Peculiarities of local immunity in dry eye disease on the background of hormonal dysfunction.

OBJECTIVE: Aim: to determine the state of local immunity in DED on the background of hormonal dysfunction. PATIENTS AND METHODS: Materials and Methods: Of 32 women, 17 patients with diagnosed SM and 15 women of the control group were examined. The Ocular Surface Disease Index and the state of local immunity were defined by determining Ig As in lacrimal fluid (LF) by radial immunodiffusion in Mancini agar. RESULTS: Results: During the OSDI questionnaire, a mild degree of DED was detected in 21 (65.6%) women, and an average degree was observed in 11 (34.4%) patients with SM. On average, OSDI was 34.54 ±2.01. As a result of studies of the state of local immunity in patients with SM, a tendency to increase Ig As was noted, compared with the control group. An increase in Ig As in the lacrimal fluid in patients with SM to 0.34 ±0.09 g/l was found, compared with the control group (0.24 ±0.03 g/l). CONCLUSION: Conclusions: Using the OSDI questionnaire, the presence of DED was detected in women with SM, mainly mild and moderate degree. The obtained results of the state of local immunity indicate in favor of a nonspecific inflammatory process, accompanied by a decrease in local immune protection and leading to further changes in the ocular surface.

Annular Leukocytoclastic Vasculitis: A New Feature of IgA Vasculitis.

Background: Annular erythema is a rare manifestation of leukocytoclastic vasculitis. It may be associated with various drugs, infections, malignancies, or systemic diseases. Case description: A 36-year-old woman with no personal medical history presented with annular erythema with target lesions and petechial purpura. The patient had fever and joint arthralgia. A skin biopsy showed leukocytoclastic vasculitis with IgA deposits on direct immunofluorescence. The diagnosis of immunoglobulin A vasculitis with annular leukocytoclastic vasculitis was made. The patient showed global improvement with topical steroids without relapse. Conclusion: An annular variant of leukocytoclastic vasculitis is a rare manifestation of immunoglobulin A vasculitis. LEARNING POINTS: Annular erythema may reveal an IgA vasculitis.Annular leukocytoclastic vasculitis is a rare manifestation of IgA vasculitis.This presentation is treated with topical steroids.

Comparison of Different Treatment Regimens for Long-term Improvement of Renal Function in Patients with Henoch-Schönlein Purpura: A Systematic Review.

BACKGROUNDS: Henoch-Schönlein purpura (IgA vasculitis) is the most common childhood vasculitis, one of its complications is renal involvement. However, several treatment regimens have been proposed to improve renal function in the long term, but which drug regimen can be most effective is still controversial. METHODS: This study was a systematic review. In order to find evidence related to the purpose of this study, databases including Google Scholar, Web of Science, ProQuest and Medline via PubMed, and Scopus were searched with the appropriate keywords. QUADAS-2 (a Quality Assessment tools for Diagnostic Accuracy Studies) checklist was also used to evaluate the quality of studies. Based on the keywords used in reviewing the information sources of scientific articles, in the first stage, 86 studies were included in the review. Taking into account characteristics such as lack of homogeneity with the objectives of the present study, finally, 11 studies were selected for analysis and final evaluation. RESULTS: A total of 11 studies, including 722 patients in the age range of 5.5 to 9.9 years with HSP were included in the study. The follow-up period of the patients varied from 6 months to 16 years in terms of examining the treatment process. In terms of study type, 7 studies were conducted as prospective or retrospective (non-interventional) cohorts and 4 studies as randomized clinical trials. The treatment regimen of injectable methylprednisolone followed by oral prednisolone resulted in a long-term recovery of 79.2% (95% confidence interval between 0.66% and 88.2%); however, the need for additional immunosuppressive in two studies was mentioned as 38% and 46.1%, respectively. In the therapeutic regimen of oral methylprednisolone alone, a significant improvement in long-term renal function was achieved in comparison with placebo. Administration of injectable methylprednisolone followed by cyclosporine A had the highest effectiveness in terms of improving renal function in the long term. CONCLUSION: Regimes based on the administration of prednisolone (either oral or injectable, either as a single drug or as a combination) lead to long-term improvement of renal function in patients with HSP, but the use of other immunosuppressive drugs such as cyclosporine A, of course, with optimizing the drug dose can lead to a significant improvement in the clinical performance.

