Non-Infectious Lung Manifestations of Autoimmune Diseases in Cameroon

Autoimmune (AI) diseases are secondary to lack of tolerance against self antigens. They may have systemic or organ-specific manifestations. All lung structures can be affected. The aim of our study was to determinate clues of diagnosis and treatment facilities for noninfectious lung manifestations of AI disease.A multi-centre retrospective study was performed from January 2006 to July 2009 in Douala, Cameroon.Twenty-nine patients were included (59% female),with an average age of 42±10 (18­58) years. The lung was the discovery mode of AI disease in 79%. Systemic lupus erythematosus (SLE) was the most frequently observed AI disease (48%). Thirty-eight percent have at least one cure against pleural or smear-negative tuberculosis. Clinical anomalies found were: cough 79%, dyspnoea 69%, and crackles 41%. Morphological anomalies were interstitial lesions in 55% of chest Xrays,50% of ground grass pattern, and 25% of fibrosis on CT scan; chest function test showed restrictive pattern in 41%. Three (10%) patients were HIV positive with a CD4 cell count more than 500/mm³. Two patients underwent talc pleurodesis for recurrent pleural effusion. General steroids were prescribed to all patients, hydroxychloroquine to 31% and azathioprine to 21%. At the time of writing, 18 patients were still being followed up and 3 (10%) had died. AIs exist in many countries. Clues of diagnosis of non-infectious pulmonary involvement are a patient presenting with chronic respiratory symptoms, crackles at physical examination, negative sputum smear,and unusual chest X-ray abnormality for tuberculosis

Wilkie's syndrome.

A superior mesenteric artery syndrome (SMAS) was diagnosed in two young women with, respectively, a 2- and 1-year history of postprandial vomiting and epigastric pain. The patients underwent a laparoscopic duodenojejunal bypass, and resumed a normal diet on the fifth postoperative day. The patients are still symptom-free with patent anastomosis on gastrointestinal radiographic control at 24 and 6 months, respectively, following their operation. Herein we also describe the varying clinical presentation of this rare syndrome, as well as treatment options. We conclude that laparoscopic duodenojejunostomy offers a new therapeutic approach to SMAS. It is reliable and safe; the operating time is acceptable; and diet recovery and hospital stay are both short. However, these preliminary results still need to be confirmed by further observations.