Étude Épidémio-Clinique et Paraclinique des Rhabdomyolyses Non Traumatiques au Service de Neurologie du CHU Point G

Sissoko Adama Seydou, Kanté I, Konaté I, Dramé M, Diallo SH, Coulibaly T, Sacko M, Coulibaly N, Fongoro S, Maïga Y, Guinto CO

Abstract


RÉSUMÉ
Introduction. La rhabdomyolyse est la perte de l’intégrité des muscles striés squelettiques occasionnant la libération de son contenu dans la circulation sanguine (créatine phospho-kinases [CPK], myoglobine, enzyme et ions). Les formes non traumatiques de ce syndrome clinico biologique  répondent à des mécanismes variés (métabolique, toxique, infectieux …). Le but du travail était de décrire les aspects clinques et paracliniques de cette entité à Bamako. Méthodologie. Il s’agissait d’une étude descriptive avec recueil prospectif des données cliniques, biologiques sur 30 mois allant du 1er janvier 2017 au 31 Mars 2018 en neurologie du CHU Point de Bamako.  Résultats. Nous avons colligé 10 patients répondant aux critères de rhabdomyolyse non traumatique. Leur âge moyen était de 33 ans avec des extrêmes allant de 16 à 63 ans. Le sexe féminin était prédominant avec un sex ratio 1/9. La faiblesse musculaire aigue ou subaiguë constituait le motif d’hospitalisation le plus fréquent (80%). Le facteur déclenchant était dominé par les vomissements gravidiques dans 70%. L’évolution a été marquée par la guérison sans séquelle dans 90% des cas malgré un taux de 30% d’insuffisance rénale aigue. Le taux de mortalité était de 10%. Conclusion.  Ce travail  attire l’attention sur une affection probablement  sous diagnostiquée, car peu  évoquée, avec comme conséquence une absence de dosage de CPK , examen clé du diagnostic. Le respect des règles de bonnes pratiques médicales simples permet d’éviter des complications parfois désastreuses (insuffisance rénale, décès…).

ABSTRACT
Introduction. Rhabdomyolysis is defined as the loss of the integrity of the skeletal striated muscles causing the release of its contents into the bloodstream (creatine phospho-kinases, myoglobin, enzymes and ions). The non-traumatic forms of this clinical biological syndrome respond to various mechanisms (metabolic, toxic, infectious, etc.). The aim of our work was to describe epidemiology and clinical features of this disease in Bamako. Methodology. This was a descriptive study with prospective collection of clinical, biological data over 30 months from January 1, 2017 to March 31, 2018. Results. We studied ten patients meeting the criteria of non-traumatic rhabdomyolysis. There were nine women and one man. The average age was 33 with extremes ranging from 16 to 63. Acute or sub acute muscle weakness was the most common reason for hospitalization (80%). The most common triggering factor was pregnancy vomiting (70%). The evolution was marked by recovery without sequel in 90% despite 30% rate of acute renal failure. The mortality rate was 10%. Conclusion. Non-traumatic rhabdomyolysis is probably underdiagnosed, because practitioners do not evoke the disease and consequently do not request CPK assays.  By implementing simple, affordable good medical practice rules, rhabdomyolysis and its possible disastrous complications (renal failure, death, etc.) may be avoided.    

Keywords


Rhabdomyolyses, CPK,

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