Unmasking Renal Disease in Systemic Lupus Erythematosus: Beyond Lupus Nephritis.

A 64-year-old Caucasian woman with a history of hypertension and systemic lupus erythematosus (SLE) was referred to a nephrology clinic due to persistent microscopic hematuria and trace proteinuria. Initial tests showed elevated antinuclear antibodies (ANA), anti-double-stranded DNA (anti-dsDNA), and anti-Sjögren's syndrome-related antigen A (anti-SSA) levels, while other markers remained within normal limits. Over the course of a year, her urine protein-creatinine ratio increased, prompting a renal biopsy. The biopsy revealed focal crescent formation in some glomeruli and mild segmental mesangial hypercellularity in others. Although the possibility of antineutrophilic cytoplasmic antibody (ANCA)-associated nephritis with superimposed IgA nephropathy was considered, negative myeloperoxidase and proteinase 3 antibody tests led to a final diagnosis of IgA nephropathy. The patient's treatment included adding prednisone to her existing valsartan prescription for hypertension, which resulted in improved proteinuria. SLE is an autoimmune disease that can cause chronic inflammation and damage to vital organs. Approximately 50% of SLE patients may experience lupus nephritis (LN), underscoring the importance of urinalysis and renal function tests. This case presents a female patient with SLE and IgA nephropathy, a rare association that requires distinction as it affects disease management. IgA nephropathy is the most common cause of idiopathic glomerulonephritis and can lead to end-stage kidney disease in around 40% of cases. A renal biopsy is also crucial for diagnosing IgA nephropathy in patients with or without another autoimmune disease. Focal crescent formation, a histological feature observed in this case, helped exclude several diagnoses, such as lupus nephritis or pauci-immune glomerulonephritis. The primary goal of treating IgA nephropathy is to prevent disease progression. Initial treatment includes controlling blood pressure, reducing proteinuria, and implementing lifestyle modifications. Corticosteroid therapy may be considered if supportive care is insufficient.

Effects of Diabetes and Voluntary Exercise on IgA Concentration and Polymeric Immunoglobulin Receptor Expression in the Submandibular Gland of Rats.

Background and Objectives: Patients with diabetes are more susceptible to upper respiratory tract infections (URTIs) because they are easily infected. Salivary IgA (sali-IgA) levels play a major role in transmitting URTIs. Sali-IgA levels are determined by salivary gland IgA production and polymeric immunoglobulin receptor (poly-IgR) expression. However, it is unknown whether salivary gland IgA production and poly-IgR expression are decreased in patients with diabetes. While exercise is reported to increase or decrease the sali-IgA levels, it is unclear how exercise affects the salivary glands of patients with diabetes. This study aimed to determine the effects of diabetes and voluntary exercise on IgA production and poly-IgR expression in the salivary glands of diabetic rats. Materials and Methods: Ten spontaneously diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats (eight-week-old) were divided into two groups of five rats each: a non-exercise group (OLETF-C) and a voluntary wheel-running group (OLETF-E). Five Long-Evans Tokushima Otsuka (LETO) rats without diabetes were bred under the same conditions as the OLETF-C. Sixteen weeks after the study began, the submandibular glands (SGs) were collected and analyzed for IgA and poly-IgR expression levels. Results: IgA concentrations and poly-IgR expression levels in SGs were lower in OLETF-C and OLETF-E than in LETO (p < 0.05). These values did not differ between the OLETF-C and OLETF-E. Conclusions: Diabetes decreases IgA production and poly-IgR expression in the salivary glands of rats. Moreover, voluntary exercise increases sali-IgA levels but does not increase IgA production and poly-IgR expression in the salivary glands of diabetic rats. Increasing IgA production and poly-IgR expression in the salivary glands, which is reduced in diabetes, might require slightly higher-intensity exercise than voluntary exercise under the supervision of a doctor.

Immunoglobulin a (IgA) Vasculitis in the Elderly.

