几内亚东卡国立医院的比尔默氏病& br/> -内科流行病学-临床、治疗和进化方面

Thierno Amadou Wann, Mamadou Sarifou Diallo, Djenabou Diallo, Kadiatou Diallo, Mamadou Lamine Yaya Bah, Mamadou Diakhaby, Mohamed Cissoko, Amadou Kaké, Djibril Sylla
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摘要

简介:比尔默氏病是一种自身免疫性疾病,其特征是缺乏维生素B12的吸收,与抗体(a)的产生有关,破坏了允许吸收维生素B12(钴胺素)的内在因子(IF)。在我们的情况下,这些临床表现是多形性的和严重的。这项工作的目的是确定比默氏病在几内亚人群中的流行病学、临床、治疗和进化特征。材料和方法:回顾性分析2012年1月至2021年12月东卡国立医院内科随访的Biermer病患者档案。结果:共纳入8例患者,其中女5例,男3例。患者平均年龄48岁。诊断延迟平均为3.6年。所有患者均有生物临床贫血(8例,即100%),其次为上腹痛4例(50%),神经损伤如敏感性多神经病变3例(37.5%)。获得性黑皮病4例(50%)。4例患者出现维生素B12缺乏症。3例(37.5%)患者骨髓造影发现髓系巨幼细胞增生。1例患者在内镜下发现桥本氏病合并Biermer氏病(FOGD), 4例(50%)在显微镜下发现眼底病变。治疗包括B12维生素治疗,所有病例均有良好的临床和生物学结果。结论:Biermer病在非洲仍然很常见,除临床和生物学表现严重外,其特点是年龄较轻。护理包括服用维生素B12在我们的环境中仍然可以获得。
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Biermer’s Disease at the Donka National Hospital in Guinea<br/>—Epidemio-Clinical, Therapeutic and Evolutionary Aspect in the Internal Medicine Department
Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.
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