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Biomedical subjects

B Diouf

Publications and source records attributed to B Diouf.

At least 37 records · Page 2Linked to original sources
PubMed1999

[First case of primary IgA glomerulonephritis (Berger's disease) in Senegal].

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.

Adrenal Cortex Hormones↗
PubMed1999

[Description of a case of Cacchi Ricci disease associated with hyperparathyroidism in the setting of multiple endocrine disease].

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.

Adult↗
PubMed1998

[Autosomal dominant polycystosis in the hospital milieu in Dakar (Senegal)].

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.

Adult↗
PubMed1998

[Evolutive aspects of systemic lupus erythematosus in Dakar. Apropos of 30 cases].

To determine the characteristics of evolution of systemic lupus erythematosus (SLE), the authors studied 30 cases retrospectively. All were black women aged from 16 to 73 years (with a mean of 30 years) at the time of diagnosis. Dermatological manifestations consisting in discoid lupus or alopecia inaugurated the disease in 12 cases, joint symptoms in 10 cases. Polyarthritis was the most common inaugural manifestation, followed by discoid lupus. Corticosteroids therapy alone or associated to chloroquine or immunosuppressor led to good results; 88% of patients who received treatment had good outcomes in the first 5 months after diagnosis. After this time lapse, 6 cases of complications related to the corticosteroids therapy occurred. After one year, 5 patients presented one or more flare-ups and had to be re-hospitalized; 8 others were lost to the follow-up. The overall mortality rate was 27% (8 cases out of 30). Causes of death were first renal failure (3/8) followed by infectious complications (2/8). The management of SLE could be improved by a close follow-up and providing the patients and their family with adequate information.

Adolescent↗
PubMed1998

[Tuberculosis among hemodialysis patients in Dakar, apropos of 2 cases].

Hemodialysis permits a long term survival to patients with End Stage Renal Disease (E.S.R.D.). However the patients ongoing hemodialysis presented a immunodeficiency and a important modification of drugs biodisponibility. Tuberculosis is an endemic disease in our countries. Extrapulmonary tuberculosis is reported from these two cases among 13 patients treated in C.H.U.A. Le Dantec hemodialysis center. Clinical symptoms are not specific bacteria is not found. Diagnosis is obtained by a bundle of arguments. Antituberculosis treatment need to be adjusted in this field. Even if Rifampicine can be administrated at normal dose. The others drugs must be adapted on their clearance and the underlying disease. The two patients presented psychiatrical symptoms motivating a reduction of isoniazide dose witch threshold toxicity is lowered by renal failure state. These observations must increase watchfulness on nephrologist of undeveloping countries, confronted with tuberculosis renewed out break.

Adolescent↗
PubMed1997

[Nephronophtisis in Senegal: first 3 cases].

Nephronophtisis is a familial tubulo-interstitial nephropathy with an autosomic recessive mode of transmission. To our knowledge, it has not been yet reported in Black Africa. We report here the case of a 17-year old female from Senegal who presented with renal failure related to a chronic interstitial nephritis characterized by polyuria, hypocalcemia, natriuresis of 23 mmol/l and serum creatinine level of 1070 mumol/l. The parents of this patient were first-degree cousins. Among the 6 siblings, 2 other males were found to have a renal disease. Ultrasound examination of the kidneys showed medullary cysts in the 2 affected brothers and the renal biopsy in one case showed tubular atrophy, with thickening of the basal lamina and an interstitial fibrosis without glomerular involvement. Molecular genetic analysis confirmed the diagnosis of nephronophtisis, with a homozygous deletion of the NPH1 region. In order to recognize this disease early in life, one has to look for it in patients with tubulo-interstitial nephritis, polyuria, childhood enuresia especially when it is associated with growth retardation or tetany. This case raises the issue of consanguinity and endogamy which are frequently encountered in Africa. It also extends the geographic and ethnic distribution of nephronophtisis, being the first cases reported Black Africans.

Adolescent↗
PubMed1997

[Echocardiographic data from chronic dialysis patients in Dakar].

The authors report the results of a prospective study about echocardiographic parameters of 14 chronic dialyzed patients. Mean age was 44.4 +/- 12 (extremes: 16 and 63). There are 12 men (86%) and 2 women (14%). The main renal disease responsible was nephroangiosclerosis (9 cases, 64.3%). Hypertension is found in all the patients, anemia in 13 (92.8%). The heart, as shown by echocardiography, was concerned in 13 patients (92.8%). The main abnormalities found were: left ventricular hypertrophy (13 cases: 92.8%), left ventricular dysfunction (4 cases: 28.5%), abnormality in left ventricular relaxation (3 cases: 21.4%), pericardial effusion (4 cases: 28.5%).

Adolescent↗
PubMed1997

[Specific antibodies against Plasmodium falciparum antigens in immune subjects: I. Comparison of detection/titration methods].

