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A potential role of hyperhomocysteinemia in bone metabolism has been considered from the observation of high prevalence of osteoporosis in subjects with homocystinuria about 50 years ago.To examine the association of homocysteine level and its determinants Methylenetetrahydrofolate Reductase [MTHFR] C677T Polymorphism, folates and vitamin B12 levels with bone mineral density [BMD] and the prevalence of vertebral fractures [VF] on postmenopausal women.Through a cross-sectional study, one hundred and twenty-two healthy postmenopausal women gave their informed consent to participate in this study. Women were recruited through advertisements and mouth to ear between January 2017 and May 2017. One serum tube and one EDTA tube were collected from fasting patients. Bone mineral density was determined by a Lunar Prodigy® Vision DXA system®. Vertebral fracture [VF] assessment image was inspected visually by 2 clinicians.We found that a high level of homocysteine and low vitamin B12 and folate levels are not associated with bone mineral density and are not risk factors for VF in healthy postmenopausal women. Whereas, the presence of VF was associated with the number of years since menopause and with the osteocalcin levels.The MTHFR C677T polymorphism, the high levels of HCY, or low levels of folate and vitamin B12 would not be risk factors for osteoporosis and VF in healthy postmenopausal women.

Introduction: Monoclonal gammopathies are a group of disorders associated with monoclonal proliferation of plasma cells that produces a monoclonal protein. To describe the epidemiological and immunochemical characteristics of monoclonal gammopathies diagnosed during a nineteen-year period in a Moroccan teaching hospital was the main objective of this study. Methods: This study was performed from January 2000 to August 2019. It was a retrospective study that included of 545 Moroccan patients with monoclonal gammopathy. Results: The patients who participated in the study, 374 (68.6%) were male and 171(31.4%) were female, with a mean ±SD age of 62.24±13.14 years. The most frequent reasons for admission were bone pain (41,60%), renal failure (19.08%), alteration of the general condition (12.21%) and anemia (10.69). Plasma cell proliferative disorders in our study were as follow, multiple myeloma (MM) (45.65%), Monoclonal gammopathies of undetermined significance (MGUS) (39.05%), Waldenstrom’s macroglobulinemia(5.58%), Lymphoma (2.27%+1.2%), Chronic Lymphocytic Leukemia (2.48%), Plasma cell leukemia (1.86%), Plasmacytoma (0.62%), POEMS syndrome (0.41%), and Amyloidosis (0.84%). The most frequent isotypes in MM were the IgGκ (62) 36.5%, IgGλ(52)30.6%, IgAκ(27)15.9% and the IgAλ (19)11.2%. It is also worthy of note, that Free light chain MM represents 20% of all cases of MM. Conclusions: This is the largest Moroccan cohort, it included 545 patients. The results of this study point to the need for an early diagnosis of monoclonal gammopathies in the Moroccan population

Introduction:partant de l´observation de manque d´informations sur les gammapathies monoclonales, nous avons fixé comme objectif de dresser les profils épidémiologiques, cliniques et biochimiques des gammapathies monoclonales, au niveau de la région de Souss-Massa au sud du Maroc. Méthodes:il s´agit d´une étude rétrospective, où nous avons sélectionné que les dossiers complets. Nous avons exploité les dossiers des patients diagnostiqués avec une gammapathie monoclonale au niveau du centre d´oncologie local, sur une période de plus10 ans. Résultats:cent dix-sept (117) patients ont été inclus dans l´étude avec une forte prédominance masculine (65%), un sexe-ratio Homme/Femme de 1,85. De même, la moyenne d´âge de notre population a été de 61,44 (ET 14,54) année. Les diagnostics qui ont été retenus et par ordre de fréquence sont, le myélome multiple 82,0% (n=96), le plasmocytome solitaire 8,5% (n=10), les gammapathies monoclonales de signification indéterminé 2,6% (n=3), trois cas de lymphome 2,5% (n=3), deux cas de leucémies à plasmocytes secondaires 1,7% (n=2), deux cas de maladie de Waldenström 1,7% (n=2) et un cas de leucémie lymphoïde chronique. La répartition selon l´isotype a été comme suit, Les IgG kappa 33,7% (n=28), Les IgG Lambda 21,7% (n=18), Les IgA Kappa 12,0% (n=10), les IgA Lambda 7,2% (n=6) les IgM kappa 3,6% (n=3) et les IgD Lambda 2,4% (n=2). Le pic biclonal a été retrouvé dans deux cas avec un pourcentage de 2,4%. Conclusion:un retard de diagnostic des patients a été remarqué par rapport aux études internationales du à la non disponibilité des électrophorèses dans les structures des soins.

