European Scientific Journal, ESJ | 2019
Complications Chroniques de la Drépanocytose dans une Population de 893 Patients Adultes Suivis au CHU Campus de Lomé
Abstract
Objective: To describe chronic complications frequencie ofsickle cell disease in adult SS and SC patients followed at Campus Teaching Hospital of Lome. Patients and methods: This was a descriptive study of the chronic complications ofsickle cell disease in 893 patients, SS and SC at least 18 years of age and followed between 2000 and 2017. Sociodemographic, clinical and progressive data (chronic complications) were collected from records. Statistical processing and data analysis were performed using the software r studio 3.3.2. Results: The sex ratio H / F was 0,81. The mean age of the patients was 31,81 ± 10.82 years. The age group 18 to 27 was the most represented (43.90%). According to the phenotype, 46.58% were sickle cell SS and 53.42% sickle cell heterozygous SC. At least one complication was present in 42.55% of our patients. This frequency was 31,97% for SS and 51,78% for SC. Ischemic complications were present in 34.15% of all our patients. They accounted for 36.78% of chronic complications among SS and 31.87 in SC: sickle cell retinopathy (17.25%) and aseptic osteonecrosis (14%) were the most common, followed by splenic atrophy (4.59%), cutaneous ulcer ( 3.25%), stroke (1.23%) and renal complications (1.12%). Hemolytic complications were present in 14.89% of patients and were statistically related to the SS phenotype. Among them, cholelithiasis was the most common (10.53%), followed by sickle cell heart disease (1.57%) and pulmonary arterial hypertension (0.22%). Conclusion: Chronic complications of adult sickle cell disease remain frequent in hospitals in Togo.Studies on the predictive factors for the development of these complications are necessary. Objectif : Decrire les frequences des complications chroniques de la drepanocytose chez le sujet adulte SS et SC suivis au CHU Campus de Lome. Patients et methodes : Il s’agit d’une etude descriptive portant sur les complications chroniques de la drepanocytose chez 893 patients drepanocytaires SS ou SC âges d’au moins 18 ans et suivis entre 2000 et 2017. Les donnees sociodemographiques, cliniques et evolutives (complications chroniques) ont ete collectees des dossiers. Le traitement statistique et l’analyse des donnees ont ete realises a l’aide du logiciel r studio 3.3.2. Resultats : La sex-ratio H/F etait de 0,81. L’âge moyen des patients etait 31,81±10,82 ans. La tranche d’âge de 18 a 27 ans etait la plus representee (43,90%). Selon le phenotype, 46,58% etaient drepanocytaires SS et 53,42% drepanocytaires heterozygotes SC. Au moins une complication etait presente chez 42,55% de nos patients. Cette frequence etait de 31,97% chez les SS et de 51,78% chez les SC. Les complications ischemiques etaient presentes chez 34,15% de l’ensemble de nos patients. Elles representaient 36,78% des complications chroniques chez les SS et 31,87 chez les SC : la retinopathie drepanocytaire (17,25%) et l’osteonecrose aseptique (14%) etaient les plus frequentes, suivies de l’atrophie splenique (4,59%), l’ulcere cutane (3,25%), les AVC (1,23%) et les complications renales (1,12%). Les complications hemolytiques etaient presentes chez 14,89% des patients et etaient statistiquement liees au phenotype SS. Parmi elles, la lithiase biliaire etait la plus frequente (10,53%), suivie de la cardiopathie drepanocytaire (1,57%) et de l hypertension arterielle pulmonaire (0,22%). Conclusion : Les complications chroniques du drepanocytaire adulte demeurent frequentes en milieu hospitalier au Togo. Des etudes sur les facteurs predictifs du developpement de ces complications s’averent necessaires.