IgA vasculitis is a small vessel vasculitis mediated by the deposition of IgA immune complexes. It mostly occurs in children and is rare in adults, with increased severity and mortality in the latter. Its aetiology remains largely unknown, and its prognosis depends primarily on the extent of renal involvement. We present the case of a 71-year-old woman with purpuric lesions in both lower and upper limbs associated with fever, abdominal pain, vomiting and blood in her stools for the past month. The patient was diagnosed with IgA vasculitis and the full systemic involvement (renal, dermatological, intestinal, and cerebral) of the disease was identified with excellent response to parenteral corticotherapy.

COVID-19 Associated Vasculitis Confirmed by the Tissues RT-PCR: A Case Series Report.

BACKGROUND: Several cases of skin and central nervous system vasculopathy associated with COVID-19 in children have been published, but the information is rather limited. Our study aimed to describe these cases of vasculitis associated with COVID-19 in children. METHODS: In the retrospective-prospective case series study we included information regarding four children with COVID-19-associated vasculitis. In every case, we had a morphological description and the etiology was confirmed via real-time polymerase chain reaction during a tissue biopsy. RESULTS: The most involved systems were skin (4/4), respiratory (3/4), cardiovascular (2/4), nervous (1/4), eye (1/4), kidney (1/4), and inner year (1/4). All patients had increased inflammatory markers and thrombotic parameters (D-dimer). No patient met the criteria for multisystem inflammatory syndrome in children. Two patients met polyarteritis nodosa criteria, one met Henoch-Schonlein purpura criteria, and one met unclassified vasculitis criteria. All patients were treated with systemic glucocorticosteroids (two-pulse therapy). Non-biologic DMARDs were prescribed in all cases; 1/4 patients (25%) was treated with intravenous immunoglobuline, and 3/4 (75%) were treated with biologics (etanercept, tocilizumab, and adalimumab). CONCLUSIONS: Vasculitis associated with COVID-19 could be a life-threatening condition; SARS-CoV-2 might be a new trigger or etiological agent for vasculitis and other immune-mediated diseases. Further research and collection of similar cases are required.

Nano-Encapsulated Melatonin: A Promising Mucosal Adjuvant in Intranasal Immunization against Chronic Experimental T. gondii Infection.

Melatonin (MLT) is now emerging as one of the universally accepted immunostimulators with broad applications in medicine. It is a biological manipulator of the immune system, including mucosal ones. MLT was encapsulated in solid lipid nanoparticles (SLNs), then 100 mg/kg/dose of MLT-SLNs was used as an adjuvant of Toxoplasma lysate antigen (TLA). Experimental mice were intra-nasally inoculated with three doses of different regimens every two weeks, then challenged with 20 cysts of T. gondii Me49 strain, where they were sacrificed four weeks post-infection. Protective vaccine efficacy was evident via the significant brain cyst count reduction of 58.6%, together with remarkably high levels of humoral systemic and mucosal anti-Toxoplasma antibodies (Ig G, Ig A), supported by a reduced tachyzoites invasion of Vero cells in vitro upon incubation with sera obtained from these vaccinated mice. A cellular immune response was evident through the induction of significant levels of interferon-gamma (IFN γ), associated with morphological deteriorations of cysts harvested from the brains of vaccinated mice. Furthermore, the amelioration of infection-induced oxidative stress (OS) and histopathological changes were evident in mice immunized with TLA/MLT-SLNs. In conclusion, the present study highlighted the promising role of intranasal MLT-SLNs as a novel mucosal adjuvant candidate against chronic toxoplasmosis.

Host's Immunity and Candida Species Associated with Denture Stomatitis: A Narrative Review.

Denture-related Candida stomatitis, which has been described clinically in the literature, is either localized or generalized inflammation of the oral mucosa in connection with a removable prosthesis. During this inflammatory process, the mycobacterial biofilm and the host's immune response play an essential role. Among microorganisms of this mixed biofilm, the Candida species proliferates easily and changes from a commensal to an opportunistic pathogen. In this situation, the relationship between the Candida spp. and the host is influenced by the presence of the denture and conditioned both by the immune response and the oral microbiota. Specifically, this fungus is able to hijack the innate immune system of its host to cause infection. Additionally, older edentulous wearers of dentures may experience an imbalanced and decreased oral microbiome diversity. Under these conditions, the immune deficiency of these aging patients often promotes the spread of commensals and pathogens. The present narrative review aimed to analyze the innate and adaptive immune responses of patients with denture stomatitis and more particularly the involvement of Candida albicans sp. associated with this pathology.

