Platelet-specific alloantigens and antibodies in Tunisian women after three or more pregnancies.

Pregnancy may allow alloimmunization against human platelet antigens (HPA), which can lead to neonatal alloimmune thrombocytopenia (NAIT). The specificities of alloantibodies are closely related to the distribution of the HPA systems. A total of 281 Tunisian multiparous women (mean number of pregnancies: 4.5) were phenotyped for the HPA-1, -3 and -5 systems, by monoclonal antibody immobilization of platelet antigens (MAIPA). We searched for antibodies against HPA-1a, HPA-3a, HPA-5b and HPA-5a in HPA-1b1b, HPA-3b3b, HPA-5a5a and HPA-5b5b individuals, respectively. The gene frequencies were: 0.83 for HPA-1a, 0.17 for HPA-1b, 0.78 for HPA-3a, 0.22 for HPA-3b, 0.82 for HPA-5a and 0.18 for HPA-5b. Anti-HPA-5b antibodies were present in eight sera and anti-HPA-3a antibodies were present in one serum. The anti-HPA-5b system is the most frequently involved in platelet alloimmunization in Tunisian multiparous women. However, prospective trials are required to confirm this result and to determine the exact frequencies and clinical relevance of platelet alloantibodies in pregnant Tunisian women.

Antibodies to anionic phospholipids and cofactors in kala-azar. Comparative study with malaria, toxoplasmosis and "autoimmune diseases".

OBJECTIVE: To investigate the distribution of various anti-anionic and anti-cofactor phospholipid antibodies in children with kala-azar, and to compare them to malaria, toxoplasmosis and auto-immune disease. PATIENTS AND METHODS: The frequency and the concentration of antibodies against cardiolipin (aCL), phosphatidylserine (aPS), phosphatidylinositol (aPI), phosphatidic acid (aPA), Beta2GPI (anti-Beta2GPI), prothrombin (aPT), annexin V (aAnnV), protein C (aPnC) and protein S (aPnS) were studied in sera from 103 children with kala-azar and compared with malaria (n=32), toxoplasmosis (n=31), systemic lupus erythematosus (SLE) (n=40) and antiphospholipid syndrome (APS) (n=35). RESULTS: The prevalence of aCL, aPS, aPI, aPA, anti-Beta2GPI, aPT, aAnnV, aPnC and aPnS was 54%, 56%, 43%, 28%, 73%, 67%, 55%, 30%, 25%, respectively. Ninety-three per cent of children with kala-azar (96/103) had one or more aPL specificities, but none had thromboses. The spectrum of aPL was quite similar to that found in patients with SLE and APS. CONCLUSION: Antiphospholipid antibodies are a frequent finding in kala-azar. The aPL produced mimic those found in autoimmune disease. However, further studies are required to assess the exact role of these aPL during leishmaniasis.

[Xg gene frequencies in Tunisia]. / Fréquence génique du système Xg dans la population tunisienne.

We report a new case of anti-Xg(a) antibody found in a man who, after receiving six units of standard red blood cells, developed a minor nonhemolytic transfusion reaction (chills-hyperthermia). The patient sera was used for an immunophenotyping scale in 777 healthy Tunisian blood donors (678 men; 99 women). The phenotype frequencies of Xg(a+) and Xg(a-) were 67.4% and 32.6% in men and 89 and 11% in women, respectively. The gene frequencies of Xg(a) and Xg were 0.67 and 0.33, respectively. These frequencies are similar to that reported in predominantly white populations.

[Gastric adenocarcinoma secondary to Hodgkin's disease treatment]. / Adenocarcinome gastrique secondaire au traitement d'une maladie de Hodgkin.

UNLABELLED: Second malignant neoplasms are a major cause of late morbidity and mortality following treatment for Hodgkin's disease. Gastric carcinoma belong to the rare secondary malignancies induced by radiation-therapy and it is associated with a poor prognosis. We report a patient treated for Hodgkin's disease by 6 ABVD and total lymphoid radiation therapy, who developed a gastric carcinoma 9 years after completing treatment. Our case fits the criteria for radiation induced malignancies reported from the literature: IN CONCLUSION: recommendations are presented for both prevention and early detection of the tumours we recommend a strict follow-up for patients treated for HD to detect second cancers.

[Acquired amegakaryocytic thrombocytopenic purpura treated with intravenous immunoglobulins]. / Le purpura thrombopénique amégacaryocytaire acquis traité par des immunoglobulines intraveineuses.

Acquired amegakaryocytic thrombocytopenic purpura is a rare disorder characterized by severe thrombocytopenia due to the absence of bone marrow megakaryocytes. The pathogenic mechanisms of this disorder have not well defined; consequently, several empirical therapies are used. We reported the case of a 38-year-old mean who was hospitalized for serious bleeding syndrome. The platelet count was 10 yen10(9)/L. The bone marrow aspirate and biopsy showed the absence of megakaryocytes but otherwise normal granulocyte and erythroid precursors. No definable etiology has been found. After the unsuccessful use of prednisone, intravenous immunoglobulin therapy was started and resulted in favorable reponse.