Co-existing autosomal dominant polycystic kidney disease and nephrotic syndrome in a Nigerian patient with lupus nephritis.

A little over 30 cases on co-existing nephrotic syndrome and autosomal dominant polycystic kidney disease (ADPKD) have been reported from different regions of the world since 1957. We present a case report on co-existence of nephrotic syndrome (secondary to lupus nephritis) with ADPKD in a 24-year-old woman from Nigeria. She was positive for anti-double stranded DNA. Renal histology showed International Society of Nephrology/Renal Pathology Society Class II lupus nephritis. The co-existence of nephrotic syndrome and ADPKD may have been overlooked in Africa in the past. There is a need to screen for nephrotic syndrome in patients with ADPKD among clinicians in the African setting.

Testicular schistosomiasis: a case report.

AIMS AND OBJECTIVES: To report a case of testicular Schistosomiasis with a suspicion of testicular cancer. PATIENT AND METHODS: Hospital record of a 16 year old patient with histopathology confirmation of testicular Schistosomiasis was reviewed and summarised. The patient who had painless testicular nodules and ultrasound features of heterogenous echotexture and hypoechoic focus was diagnosed as testicular cancer and treated with radical orchidectomy. Histopathology confirmed testicular Schistosomiasis and the patient had additional praziquantel therapy. RESULTS: Patient was followed up for over 26months post-operative. CONCLUSIONS: Testicular Schistosomiasis can mimick malignant testicular tumour. Hard nodular testicular mass in a patient with recent past history of schistosomiasis should arouse suspicion of testicular Schistosomiasis. Awareness and early presentation will prevent unwarranted orchidectomy.

Testicular and para-testicular tumors in south western Nigeria.

BACKGROUND: Tumors of the testis and paratesticular tissues are rare, especially in men of African descent. In recent reviews however, the incidence is rising among the Caucasians and black Americans. We set out to determine the incidence in South-Western Nigeria and to examine the histopathologic variants. METHODS: A retrospective study of patients who had histopathologically confirmed testicular and para-testicular tumours between 1989 and 2005 (17 years). Their records were documented at the Ife-Ijesha cancer registry which serves 4.7 million men residing in three states of South-Western Nigeria. RESULTS: There were 26 cases of testicular and para-testicular tumors with an average incidence of 1.5 cases per year. The incidence of testicular cancer in our study was 0.55 per 100,000 population (95% CI, 0.52-0.57) and accounted for 1.1% of all male cancers. Rhabdomyosarcomas were the most common variety (70% of the paratesticular tumors and 26.8% of all tumors of the testis). Seminomas comprised 50% of the germ cell tumors and 15.4% of all testicular tumors in this series. CONCLUSION: There still remains a low incidence of testis cancer in the South Western Nigeria. The reduction in the incidence of seminomas makes rhabdomyosarcomas the most predominant tumor in South Western Nigeria.

Pattern of death in a Nigerian teaching hospital; 3-decade analysis.

BACKGROUND: In developing countries such as Nigeria, limited resources require that health priorities be selected wisely and death-related research is clearly warranted. The aim of this study is to provide a comprehensive report on the various causes of death in our center from 1978 to 2006. METHODS: This was a descriptive, retrospective study of all deaths recorded at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile - Ife, Osun State in Southwest Nigeria from 1978 to 2006. RESULT: A total number of 9,947 deaths were recorded during the study period and there were 6,277 male deaths (63.1%) and 3,670 female deaths (36.9%) with a female to male ratio of 1:1.5. The age ranged from birth to 100 years with a median of 25 years. Infection (2,594 patients; 26.1%) was the most common cause of death and this was followed closely by trauma death (2,028 patients; 20.4%) and neonatal death (1,074 patients; 10.8%). Death from infectious disease and trauma reduced from 1,048 and 1,441 in the first decade (1977 - 1986) to 478 and 133 in the last decade respectively. While death from neoplasia increased from 112 in the first decade to 354 in the last decade of the study period. CONCLUSION: Our study shows that death from infectious disease in the present decade has reduced to almost half that was recorded in first decade. Similarly death from trauma has also reduced compared to the first decade of the study. Death from neoplasia is however higher in the last decade.

Clinicopathological review of schistosomal appendicitis in south western Nigeria.

BACKGROUND: Gastrointestinal schistosomiasis may involve the appendix and there is no specific clinical picture associated with the same. METHODS: The clinical records and histopathological slides of all patients diagnosed with schistosomal appendicitis between January 1989 and December 2006 in Ile-Ife, south west Nigeria, were reviewed. RESULT: Of 956 patients who had appendectomy at the Obafemi Awolowo University Teaching Hospital within the study period, 22 (2.3%) had histopathological diagnosis of schistosomal appendicitis. Eighteen (81.8%) were male whilst 4 (18.2%) were female. Their ages ranged between 15 and 63 years with a mean of 28.2 (+/- 5.6) years. The mean duration of right lower quadrant abdominal pain was 4.2 years. Appendiceal and periappendiceal adhesions were noted intraoperatively in 17 (77.3%) and the appendix was adjudged grossly inflamed in 9 (40.9%) patients. Submucosal fibrosis and eosinophilia were the common histopathological findings aside from submucosal oviposition. All patients received antischistosomal drugs and one patient developed adhesive intestinal obstruction 9 months after surgery. CONCLUSION: Schistosomal appendicitis may present acutely but diagnosis is only reliably made at histopathological examination. Adequate follow-up is however required to ascertain long-term outcome.