Presentación inusual de infección por SARS-CoV-2 simulando púrpura de Schönlein Henoch (vasculitis por inmunoglobulina A) / Unusual presentation of SARS-CoV-2 infection simulating Schönlein Henoch purpura (immunoglobulin A vasculitis)

La vasculitis por inmunoglobulina A, anteriormente llamada púrpura Schönlein Henoch (VIgA/PSH), es la vasculitis sistémica más frecuente en la infancia. El desencadenante más común es una infección previa del tracto respiratorio superior. Se caracteriza por púrpura palpable no trombocitopénica con artralgias y/o artritis, afectación gastrointestinal y compromiso renal. SARS-CoV-2 es un virus ARN que causa la enfermedad COVID-19. Afecta frecuentemente el sistema respiratorio con presentaciones que varían desde una rinitis hasta condiciones severas como síndrome de distress respiratorio, shock séptico o síndrome de inflamación multisistémica (multi-system inflammation syndrome, MIS). Se describe el caso de un niño de 5 años de edad con clínica de VIgA/PSH como forma inicial de presentación y diagnóstico posterior de infección por SARS-CoV-2, derivado al hospital de mayor complejidad, con encefalopatía hipertensiva que presentó evolución favorable y restitución completa del cuadro clínico

Immunoglobulin A vasculitis, previously called Henoch Schonlein purpura (IgAV/ HSP), is the most common systemic vasculitis in childhood. The most common trigger is a previous upper respiratory infection. It is characterized by palpable non-thrombocytopenic purpura with arthralgia and/or arthritis, gastrointestinal and kidney involvement. SARS-CoV-2 is an RNA virus that causes COVID-19 disease. It frequently affects the respiratory system with presentations ranging from rhinitis to severe conditions such as respiratory distress syndrome, septic shock, or multi-system inflammation syndrome (MIS). We describe the case of a 5-year-old boy with symptoms of IgAV/HSP as the initial form of presentation and subsequent diagnosis of SARS-CoV-2 infection, being referred to a more complex hospital with hypertensive encephalopathy, presenting a favorable evolution and complete restoration of the clinical picture.

Adult Onset Immunoglobulin A (IgA) Vasculitis Secondary to Group A Streptococcus Infection.

Immunoglobulin A (IgA) vasculitis is a small blood vessel vasculitis that is mediated by immune complex deposition. While it is the most common cause of childhood vasculitis, the disease is uncommon in adults with variable clinical manifestations. A 65-year-old female presented with a diffuse erythematous, pruritic, painful rash across her legs, back, and arms of 12 days' duration. Associated symptoms included fatigue, lower extremity swelling, and migratory arthralgias of the knees and ankles. Skin examination revealed edematous, blanchable, erythematous, annular papules and plaques on the legs, back, and arms with pitting edema of the lower legs. Laboratory testing revealed an elevated erythrocyte sedimentation rate, hypoalbuminemia, proteinuria, hematuria, and a positive antistreptolysin O titer, indicative of recent group A Streptococcus infection. Treatment with systemic corticosteroids led to a resolution of all her symptoms. Adult onset IgA vasculitis differs in clinical manifestation and treatment from that of the pediatric population. This case demonstrates the importance of considering IgA vasculitis as a differential diagnosis in adults presenting with small vessel vasculitis.

Development and evaluating the biopotency of ready to eat liver meat balls in fighting anaemia and vitamin A deficiency, improving selected nutritional biochemical indicators and promoting the cognitive function among mildly anaemic Egyptian children aged 3-9 years.

