Enzymatic protein degradation confers anti-oxidant, anti-inflammatory and immunomodulating potentials to pea proteins, and the resulted peptides could be used as an alternative therapy for the prevention of inflammatory-related diseases.

Limited access to nucleic acid tests for hepatitis B virus (HBV) DNA is a significant barrier to the effective management of chronic HBV infection in resource-poor countries. Alternatively, HBV e antigen (HBeAg) may accurately indicate high viral replication. We assessed the diagnostic performance of three commercially available rapid diagnostic tests (RDTs) for HBeAg (SD Bioline, Insight and OneStep) against a quantitative chemiluminescent immunoassay (CLIA, Architect). Using stored sera from adults with chronic HBV infection, we tested RDTs in three groups in Senegal (48 HBeAg-positive, 196 HBeAg-negative, and 117 cases with high HBV DNA (≥ 10 IU/mL)) and one group in France (17 HBeAg-positive East Asians). In Senegal, the sensitivity and specificity for HBeAg detection were 29.8% and 100% for SD Bioline, 31.1% and 100% for Insight, and 42.5% and 98.4% for OneStep, respectively. The lower limits of detection of these RDTs were very high (> 2.5 log10 Paul Ehrlich Institut units/mL). Their low sensitivity was also confirmed in HBeAg-positive Asian samples (35.3-52.9%). The prevalence of HBeAg in highly viremic (≥ 10 IU/mL) Senegalese patients was low: 58.1% using CLIA and 24.5-37.5% using RDTs. Hepatitis B e antigen prevalence was similarly low in a subgroup of 28 Senegalese women of childbearing age with a high viral load (≥ 10 IU/mL). Approximately, half of highly viremic adults do not carry HBeAg in Africa, and HBeAg RDTs had remarkably poor analytical and diagnostic sensitivity. This implies that HBeAg-based antenatal screening, particularly if using the currently available HBeAg RDTs, may overlook most pregnant women at high risk of mother-to-child transmission in Africa.

Purpose: The unfortunate association between myasthenia gravis and Graves' disease is not widely appreciated. It would be consistent with a genetic predisposition for autoimmune disease. The frequency of this association is variously appreciated in the literature. Case: We report a case of a 20 years old patient with a two years history of Graves' disease, who presented with a myasthenic syndrome leading to an acute respiratory failure. This was found to be reversible with prostigmine, and the diagnosis of myasthenia gravis (MG) was confirmed by EMG and positive immunology. There was a positive response to medical treatment. Discussion: The frequency of this association is variously appreciated in the literature. MG has been reported to be discovered simultaneously with, or prior to, the diagnosis of Graves' disease, but is most commonly subsequent to it. The similarity of symptoms makes diagnosis difficult. Furthermore, an excess of thyroid hormones worsens MG and the existence of MG imposes certain precautions in the management of hyperthyroidism. Conclusion: Research is called for into the surveillance and management of specific manifestations of the co-occurrence of these conditions.

Le myélome multiple (MM) ou maladie de Kahler est une prolifération maligne monoclonale plasmocytaire se développant dans la moelle osseuse avec la production d'une immunoglobuline (Ig) monoclonale. L'objectif de cette étude est de décrire la présentation clinique du MM dans un service de médecine interne. Patients et méthode : Il s'agit d'une étude descriptive réali-sée sur une période de huit ans au CHU Aristide-Le-Dantec de Dakar (Sénégal). Était inclus dans l'étude, tout patient présentant des critères biologiques, cytologiques ou histologiques de MM. Résultats : L'âge moyen au moment du diagnostic était de 55,7 ans. Sur le plan clinique, un syndrome osseux était retrouvé dans 69 % des cas, des fractures pathologiques dans 30,9 % des cas. Sur le plan paraclinique, une anémie était observée chez 57,7 % des malades, l'hyperprotidémie était notée chez 48,3 % des malades, une hypercalcémie était observée dans 69 % des cas et une insuffisance rénale était retrouvée dans 28,6 % des cas. L'électrophorèse des protéines sériques avait mis en évidence un pic au niveau des gammaglobulines dans 55 % des cas. Dans les urines, on notait l'existence des chaînes légères de type lambda dans 80 % des cas et de type kappa dans 20 % des cas. Conclusion : Le tableau clinique du myélome dans nos régions est bruyant, avec des complications présentes dès le diagnostic. Cette présentation clinique reflète la lenteur diagnostique et donc de la prise en charge de cette pathologie. Pour citer cette revue : J. Afr. Cancer 3 (2011). Mots clés Myélome multiple · Présentation clinique · SénégalAbstract The multiple myeloma (MM) or Kahler disease is a clonal malignant proliferation of plasmocytes in bone marrow with monoclonal immunoglobulin proliferation. The aim of this study is to describe the clinical presentation of MM in the Department of Internal Medicine of Dakar (Senegal). Patients and method: It is a descriptive study conducted over a period of eight years. Any patient who presented with biological, cytological, or histological criteria of MM was included in the study. Results: The average age at diagnosis was 55.7 years. Clinically, bone syndrome was found in 69% of the cases, and pathological fractures in 30.9% of the cases. Paraclinically, anemia was found in 57.7% of the patients, hyperprotidemy in 48.3%, hypercalcemia in 69%, and kidney disease in 28.6% of the cases. Electrophoresis of serum protein had revealed a high level of gammaglobulins in 55% of the cases. In urine samples, we noted the existence of light chains of lambda type in 80% and kappa type in 20% of cases. Conclusion: Clinical presentation of MM in Dakar showed that complications were present at the diagnosis; it reflects slow diagnosis and thus the management of the disease. To cite this journal: J. Afr. Cancer 3 (2011).