We report a comparative study of specific antibody levels to the blood stages of P. falciparum in individuals living in two different areas with different transmission levels of malaria. We have compared 2 techniques for the detection/titration of antibodies i.e. ELISA and IFI, ELISA being particularly suitable for immuno-epidemiological related studies. A schizont lysate from P. falciparum infected red blood cells from FUP/CB Marburg strain as antigen proved usefullness, as compared with an antigen extracted from a local strain recently adapted to in vitro culture. Using these techniques, high specific antibody responses were found in the villagers' sera and mean levels of antibodies increased with age. Levels of specific IgG were comparable between those two locations, in spite of a ten fold higher level of transmission between the two villages. In contrast, a significantly higher level of IgM in adults living in holoendemic.

Adolescent↗
PubMed1997

[Specific antibodies against Plasmodium falciparum antigens in immune subjects: II. Screening of responses against the merozoite major surface antigen (MSP!)].

Specific immune responses to asexual blood stages of P. falciparum antigens (a lysate of parasitized red blood cells and a characterized vaccine candidate i.e. MSP1 p19) were analyzed in plasma samples from immune adult individuals living in three different areas of Senegal, where malaria transmission is different. Most individuals in the three sites had specific IgG and IgM to total P. falciparum antigens, whereas approximately 50% had either IgG or IgM specific to MSP1 p19. Further, no anti-MSP1 p19 IgG2 and IgG4 antibody was noticed in any individual whereas the distribution of anti-MSP1 p19 IgG1 and IgG3 was different upon the epidemiological context. In addition, no relationship was found between antibody responses and in vitro T cell responses against P. falciparum antigens upon those experimental conditions. These data stress on the relatively elevated distribution of specific antibodies to MSP1 p19 in P. falciparum hyperendemic areas and suggest a differential regulation of isotypes depending on individual parasite exposure.

Adolescent↗
PubMed1997

[Management of lupus nephritis in Senegal].

Systemic lupus erythematosus is a disease considered as seldom in Senegal. Nevertheless its incidence is increasing these last years. The prognosis is significantly related to the renal involvement, classified into 6 classes by the WHO. The treatment of these different forms is variable, consisting on abstention or symptomatic treatment for the class III (with low activity index), class II, I, and V (without renal failure). In the other hand a vigorous treatment is indicated in the class III, with consistent activity index, class IV and class V with renal failure. The most frequent of these treatment remains the association using corticosteroids and immunosuppressants. Among immunosuppressants, cyclophosphamide and azathioprine are the most commonly used. The case we reported is about a 41 years old woman who presented a class IV lupic nephropathy, with a good outcome after a 18 months corticosteroid and immunosuppressants association treatment. This case leads us to some recommendations. Considering our poor socioeconomical conditions, we suggest to treat all patients presenting proteinuria higher than 2 mg/24h. However it is more judicious to perform renal biopsy on patients with signs evocating renal impairement and to treat the class III, IV and V whatever would be the degree of activity and chronicity indexes. This treatment must associate immunosuppressive drugs and corticosteroids; the modalities and duration depending on clinical presentation, histologic features and evolution.

Amenorrhea↗
PubMed1996

[Current aspects of gastric cancer in Senegal. Epidemiological and clinical study of 220 cases (1984-1991)].

220 cases of gastric cancer were selected from Dakar Hospitals during seven years (1984-1991). This retrospective study confirms that gastric cancer is the most common cancer of the Gastro-intestinal tract (48.4%). The sex ratio was 2.7 (M/F) with mean age of 50 years. However, a steady progression of gastric cancer was noticed beginning at 40 years. Despite the introduction of upper gastro-intestinal endoscopy the classical evolved form was the most commonly found (83.2%). The associated lesions known to be premalignant were found in 22.7% of cases. The patients were seen with a long delay after the first symptoms. This is why we have long delays of diagnosis in our centers. 61.7% of them are seen 3 to 12 months after their first symptoms. In 70% of cases, lesions were found on antropyloric region. The most common histological type remain adenocarcinoma (90% of cases). Even though endoscopy has contributed to increase the incidence of gastric cancer, it did not allow to discover early gastric carcinoma.

Adult↗
PubMed1996

[A case of joint toxicity from pefloxacin in the treatment of nephrotic syndrome in a child].

In order to improve the nephrotic syndrome management, we tried to treat one patient by pefloxacin. A polytenosynotis was noticed during this treatment and motivated it stopping. Remission of proteinuria was obtained after an eleven days treatment. This case give us the opportunity to discuss the possible toxicity of quinolones on joints and the efficacy of pefloxacin in this disease.

Adolescent↗
PubMed1993

[Nephropathies and HIV virus infection. Anatamo-clinical study].