OBJECTIVE: Ready to eat fried liver meat balls (LMB) were developed to fight anaemia and vitamin A deficiency and promote cognitive function. DESIGN: Randomised controlled trial consisting of two arms: control group with no supplement and LMB group receiving LMB supplement three times a week for 90 d. Criteria of evaluations included dietary assessment, anthropometric measurements, laboratory investigations and cognitive function by Wechsler test. SETTING: Kinder Garten and primary school in Urban Giza. PARTICIPANTS: Sixty boys and girls aging 3-9 years. RESULTS: The LMB supplement contributed to significant increases in the intakes of high bioavailable Fe and vitamin A in the diets of all children. Initial overall prevalence of mild and moderate anaemia was 43 %, which disappeared completely from all children aging < 72 months and from 88 % of children ≥ 72 months after the 90 d dietary intervention with the LMB. Faecal systemic immune globulin A, urinary hydroxyproline index and urinary iodine excretion increased significantly (P < 0·05) only after the dietary intervention with the LMB supplement for 90 d. The standard scores of verbal and non-verbal cognitive function tests (Δ day 90-day 0) increased significantly (P < 0·05) among the LMB group compared with the respective changes observed among the control group. The increase in height-for-age Z score and blood Hb were good predictors for improvement in cognitive function. CONCLUSION: LMB supplement is effective sustainable nutritious biotherapeutic food in fighting hidden hunger and promoting the cognitive function.

Cochlear and vestibular involvement in children with IgA vasculitis.

In this study, our purpose is to evaluate cochlear and vestibular function in juveniles with IgA vasculitis using audiometry, distortion product otoacoustic emissions, and cervical vestibular evoked myogenic potential (cVEMP) tests. Forty children diagnosed with IgA vasculitis from the pediatry clinic and 40 age- and sex-matched healthy children were evaluated with distortion product otoacoustic emissions, audiometry, and cVEMP test in a tertiary hospital. The audiometry average values for both ears of the IgA vasculitis group and the control subjects were compared, and as a result, median 4.7-dB sensorineural hearing loss (SHL) was found for the IgA vasculitis group compared to the control group at 250 Hz and it was statistically significant (p < 0.001). An average of 6.4-dB SHL was detected at 8000 Hz (p < 0.001). There was a statistically significant difference among IgA vasculitis and control groups regarding measurement results of average p1-n1 latency time of both ears (0.9 ms (ms) increase, p = 0.035). In IgA vasculitis patients, the median amplitude difference of both ears' average p1 n1 was found to be 5.6 mV, statistically significantly decreased compared to the control group (p = 0.003). CONCLUSION: This study, firstly in literature, demonstrated that IgA vasculitis may have association with hearing loss and vestibular dysfunction in children. We think this might be due to autoimmune mechanisms. WHAT IS KNOWN: • Ig A vasculitis is a leukocytoclastic vasculitis with unknown etiology, involving the skin, joints, gastrointestinal system, kidneys, and rarely other organs. • No study has been reported for the cochlear and vestibular association of Ig A vasculitis in current literature. WHAT IS NEW: • This study demonstrated that Ig A vasculitis may have association with hearing loss in children. • This study also demonstrated that Ig A vasculitis may have association with vestibular dysfunction in children.

Nivolumab-Induced Crescentic Immunoglobulin A Nephropathy With Henoch-Schonlein Purpura Features in a Patient Diagnosed With Hepatocellular Carcinoma.

A 60-year-old Polish male with a history of alcoholism, liver cirrhosis, and hepatocellular carcinoma presented via a referral from his primary medical doctor to the emergency room with respiratory distress, acute kidney injury (AKI), and a purpuric rash on both lower extremities. He had received a total of 16 doses of Nivolumab for hepatocellular carcinoma. He had a baseline serum creatinine of 1.5 and Nivolumab was skipped a month prior to presentation because of a rise in creatinine and the onset of the rash. Labs showed a blood urea nitrogen (BUN) level of 52 mg/dl and creatinine of 3.2 mg/dl. Urinalysis revealed 300 mg proteinuria and 25-50 red blood cells on a high-power field. He was subsequently placed on steroids for vasculitis manifesting as glomerulonephritis and dermatitis. Biopsy specimens of the kidney and skin were taken and showed focally crescentic diffuse proliferative glomerulonephritis with low-grade A IgA deposits and acute tubular necrosis. The skin biopsy revealed leukocytoclastic vasculitis. We hereby describe a case of focally crescentic diffuse proliferative glomerulonephritis with low-grade A IgA deposits and acute tubular necrosis in an individual with Nivolumab-treated hepatocellular carcinoma.

