[Hepatosplenic sarcoidosis: description of a case at the University hospital center of Brazzaville, Congo]. / Sarcoïdose à localisation hépatosplénique : description d'un cas au Centre hospitalier universitaire de Brazzaville, Congo.

Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The isolated extrapulmonary form is rare. We report the case of hepatosplenic sarcoidosis in a 29-year-old female patient.It is a patient with no notable medical history, who was seen in consultation for repeated epistaxis. Clinical examination noted nodular hepatomegaly associated with signs of portal hypertension and splenomegaly. Sedimentation rate, alkaline phosphatase, serum angiotensin converting enzyme, aminotransferases were high. Histological examination of the spleen and liver biopsy noted granulomatous inflammatory infiltration without cancerous lesion or tonsil stones.This picture is comparable with sarcoidosis, despite the absence of PET scans. The main challenge remains the differential diagnosis with other granulomatoses. Corticosteroid therapy is the first-line treatment, and after splenectomy the patient has achieved clinical and biological stability.

Hospital acquired infection in a department of hematology-oncology care in the Congo.

OBJECTIVES: Hospital Acquired Infection (HAI) is a major cause of morbidity and mortality in hemato-oncology. The study aims to report the incidence of hospital-acquired infections in patients with hematological malignancies and the risk factors associated with them. MATERIAL AND METHODS: An observational study with cross-sectional data collection was carried out from January 1, 2019, to April 30, 2020, in the department of hematology of Brazzaville University Hospital. The study concerned 77 patients diagnosed with hematological malignancies admitted for a course of chemotherapy. Written consent was obtained from each participant. Participants were divided into two groups: with HAI (n=50) and without HAI (n=27). They were compared using the chi-square test and Student's T-test. Univariate and multivariate analyses of the association of HAI with all the risk factors were performed for analysis of the 2 x k contingency tables and repeated using logistic regression. RESULTS: The cumulative incidence was 64.9% with a 95% confidence interval of [53.8-74.7]. The time to onset of HAIs was 10.6±6.50 days. The incidence of HAI was significantly greater in acute myelogenous leukemia (80%), grade 4 neutropenia (80%). The risk factors were hospitalization stay of over 14 days (OR: 1.09), the regimen: daunorubicin-aracytine (OR: 5.96), the hemoglobin level on admission (OR: 0.72), and the neutropenia of grade 4 (OR: 7.9). The most common clinically identified focus of infection was peripheral venous infections. The fatality rate was 10%. CONCLUSION: The determination of HAI and the identification of its risk factors make it possible to establish prevention strategies.

Addressing the Challenges to Diagnose Neonatal Hemolytic Anemia's Aetiologies in Low Ressources Countries: A Case Report.

Background. The diagnosis of neonatal hemolysis is an easy exercise. However, the diagnosis of its etiology can be very challenging especially in low ressources countries where laboratory capacities are limited. We report the case of hemolytic anemia episodes that started in the neonatal period, for which the trigger factor, infectious of paracetamol, is debatable.

Incidence hospitalière des hémopathies malignes de l'enfant à Brazzaville

Objectif. L'épidémiologie des hémopathies malignes chez l'enfant au Congo n'est pas connue. L'objectif de cette étude est de rapporter le type et la distribution des hémopathies malignes chez l'enfant à Brazzaville. Matériels et méthodes. Il s'agit d'une étude transversale descriptive réalisée dans le Service d'hématologie Clinique du CHU de Brazzaville au Congo sur une période de 10 ans (du 1er janvier 2006 au 31 décembre 2015). Nous avons analysé tous les dossiers des enfants hospitalisés, âgés de 0 à 14 ans portant le diagnostic d'hémopathie maligne. Les hémopathies malignes étaient définies comme des proliférations monoclonales de cellules hématopoïétiques selon la classification de l'OMS. Résultats. Trente cas d'hémopathies malignes ont été diagnostiquées durant la période d'étude. Il s'agissait de leucémies aigues n=23 (76,67%), de lymphomes n=6 (20%) et de leucémie myéloïde chronique n=1 (3,33%). Les leucémies aigues étaient de type lymphoblastique dans 17 cas et myéloblastique dans 6 cas. Une prédominance masculine était observée dans toutes les hémopathies malignes sauf pour la leucémie myéloïde chronique. Les hémopathies malignes étaient plus fréquentes dans la tranche d'âge de 7 à 14 ans (63,33%). Conclusion. Les hémopathies malignes à Brazzaville atteignent surtout l'enfant d'âge scolaire de sexe masculin. Il s'agit avant tout de leucémie aigue lymphoblastique ou plus rarement myéloblastique.

