{"id":1756,"date":"2003-10-01T01:00:00","date_gmt":"2003-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/comment-ameliorer-le-depistage-de-lhemochromatose-resultats-dune-etude-en-medecine-generale\/"},"modified":"2018-10-20T18:39:30","modified_gmt":"2018-10-20T16:39:30","slug":"comment-ameliorer-le-depistage-de-lhemochromatose-resultats-dune-etude-en-medecine-generale","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/comment-ameliorer-le-depistage-de-lhemochromatose-resultats-dune-etude-en-medecine-generale\/","title":{"rendered":"COMMENT AMELIORER LE DEPISTAGE DE L’HEMOCHROMATOSE ? RESULTATS D’UNE ETUDE EN MEDECINE GENERALE."},"content":{"rendered":"

2003<\/strong><\/p>\n

S\u00e9bastien Carpentier (1), Marie Claude Konan (1), B\u00e9rang\u00e8re Marks-Brunel (1), Claudine Gamblin (1), Philippe Gower (1), Dominique Hanon (1), St\u00e9phanie Poulain (2), Arnaud Boruchowicz (1).
\n(1) Service des Maladies de l’Appareil Digestif et de la Nutrition, (2) Laboratoire de biologie, Centre Hospitalier de Valenciennes, avenue D\u00e9sandrouin 59350, Valenciennes.<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a02000-03-09 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

L’h\u00e9mochromatose est la maladie g\u00e9n\u00e9tique la plus fr\u00e9quente de l’adulte caucasien. Son diagnostic pr\u00e9coce permet par un traitement simple (saign\u00e9es) d’\u00e9viter des complications graves. Les r\u00e9sultats de l’enqu\u00eate de l’ANGH publi\u00e9s en 2002 ont mis en \u00e9vidence que seulement 24% des gastroent\u00e9rologues interrog\u00e9s avaient particip\u00e9 \u00e0 un enseignement post-universitaire sur l’h\u00e9mochromatose aupr\u00e8s des m\u00e9decins g\u00e9n\u00e9ralistes (1). L’association de malades demande au corps m\u00e9dical de promouvoir la connaissance de la maladie et de favoriser la mise en place d’un d\u00e9pistage de masse
\nButs de l’\u00e9tude : Evaluer 1) la connaissance de la maladie dans un groupe de m\u00e9decins g\u00e9n\u00e9ralistes (MG), 2) l’impact d’une information sur le d\u00e9pistage de la maladie.
\nM\u00e9thodes : 41\/41 MG de Valenciennes (42343 habitants) ont accepter de participer \u00e0 l’\u00e9tude. Ils ont \u00e9t\u00e9 interrog\u00e9s \u00e0 leur cabinet, en utilisant un questionnaire, en avril 2002 puis tous revus \u00e0 leur cabinet en f\u00e9vrier 2003 pour \u00e9valuer leur pratique vis \u00e0 vis du d\u00e9pistage. .
\nR\u00e9sultats : En avril 2002, 28\/41 MG ne suivaient pas de patient pour h\u00e9mochromatose. 13 MG suivaient un total de 13 patients (incidence \u00ab\u00a0estim\u00e9e\u00a0\u00bb de 0,28\/1000 pour une incidence attendue de 2 \u00e0 6\/1000). Les signes cliniques \u00e9vocateurs pour les MG \u00e9taient : hyperpigmentation cutan\u00e9e (n=24), h\u00e9patom\u00e9galie (n=16), asth\u00e9nie (n=16), douleurs abdominales (n=10), arthralgies (n=5). 2 MG avaient connaissance du risque de cardiopathie. 12 praticiens n’ont cit\u00e9 qu’un seul signe clinique. 4 praticiens n’avaient pas d’id\u00e9e sur la clinique. La r\u00e9alisation d’un coefficient de saturation de la sid\u00e9rophylline \u00e9tait demand\u00e9e par 24 MG. 7 MG ne demandaient pas de bilan du fer. 7 MG avaient connaissance du test g\u00e9n\u00e9tique et 9 demandaient une biopsie h\u00e9patique. 24 MG envisageaient une \u00e9chographie h\u00e9patique. 28 MG conseillaient un d\u00e9pistage familial. En fin d’entretien, une information \u00e9tait rappel\u00e9e au MG sur les tableaux cliniques \u00e9vocateurs (diab\u00e8te, arthralgies, anomalies h\u00e9patiques, asth\u00e9nie, cardiopathie dilat\u00e9e, impuissance et am\u00e9norrh\u00e9e). En f\u00e9vrier 2003 : En 9 mois, 18 praticiens avaient recherch\u00e9 une h\u00e9mochromatose, 18 ne l’avaient pas fait et 5 y on pens\u00e9 sans la rechercher. 7 diagnostics confirm\u00e9s ont \u00e9t\u00e9 fait par 5 MG. Aucun de ces praticiens n’avait fait de diagnostic d’h\u00e9mochromatose au cours des 5 ann\u00e9es pr\u00e9c\u00e9dentes. Les circonstances diagnostiques \u00e9taient les suivantes : bilans syst\u00e9matiques (n=2), cytolyse h\u00e9patique (n=2), d\u00e9pistage familial (n=1), asth\u00e9nie (n=1), diab\u00e8te (n=1).
\nConclusion : 1) La maladie est peu connue des MG et le nombre de patients suivis inf\u00e9rieur \u00e0 celui attendu, 2) L’information des MG sur l’h\u00e9mochromatose pourrait permettre d’am\u00e9liorer la qualit\u00e9 du d\u00e9pistage.<\/p>\n

(1) Barbare JC, Nouel O et ANGH, Gastroenterol Clin Biol 2002; 26 : 636-7.<\/p>\n","protected":false},"excerpt":{"rendered":"

2003 S\u00e9bastien Carpentier (1), Marie Claude Konan (1), B\u00e9rang\u00e8re Marks-Brunel (1), Claudine Gamblin (1), Philippe Gower (1), Dominique Hanon (1), St\u00e9phanie Poulain (2), Arnaud Boruchowicz (1). (1) Service des Maladies de l’Appareil Digestif et de la Nutrition, (2) Laboratoire de biologie, Centre Hospitalier de Valenciennes, avenue D\u00e9sandrouin 59350, Valenciennes. H\u00e9patologie – \u00a02000-03-09 –\u00a0CO – ________________________________ […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[14],"class_list":["post-1756","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-14"],"yoast_head":"\nCOMMENT AMELIORER LE DEPISTAGE DE L'HEMOCHROMATOSE ? 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