodies. This disease is reported at adult women in 90 % of cases. We report a 59 years old man case. OBSERVATION: The patient was admitted for a diffuse melanodermy, a physical asthenia and a slimming which preceded 4 months by a pruritus with cholestatic jaundice. Biology showed a normal rate of transaminase. Alkaline phosphatases and direct bilirubine were high. Hepatitis (B and C) and HIV serologies were negative. Abdominal ultrasound showed a homogeneous liver. There were no dilations of the bile ducts. Antimitochondrial antibodies were negative and the histological examination confirms diagnosis. CONCLUSION: Progress was good with ursodesoxycholic acid even if interval is short (5 months of evolution).

Gorillibacterium timonense sp. nov. and Vitreoscilla massiliensis sp. nov., two new bacterial species isolated from stool specimens of obese Amazonian patients.

We report the main characteristics of Gorillibacterium timonense strain SN4T sp. nov. and Vitreoscilla massiliensis strain SN6T sp. nov., two new bacterial species isolated from stool specimens of obese Amazonian patients.

'Cellulomonas timonensis' sp. nov., taxonogenomics description of a new bacterial species isolated from human gut.

'Cellulomonas timonensis' sp. nov. strain sn7T is a new species within the Cellulomonas genus. We present the main phenotypic characteristics and provide a complete annotation of its genome sequence. This facultative anaerobic bacterium, isolated from the stool of 38-year-old obese Frenchman, is Gram-positive, has motile rods and is sporulating. The genome is 4 057 828 bp long with 72.42% G + C content. Of the 3732 predicted genes, 3667 were protein-coding genes and 65 were RNAs.