Les hémopathies lymphoïdes chroniques à Brazzaville

L'épidémiologie des hémopathies lymphoïdes chroniques au Congo n'est pas connue. L'objectif de cette étude est de rapporter la distribution des hémopathies lymphoïdes chronique à Brazzaville.Patients et méthodes : Il s'agi d'une étude transversale descriptive réalisée dans le Service d'Hématologie Clinique du CHU de Brazzaville au Congo. La période étudiée est de 10 ans (du 1er janvier 2006 au 31 décembre 2015). Etaient inclus dans l'étude tous les dossiers de consultation et d'hospitalisation portant le diagnostic d'hémopathie lymphoïdes chroniques.Résultats : 150 cas d'hémopathies lymphoïdes chroniques ont été diagnostiquées durant la période d'étude. Parmi elles, le myélome multiple représentait 52% de la population étudiée (n=78), le lymphome malin non Hodgkinien 22,67% (n=34), le lymphome de Hodgkin et la leucémie lymphoïde chronique respectivement 9,33% (n=14) et la leucémie à tricholeucocyte 6,67% (n=10). La distribution était essentiellement féminine (sex-ratio=0,70). Les pathologies lymphoprolifératives chroniques étaient plus observées dans la tranche d'âge de 45 à 49 ans (66,7%).Conclusion : Les hémopathies lymphoïdes chroniques constituent par leur fréquence un problème sanitaire. Elles plaident pour des études épidémiologiques analytiques afin de mettre en place une politique préventive de celles-ci

[Secondary cutaneous plasmacytoma revealing multiple myeloma: about a case]. / Plasmocytome cutané secondaire révélant un myélome multiple: à propos d'un cas.

Secondary metastatic cutaneous plasmacytoma is a multiple extramedullary plasma cell proliferation involving skin. Its diagnosis is based on the identification of malignant plasma cells proliferation in the bone marrow and in the skin. Its occurrence is associated with advanced myeloma and a poor prognosis.

Pregnancy and Accelerated Phase of Myeloid Chronic Leukemia Treated with Imatinib: A Case Report from a Developing Country.

Background. Chronic myeloid leukemia is a hematological malignancy caused by expression of BCR-ABL tyrosine kinase oncogene, product of the t(9;22) Philadelphia translocation. Accelerated phase of this disease marks the onset of advanced rapidly progressive disease unresponsive to many therapies. Pregnancy limits broad number of therapies on patients because of their potential teratogenic effects. We report the case of a pregnant 34-year-old patient on accelerated phase successively managed by imatinib. She achieved a safe pregnancy and delivered at 39 weeks a healthy baby without congenital abnormalities. Our case is unusual because of the accelerated phase of the disease. Case Presentation. A 34-year-old African female with history of chronic phase of myeloid leukemia on imatinib, lost to follow-up for 4 months, presented to the hematological department for abdominal discomfort. Accelerated phase of chronic myeloid leukemia was diagnosed. Complete hematological response was achieved on high doses of imatinib. At the completion of 39 weeks, she delivered a healthy child without congenital anomalies. Conclusion. Despite its teratogenic and embryotoxic effects, front line imatinib is the only effective, well-tolerated treatment for patient on accelerated phase that can be offered to patients in sub-Saharan countries.