ABSTRACT
Loiasis is a chronic cutaneous disease caused by a filarial nematode for whom humans are the only definitive host: Loa loa, an African eyeworm transmitted by Chrysops flies. The parasite is seen on blood smears, in the skin, or during its ocular migration, but rarely on a bone marrow smear. We report the case of a 57-year-old Gabonese woman whose bone marrow aspiration during a work-up for T-cell leukemia fortuitously found Loa loa filariae.
Subject(s)
Bone Marrow/parasitology , Loa/isolation & purification , Loiasis/parasitology , Animals , Bone Marrow Examination , Female , Granulocyte Precursor Cells , Humans , Incidental Findings , Leukemia, Prolymphocytic, T-Cell/complications , Leukemia, Prolymphocytic, T-Cell/parasitology , Leukemia, Prolymphocytic, T-Cell/pathology , Loiasis/complications , Middle AgedABSTRACT
B lymphoproliferative disorders (B-LPD) are the most frequent types of lymphoid malignancies encountered in Gabon where HCV, HBV, HTLV-I and HIV are highly prevalent and all known for lymphotropism. Prevalences of HBs Ag, antibodies to HCV, HTLV-I and HIV were compared in 40 patients (21 men, 19 women; 17 < age < 75 years) with newly diagnosed B-LPD (low grade lymphoma = 6, intermediate grade = 21, high grade = 8: chronic lymphocytic leukaemia = 5) and 160 age and sex-matched controls. None of the B-LPD patients had got transfusion or parenteral care from the onset of symptoms to the inclusion day. In the B-LPD group, 13 patients had HBs Ag and antibodies to HCV, HIV and HTLV-1 were detected in 11, 6 and 10 subjects. In monovariate analysis, HBs Ag, antibodies to HIV or HTLV-1 were risk factors for B-LPD but antibodies to HCV were not associated with such diseases. Multivariate analysis showed only a relationship between HBs Ag and B-LPD (OR = 3.86; IC: 1.11-13.48). In such patients, reactivation of B hepatitis by treatment of B-LBD may be an important concern. If a background poor immune system could explain both susceptibility to long standing virus carriage and lymphoma development, a participating action of the HBV in lymphomagenesis could not be excluded.
Subject(s)
HIV/isolation & purification , Hepacivirus/isolation & purification , Hepatitis B virus/isolation & purification , Human T-lymphotropic virus 1/isolation & purification , Lymphoproliferative Disorders/virology , Adolescent , Adult , Aged , Antibodies, Viral/blood , Female , Gabon , HIV/immunology , Hepacivirus/immunology , Hepatitis B Surface Antigens/blood , Hepatitis B virus/immunology , Human T-lymphotropic virus 1/immunology , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/virology , Lymphoma/virology , Male , Middle AgedSubject(s)
Diabetes Complications , Hepatitis C/complications , Adult , Female , Gabon , Humans , Male , Middle AgedSubject(s)
Tropical Medicine/statistics & numerical data , Adolescent , Adult , Child, Preschool , Endemic Diseases , Female , Gabon/epidemiology , Government , HIV Infections/epidemiology , Health Personnel/statistics & numerical data , Hepatitis C/epidemiology , Humans , Infant , Infant Mortality , Infant, Newborn , Insurance, Health , Malaria, Falciparum/epidemiology , Middle Aged , Parasitic Diseases/epidemiology , Parasitic Diseases/mortality , Population , Pregnancy , Socioeconomic Factors , Tropical Climate , Trypanosomiasis/epidemiologyABSTRACT
Le lupus familial est rare, et le mode de transmission complexe et polygénique. La transmission génétique serait liée à des gènes codant pour des traits auto-immuns, et à des gènes régulateurs ou accélérateurs de la maladie, dont l'expression serait amplifiée par l'environnement chez des patients/familles prédisposés. Les observations portant sur le caractère familial du lupus sont rarement retrouvées dans la revue de la littérature noire africaine. Nous rapportons les particularités retrouvées entre une mère et sa fille chez qui le diagnostic de lupus a été retenu sur les critères de l'American College of Rheumatology (ACR), dans une population de 103 patients lupiques régulièrement suivis dans le service de médecine interne du CHU de Libreville. Les manifestations cutanées, rhumatologiques, hématologiques et immunologiques étaient communes, la gravité moyenne du lupus lors du diagnostic dans les deux cas (SLEDAI à 9 et 11) mais sévère dans l'évolution de la maladie chez la fille ; avec des complications majeures (néphrite, vascularite, polyarthrite diffuse, diabète myopathie et ostéoporose cortico-induits, tuberculose). Le décès survenait à 2 ans du diagnostic chez la mère et 27 mois chez la fille