given the lack of information about monoclonal gammopathies, our primary study outcome was to describe the epidemiological, clinical and biochemical profiles of monoclonal gammopathies in the Souss-Massa region, in southern Morocco.we conducted a retrospective study, by selecting only complete medical records. We used records of patients diagnosed with monoclonal gammopathy at the local oncology center during a period of over 10 years.one hundred and seventeen patients were included in the study, with a high male predominance (65%) and a male/female sex-ratio of 1.85. The average age of our study population was 61.44 (ET 14.54) years. Diagnoses (based on frequency) included: multiple myeloma 82.0% (n=96), solitary plasmacytoma 8.5% (n=10), monoclonal gammopathies of undetermined significance 2.6% (n=3), lymphoma 2.5% (n=3), secondary plasma cell leukaemia 1.7% (n=2), Waldenström´s disease 1.7%(n=2) and chronic lymphoid leukemia (n=1). The isotype distribution was as follows: IgG Kappa 33.7% (n=28), IgG lambda 21.7% (n=18), IgA Kappa 12.0% (n=10), IgA lambda 7.2% (n=6), IgM kappa 3.6% (n=3), and IgD lambda 2.4% (n=2). Biconal peak was reached in two cases, with a percentage of 2.4%.diagnostic delay was observed compared to international studies due to the unavailability of electrophoresis in the care structures.

Monoclonal gammopathies are a clonal proliferation of plasma cells or lymphoplasmocytes, responsible of the secretion of a monoclonal protein. Its pathophysiology is characterized by the presence of several cytogenetic and molecular anomalies The generalization of the demand protein electrophoresis, the improvement of the knowledge on the topic, which represent a heterogeneous group of diseases, and especially the evolution of radiological and biochemical techniques, have made it possible to diagnose GM at early stages. The hematological malignancies associated with the detection of a monoclonal protein in the serum or in the urine, are monoclonal gammopathy of undetermined signification (MGUS), indolent myeloma (IM), multiple myeloma (MM), AL amyloidosis, polyneuropathy, organomegaly, endocrinopathy, monoclonal dysglobulinemia, skin abnormalities) syndrome, light and heavy chain deposition diseases, Waldenstr��m disease, chronic lymphocytic leukemia., Les gammapathies monoclonales (GM) sont des prolif��rations clonales des plasmocytes ou des lymphoplasmocytes, responsables de la s��cr��tion d���une prot��ine monoclonale ou paraprot��ine. Sa physiopathologie est caract��ris��e par la pr��sence de plusieurs anomalies cytog��n��tique et mol��culaire. La g��n��ralisation de la demande de recherche de GM, l���am��lioration de la connaissance des GM qui repr��sentent un groupe h��t��rog��ne de maladies et surtout l�����volution des techniques radiologiques et biochimiques ont permis de diagnostiquer les GM �� des stades pr��coces. Les pathologies h��matologiques malignes associ��es �� la d��tection d���une prot��ine monoclonale dans le s��rum ou dans les urines, sont les gammapathies de signification ind��termin��s (GMSI), le My��lome indolent (SM), le My��lome multiple (MM), l���Amylose AL, POEMS (Polyneuropathie, organom��galie, endocrinopathie, dysglobulin��mie monoclonale, anomalies cutan��es) Syndrome, Maladies de d��position des chaines l��g��res et lourdes, maladie de Waldenstr��m, leuc��mie lympho��de chronique et le lymphome de la zone marginale.

Even though the North African countries are located in one of the sunniest place in the world, several North African studies from there proved a high prevalence of hypovitaminosis D in men and women. The objectives of the present review are to summarize the existing literature on vitamin D status and to list the main predictors of hypovitaminosis D in North African population. We searched Medline/PubMed, Cochrane, CINAHL, Embase, Scopus, and Springerlink for the published data on vitamin D in North African countries. The identified articles had to meet all the following criteria: human clinical outcomes rather than animal experiments, a cross-sectional or longitudinal study and quantitative information on vitamin D status in North Africa must be included. Several studies proved a high prevalence of hypovitaminosis D in North African men and women. Also, these studies reported that determinants of vitamin D status were the culture of avoiding the sun, the wearing of the veil for women, the pigmented skin, the lack of vitamin D supplementation in the aliments, the breastfeeding for 2 years. This review on vitamin D status in North Africa indicates a high prevalence of vitamin D insufficiency in men and women (among all age groups).

