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Research Article
Adult-onset Still's Disease in a Health Center: A Report of 10 Cases
Jean Noel Diokel Ndour*
,
Bachir Mansour Diallo,
Fulgence Faye,
Aicha Kaneye,
Melissa Derneville,
Eunice Thiendrbéogo,
Amy Dioum,
Atoumane Faye,
Adama Berthé,
Papa Souleymane Touré,
Madoky Magatte Diop,
Mamadou Mourtalla Ka
Issue:
Volume 12, Issue 6, December 2024
Pages:
104-109
Received:
20 September 2024
Accepted:
11 October 2024
Published:
13 November 2024
Abstract: Introduction: Adult-onset Still's disease is a rare systemic inflammatory disease in Africa. Observations have been published in Senegal. Materials and Methods: We conducted a retrospective descriptive study to establish the epidemiological profile of patients presenting with adult-onset Still's disease (AOSD) in a health center. The patients included met the diagnostic criteria of Fautrel and/or Yamaguchi. Results: During our study (2020-2024), we included 10 patients with a hospital incidence of 2 patients per year. The average age of the patients was 29.5 years ±11.9, ranging from 15 to 49 years. Females predominated with a sex ratio of 0.67. Clinical manifestations were polymorphic, dominated by fever (100%), inflammatory polyarthralgia (60%), tachycardia (80%), physical asthenia (70%), altered general condition (50%), and erythema (30%). The biological inflammatory syndrome was found in all patients. The glycosylated fraction of ferritin was depleted in all patients. We noted a good outcome after treatment with prednisone 1 mg/kg/day in all patients, methotrexate in six patients, and hydroxychloroquine in one patient. Conclusion: Adult-onset Still's disease is a rare condition, unknown to most practitioners. Its prognosis is severe, especially with visceral involvement.
Abstract: Introduction: Adult-onset Still's disease is a rare systemic inflammatory disease in Africa. Observations have been published in Senegal. Materials and Methods: We conducted a retrospective descriptive study to establish the epidemiological profile of patients presenting with adult-onset Still's disease (AOSD) in a health center. The patients inclu...
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Research Article
Therapeutic Benefit of Ursodeoxycholic Acid in Tamoxifen-Induced Hepatotoxicity in Rats
Issue:
Volume 12, Issue 6, December 2024
Pages:
110-119
Received:
27 September 2024
Accepted:
25 October 2024
Published:
18 November 2024
Abstract: The use of tamoxifen (TAM) for breast cancer treatment may cause hepatotoxicity. Ursodeoxycholic acid (UDCA) is a potential liver protective chemical compound. The protective effect of UDCA on TAM-induced hepatotoxicity in rats was analyzed in this study. Thirty five adult female Wistar rats grouped into 7 of n=5/group were used. The rats were treated for 10 days as follows: Group 1: (Placebo control) Water (10 mL/kg/day/oral), group 2: (Vehicle control) Ethanol 1% (1mL/kg/day) intraperitoneally (i.p), group 3: UDCA (40 mg/kg/day/oral) and group 4: TAM (45 mg/kg/day) i.p. Groups 5-7 were pretreated with UDCA (10, 20 and 40 mg/kg/day/oral) before treatment with TAM (45 mg/kg/day) i.p, respectively. On day 11, blood samples were collected and evaluated for biochemical markers. Liver tissues were analyzed for oxidative stress markers and histology. Results: TAM decreased body weight and increased liver weight significantly (p<0.01) when compared to the placebo control. Serum bilirubin, alkaline phosphatase, gamma-glutamyl transferase, lactate dehydrogenase, aminotransferases, high density lipoprotein cholesterol and liver malondialdehyde levels were significantly (p<0.001) elevated by TAM when compared to control. TAM significantly (p<0.001) decreased serum triglyceride, very low density lipoprotein cholesterol, total cholesterol, liver glutathione, catalase, superoxide dismutase and glutathione peroxidase levels when compared to the control. TAM caused liver steatosis and necrosis in rats. However, UDCA pretreatment significantly prevented the aforementioned changes caused by TAM in a dose-related fashion. UDCA may be a therapeutic option for TAM associated hepatotoxicity.
Abstract: The use of tamoxifen (TAM) for breast cancer treatment may cause hepatotoxicity. Ursodeoxycholic acid (UDCA) is a potential liver protective chemical compound. The protective effect of UDCA on TAM-induced hepatotoxicity in rats was analyzed in this study. Thirty five adult female Wistar rats grouped into 7 of n=5/group were used. The rats were trea...
