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.

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.

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

Massilicoli timonensis sp. nov., strain Marseille-P3755^T (= 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.

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.

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

Corynebacterium bouchesdurhonense sp. nov. strain Marseille-P2067^T (= CSURP2067; = DSM100846) and Corynebacterium provencense sp. nov. strain Marseille-P2161^T (= CSURP2161; = DSM101074) are two new species from the order Corynebacteriales that were isolated from obese French individuals.

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-P2417^T (= CSUR P2417), Alistipes megaguti strain Marseille-P5997^T (= CSUR P5997) and Alistipes provencensis strain Marseille-P2431^T (= 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.

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

Bacteroides bouchesdurhonensis sp. nov., strain Marseille-P2653^T (= 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.

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.

Noncontiguous finished genome sequences and descriptions of Actinomyces ihuae, Actinomyces bouchesdurhonensis, Actinomyces urinae, Actinomyces marseillensis, Actinomyces mediterranea and Actinomyces oralis sp. nov. identified by culturomics

The taxonogenomic approach, including the culturomics techniques, is now currently used to isolate and characterize new bacteria. These approaches notably allowed us to discover six new species of the Actinomyces genus: Actinomyces ihuae strain SD1, Actinomyces bouchesdurhonensis strain Marseille-P2825, Actinomyces urinae strain Marseille-P2225, Actinomyces marseillensis strain Marseille-P2818, Actinomyces mediterranea strain Marseille-P3257 and Actinomyces oralis strain Marseille-P3109. Each is the type strain of the corresponding bacterial species. 16S ribosomal RNA gene sequence comparison was used to classify these strains among the Actinomyces genus. These strains are all Gram positive, rod shaped and facultative aerobic. We describe the main characteristics of each bacterium and present their complete genome sequence and annotation.

Genome analysis and description of Xanthomonas massiliensis sp. nov., a new species isolated from human faeces

Xanthomonas massiliensis strain SN6^T is a Gram-negative bacterium which is aerobic, motile and nonsporulating. This new species isolated from human faeces exhibited the characteristic traits of members of this genus, such as yellow pigmentation and viscosity. Here we present the main phenotypic characteristics and the taxonogenomics description of this strain. The genome is 3 690 720 bp long with DNA G + C content of about 70.52%.

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

‘Cellulomonas timonensis’ sp. nov. strain sn7^T 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.

Taxonogenomic description of four new Clostridium species isolated from human gut: 'Clostridium amazonitimonense', 'Clostridium merdae', 'Clostridium massilidielmoense' and 'Clostridium nigeriense'

Culturomics investigates microbial diversity of the human microbiome by combining diversified culture conditions, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA gene identification. The present study allowed identification of four putative new Clostridium sensu stricto species: ‘Clostridium amazonitimonense’ strain LF2^T, ‘Clostridium massilidielmoense’ strain MT26^T, ‘Clostridium nigeriense’ strain Marseille-P2414^T and ‘Clostridium merdae’ strain Marseille-P2953^T, which we describe using the concept of taxonogenomics. We describe the main characteristics of each bacterium and present their complete genome sequence and annotation.

'Clostridium mediterraneense,' a new bacterial species isolated from the human gut

We report the main characteristics of ‘Clostridium mediterraneense’ sp. nov., strain Marseille-P2434^T (CSUR P2434), a new species within the genus Clostridium. This strain was isolated from the gut microbiota of a 66-year-old diabetic patient in Marseille, France.

'Actinomyces provencensis' sp. nov., 'Corynebacterium bouchesdurhonense' sp. nov., 'Corynebacterium provencense' sp. nov. and 'Xanthomonas massiliensis' sp. nov., 4 new species isolated from fresh stools of obese French patients

We report the main characteristics of ‘Actinomyces provencensis’ strain SN12^T sp. nov., ‘Corynebacterium bouchesdurhonense’ strain SN14^T sp. nov., ‘Corynebacterium provencense’ strain SN15^T sp. nov. and ‘Xanthomonas massiliensis’ strain SN8^T sp. nov., which were all isolated from stool samples from obese French patients.