Co-occurrence of Behçet disease with Ig A vasculitis revealed by ophtalmic examination: A case report.

INTRODUCTION: Renal involvment of Behçet disease is not usual and Ig A vasculitis complicated by Behçet disease is extremely rare. CASE PRESENTATION: We report a case of Henoch Scholein purpura and nephritis associated with Behçet disease revealed by ophthalmic examination. CLINICAL DISCUSSION: Recurrent oral ulcer is not a manifestation of Ig A vasculitis which doesn't affect large or middle sized arteries. If the patient had'nt been referred to our department for ophthalmic examination, we may have failed to make the diagnosis and treat coexisting Behçet disease. CONCLUSION: The link of HSP and BD has yet to be fully understood, and more researchisdefinitelyneeded.

Evaluating association of vaccine response to low serum zinc and vitamin D levels in children of a birth cohort study in Dhaka.

BACKGROUND: Vaccine-preventable infectious diseases are often responsible for childhood morbidity and high rates of mortality. Immune response to the vaccine is associated with multiple factors in early childhood and measured by antibody titers. Among them, micronutrient deficiencies such as vitamin D and zinc deficiencies are the most important in resource-limited settings like Bangladesh. OBJECTIVE: We aimed to evaluate the association of vaccine response to low serum zinc and vitamin D levels in children. METHODS: We evaluated vaccine response for measles and poliovirus, tetanus and pertussis toxoid, and Ig A antibody levels to rotavirus by ELISA and serum vitamin D and zinc at 7 and 15 months in the MAL-ED birth cohort of the Bangladesh site. By using population-specific generalized estimating equations (GEE), the association between each explanatory variable and the binary outcome variable was examined longitudinally where the dependent variable was vaccine titers and the independent variables were low serum vitamin D and zinc levels. RESULTS: The GEE multivariable model identified a positive association between serum zinc level and tetanus vaccine titer (OR: 1.84; 95% CI: 1.07-3.17 and p value = 0.028) after adjusting for age, gender, birth weight, WAMI score, diarrhea, ALRI, exclusive breastfeeding, serum ferritin, serum retinol and undernutrition (stunting, wasting, underweight). No association was found between the rest of the vaccine titers with serum vitamin D and zinc level (p > 0.05). CONCLUSION: In the MAL-ED birth cohort, where children were followed for five years, serum zinc level had a positive impact on tetanus vaccine titers.

Reporting Apparent Biclonal Immunoglobulin-A Monoclonal Proteins with Identical Light Chains.

It is generally not well appreciated that Immunoglobulin A (IgA) can present as apparent biclonal monoclonal protein (M-protein) comprising monomers and polymers, despite the fact that Kyle pointed this out in 1999. In this clinical communication, we report on 3 patients with Ig-A multiple myeloma (MM) who displayed this phenomenon. Of these 3 patients, 2 had identical kappa light chains suggesting biclonality, while the other had 2 lambda light chains. Because the Ig-A M-proteins are clustered in the beta-area, accurate densitometric quantification is made difficult. Hence, we suggest assaying Ig-A levels and free light chains in concert with the M-protein levels to monitor these patients on therapy. In conclusion, when encountering biclonal Ig-A M-proteins with identical light chains, the laboratorian should add the 2 values and present one composite number to the clinician.

A Rare Case of Cerebral Amyloidoma Mimicking a Hemorrhagic Malignant Central Nervous System Neoplasm.

