[Prevalence of albuminuria in sickle cell disease patients at the Campus university hospital of Lome, Togo]. / Prévalence de l'albuminurie chez les drépanocytaires au Centre hospitalier universitaire Campus de Lomé au Togo.

OBJECTIVES: The objective of this study was to assess the prevalence of albuminuria in sickle cell disease patients at the Campus University Hospital of Lome. PATIENTS AND METHOD: Albuminuria was assessed by the urinary albumin-to-creatinine ratio (UACR) in sickle cell disease individuals who attended the outpatient consultation in their steady state. RESULTS: The prevalence of albuminuria was 21% (14/67). Albuminuria was more frequent (32% vs 13%, p=0,054) and occurred earlier (6 years vs 21 years) among the 28 SS/Sß0-thalassemia sickle-cell diseases individuals than the 39 SC ones. Albuminuria was associated with high counts of leukocytes (p=0.033) and neutrophils (p=0.008). It was negatively correlated with hemoglobin level (p=0.032) and positively with LDH (p=0.002), SGOT (p=0.002), leukocytes (p=0.003), neutrophils (p< 0.001) and thrombocytes (p=0.010) counts for all sickle cell patients without statistical confirmation for each sickle cell phenotype apart from neutrophils in SS/Sß0-thalassemia. Defining albuminuria as an UACR greater than 20 mg/g had a specificity of 100% and a sensibility and 90% when the UACR was compared to the 24-hours urines albumin quantification. CONCLUSION: The assessment of albuminuria should begin at age 5 years in SS/Sß0-thalassemia sickle-cell anemia patients and from 20 years old in SC patients by the UACR.

[Types of bcr-abl and their correlations with the blood count in chronic myeloid leukemia (CML) in Togo]. / Les transcrits bcr-abl et leurs corrélations avec l'hémogramme au cours de la leucémie myéloïde chronique (LMC) au Togo.

This study aims to describe the different bcr-abl gene transcript variants in order to determine their frequency and to study their influence on CBC diagnostic test. We conducted a cross-sectional study of 34 patients with chronic myeloid leukemia in Togo. The search for fusion transcripts was performed in the laboratory of biological haematology at the Henri Mondor Hospital, Créteil (France). The average age of patients was 42,32±14,87 years ranging between 9 and 65 years. Most patients were male, with a sex- ratio of 1.61 (21 men and 13 women). Molecular examination showed b3-a2 transcript and b2-a2 transcript. Nineteen patients (55.88%) expressed b3-a2 transcript, 13 patients (38.24%) b2-a2 transcript (32.10%) and two patients expressed both b3-a2 and b2-a2 transcripts (5.88%). At diagnosis, mean hemoglobin level, the average number of white blood cells and the average number of platelets in patients expressing b3-a2 transcript were 99,2g/L; 207,63g/l and 451,28g/l respectively. In patients expressing b2-a2 transcript values were 104,6g/l, 114,32g/l and 486,11g/l. In patients with both transcripts, values were 67g/L, 867g/l and 780g/l respectively. CBC parameters are more significantly altered in patients with both transcripts b3-a2 and b2-a2.

[Myeloproliferative disorders "Philadelphia negative" and JAK2V617F mutation: study of 15 cases in Togo]. / Syndromes myéloprolifératifs « Philadelphie négatif ¼ et mutation JAK2V617F : étude des 15 premiers cas ayant bénéficié de cette recherche au Togo.

The goal of our study is to document the prevalence of change JAK2V617F among patients reached of myeloproliferative syndromes (MPS) in Togo in order to evaluate frequencies. This descriptive study included 15 patients followed with the CHU Campus for a SMP. The research of JAK2 change by PCR was carried out with the APHP Henri Mondor of Creteil (France). During the study period, 15 patients followed for MPS (9 cases of polycythemia Vera, 5 cases of essential thrombocytemia and a case of primitive myelofibrosis) profited from the research of JAK2 change. The Middle age of the patients was respectively of 45±18 years; of 55±6 years for the PV and the essential thrombocytemia. The patient followed for primitive myelofibrosis was 72 years old. Sex-ratio (H/F) was of 2. JAK2 Change was positive in 5 cases out of 9 (55.5%) of the polycythemia Vera, at 3 patients out of 5 (60%) followed for essential thrombocytemia but negative for patient reached of primitive myelofibrosis. In conclusion, JAK2 Change has an interest diagnosis and forecast in the MPS negative Chromosom Philadelphia and can be systematic even in Africa Sub-saharian.

Clonal hypereosinophilic syndrome: two cases report in black men from sub-saharan Africa and literature reviews.

The first case is about a man of 60 years old suffering of hypereosinophilic syndrome (HES) developed since 1998. He presented chronic cough, insomnia, and negative parasitical test. We observed hypereosinophilia and fibroblastic hyperplasia at the bone marrow biopsy. Initially, hydroxyurea and α-interferon treatment failed. We proposed to him imatinib mesylate in May 2003. The FIP1L1-PDGFRA gene was detected. The second case is about a man of 34 years old seen in March 2002. First investigation concluded to CML. Progressively, eosinophil cells increased, and complications occurred as oedema syndrome, dyspnoea, and parietal chronic endocarditic fibrosis associated with pericarditis. In addition, a bowel obstruction happened and was cured by surgery. Bcr-abl fusion was negative, and FIP1L1-PDGFRA gene was detected after and imatinib mesylate was given. Actually, endocarditic fibrosis decreased. The two patients are in haematological and cytogenetic remission. We concluded that clonal HES is present in Africa, and imatinib mesylate is effective.

Hematological reference values for healthy adults in togo.

The hematological reference values are very important for diagnostic orientation and treatment decision. The aim of this study was to establish hematological reference values for healthy adults in Togo. A total of 2571 voluntary blood donors participated to this study. Only 1349 subjects negative for HIV, HBV, HCV, malaria, and without hemoglobin abnormalities in electrophoresis and hypochromia on blood smear, were definitively retained for the study. Median hemoglobin level was higher in males than females (15.1 g/dL versus 13.0 g/dL, p = 0.000). Median total WBC (4.2×10(9)/L) and absolute neutrophil counts (1.6×10(9)/L) were similar by gender. The median lymphocyte counts in males and females were, respectively, 2.1×10(9)/L and 2.2×10(9)/L (p = 0.11). The median platelet count was lower in males than females (236×10(9)/L versus 247×10(9)/L, p = 0.004). Our median values for RBC parameters differ from those of African countries probably because of our inclusion criteria which eliminate most cases with iron deficiency and/or thalassemia.