RESUMO
Poor specific antibody response is a well-known primary immunodeficiency that is related to hypogammaglobulinemia or common variable immunodeficiency (CVID). The co-existence of CVID or hypogammaglobulinemia and systemic lupus erythematosus (SLE) has been rarely described. In all reported cases, the diagnosis of SLE antedates CVID. We report a 15-year-old Saudi girl who was diagnosed with poor specific antibody response at age 6 years in the form of poor or no antibody response and dysgammaglobulinemia. She developed SLE with musculoskeletal and hematological manifestations, positive antinuclear antibody and high anti-dsDNA nine years later. She was treated with rituximab with good response.
Assuntos
Formação de Anticorpos/imunologia , Disgamaglobulinemia/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Adolescente , Anticorpos Antinucleares/imunologia , Anticorpos Monoclonais Murinos/uso terapêutico , Disgamaglobulinemia/imunologia , Feminino , Humanos , Fatores Imunológicos/uso terapêutico , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Rituximab , Resultado do TratamentoRESUMO
To evaluate the performance of health workers with respect to diagnosis and treatment of acute respiratory infection (ARI) and acute diarrhoea (AD) in children < 5 years in 11 rural heath facilities in Yemen, we carried out a cross-sectional study on 219 cases of ARI and 93 cases of AD. Mean score for performance was 30.04 (range 21-39). The quality of care provided was fair in 89.4% and poor in 4.5% of cases. A "well done" performance of 6.3% was achieved by medical doctors but only 3.6% of medical assistants and 25% of medical assistants scored "poor" for performance, but only 2.5% of medical doctors. Health workers who had received training courses in ARI and AD performed slightly better than those who had not.
Assuntos
Diarreia , Qualidade da Assistência à Saúde/normas , Infecções Respiratórias , Serviços de Saúde Rural/normas , Doença Aguda , Distribuição de Qui-Quadrado , Pré-Escolar , Estudos Transversais , Diarreia/diagnóstico , Diarreia/terapia , Prescrições de Medicamentos/normas , Fidelidade a Diretrizes/normas , Pesquisa sobre Serviços de Saúde , Humanos , Anamnese/normas , Pais/educação , Exame Físico/normas , Assistentes Médicos/educação , Assistentes Médicos/normas , Médicos/normas , Guias de Prática Clínica como Assunto , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/terapia , Organização Mundial da Saúde , IêmenRESUMO
To evaluate the performance of health workers with respect to diagnosis and treatment of acute respiratory infection [ARI] and acute diarrhoea [AD] in children < 5 years in 11 rural heath facilities in Yemen, we carried out a cross-sectional study on 219 cases of ARI and 93 cases of AD. Mean score for performance was 30.04 [range 21-39]. The quality of care provided was fair in 89.4% and poor in 4.5% of cases. A "well done" performance of 6.3% was achieved by medical doctors but only 3.6% of medical assistants and 25% of medical assistants scored "poor" for performance, but only 2.5% of medical doctors. Health workers who had received training courses in ARI and AD performed slightly better than those who had not