PREVALENCE DE L’ANEMIE HEMOLYTIQUE AUTO- IMMUNE DANS LE SERVICE DE NEPHROLOGIE ET D’HEMODIALYSE DU CHU DU POINT G

RESUMEIntroduction. L’anemie hemolytique auto-immune designe une anemie causee par la destruction des globules rouges par des anticorps diriges contre les propres antigenes membranaires non modifies des globules rouges du patient. Il s’agit d’une affection relativement rare puisque son incidence etait d’environ 1 cas/100 000 habitants par an dans le monde occidental. Objectif. Determiner la prevalence de l’anemie hemolytique auto- immune et les facteurs de risque associes. Methodologie. Etude retrospective et descriptive du 1er janvier 2013 au 30 juin 2015. Ont ete inclus les patients ayant consulte et qui presentaient une anemie hemolytique associee a la positivite d’un ou plusieurs marqueurs suivants: anti-corps anti-DNA, test de Coombs, presence d’immunoglobuline. Resultats : la prevalence de l’anemie auto-immune etait de 4,7%.Le sex-ratio etait a 2. L’âge moyen etait de 41 ans avec des extremes de 15 et 87 ans. L’elevation de la creatininemie etait le principal motif de consultation. Les signes physiques etaient : pâleur conjonctivale 89,8% ; syndrome hemorragique 14.8% ; splenomegalie et l’urine foncee 4,08%.Le test de Coombs direct etait positif chez 48,1% de nos patients. Il etait associe a l’anemie grade III (44,7%), regenerative (50%), LDH augmentee (40,7%) avec 41,7% d’haptoglobine effondree et la bilirubine etait augmentee dans 66,7%. Les facteurs de risque etaient les infections bacteriennes urinaires et digestives, le lupus, les infections virales et le myelome dans respectivement 32,5%,30%,30% et 7,5%. Conclusion. Il ressort de cette etude que l’anemie hemolytique auto-immune est frequence en milieu nephrologique.ABSTRACTIntroduction. Autoimmune haemolytic anaemia is an anaemia caused by the destruction of red blood cells by antibodies directed against the patient's own unmodified red blood cell membrane antigens. It is a relatively rare condition with an incidence of approximately 1 case/100,000 population per year in the Western world. Objective. To determine the prevalence of autoimmune haemolytic anaemia and associated risk factors. Methodology. Retrospective and descriptive study from 1 January 2013 to 30 June 2015. Patients presenting with haemolytic anaemia associated with the positivity of one or more of the following markers were included: anti-DNA antibodies, Coombs test, presence of immunoglobulin. Results. The prevalence of autoimmune anaemia was 4.7% and the sex ratio was 2. The mean age was 41 years with extremes of 15 and 87 years. Elevated creatinine levels were the main reason for consultation. Physical signs were: conjunctival pallor 89.8%; haemorrhagic syndrome 14.8%; splenomegaly and dark urine 4.08%.The direct Coombs test was positive in 48.1% of our patients. It was associated with grade III anaemia (44.7%), regenerative anaemia (50%), increased LDH (40.7%) with 41.7% collapsed haptoglobin and bilirubin was increased in 66.7%. The risk factors were bacterial urinary and digestive infections, lupus, viral infections and myeloma in 32, 5%, 30%, 30% and 7.5% respectively. Conclusion. This study shows that autoimmune hemolytic anemia is common in nephrology.