Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 4 Issue 11

Wandering Diagnosis of Rheumatoid Arthritis in Lomé: Regarding a Case Secondary to Self-Medication based on Diclofenac for 11 Years

Komi Dzidzonu Nemi1*, Kodjo Agbeko Djagadou1, Komi Edem Mossi1, Abdou Razak Moukaila1, Toyi Tchamdja1, Abago Balaka1 and Mohaman Awalou Djibril1

1Department of Internal Medicine, Sylvanus Olympio Teaching Hospital, University of Lomé, Togo
2Department of Internal Medicine, Kara Teaching Hospital, University of Kara, Togo

*Corresponding Author: Komi Dzidzonu Nemi, Department of Internal Medicine, Sylvanus Olympio Teaching Hospital, Lomé, University of Lomé, Togo.

Received: September 30, 2020; Published: October 17, 2020

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Abstract

  This is a 45-year-old housewife who was referred by a paediatrician for an inability to lead an active life following polyarthralgia with bilateral deformity of the hand and bilateral knee swelling requiring self-medication based on diclofenac for 11 years without success. The examination on his admission noted a blood pressure = 151/120 mmHg, a deterioration of the general condition, the ulnar gale and a bilateral knee swelling. Additional tests have enabled to note: a biological inflammatory syndrome, microalbuminuria (165mg / 24h), one of bone mineralisation focal both wrists, a global toe interphalangeal distal joint spaces and metacarpophalangeal joint of the 3 rd ray right with erosion the adjacent metacarpal head, and multiple geodes of the carpal bones with bilateral carpal joint space pinching with tendency to form carpal block. There was also left atrial hypertrophy and apico-lateral subepicardial ischemia on the electrocardiogram and papillary excavation at the fundus. The diagnosis of rheumatoid arthritis was made based on a score greater than 6 from the American College of Rheumatology and the European League Against Rheumatism (2010). Management was carried out by corticosteroid therapy based on prednisone combined with functional rehabilitation of the joints. The frequency of rheumatoid arthritis would be underestimated in our country because of self-medication since the disease is sensitive to NSAIDs very accessible to the population, especially in illicit drug sales markets. We must make our populations more aware of the harmful effects of this practice.

Keywords: Rheumatoid Arthritis; Self-Medication; Lomé-Togo

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Citation

Citation: Komi Dzidzonu Nemi., et al. “Wandering Diagnosis of Rheumatoid Arthritis in Lomé: Regarding a Case Secondary to Self-Medication based on Diclofenac for 11 Years". Acta Scientific Medical Sciences 4.11 (2020): 48-51.




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