Les manifestations cardio-vasculaires au cours du lupus érythémateux systémique à Dakar : étude descriptive à propos de 50 cas

Abstract

Systemic lupus erythematosus is a non-specific inflammatory disorder of an organ of unknown cause and autoimmune origin. Visceral injuries, including those cardiovascular, determine the prognosis of this disease primarily affecting women. The objectives of this study were to determine the frequency and describe the cardiovascular manifestations in systemic lupus erythematosus in a lupus population of the Dakar region. This is a multicenter prospective study descriptive and analytical conducted in the region of Dakar (Senegal) from 14 February 2011 to 2 July 2012. Patients were either hospitalized or monitored as outpatients. Included were all patients with lupus and meeting at least four criteria of the American College of Rheumatology of lupus disease classification 1997. All patients underwent physical examination, an electrocardiogram and an echocardiogram looking for cardiovascular damage. The collected data were entered into the Epi Info version 3.5.1 and processed with SPSS 16.0 software. Quantitative variables are described in the median and the qualitative workforce, percentage and frequency. We have included 50 patients. The average age of the population was 36.18 years. A female predominance is noted with a sex ratio man/woman of 0.09. Cardiovascular functional symptoms were dominated by dyspnea stage II to IV NYHA (26%) and palpitations (22%). The physical signs we have found were mainly tachycardia (40%), spontaneous turgor of the jugular veins (29%), a muffling of the heart sounds (29%) and a infandibulopulmonairy shock (18%). The frequency of cardiovascular events was 46%. Electrical cardiac events were dominated by sinus tachycardia (40%) of repolarization disorders (16.3%) type of ischemia, injury, ischemia injury, necrosis and hypertrophy with 18% atrial and left ventricular hypertrophy each. Furthermore, one case of BAV first degree at 280 ms was recorded. We found 19 cases of pericarditis including 2 tamponade, 3 cases of dilated cardiomyopathy hyperkinesias with impaired ejection fraction less than 35% and 8 patients with mild PAH important. In systemic lupus erythematosus, cardiovascular events are worrying and may remain asymptomatic for awhile. Their research must be systematic in order to treat early.

Systemic Inflammatory Diseases in Internal Medicine at the CNHU-HKM of Cotonou: Frequency, Clinical, And Immunological Aspects

“…The reason for admission was dominated by prolonged fever (34.8%). Our results were not similar to the work of Ngaïdé et al [3] in Senegal who found that the symptomatology was dominated by dyspnea stages II and IV according to NYHA, at 26%. Our results could be explained by the fact that systemic inflammatory diseases are known to be etiologies of prolonged fever and especially in a tropical context.…”

“…Our study population was predominantly female with a male to female sex ratio of 0.1. This female predominance was similar to that of several others such as Ngaïdé et al in Senegal [3] and Tazi-Mezalek et al in Morocco [4]. Estrogens are thought to increase the secretion of prolactin and growth hormones, which in turn may play a role in the proliferation of T and B lymphocytes [5], androgen deficiency may be associated with the development of immune-related events [6].…”

Cardiac Diseases During Systemic Inflammatory Diseases in the Internal Medicine and Medical Oncology Department of NTHC-HKM of Cotonou

“…A clear female predominance with a male to female sex ratio of 0.09 was found. This female predominance was also found by several other authors [5][6][7][8][9].…”

“…Pericarditis represents the most common cardiac involvement in rheumatoid arthritis. This result is superior to that of Kapkovi et al [11] in Togo who had noted it in 1.1% of patients and is inferior to that of Ngaïdé et al [8] in Senegal who had found 38% of pericarditis during lupus pathology. This could be explained by the fact that the majority of patients were already under specific treatment, which would have already improved the pericardial effusion.…”

Pediatric systemic lupus erythematosus patients in South Africa have high prevalence and severity of cardiac and vascular manifestations

“…Few published reports on cardiovascular complications of SLE in African populations exist [21–23], although a recent study described high severity of lupus myocarditis in adult SLE patients in Cape Town [24]. A similar study of 50 adult patients in Senegal reported 3 cases of cardiomyopathy and 19 cases of pericarditis, 2 with tamponade physiology [25].…”