Vitiligo and autoimmunity.

BACKGROUND: Vitiligo is an acquired skin disorder characterized by depigmented maculae resulting from a reduction of the number and function of melanocytes. The etiopathogenesis of the disease is still unclear, but there is evidence that autoimmunity may be involved. OBJECTIVE: The aim of this study was to determine the prevalence and significance of antinuclear (ANA) and thyroid peroxidase (anti-TPO) antibodies in patients with vitiligo and control group. METHODS: In a prospective case-control study, we compared the frequency of antibodies (ANA and anti-TPO) in 40 patients with vitiligo and in 40 healthy volunteers. RESULTS: ANA were positive in 7 (17%) patients, which was insignificantly higher than control group, 2 (5%). Anti-TPO were positive in 11 (27%) patients. In control group, only two subjects (5%) had positive anti-TPO. Compared with the control group, the frequency anti-TPO were significantly higher in those with vitiligo (p < 0.05). CONCLUSION: Our findings show a significant association between vitiligo and thyroid autoimmunity, and that tests to detect anti-TPO are useful markers in patients with vitiligo. In contrary, ANA seems to have limited diagnostic relevance in routine clinical practice. Additional studies of a wider sample are warranted to confirm these findings and allow a detailed analysis.

Reibergram and oligoclonal bands in diagnosis of multiple sclerosis.

INTRODUCTION: In this study authors have analyzed the correlation between the IgG immunoglobulins in cerebrospinal fluid and the findings of oligoclonal bands on gel. Immunoglobulin IgG in cerebrospinal fluid (CSF) can be detected in neurological diseasses (infections and inflammatory neurological diseases and in demyelinating diseases, like multiple sclerosis (MS)). Quantitative IgG in CSF can be expressed by different formulae Reiber (Reiber and Felgenhauer 1987), Tourtellotte (Tourtellotte 1970), Schuller (Schuller and Sagar 1983) and IgG Index (Link and Tibbling 1977). In this study we used Reibergram. Qualitative CSF IgG can be measured by electrophoresis and isoelectric focusing (IEF). We used IEF for analysig CSF and seum because of its higher sensitivity. AIMS OF THE STUDY: To determine the correlation of immunoglobulins IgG positivity in CSF with the finding of oligoclonal bands on the gel. MATERIAL AND METHODS: The retrospective study based on data processed in OJ Clinical Immunology KCUS. Patients were suspicious of multiple sclerosis according to clinical findings and magnetic resonance imaging. All CSF and serum samples were processed by nephelometry, isoelectric focusing on the gel. Statistical analysis of intrathecal synthesis was also performed according to Reibergram. RESULTS: Analyses were performed on 76 samples of cerebrospinal fluid and serum of patients from neurological clinic, suspected of multiple sclerosis. We received following results: 42 samples tested had type 1.25 samples tested showed type 2.3 samples had type 3.5 samples had type 4.1 sample had a fifth type. When we compare these results with values obtained by intrathecal synthesis of which is determined by Reibergram we obtained the following values: 16 samples had intrathecal synthesis of 20%-60%, 9 samples had a negative value of intrathecal synthesis of 10% or less. DISCUSSION AND CONCLUSION: For most patients with established MS we found intrathecal humoral response, type two, and the number and arrangement of IgG bands generally does not change during the disease, because they reflect long-term non-specific immune stimulation rather than a specific immune response that during infectious disease changes (quantitatively and qualitatively).