Association of APOE gene polymorphism with lipid profile and coronary artery disease in Afro-Caribbeans.

OBJECTIVES: Apolipoprotein E gene (APOE) polymorphism is associated with the lipid profile and cardio-vascular disease. However, these relationships vary between ethnic groups. We evaluated, for the first time in an Afro-Caribbean population, the distribution of APOE polymorphisms and their associations with coronary artery disease (CAD), the lipid profile and other cardio-metabolic risk factors. METHODS: We studied 712 Afro-Caribbean subjects including 220 with documented CAD and 492 healthy subjects. TaqMan assays were performed to genotype rs7412 and rs429358, the two variants that determine the APOE alleles ε2, ε3 and ε4. The association between APOE genotype and the lipid profile was analysed by comparing ε2 carriers, ε3 homozygotes and ε4 carriers. RESULTS: The frequencies of ε2, ε3 and ε4 in the overall sample were 8%, 70% and 22%, respectively. CAD was not associated with APOE polymorphism. The total cholesterol level was higher in ε4 carriers compared with ε2 carriers: 5.07 vs 4.59 mmol/L (P = 0.016). The LDL-cholesterol level was lower in APOE ε2 carriers compared with ε3 homozygotes and ε4 carriers: 2.65 vs 3.03 and 3.17 mmol/L, respectively (p = 0.002). The total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios were similar in the three allelic groups. APOE polymorphism was not associated with diabetes, hypertension, waist circumference or body mass index. CONCLUSIONS: Our results indicate that APOE gene polymorphism is associated with the lipid profile but not with CAD in Afro-Caribbean people. This lack of association with CAD may be explained by the low atherogenic profile observed in ε4 carriers, which may warrant further investigation.

Multiple cerebral infarctions following a snakebite by Bothrops caribbaeus.

Bothrops caribbaeus, a species of the Bothrops complex, is found only in the island of Saint Lucia, West Indies. Snakebite from this pitviper is very rare. We report the case of a healthy 32-year-old Saint Lucian man who developed multiple cerebral infarctions following envenoming by this snake. This patient developed signs and symptoms very similar to those observed in patients envenomed by Bothrops lanceolatus, a snake found only in Martinique, the neighbor island of Saint Lucia. This clinical presentation differs dramatically from coagulopathies and systemic bleeding observed with the Central and South American bothropic envenomings. The exact mechanism of this thrombogenic phenomenon, leading to a unique envenoming syndrome, remains unknown.

[Primary pulmonary hypertension associated with HTLV-I retrovirus infection at the adult T-cell leukemia lymphoma stage]. / Hypertension artérielle pulmonaire primitive et infection par le rétrovirus HTLV-1 au stade de leucémie-lymphome T de l'adulte.

INTRODUCTION: Primary pulmonary hypertension is a rare condition characterized by sustained elevation of pulmonary artery pressure without demonstrable cause. Risk factors such as HIV infection are associated with this disease. HTLV-1 is a retrovirus endemic in Japan and in the Caribbean and an adult T-cell leukaemia-lymphoma is the most severe complication induced. OBSERVATION: A 59 Year-old West Indian woman who had an HTLV-1 retrovirus infection complicated by adult T-cell leukaemia lymphoma developed primary pulmonary hypertension. COMMENT: The link between HIV infection and primary pulmonary hypertension is already known. The hypothesis of a link with an other retrovirus has to be confirmed by furthers studies.

Dengue fever in patients under biologics.

Dengue fever (DF) is an epidemic viral mosquito-borne infection limited to tropical and subtropical countries. Biological therapies have been frequently used for the last 15 years in the treatment of inflammatory rheumatic conditions like rheumatoid arthritis. However, no data is available regarding the characteristics of this infection in patients on biological therapy. Yet, numerous patients on biotherapy have holidays in countries where DF exists. Moreover, the mosquitoes Aedes albopictus, vector of this viral disease, is now found in some developed countries such as southern Europe and the USA, allowing the possibility of a DF outbreak. We conducted a survey of individuals on biotherapy and described a case series of the patients experiencing DF. Our 8 patients on biotherapy (anti-TNF, n=6; rituximab, n=2) for a rheumatic condition did not experience severe DF.