'Collinsella phocaeensis' sp. nov., 'Clostridium merdae' sp. nov., 'Sutterella massiliensis' sp. nov., 'Sutturella timonensis' sp. nov., 'Enorma phocaeensis' sp. nov., 'Mailhella massiliensis' gen. nov., sp. nov., 'Mordavella massiliensis' gen. nov., sp. nov. and 'Massiliprevotella massiliensis' gen. nov., sp. nov., 9 new species isolated from fresh stool samples of healthy French patients

Here we report of summary of the characteristics of 'Collinsella phocaeensis' strain Marseille-P3245^T sp. nov., 'Clostridium merdae' strain Marseille-P2953^T, 'Sutterella massiliensis' strain Marseille-P2435^T sp. nov., 'Sutturella timonensis' strain Marseille-P3282^T sp. nov., 'Enorma phocaeensis' Marseille-P3242^T sp. nov., 'Mailhella massiliensis' strain Marseille-P3199^T gen. nov., sp. nov., 'Mordavella massiliensis' strain Marseille-P3246^T sp. nov. and 'Massiliprevotella massiliensis' strain Marseille-P2439^T sp. nov. isolated from fresh stool samples of healthy French patients.

Marseillibacter massiliensis gen. nov., sp. nov., a new bacterial genus isolated from the human gut

In this manuscript, we report the main characteristics of Marseillibacter massiliensis gen. nov., sp. nov., strain Marseille-P2840^T (CSUR P2840), a new member of the family Oscillospiraceae that was isolated from the stool of a healthy 29-year-old Senegalese woman.

Noncontiguous finished genome sequence and description of Prevotella phocaeensis sp. nov., a new anaerobic species isolated from human gut infected by Clostridium difficile

Prevotella phocaeensis sp. nov. strain SN19^T (= DSM 103364) is a new species isolated from the gut microbiota of patient with colitis due to Clostridium difficile. Strain SN19^T is Gram-negative rod-shaped bacteria, strictly anaerobic, nonmotile and non-endospore forming. The predominance fatty acid is hexadecanoic acid. Its 16S rRNA showed a 97.70% sequence identity with its phylogenetically closest species, Prevotella oralis. The genome is 2 922 117 bp long and contains 2486 predicted genes including 56 RNA genes.

"Prevotellamassilia timonensis," a new bacterial species isolated from the human gut

We describe here the main characteristics of "Prevotellamassilia timonensis" gen. nov., sp. nov., strain Marseille-P2831(T) (CSUR P2831), a new member of the Prevotellaceae family that was isolated from stool samples from a 45-year-old patient.

"Massiliomicrobiota timonensis," a new bacterial species isolated from the human gut

We report the main characteristics of a new bacterium, “Massiliomicrobiota timonensis” strain SN16 (= CSUR P2264), which was isolated from the stool of a 87-year-old patient.

'Neglecta timonensis' gen. nov., sp. nov., a new human-associated species

We herein describe the main characteristics of ‘Neglecta timonensis’ strain SN17 (CSUR P2265) that was isolated from the stool of an 88-year-old woman with type 2 diabetes.

'Culturomica massiliensis', a new bacterium isolated from the human gut

We report here the main characteristics of ‘Culturomica massiliensis’, strain Marseille-P2698^T (CSUR P2698) a new genus isolated from the stool specimen in a 66-year-old man.

'Phocea massiliensis' a new bacterial species isolated from the human gut

We present here the main characteristics of ‘Phocea massiliensis’ strain Marseille-P2769^T (CSUR P2769), which is a new genus isolated from the stool of a 45-year-old patient.

Christensenella timonensis, a new bacterial species isolated from the human gut

We propose a new species, Christensenella timonensis, strain Marseille-P2437(T) (CSUR P2437(T)), which was isolated from gut microbiota of a 66-year-old patient as a part of culturomics study. C. timonensis represents the second species isolated within the Christensenella genus.

"Emergencia timonensis," a new bacterium isolated from the stool of a healthy patient

We present the essential characteristics of “Emergencia timonensis” strain SN18 (= CSUR P2260), a new member of the order Clostridiales that was isolated from the stool of healthy patient.

[Study of echocardiographic parameters of rheumatoid arthritis black African without clinically evident cardiovascular manifestations: A cross-sectional study of 73 cases in Senegal]

INTRODUCTION

Research of cardiac involvement in patients with rheumatoid arthritis can prevent complications and place in a logical secondary prevention. The objective of this study was to investigate the echocardiographic parameters in a population of Senegalese patients with rheumatoid arthritis without clinically evident cardiovascular manifestations.

