Le Genou Serait la Localisation Préférentielle de la Goutte en Afrique Subsaharienne : Une Analyse Rétrospective Hospitalière avec Revue de la Littérature
The Knee May Be the Preferred Localization of Gout in Sub-Saharan Africa: An Hospital Retrospective Analysis With Literature Review
Mots-clés :
Goutte, Genou, Cameroun, LocalisationRésumé
RESUME
Introduction. De nombreuses publications en Afrique subsaharienne remettent en question la place prépondérante occupée par l’arthrite de la première métatarso-phalangienne (MTP1) ou podagre dans le diagnostic de la goutte. C’est ainsi que nous avons réalisé cette étude afin de déterminer l’articulation la plus touchée au moment du diagnostic de la goutte en Afrique Subsaharienne. Méthodologie. Nous avons réalisé une étude transversale des dossiers de patients vus à l’Hôpital Général de Douala, Cameroun, entre 2004 et 2014. Nous avons inclus les patients avec diagnostic de goutte (critères de l’ACR 1977). Les principales caractéristiques sociodémographiques, cliniques et biologiques des personnes présentant une goutte ont été collectées au moment du diagnostic. Résultats. Nous avons colligé 511 dossiers (415 hommes et 96 femmes). L’âge moyen était de 55,9 ± 10,8 ans. La douleur articulaire (n=508; 99,4 %) était le principal motif de consultation au moment du diagnostic. Les genoux (n=300; 62,6 %), les chevilles (n=187; 39,0 %), et les MTP1 (n=128; 26.7%) étaient les articulations les plus touchées. L’hypertension artérielle était la comorbidité la plus fréquemment retrouvée. L’hyperuricémie était retrouvée chez plus des trois-quarts des patients. Celle-ci s’associait à une syndrome inflammatoire biologique et des lésions d’arthropathies uratiques dans la même proportion de patients. Conclusion. Le genou est l’articulation la plus concernée par la goutte au moment du diagnostic au Cameroun, comme dans de nombreuses publications africaine. En Afrique subsaharienne, la MTP1 occupe en général la deuxième voire la troisième place parmi les articulations les plus fréquentes au moment du diagnostic de la goutte.
ABSTRACT
Introduction. Many publications in sub-Saharan Africa question the predominant role of first metatarsophalangeal joint (MTP1) or gout in the diagnosis of gout. This study was conducted to determine the most affected joint at the time of gout diagnosis in sub-Saharan Africa. Methodology. We conducted a cross-sectional study of patient records seen at the Douala General Hospital, Cameroon, between 2004 and 2014. We included patients with a diagnosis of gout (ACR 1977 criteria). The main sociodemographic, clinical, and biological characteristics of individuals with gout were collected at the time of diagnosis. Results. We collected 511 records (415 men and 96 women). The mean age was 55.9 ± 10.8 years. Joint pain (n=508; 99.4 %) was the main reason for consultation at the time of diagnosis. Knees (n=300; 62.6%), ankles (n=187; 39.0%), and MTP1 (n=128; 26.7%) were the most affected joints. Hypertension was the most commonly found comorbidity. Hyperuricemia was found in over three-quarters of patients. This was associated with biological inflammatory syndrome and urate arthropathy lesions in the same proportion of patients. Conclusion. The knee is the joint most affected by gout at the time of diagnosis in Cameroon, as in many African publications. In sub-Saharan Africa, the MTP1 generally ranks second or third among the most common joints at the time of gout diagnosis.
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(c) Tous droits réservés Fernando Kemta Lekpa, Sylvain Raoul Simeni Njonnou, Baudelaire Fojo Talongong, Abdoul Salam Hamadama, Paul Eloundou, Christian Ngongang Ouankou, Francine Same Bebey, Henry Namme Luma, Madeleine Ngandeu-Singwe, Siméon Pierre Choukem 2024
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