A detailed investigation of maternally inherited diabetes and deafness (MIDD) including clinical characteristics, C-peptide secretion, HLA-DR and -DQ status and autoantibody pattern.

BACKGROUND: This article presents a clinically characterization of the mitochondrial DNA mutation (A3243G) associated with maternally inherited diabetes and deafness (MIDD) syndrome in two families. METHODS: Six patients with MIDD and one mutation-positive relative with normal glucose tolerance (NGT) were examined. Fasting serum C-peptide was measured in all subjects and compared with controls having NGT (n = 14). C-peptide response to an intravenous glucose tolerance test (IVGTT) was investigated in the diabetic patients not treated with insulin (n = 3) and in the mutation-positive healthy individual and compared with the controls. RESULTS: The A3243G heteroplasmy value varied between 5 and 30%. All A3243G carriers had HLA-DR1-DQ5 haplotype, and either the -DQ5 or the -DQ6 allele. The fasting and the serum C-peptide levels at 120 min during the IVGTT did not differ between the A3243G carriers and the controls. A missing first phase and a decreased total C-peptide response was detected in the mutation-positive diabetics compared with controls (p < 0.0001). The same abnormality was found in the A3243G carrier with NGT. Circulating islet cell antibody (ICA) was present in three patients with MIDD. Glutamic acid decarboxylase (GAD), tyrosine phosphatase-like protein IA-2 (IA-2) and mitochondrial antibodies were missing. The diagnosis of MIDD was delayed in each case. CONCLUSIONS: A missing first phase and a decreased total C-peptide response during an IVGTT was characteristic for the A3243G mutation. The fasting C-peptide level of the carriers did not differ from the controls. Circulating ICA was present in some patients, but GAD, IA-2 and mitochondrial antibodies were absent. All subjects had HLA-DR1-DQ5 haplotype, and either -DQ5 or -DQ6 alleles.

Proliferative and necrotising pneumonia and severe vascular lesions in pigs naturally infected with porcine circovirus type 2.

Severe disease induced by porcine circovirus type 2 (PCV2) was observed in three pigs originating from a large herd affected by respiratory and digestive signs as well as wasting. Proliferative and necrotising pneumonia (PNP) was diagnosed in two animals, while severe acute interstitial pneumonia characterised by the presence of abundant hyaline membrane in the alveoli and fibrin in the bronchioles was found in one pig. In all cases, large amounts of PCV2 antigen were found in each tissue sample collected from the lungs and mediastinal lymph nodes. Neither porcine reproductive and respiratory syndrome virus (PRRSV) nor swine influenza virus (SIV) was detected, and no bacteria could be cultured in any of the cases. Vascular lesions, e.g. degeneration of endothelial cells, perivascular and intramural oedema, fibrinoid necrosis, vasculitis, perivasculitis, and vascular thrombi were observed in all cases, associated with the presence of PCV2 antigen. The viral antigen was present in the intravascular mononuclear cells, endothelial cells, myocytes and infiltrating inflammatory cells in lymph and blood vessels. In one case, obliterating thrombi in the lymph and blood vessels were directly connected to areas of tissue necrosis and were associated with abundant PCV2 antigen. The results further suggest the causative role of PCV2 infection in PNP, and the importance of the vascular system in the pathogenesis of PCV2-associated diseases of swine.

Gastric zygomycosis in a pig affected with postweaning multisystemic wasting syndrome--case report.

A postweaning pig died in spite of antibiotic therapy showing wasting in a small herd. Postweaning multisystemic wasting syndrome (PMWS) was diagnosed on the basis of gross pathological and histological lesions and the presence of moderate amounts of porcine circovirus 2 (PCV2) antigen in tissue samples. Mycotic gastritis caused by Zygomycetes spp. was found on round areas with a diameter of 1 to 3 cm in the glandular mucosa of the stomach. Moderate amount of PCV2 viral antigen was detected almost evenly in the stomach and mostly in the macrophages. In addition, acute uraemia, revealed by an ammonia-like stink of the gastric mucosa and the presence of acute erosions on the glandular mucosa of the stomach, was observed as a consequence of PCV2-induced interstitial nephritis. Only PCV2 infection could be identified as a cause of secondary mycotic gastritis. The results further support the immunosuppressive ability of PCV2 infection in PMWS-affected pigs.