Clinical manifestations of HTLV-1 infection

Adult T-cell leukaemia/lymphoma (ATL) and tropical spastic paraparesis/HTLV-1 associated myelopathy (STSP/HAM) are the major clinical manifestations of HTLV-1 infection in adults. Susceptibility is related not only to the mode and age of acquisition of the virus but also to genetic, socio-economic and geographic factors. Recently there has been documentation of a number of other disease associations in adults including: polymyositis, uveitis, arthropathy, cystitis and prostatitis. These diseases which exhibit an autoimmune mode of pathogenesis underscore the widespread systemic effects of the virus. In childhood infective dermatitis is a specific marker for HTLV-1 infection with a risk of evolution into either ATL or TSP/HAM in adult life (AU)

Seroprevalence of autoantibodies in selected and unselected populations in Jamaica

Various serological techniques were used to investigate the prevalence and distribution of autoantibodies in healthy Jamaicans and patients with autoimmune and non-autoimmune disease. Low concentrations of autoantibodies were found in healthy Jamaicans, including thyroid (1.5 percent), gastric parietal cell (1.4 percent) and smooth muscle (11.3 percent). There was no significant age or sex predominance in the distribution of autoantibodies in the healthy population though autoimmune disease was more prevalent in females. Serological overlaps occurred but the comparative distributions and concentrations of autoantibodies in patients with autoimmune disease and non-autoimmune disease, and health subjects indicate that currently available methods of autoantibody determination may be used successfully in diagnosis in Jamaica. Failure to detect circulating pancreatic islet cell antibodies in insulin-dependent diabetic patients as well as in healthy Jamaicans questions the pathogenicity of these antibodies and diminished their diagnostic usefulness in this population. (AU)

Autoantibodies and autoimmune disease in Jamaica

This study investigated the repertoire of autoantibodies found in normal healthy Jamaicans as it relates to the efficacy of laboratory diagnosis of autoimmune disease. Clinical, immunological and genetic features of certain autoimmune diseases as they occur in Jamaicans were also examined. A number of immunological techniques were applied. There was no marked female preponderance of thyroid autoantibodies in the normal population although autoimmune thyroid disease was found predominantly in females. This indicates that gonadal hormones may be important in the development of disease. The low frequency and concentrations in which islet cell autoantibodies occur in Jamaican type 1 diabetics (3.2 percent) supports a non-pathogenetic role for these antibodies (Chapter 6). The bimodal clinical distribution of myasthenia gravis found elsewhere was not observed in Jamaicans (Chapter 10). There was no female preponderance in the ocurrence of rheumatoid factors. The frequency of certain ARA criteria were statistically significantly lower in Jamaican systemic lupus erythematosus (SLE) patients compared with American patients. Several HLA associations were found with myasthenia gravis, SLE and rheumatoid arthritis although these were mostly weak. The data obtained herein will contribute to the improvement in diagnosis and management of autoimmune diseases in Jamaica and the lack of understanding of the pathogenesis of autoimmune diseases

Pregnancy in chronic active hepatitis with cirrhosis

Pregnancy in chronic active hepatitis and cirrhosis is rare. There is an appreciable perinatal mortality and the effect of pregnancy on the underlying liver disease remains uncertain. Two patients with autoimmune chronic active hepatitis with cirrhosis who became pregnant during an active stage of their disease while on therapy are described. Both had an uneventful pregnancy with successful deliveries. One of the patients had two other prenancies but the pregnancy had to be terminated because of clinical deterioration. With close supervision patients with chronic active hepatitis and cirrhosis may have successful pregnancies. (AU)

Review of the aetiology and pathogenesis of acute pancreatitis: Part IV: Auto-immune reactions, neurogenic and miscellaneous factors

It is possible that in many cases, acute pancreatitis may develop because of auto-immune reactions. There are positive indications that neurogenic factors may play an important role in the development of some cases of acute pancreatitis. The problems pertaining to hereditary pancreatitis, the association of pancreatitis with pregnancy, ureamia, certain drugs and the sting of scorpions have been discussed (AU)

Clonal evolution in two patients with autoimmune disease and lymphoreticular neoplasia

Two cases are described, one with proven lymphosarcoma and doubtful autoimmune disease, and the second with the reverse situation, in which circulating abnormal mononuclear cells showed PHA responsiveness and an abnormal chromosomal constitution (clonal evolution). These findings are discussed in the light of previous cytogenic studies of lymphoreticular neoplasia and autoimmune disease and the relationship between these two conditions (Summary)