[Lupus nephritis in Senegal: study of 42 cases].
BACKGROUND
Renal involvement determines the prognosis of systemic lupus erythematosus. The aims of this study were to precise clinical, laboratory, therapeutic and evolutive aspects of lupus nephritis in Senegal in order to improve its management.


METHODS
According to ACR criteria we included all patients presenting a systemic lupus erythematosus followed in internal medicine and in the dermatology services of university teaching hospital Aristide le Dantec of Dakar from January 1993 to December 2002. All the patients who didn't have a lupus nephritis defined by the existence of more than 0.5 g/24 h of proteinuria and or hematuria were excluded.


RESULTS
The prevalence of lupus nephritis was 56.75% among 74 patients with systemic lupus erythematosus. Mean age was 29.6 years and sex ratio 0.13 (male to female). There was a nephritic syndrome in 45.23% of the cases and renal insufficiency in 37.71%. Renal biopsy performed in 52.38% of cases showed predominantly WHO classes IV and V. The key treatment was corticotherapy while immunosuppressive were used in 35.71%. The short term evolution was favourable but in the medium term, many patients were lost or followed up irregularly.


CONCLUSIONS
To improve the management and the prognosis of lupus nephritis in Senegal it is necessary to make patients with a systemic lupus erythematosus sensitive to it and to make systematically urine tests aiming the screening for an early diagnosis of lupus nephritis. In addition we should have aggressive policies in order to lower the costs of immunosuppressive therapy and haemodialysis.
Dia
D
D
Service de médecine interne, CHU Aristide Le Dantec, Dakar. daouda.dia@netcourrier.com
Ka
E F
EF
Cissé
M
M
Pouye
A
A
Niang
N M
NM
Kane
A
A
Dieng
M T
MT
Niang
A
A
Ka
M M
MM
Diouf
B
B
Ndiaye
B
B
Moreira-Diop
T
T
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D001706:Biopsy; D002648:Child; D003165:Complement System Proteins / Q000032:analysis; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012675:Senegal / Q000453:epidemiology; D012737:Sex Factors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007136:Immunoglobulins; D007166:Immunosuppressive Agents; D003165:Complement System Proteins