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与西方病例系列相比,患有镰状细胞贫血的刚果儿童和青少年的临床特征表现为鼻出血的高发生率。

The clinical characteristics of Congolese children and adolescents suffering from sickle-cell anemia are marked by the high frequencies of epistaxis compared to Western series.

作者信息

Kazadi Aimé L, Ngiyulu René M, Gini-Ehungu Jean L, Mbuyi-Muamba Jean M, Aloni Michel N

机构信息

Division of Paediatric Haemato-oncology and Nephrology, Department of Paediatrics, University Hospital of Kinshasa,Faculty of Medicine, University of Kinshasa , Kinshasa , Democratic Republic of Congo.

Department of Internal Medicine, Faculty of Medicine, University of Kinshasa , Kinshasa , Democratic Republic of Congo.

出版信息

Pediatr Hematol Oncol. 2019 Aug;36(5):267-276. doi: 10.1080/08880018.2017.1365397. Epub 2019 Jul 24.

Abstract

Sickle cell anaemia (SCA) is the most common genetic diseases in the Democratic Republic of Congo (DRC). It is estimated 30,000 to 40,000 neonates with SCA are born annually. Despite this high incidence rate, and the severity of the Bantu haplotype found in Congolese patients, major clinical characteristics remain poorly defined. The objective of this study was to assess the clinical and haematological profile of the SCA in patients less than 24 years of age. A cross-sectional study was conducted in Kinshasa, the large city of the DRC. Patients were consecutively selected in three health institutions. The study includes 256 sickle cell patients. The mean age of 8.4 (SD = 4.9) years. The Hand-foot syndrome was most common (52.7%) first presentation revealing the disease in our series. The most prevalent crises found in our series were vaso-occlusive crises (VOC) in 170 cases (66.4%) and severe hemolysis in 136 cases (53.1%). Splenic sequestration was noted in 19 cases (7.4%). The age at the first pain crisis was 18.2±15.2 months-of-age and the age at the first transfusions was 29.2±27.6 months-of -age. The most common signs associated with sickle cell disease in our series were hepatomegaly (53.9%), splenomegaly (41.7%), and adenotonsillar hypertrophy (34.8%). Epistaxis was reported in 9.4%. The clinical course of patients in DRC was comparable to reports from Western countries, with the notable exception of epistaxis which was significantly higher in patients in the DRC.

摘要

镰状细胞贫血(SCA)是刚果民主共和国(DRC)最常见的遗传疾病。据估计,该国每年有3万至4万名患有SCA的新生儿出生。尽管发病率很高,且在刚果患者中发现的班图单倍型较为严重,但主要临床特征仍未明确界定。本研究的目的是评估24岁以下SCA患者的临床和血液学特征。在刚果民主共和国的大城市金沙萨进行了一项横断面研究。在三个医疗机构连续选取患者。该研究纳入了256例镰状细胞病患者。平均年龄为8.4岁(标准差=4.9)。手足综合征是最常见的(52.7%)首发症状,在我们的系列研究中揭示了该病。我们系列研究中最常见的危象是血管闭塞性危象(VOC),有170例(66.4%),严重溶血有136例(53.1%)。观察到19例(7.4%)脾滞留。首次疼痛危象的年龄为18.2±15.2月龄,首次输血的年龄为29.2±27.6月龄。我们系列研究中与镰状细胞病相关的最常见体征是肝肿大(53.9%)、脾肿大(41.7%)和腺样体扁桃体肥大(34.8%)。鼻出血的报告率为9.4%。刚果民主共和国患者的临床病程与西方国家的报告相当,但值得注意的是,刚果民主共和国患者的鼻出血发生率明显更高。

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