PATIENTS AND METHOD

We conducted a descriptive cross-sectional study, which included prospectively from outpatients in the internal medicine department of university hospital center Aristide Le Dantec in Dakar, Senegal, with a diagnosis of rheumatoid arthritis without clinically evident cardiovascular disease. It focused on a sample of 73 patients of both sexes aged at least 18 years. Following clinical examination, we conducted laboratory tests (CRP, fibrinogen, ESR, rheumatoid factors: Latex and Waaler-Rose, anti-CCP, antinuclear factors and anti-ENA antibodies), ECG, echocardiography standard. Data were analyzed using a descriptive study of the different variables with the calculation of proportions for categorical variables, and the positional parameters and dispersion for quantitative variables.

RESULTS

A total of 73 patients with rheumatoid arthritis without obvious cardiac events and meeting the criteria of definition of the ACR 1987 were included in the study. The mean age was 44.17±14.43 years with extremes of 18 and 75 years. The mean duration of RA was 5.93±4.78 years. The concept of family inflammatory arthritis was reported in 35.60% of cases and almost one in six patients had at least a factor of cardiovascular risk (16.96%). The abnormalities found in Doppler echocardiography were dominated by diastolic LV dysfunction (42.46%), increased left ventricular mass in 35.61%. Valvular leaks of variable grades were highlighted regarding all orifices but were rarely significant.

CONCLUSION

The realization of echocardiography in patients with rheumatoid arthritis without clinically evident cardiovascular manifestations helps to highlight cardiovascular abnormalities related to the natural course of the disease.

[How Bone Densitometry contributes to the diagnosis of Osteoporosis at the Gerontology and Geriatrics Center of Ouakam, Dakar City: 102 observation]

INTRODUCTION

This study aims at assessing the morbidity rate and risk factors of osteoporosis.

METHODS

This is a cross-sectional study conducted at the Gerontology and Geriatrics Center of Ouakam from 2010 to 2012 with patients who had benefited from a bone densitometry examination. The study variables were: sex, current age, menopausal age, past individual fractures, past family fractures, prolonged corticoid intake, prolonged immobilization, tobacco addiction, and alcoholism. Epi-info version 6 Software was used to process and analyze the data.

RESULTS

The study included 102 patients the majority of which were women (75%), with an average age of 74 years; among these people, 31% had individual past fractures and 10% had family fractures; 8% of the patients had used a prolonged corticoid-based therapy and 2% were tobacco-addicts. The average age of menopause was 48 years. The prevalence rate for osteoporosis was 44%, based on Rachis T-score, 20%, based on Femur T-score and 45%, based on Rachis and Femur T-score. It has been noted that being a woman and past individual fractures rated among the major risk factors of osteoporosis.

CONCLUSION

These results speak in favor of health authorities setting-up a program to fight osteoporosis centered mainly on primary prevention and screening.

[Seroprevalence of HBsAgs in patients with rheumatoid arthiritis in a hospital setting in Senegal]

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]

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.

[Contribution of coloscopy to diagnosis of rectal bleeding in Dakar (Senegal)]

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.

[Tuberculosis and systemic diseases: study of 8 Senegalese cases]

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.

[Etiologic profile of cervical adenopathology observed in an internal medicine department in Dakar, Senegal. A 66 case series]

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.

[Destombes Rosaï Dorfman syndrome: description of one case and diagnostic challenges in the tropical setting]

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.

[Autoimmune cholangitis or seronegative biliary cirrhosis: report of one case]

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).

[Frequency of hematological and immunological manifestations of lupus in 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.

[Undesirable effects of methothrexate during treatment of rheumatoid arthritis]

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.

[Pulmonary hypertension revealing systemic diseases: two Senegalese case reports]

INTRODUCTION

Pulmonary hypertension (PH) is a complication of autoimmune diseases which worsen the prognosis. In Senegal, a few cases of PH have been previously reported in patients with systemic sclerosis.

CASE REPORTS

We report two cases of patients with PH that revealed autoimmune diseases (Sharp' syndrome and Sjögren syndrome). Epidemiological, clinical, evolutive and laboratory data were analyzed. Evolution of disease was favourable for one patient and fatal for the other.

CONCLUSION

These two cases show necessity of early diagnosis of systemic diseases in our countries. PH should be screened in each patient with autoimmune disease before installation of irreversible pulmonary arterial lesions that respond to treatment. New therapy used in idiopathic PH are not yet accessible for our patients.