We report 16 patients with HIV1 infection with biopsy-proven renal involvement. Nine patients were caucasians and seven were blacks. There were 11 patients at stage II and 5 at stage IV of the HIV1 infection. Three patterns of histologic lesions were found: 6 patients, all blacks, with nephrotic syndrome and/or renal insufficiency had focal and segmental glomerulosclerosis (FSGS) with tubulo-interstitial lesions. In contrast, 6 patients, all caucasians, had various types of glomerulonephritis characterized by immunoglobulin and complement deposits; 3 of them were membranoproliferative glomerulonephritis (MPGN). The four remaining patients had predominant tubulointerstitial lesions. In three patients who had FSGS, treatment by AZT induced temporary improvement of renal function and hemodialysis could be interrupted for a few months. The cure of infectious foci was followed by improvement in renal signs in two out of the 3 MPGN patients. Our study further underlines: 1) the importance of genetic/racial factors in the occurrence of HIV1-associated glomerular lesions and 2) the relatively frequent occurrence of MPGN related to bacterial infections in caucasian patients.

Adult↗
PubMed1991

T cell response to purified filtrate antigen 85 from Mycobacterium bovis Bacilli Calmette-Guérin (BCG) in leprosy patients.

T cell proliferation and IFN-gamma production of peripheral blood mononuclear cells from 25 healthy controls and 39 leprosy patients were tested against BCG-bacilli and culture filtrate. Mycobacterium leprae and purified antigen 85 (the major secreted 30-32 kD protein antigen) from M. bovis strain BCG. In lepromin negative healthy controls, blastogenesis was low to M. leprae and completely negative to antigen 85. IFN-gamma levels were very low, close to detection limits. In all lepromin positive controls, significant proliferation and IFN-gamma secretion was found in response to M. leprae and antigen 85. In the group of lepromatous leprosy (LL) patients, 25/29 of patients (with either positive (13) or negative (12) lymphoproliferative response to BCG) were unreactive to M. leprae or to antigen 85. Four LL patients with positive T cell response to BCG responded with detectable lymphoproliferative response and IFN-gamma secretion to antigen 85. All tuberculoid (TT) leprosy patients responded to BCG, M. leprae and antigen 85. Hence, T cells from leprosy patients and controls demonstrate a marked parallelism of responsiveness towards whole M. leprae and purified antigen 85 from M. bovis BCG, suggesting strong cross-reactivity between the two species and underlining the biological importance of such secreted antigens.

Antigens, Bacterial↗
PubMed1990

[Restoration of continuity after rectosigmoidectomy by colorectal intubation and transproctoanal anastomosis. An African experience with 10 cases].

On the basis of 10 cases (8 cases of rectosigmoid cancer and 2 of sigmoid volvulus), the authors report about their experience in the restoration of GI tract continuity using colorectal intubation into the rectal lumen and a transproctoanal anastomosis. This technique helps avoiding subperitoneal sutures, which are a cause of fistulae and shrinkage. It is simple enough to be performed by younger surgeons. This technique was initially developed for anterior resections for rectosigmoid cancer, and it can be utilized as an emergency procedure with single-piece resection without untwisting the sphacelous sigmoid loops, so that neither a temporary left iliostomy nor a second operation are needed.

Adult↗
PubMed1990

[Right ileocolonic intubation after resection of the terminal ileum for generalized peritonitis caused by ileal perforation. An African experience with 33 cases].

Generalized peritonitis due to ileal perforation is common in Africa, and is caused by typhoid fever in most cases. For various reasons, the patients arrive at hospital in a poor general condition. In spite of combined intensive care and surgery, the general evolution of the disease resulted in a high mortality rate. All surgical techniques requiring sutures on a poor-quality ileon, ie. excision and suture, limited segmental resection or extensive ileal resection, most often lead to the breakdown of suture lines, so that the patient enters the vicious circle of repeated peritonitis and hazardous re-operations. Even exteriorized suture lines turn into fistulae, and temporary terminal ileostomy requires an amount of maintenance that is sometimes difficult to ensure in Africa. The technique proposed by the authors was developed in the department of surgery of the Dakar Main Hospital and has several advantages: It is a simple and quick procedure, which does not require the surgeon to be very experienced and can be performed in underequipped hospitals. There is no procedure-associated mortality. Morbidity decreases as the surgeon's experience increases. GI continuity can be established even in a septic environment. No second-look operation is necessary, so that the stay at hospital becomes shorter and the costs of treatment lower. Lastly, this type of restoration can be applied to other indications such as right colectomy and ileocolic or transverse ileal intubation.

Adolescent↗
PubMed1989

[Hospital septicemias in Dakar. Epidemiologic study].

The authors examine the epidemiological character of septicemia at A. Le Dantec Paupers' Hospital, which admits an average of 10.000 patients per year to its surgical, medical, specialized medical and paediatric units. Distribution is studied in function of age, sex, unit, field of origin and germs, and according to whether the case was nosocomial or not.

Adolescent↗