Cerebral amyloidoma is a rare form of amyloidosis with a localized tumor like an amyloid deposition in the brain composed of insoluble fibrillary protein with cross beta-sheet conformation. Its usual presentation includes vision loss, seizures, behavioral changes, cognitive decline, and recurrent headaches. It has a benign course with a slow progression, and it is not associated with dissemination. We report a case of a 65-year-old Caucasian woman who presented with symptoms of progressively worsening cognitive dysfunction of six months' duration. From CT of the brain, it was found that she had a right frontal and left parietal hemorrhagic mass with a large amount of vasogenic edema and a midline shift. MRI showed heterogeneously enhancing hemorrhagic mass of 5.2 cm x 2.6 cm x 3.6 cm in size, with a satellite lesion. Initially, this was suspected to be a high-grade glioma vs. metastatic hemorrhagic lesions. She underwent stereotactic biopsy of the mass, and histopathology was consistent with cerebral amyloidoma with marked IgA lambda plasma cell differentiation. She did not have any evidence of systemic amyloidosis, and therefore, she is being clinically observed with a regular follow-up and annual CT surveillance. She has remained stable over the past two years, although she has residual cognitive dysfunction. Cerebral amyloidoma can mimic malignant central nervous system (CNS) neoplasms and should be considered as a differential of any single or multiple mass lesions occurring in the white matter region of the brain with a characteristic appearance of "hyperdense lesions" on CT. It is a benign disease with no metastatic potential that usually resolves entirely after resection.

The Effects of Hyperuricemia on the Prognosis of IgA Nephropathy are More Potent in Females.

Hyperuricemia is a potential risk factor for immunoglobulin A nephropathy (IgAN) progression but its sex-specific effects on IgAN progression remain unclear. This study aimed to determine the effect of serum uric acid on IgAN progression and whether its effect varied according to sex. A total of 4339 patients who diagnosed with IgAN by renal biopsy were retrospectively analyzed. We assessed the association of serum uric acid on IgAN progression using Kaplan-Meier survival analyses and Cox proportional hazards models. The study's primary end point was IgAN progression that was defined as a 50% decline in the estimated glomerular filtration rate or the initiation of dialysis. On average, the serum uric acid levels were higher in the men than in the women. In the fully adjusted Cox proportional hazards model that considered all subjects, the risk of IgAN progression increased by about 25.6% for every 1 mg/dL increase in the baseline uric acid level. The serum uric acid level was an independent risk factor for IgAN progression in both sexes but its effect was more pronounced in the women (hazard ratio [HR], 1.383; confidence interval [CI],1.263 to 1.514; p < 0.001) than in the men (HR, 1.181; CI, 1.097 to 1.272; p < 0.001) (pinteraction < 0.001). A sensitivity analysis involving serum uric acid quartiles generated consistent and robust results. In conclusion, the serum uric acid level was an independent risk factor for IgAN progression and its effect was more pronounced among the women compared with that among the men.

Allele-Specific Loop-Mediated Isothermal Amplification for the Detection of IVSII-I G>A Mutation On ß-Globin Gene.

BACKGROUND: Thalassemia is one of the most common genetic health problems in the world. More than 200 different mutations have been identified in the beta-globin gene and among the 24 ß-globin gene mutations in ß-thalassemia carriers in the north of Iran IVSII-I G>A mutation has the highest frequency. Using fast, inexpensive, simple and reliable methods for the detection of the mutations in ß-thal carriers is very important in prenatal diagnosis, and introduction of alternative methods to the existing ones can help to simplify the detection of mutations. Since its introduction, different methods derived from LAMP have been widely used for SNPs detection. AIM: This study was aimed to design a new method for the detection of IVSII-I G>A mutation on ß-globin gene based on AS - LAMP technique. METHODS: Primer explorer V5 software was used for the design of LAMP primers. Three sets of primers were designed. In the first set, the BIP primers were exactly complementary to the normal and mutant alleles. In the second set, 1 nucleotide (T) was inserted at the 5' end of BIP primers, and in the last set, one nucleotide at the 5' end of BIP primer was changed. The other required primers for the LAMP reaction (FIP, B3, and F3) were the same for all 3 sets of primers. The LAMP reaction was applied on three DNA samples (Wild type, Heterozygote and Homozygote for IVSII-I G>A mutation) and synthetic DNA. RESULTS: The results of the present study showed that LAMP reaction using three sets of primers could not successfully detect the IVSII-I G > A mutation among subjects DNA sample and synthetic DNA. CONCLUSION: Although several studies have successfully used ARMS-LAMP method to detect the SNPs, and other studies use a variety of methods to identify IVSII-I G>A mutation, the present study was unable to differentiate between a normal allele and IVSII-I G>A mutation. Hence further studies are recommended to consider redesigning of primer set, DNA concentration and using commercial LAMP Master Mix to detect the mutation.