Introduction : L'objectif de cette etude prospective, realisee sur une annee au laboratoire de biochimie de l'HMIMV de Rabat, vise a etudier la cinetique de la Troponine Ic (TnIc) apres chirurgie cardiaque sous circulation extracorporelle (CEC) en vue d'etablir des valeurs seuils pour le diagnostic d'infarctus de myocarde peri-operatoire (IDMPO). Methodes : Nous avons inclus 58 patients operes pour chirurgie valvulaire ou pontage coronarien sous CEC. Ces patients ont ete separes en 3 groupes selon l'evolution clinique, biologique (TnIc) et electrique durant la periode post operatoire precoce. Nous avons dose et suivi la cinetique de la TnIc par une technique immuno-enzymatique, au moyen du reactif FlexR CTNI avant et apres la CEC, a H 0 , H 3 , H 6 , H 12 , H 21 , H 24 et H 72 sur l'automate Dimension Xpand plusR de la societe Siemens. Resultats : Les resultats obtenus sont plus eleves qu'en cardiologie, meme chez le groupe des patients sans complications cardiaques post operatoires, avec un taux moyen de TnIc environ 2,5 fois superieur a la valeur seuil en cardiologie. La cinetique de liberation est significativement differente entre les 3 groupes (p‹0,05). Conclusion : La valeur seuil que nous proposons pour confirmer le diagnostic de l'IDMPO est de 13ng/ml obtenue entre H12 et H24. Nous recommandons, de ce fait, un a deux prelevements vers H12 puis entre H20 et H24.

Hemoglobin C is a hemoglobin variant encountered worldwide. The regionswith high prevalence are West Africa and South-East Asia.The objective of this study is to report cases of hemoglobin C disease brought together during these last twelve years in the Laboratory of Biochemistry and Toxicology of RabatMilitary Hospital Mohammed V (MHIMV).- This was a retrospective study including111 cases of hemoglobin C disease collected in the Laboratory of Biochemistry of the MHIMVover the past 12 years. A questionnairewasfulfilledwith the epidemiological data,clinical data and the results of the biological explorations. The screening of the hemoglobin variant in this study included several biochemical (hemoglobin electrophoresis at acid and alkalinepH) and hematological tests.- Sex-ratio was equal to 1,22. The age at the time of diagnosis ranges between 4 and 80years old, with the mean of 38. North-West regions of Morocco seem most affected. The most frequent reasons for prescription of the hemoglobin's studywere: biological abnormalities, splenomegaly and anemic syndrome. Blood smear reveals frequently anisopoikilocytosis and red blood target. The biochemical tests contribute to the diagnosis and reveal various and varied etiological groups: heterozygous A/C (75%),homozygous C/C (8%), double heterozygous S/C (9%),C/β+-thal (6%) andC/O-Arab (2%). Conclusion - The results of the present descriptive study are in line with the literature data. The importance of genetic counseling and the installation of a national card of systematic neonatal tracking seemto be unavoidable.

La procalcitonine (PCT) est un marqueur de gravite du sepsis, dont la valeur absolue et la cinetique sont correlees a la severite de l'infection. On rapporte le cas d'un patient qui presente une PCT tres elevee sans relation avec un sepsis. Il s'agit d'un homme âge de 55 ans, admis en rhumatologie pour des lombosciatalgies hyperalgiques febriles. Le bilan biologique a montre une hyperleucocytose a 15000 element/mm3 a predominance neutrophile, associee a une CRP et une PCT seriques, respectivement a 305 mg/l et 2,5ng/ml. Devant ce tableau evocateur de sepsis, des hemocultures etaient realisees et un traitement antibiotique probabiliste etait instaure. L'absence d'evolution favorable du malade ainsi que la discordance entre les chiffres de la PCT demeurant tres eleves et les hemocultures negatives, une IRM dorso-lombaire etait realisee. Elle a objective une arthrite de la hanche droite, associee a des lesions osseuses multiples secondaires du squelette axial evoquant une origine neoplasique. Une TDM thoraco-abdomino-pelvienne a montre la presence d'une masse pulmonaire gauche. La biopsie pulmonaire a revele un adenocarcinome infiltrant.

The main of this study was to examine the relationship between plasma homocysteine (Hcy), asymptomatic osteoporotic vertebral fractures (VFs) using vertebral fracture assessment (VFA) and prevalent abdominal aortic calcification (AAC) in Moroccan postmenopausal women. The study cohort consisted of 188 consecutive postmenopausal women with no prior known diagnosis of osteoporosis or taking medication interfering with bone metabolism. Mean age, weight, height, body mass index and plasma homocysteine were determined. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy Vision densitometer (GE Healthcare Inc., Waukesha, WI). VFs were defined using a combination of Genant’s semiquantitative approach and morphometry. VFA images were also scored for prevalent AAC using a validated 24 point scale. Fifty-eight (30.9%) patients had densitometric osteoporosis. VFs were identified using VFA in 76 (40.4%) patients: 61 women had grade 1 VFs and 15 had grade 2 or 3 VFs. One hundred twenty nine women (68.6%) did not have any detectable AAC, whereas the prevalence of significant atherosclerotic burden defined as AAC score of 5 or higher, was 13.8%. A significant positive correlation between AAC score and homocysteine was observed. Women with extended AAC, were older, had a lower weight, BMI and BMD, higher homocysteine levels and more prevalent VFs than women without extended AAC. Multiple regression analysis showed that the presence of extended AAC was significantly associated with Age and grade 2/3 VFs and not independently associated with homocysteine levels.This study did not confirm that homocysteine is important determinant of extended AAC in postmenopausal women. However, this significant atherosclerotic marker is independently associated with VFs regardless of age.

