[Sjögren's Syndrome: Epidemiological, Diagnostic, Therapeutic and Evolutionary Aspects in the Aristide-Le-Dantec Teaching Hospital of Dakar, Senegal (2012-2016)].

Abstract

Sjögren's syndrome (SS) is an autoimmune epithelitis, rarely described in black Africa. We report its epidemiological, diagnostic, therapeutic and evolutionary aspects in a Senegalese hospital environment. A retrospective, crosssectional study was carried out in the rheumatology and internal medicine departments of Aristide-Le-Dantec University Hospital of Dakar, between January 2012 and September 2016, where the observations of SS whose diagnosis, in line with the American-European consensus criteria of 2002, were enrolled. We collected 370 observations of SS, 327 women and 43 men, a sex-ratio of 1:9. These were 251 primitive forms (pSS) and 119 secondary forms (sSS). The hospital prevalence of pSS was 5%. The mean age was 42 ± 15 years and the time taken for diagnosis was 7 years. The familial forms totaled 47 index cases with a relative risk of occurrence of the disease estimated at 6.3% for firstdegree relatives. The juvenile forms totaled 7 cases of pSS. Dry syndrome was constant: oral (87%) and ocular (84%). Extra glandular manifestations were present in 87%. Arthritis was erosive in 75 cases and secondary to Rheumatoid arthritis. Autoantibodies (rheumatoid factors [49/147], anti-CCP [24/79], Sjögren's syndrome autoantigen A [anti- Ro/SSA] 41/140, Sjögren's syndrome autoantigen B [anti-La/SSB] [22/140], anti-nuclear [14/55] and cryoglobulin 1) were objectified. The histology practiced in 253/370 patients was contributory in 229 of them. According to the ESSPRI score (Eular Sjögren's Syndrome Patient Reported Index), 77% of patients had unbearable symptoms. NHP (Nottingham Health Profile) and SF-36 (Short Form [36] Health Survey) confirmed this deterioration in the quality of life. The ESSDAI score (Eular Sjögren Syndrome Disease Activity Index) showed persistent activity of the disease. The evolution was overall favorable. The hospital prevalence of pSS was 5%. It is predominant in women with an average age of 42 years. Glandular and systemic manifestations are frequent. The functional repercussions and the alteration of the quality of life are notable.