Identification of the novel HLA-C*04:495 allele by sequencing-based typing.

The HLA-C*04:495 allele differs from HLA-C*04:01:01:31 by two nucleotide changes in the 5'UTR and exon 5.

Erythema ab igne masking cutaneous metastasis of colorectal adenocarcinoma.

Skin metastasis commonly manifest as subcutaneous or intradermal violaceous nodules that coalesce with a firm rubbery appearance. Few cases reported an erythema ab igne-like appearance in the presence of internal malignancy. We report a case of metastatic colorectal adenocarcinoma with erythema ab igne-like presentation. We also review cases of erythema ab igne in association with internal malignancy.

Evolving sequence mutations in the Middle East Respiratory Syndrome Coronavirus (MERS-CoV).

BACKGROUND: Middle East respiratory syndrome coronavirus (MERS-CoV) has continued to cause sporadic outbreaks of severe respiratory tract infection over the last 8 years. METHODS: Complete genome sequencing using next-generation sequencing was performed for MERS-CoV isolates from cases that occurred in Riyadh between 2015 and 2019. Phylogenetic analysis and molecular mutational analysis were carried out to investigate disease severity. RESULTS: A total of eight MERS-CoV isolates were subjected to complete genome sequencing. Phylogenetic analysis resulted in the assembly of 7/8 sequences within lineage 3 and one sequence within lineage 4 showing complex genomic recombination. The isolates contained a variety of unique amino acid substitutions in ORF1ab (41), the N protein (10), the S protein (9) and ORF4b (5). CONCLUSION: Our study shows that MERS-CoV is evolving. The emergence of new variants carries the potential for increased virulence and could impose a challenge to the global health system. We recommend the sequencing every new MERS-CoV isolate to observe the changes in the virus and relate them to clinical outcomes.

Incidence, predictors and severity of adverse events among whole blood donors.

BACKGROUND: Adverse events have been reported post blood donation. Donors might refrain from donating again due to such events which lowers the blood supply in collection centers. AIM: This study measured the incidence, predictors and severity of adverse events among donors of a single whole blood unit at one of the largest donation centers in Saudi Arabia. METHODS: A retrospective cohort was conducted in 2015 to investigate the adverse events immediately post donation. Donor characteristics such as age, blood pressure, hemoglobin level, weight and history of donation were described and tested as potential risk predictors. Eligible blood donors were 18,936/24,634 (76.8%). RESULTS: Incidence of adverse events found 1.1% (208 donors), of which 0.65% had mild symptoms (chills; nausea; pallor; dizziness; nervousness; headache), while 0.45% had severe symptoms (hypotension; convulsions; syncope; respiratory distress; emesis). Multiple logistic regression showed that, the incidence of adverse events was significantly higher among young age donors <30 years RR[95%CI] = 1.58[1.18-2.12], p < 0.002, higher hemoglobin levels RR[95%CI] = 1.30[1.15-1.46], lower weight donors <75kg RR[95%CI] = 1.71[1.29-2.27], p <0.001 and first time donors RR[95%CI] = 2.21[1.64-2.97], p < 0.001 compared to older age donors ≥30, lower hemoglobin levels, heavier weight donors ≥ 75, and previous donors, respectively. More severe adverse events were observed among older and heavier donors, previous donors, lower hemoglobin levels and hypertensive donors but with no statistical significance. CONCLUSION: Young blood donors, donors with lower weight and first time donors are at higher risk of contracting adverse events. Higher hemoglobin level is also a potential risk predictor of adverse events post whole blood donation.