Background The retinopathy is an uncommon complication in individuals with sickle cell trait except for the cases of sickle cell trait associated with systemic arterial hypertension, diabetes mellitus, syphilis, tuberculosis and sarcoidosis. Case Presentation A retinopathy in a 16 year-old child with no history of consanguinity in the parents revealed a sickle S trait associated to heterozygous alpha thalassemia. His mother has Sickle cell anaemia (Hb SS) and his father is a carrier of heterozygous alpha-thalassemia status that it was unknown before. Conclusion This case report describes a proliferative retinopathy in a 16 year-old patient with co-inheritance of heterozygous alpha + −thalassemia and sickle trait.

This study aimed to compare the vitamin D status in healthy Moroccan men and women aged 50 years and older. A total of 186 Moroccan women and 68 men, who had no previous diagnosis of osteoporosis, were recruited prospectively. We found in this study a high prevalence of hypovitaminosis D with no difference between men and women. The main purpose of this study was to describe and compare the vitamin D status, parathormone, calcium, and phosphate of healthy Moroccan men and women aged 50 years and older. We conducted two cross-sectional studies, in postmenopausal women from October 2008 to November 2009 and in men over 50 years old, from December 2009 to August 2010. A total of 186 Moroccan women and 68 men, who had no previous diagnosis of osteoporosis, were recruited prospectively. For the definition of hypovitaminosis D, the preferred level for 25-hydroxyvitamin D (25(OH)D) insufficiency, which is now recommended by many experts, is 30 ng/mL (75 nmol/L), and the levels below 10 ng/ml (25 nmol/L) indicate deficiency. The prevalence of vitamin D deficiency in men and women was 4.4 and 8.6 %, respectively, and the prevalence of vitamin D(25(OH) D) insufficiency in men and women were 85.2 and 77.4 %, respectively. In men and women, no correlations were found between intact parathormone (PTHi) and 25(OH) D (r = 0.056). Despite a sunny environment, we found in this study a high prevalence of hypovitaminosis D (insufficiency + deficiency) in Moroccan men over 50 years old and postmenopausal women.

Introduction: Multiple myeloma (MM) is defined by the presence of monoclonal protein in the urine and/or serum, and bone-marrow plasma cells greater than 10%. Musculoskeletal manifestations of this disorder are rare. Case Report: We report a case of an 80-year-old female patient presenting with monoarthritis and joint swelling, detailed investigations revealed that she was suffering from multiple myeloma in which monoarthritis was a musculoskeletal complication of the disease. Conclusion: We report a case of a patient presenting with monoarthritis and joint swelling diagnosed with multiple myeloma.

Background Vertebral Fractures (VFs) are associated with bone loss that occurs before menopause but is accelerated at menopause as a result of sex hormone deficiency. To determine the association of sex hormones, bone remodeling markers and vitamin D levels with bone mineral density (BMD) and asymptomatic VFs prevalence using vertebral fracture assessment (VFA) in a cohort of Moroccan menopausal women. Methods This was a cross-sectional study conducted from October 2012 to April 2013 with menopausal women aged 50 years old and over. A total of 207 women who had no previous diagnosis of osteoporosis were enrolled in this cross-sectional study. Women were recruited prospectively from our laboratory department. VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry. Serum levels of estradiol, dehydroepiandrosterone sulfate, Sex hormone binding globulin, vitamin D, Osteocalcin, Crosslaps, intact parathormone were measured by Electrochemiluminescent immunoassay technique. Results Among the 207 women, 18.3 % (n = 38) had densitometric osteoporosis. On VFA, VFs were detected in 134 (62.3 %), including 96 (44.6 %) grade 1 and 38 (17.6 %) grade 2/3. There was no difference in the plasma levels of sex steroids, bone remodeling markers and vitamin D in the group of women with VFs (grade 1 and grade 2/3) and without VFs. The combination of variables that best predicted grade 2/3 VFs included the number of years since menopause and the lumbar spine T-score. Conclusion These data confirm the importance of postmenopausal estrogen and SHBG concentrations in the bone loss and the pathogenesis of osteoporosis in elderly women, but not in the occurrence of the VFs.