Tuberculose ostéoarticulaire (mal de Pott exclu) : à propos de 120 cas à Abidjan

Introduction: La tuberculose ostéoarticulaire (TOA) représente 2 à 5 % de l'ensemble des tuberculoses .Elle demeure d'actualité surtout dans les pays à forte endémicité tuberculeuse. L'objectif était de déterminer la prévalence, les aspects topographiques, radiologiques de la TOA en milieu hospitalier ivoirien. Méthodes: Les auteurs rapportent une expérience de 11 ans, à travers une étude rétrospective de 120 dossiers de patientsatteints de la tuberculose ostéoarticulaire (le mal de Pott est exclu de cette étude).N'ont pas été inclus dans l'étude les dossiers ne comportant pas d'imagerie. Résultats: L'atteinte extra vertébrale représentait 09,2% de la tuberculose ostéoarticulaire. Il s'agissait de 54 hommes et 66 femmes, l'âge moyen était de 43,13 ans. On notait 123 cas d'ostéoarthrites, et 8 cas d'ostéites des os plats. L'atteinte des membres inférieurs prédominait dans 91,87% des cas. La hanche était la première localisation (45,04%), suivie du genou (25,19%). Les atteintes étaient multifocales dans 20% des cas. L'atteinte osseuse était associée à une tuberculose pulmonaire dans 05,83% des cas. Des localisations inhabituelles ont été rapportées : poignet (n=2), branches ischiopubiennes (n=4), atteinte sternoclaviculaire (n=4), médiopieds (n=2). Les lésions radiologiques étaient avancées (stades III et IV) dans 55,73% des cas. A la TDM, la prévalence des abcès était de 77%. Un geste chirurgical a été réalisé sur 16 articulations (2 épaules, 13 genoux, une cheville). Conclusion: La TOA des membres est peu fréquente contrairement à l'atteinte vertébrale. La hanche est la principale localisation. Le retard au diagnostic explique l'étendue des lésions anatomoradiologiques

Quality of life of women followed up for systemic lupus erythematosus in Abidjan, Côte d’Ivoire: a cross-sectional study of 51 cases

Objective: To determine the quality of life of Systemic Lupus Erythematosus (SLE) patients attending Cocody  University Teaching Hospital in Abidjan using the SF 36 tool.Design: A descriptive and analytical cross-sectional prospective study.Methods: The study was carried out at the Rheumatology Department of Cocody’s University Teaching Hospital in Abidjan, Côte d’Ivoire over a period of seven months from January 2019 to July 2019. Women diagnosed with SLE fulfilling American College of Rheumatology 1997 criteria and/or Systemic Lupus International  Collaborating Clinics classification (SLICC) 2012 criteria for SLE were included. These patients completed the SF-36 questionnaire. The SF-36 scores reflected the degree of achievement in each domain. The lower the SF 36 scores the lower the quality of life. Quality of life was altered for any score below 40. For the disease activity, we used the systemic lupus erythematosus disease activity index. We looked for an association between the characteristics of the patients and the disease and the domains of the QOL.Results: The study included 51 women and with a mean age of 35.88 ± 12.37 years. The patients were mostly single (65.38%) with a university level of education (59.62%). Most of them had low monthly income (82.69%) and they were without health insurance (51.92%). The mean duration of SLE was 76.79 ± 59.37 months. The  mean disease activity score (mean SLE disease activity index) was 9.92. The affected domains of the SF- 36  questionnaire showing altered quality of life were “physical role” (37.02) and “vitality” (39.99). Patients with lower quality of life were found to be young women, not married, have high disease activity, had skin and  haematological manifestations, very high disease activity (SLEDAI) and without treatment.Conclusion: In Abidjan, SLE patients attending Cocody University Teaching Hospital have a lower quality of life. Determinants of low quality of life are: young women, not married, secondaryeducated level, mucocutaneous and haematological manifestations, very high disease activity (SLEDAI) and patient without treatment

Factors associated with extra-articular manifestations of rheumatoid arthritis in Abidjan, Côte d’Ivoire

Objective: The aim of this study was to identify factors associated with extra-articular manifestations of rheumatoid polyarthritis in Abidjan, Côte d'Ivoire. Design: A descriptive and analytical retrospective study. Methods: The study was conducted at the Rheumatology Department of Cocody’s University Teaching Hospital in Abidjan from January 2009 to December 2018. The study participants were 106 patients with rheumatoid arthritis diagnosed on the basis of ACR 1987 and ACR/EULAR 2010 criteria, with extra articular manifestations. Results: The study included 129 cases of rheumatoid polyarthritis and 106 of them had extra-articular manifestations. The hospital frequency of extra-articular manifestations in rheumatoid arthritis was 82.17%. Our sample population were 92 females (86.79%) and 14 males (13.21%) with an average age of 44.69 years. The average duration of disease progression was 62.36 months. Extra-articular manifestations observed were largely dominated by general signs (83.86%) and haematological manifestations (78%). Other cases included rheumatoid nodules (10%), abarticular manifestations (7.62%) and dry syndrome in 8.70% of cases. Visceral manifestations were cardiovascular (3.77%), neurological (1.89%) and pulmonary in 1% of cases. Only articular deformities (OR=2.4; IC 95% = [1.4-6.3]; P=0.03) were significantly associated to the presence of extra-articular manifestations. Conclusions: Extra-articular manifestations are very common during the rheumatoid arthritis in Abidjan. Joint deformities are the major factors significantly associated to the presence of extra-articular manifestations