Association between autoimmune disease and cutaneous melanoma with regard to melanoma prognosis.

BACKGROUND: An association between autoimmune disease and malignant melanoma (MM) has often been reported in the literature as a positive prognostic factor for MM. Consequently, we evaluated the influence of different autoimmune diseases on the prognosis of MM. AIM: To evaluate the prognosis of patients with MM who also had an autoimmune disorder, whether tumour-associated, paraneoplastic or drug-induced. METHODS: Autoimmune diseases were classified and analysed as tumour-associated, paraneoplastic or drug-induced. Patients were enrolled according to their clinicopathological features and matched with control groups. Kaplan-Meier analysis was used to estimate disease-free survival (DFS) and overall survival (OS), and log-rank test was used to evaluate differences between the survival curves. RESULTS: In total, 49 patients with MM and tumour-associated autoimmune disease were included in our analysis. No case of paraneoplastic autoimmune disease was detected. The survival analyses showed a range of results, from a worsening of DFS and OS to a lack of any difference. In a second analysis, we separately analysed patients who developed autoimmune disorders after starting adjuvant therapy with interferon-α; we did not find significant differences between these patients and the untreated patients. CONCLUSIONS: Autoimmune disease, whether tumour-associated or drug-induced, was not associated with better prognosis in patients with MM. The results suggest that the reported relationship between autoimmunity and MM may be a result of individual variation in sensitivity to the autoimmune disease, the tumour or the treatments.

Pregnancy in a woman with Turner syndrome and celiac disease.

BACKGROUND: Studies on fertility in women with Turner syndrome have shown that spontaneous pregnancies occur in about 2-7% of patients. Fertility problems and obstetrical complications are frequently observed in untreated patients with celiac disease. We report the case of a patient, affected by Turner syndrome and celiac disease, in whom a spontaneous pregnancy occurred. CASE: One patient affected by Turner syndrome at the age of 30 yr conceived spontaneously. Celiac disease was diagnosed during pregnancy. The pregnancy progressed uneventfully. After 39 weeks of gestation, she vaginally delivered a normal male infant. CONCLUSION: Our patient had a successful pregnancy, giving birth to a healthy child, although she presented two pathological conditions affecting fertility and pregnancy outcome: Turner syndrome and celiac disease.

High IgE levels in patients affected by psoriasis: review of the literature and personal observations.

OBJECTIVE: The concomitance of psoriasis and high IgE levels in the same patient, possibly associated to allergies, should not come as a surprise anymore, because both diseases are characterised by an immunological disorder, involving cytokines and other inflammatory mediators, with massive activation of the cell-mediated immunity. MATERIALS AND METHODS: During a period of 18 months, using a radio-immunologic method, we assessed the level of IgE in patients with severe psoriasis who were not responding to the common therapy. RESULTS: Patients with severe psoriasis had high levels of IgE. CONCLUSIONS: IgEs have an important role in pathogenesis of psoriasis and atopic dermatitis, but the mechanism is not yet clear.

Chronic urticaria with high IgE levels: first results on oral cyclosporine A treatment.

INTRODUCTION: Chronic Urticaria is a difficult to define condition from the nosographic standpoint, with complex pharmacological management, that heavily impacts the life of the patient. Some forms show not to be responsive to anti H1 anti-histaminic and require other treatments. One of these can be the treatment with Cyclosporine A (CsA). MATERIALS AND METHODS: This study, open and sequential, reports the results of short-term treatment over a sample of adults (21 patients) of both sexes, all suffering from chronic urticaria with IgE levels higher than 200 mU/ml treated with 4 mg/kg/die of CsA. RESULTS: The results obtained show a reduction in the levels of total IgE and a significant improvement in symptoms; there were no adverse effects. CONCLUSIONS: Cyclosporine is an excellent treatment for chronic urticaria because it reduces the activity of T lymphocytes and reduction of the histamine release from the mast cells and basophils.

The effectiveness of oral goat colostrum in the treatment of patients with type 2 diabetes mellitus: our preliminary experience.

INTRODUCTION: The properties of colostrum were recognized and investigated more thoroughly in the first half of the eighties, when the immune factors and growth factors it contains were pointed out. Numerous studies show that the administration of colostrum benefits the subjects with type 2 diabetes mellitus as it gradually regulates appetite, improves utilization of nutrients, especially glucose, and leads to a significant decrease in body fat. MATERIALS AND METHODS: The following study is aimed at verifying a possible reduction in the use of insulin in 27 subjects with type 2 diabetes, treated with goat colostrum in the form gastro-resistant tablets of 300 mg (4/die). RESULTS: In subjects with type 2 diabetes treated with insulin, the administration of colostrum has obtained a significant reduction of insulin dosage and normalization of blood glucose levels. CONCLUSIONS: The effects of colostrum are presumably linked to increased levels of IGF-1 that improves the utilization of glucose, stimulates glycogen and protein synthesis.