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Case Report
Autologous Bone Marrow-Derived Mesenchymal Stem Cell Transplantation for Decompensated Post-Hepatitis B Cirrhosis: A Case Report
Issue:
Volume 12, Issue 6, December 2024
Pages:
120-124
Received:
4 October 2024
Accepted:
23 October 2024
Published:
28 November 2024
DOI:
10.11648/j.ajim.20241206.13
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Abstract: End-stage liver disease (ESLD) represents the terminal phase of chronic liver injury, characterized by overt clinical manifestations and severe complications that significantly impair the quality of life. The condition often culminates in a variety of symptoms, including jaundice, ascites, and hepatic encephalopathy, which reflect the liver's inability to perform its essential functions. Liver transplantation remains the definitive treatment for ESLD; however, limitations in donor organ availability necessitate exploration of alternative therapeutic strategies. we present a case of a 71-year-old Asian male with decompensated post-hepatitis B cirrhosis, who had a one-year history of hematemesis and melena. Endoscopic evaluation confirmed the presence of esophageal-gastric varices, further corroborating portal hypertension and hypersplenism. This patient underwent treatment with autologous bone marrow-derived mesenchymal stem cell (BM-MSC) transplantation. Following the procedure, the patient demonstrated significant clinical improvement, suggesting the safety and potential feasibility of BM-MSC transplantation for patients with ESLD. The field of BM-MSC transplantation has witnessed significant progress in recent years, emerging as a promising therapeutic approach for ESLD. This innovative treatment modality harnesses the regenerative capabilities of stem cells to promote liver repair and function. Notably, BM-MSCs possess immunomodulatory properties that may mitigate inflammation and fibrosis in the liver, thereby addressing some of the underlying pathophysiology associated with ESLD. This case presentation highlights the potential application of BM-MSC therapy in patients with decompensated cirrhosis. The findings underscore the need for further research and refinement of clinical application techniques to fully realize the broad therapeutic possibilities of BM-MSC transplantation for ESLD. As we advance our understanding of stem cell therapies, it is crucial to conduct larger studies to evaluate long-term outcomes and establish standardized protocols for treatment.
Abstract: End-stage liver disease (ESLD) represents the terminal phase of chronic liver injury, characterized by overt clinical manifestations and severe complications that significantly impair the quality of life. The condition often culminates in a variety of symptoms, including jaundice, ascites, and hepatic encephalopathy, which reflect the liver's inabi...
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Case Report
The Neurological and Hemorrhagic Faces of Dengue: A Case of Encephalitis with Upper GI Bleed
Issue:
Volume 12, Issue 6, December 2024
Pages:
125-130
Received:
30 November 2024
Accepted:
11 December 2024
Published:
27 December 2024
DOI:
10.11648/j.ajim.20241206.14
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Abstract: Dengue fever is a mosquito-borne viral infection caused by the dengue virus, belonging to the Flavivirus genus and primarily transmitted by Aedes mosquitoes. It is prevalent in tropical and sub-tropical regions, affecting millions of people globally each year. The World Health Organization (WHO) estimates that about 390 million dengue infections occur annually, with approximately 96 million manifesting clinically. The epidemiology of dengue is influenced by several factors, including climate change, urbanization, and globalization, which facilitate the spread of the vector and the virus. While the typical presentation of dengue includes high-grade fever, headache, myalgia, arthralgia, and rash, the disease can escalate to more severe forms, such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). These severe forms can lead to life-threatening complications, necessitating prompt recognition and intervention. DHF is characterized by plasma leakage, thrombocytopenia, and hemorrhagic manifestations, which can culminate in significant morbidity and mortality. The pathophysiology underlying these severe manifestations is complex and involves the interplay of the virus, host immune response, and genetic predisposition. Additionally, neurological involvement, such as dengue encephalitis, and gastrointestinal (GI) complications, such as upper GI bleeding, are rare but increasingly recognized complications. This case report describes the clinical course of a young adult male who initially presented with typical dengue symptoms but developed severe complications during hospitalization. His clinical course included the development of dengue encephalitis and upper GI bleeding, both of which were primarily driven by plasma leakage and dengue hemorrhagic fever. Through this case, we aim to shed light on the atypical manifestations of dengue fever and the importance of early recognition and management of these complications.
Abstract: Dengue fever is a mosquito-borne viral infection caused by the dengue virus, belonging to the Flavivirus genus and primarily transmitted by Aedes mosquitoes. It is prevalent in tropical and sub-tropical regions, affecting millions of people globally each year. The World Health Organization (WHO) estimates that about 390 million dengue infections oc...
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