Tuberculose chez les patients hémodialysés chroniques au Togo : à propos de 10 observations

GoalsTo determine the frequency of tuberculosis among hemodialysis patients in Togo, specify its different localizations and identify its diagnostic and therapeutic difficulties.Patients and methodsThis was a retrospective study over a period of 5 years (2010–2015). It includes the records of periodic hemodialysis patients in the Nephrology Department of the Sylvanus-Olympio University Teaching Hospital in Lomé. The diagnosis of tuberculosis was selected on the basis of clinical and laboratory data. The specific treatment has involved the association of 4 antituberculosis, which was adapted to the renal function.ResultsOf 91 chronic hemodialysis patients treated in Hospital Sylvanus-Olympio hemodialysis center, 10 cases (10.9%) of tuberculosis were diagnosed. The mean age was 37.3 ± 12.8 years, and the sex ratio was 1.5. The median time to onset of tuberculosis after initiation of hemodialysis was 16.8 ± 9 months. Extrapulmonary sites are found in 100% of cases (5 had both peritoneal and pleural localization, only 5 had pleural localization). The tuberculin skin test was positive in 4 patients (40%). The search for Mycobacterium tuberculosis was unsuccessful in all types of samples. Tuberculosis treatment was generally tolerated. Two patients (20%) had died during treatment.ConclusionTuberculosis is relatively common in hemodialysis patients. Diagnosis is difficult and may be based on the therapeutic trial.     

Syndrome des ongles jaunes survenant au cours du traitement d’une polyarthrite rhumatoïde par dérivés thiolés : à propos de deux observations et revue de la littérature

Yellow nail syndrome is characterised by the following symptoms: yellow nails, lymphoedema of the lower limbs and pleuropulmonary manifestations as pleural effusions or bronchiectasies. This association with auto-immune disorders such as rheumatoid arthritis is well known. We report two new cases of yellow nail syndrome associated with rheumatoid arthritis with D-penicillamine therapy. Since 1979, eight similarly cases have been reported. Possible responsibility of D-penicillamine therapy in yellow nail syndrome is discussed.