Frequency of autoimmune thyroid disease in chronic urticaria.

OBJECTIVE: To determine the frequency of autoimmune thyroid disease in diagnosed cases of chronic urticaria (CU) and the association between hypothyroidism and chronic urticaria if any. STUDY DESIGN: Non-interventional, descriptive study. PLACE AND DURATION OF STUDY: Department of Physiology, Dow University of Health Sciences, Karachi, from December 2004 to January 2006. METHODOLOGY: The patients were selected from Department of Dermatology and Medical Units of Civil Hospital, Jinnah Postgraduate Medical Centre, the Aga Khan Hospital and community clinics. A total number of 60 patients were enrolled in this study. In all patients, serum antithyroid autoantibodies (antithyroglobulin and antimicrosomal/thyroperoxidase), thyroid profile (serum TSH, T3 and FT4), complete blood count, erythrocyte sedimentation rate and IgE levels were carried out. The proportions were compared using chi-square test with significance at p < 0.05. RESULTS: Forty seven (78%) patients were found to have chronic urticaria (history and laboratory reports). Out of 47 patients with diagnosis of CU, elevated titres of antithyroglobulin (TGA) and antimicrosomal antibodies (TMA) were found to be present in 20 (42.6%) and 27 (57.4%) patients respectively. Serum TSH level (thyroid stimulating hormone) was increased and T3, FT4 were decreased in 20 (42.6%) patients (p < 0.001). A total number of 20 (42.5%) patients were found to be hypothyroid with chronic urticaria of greater than 6 weeks duration. CONCLUSION: This study shows a statistically significant association between hypothyroidism and chronic urticaria. Full thyroid profile (serum thyroid autoantibodies, serum TSH, T3 and FT4) is highly recommended in patients with diagnosis of chronic urticaria.

Serum antithyroid antibodies in female patients with chronic urticaria.

OBJECTIVE: To determine the frequencies of serum antithyroglobulin and antimicrosomal autoantibodies in female patients with chronic urticaria, and the association between thyroid autoantibodies and chronic urticaria, if any. STUDY DESIGN: Non-interventional, case-control analytic study. PLACE AND DURATION OF STUDY: This study was carried out by the Department of Physiology, Dow University of Health Sciences, Karachi, from December 2004 to January 2006 on patients selected from Department of Dermatology and Medical Units of Civil Hospital, Jinnah Postgraduate Medical Centre and The Aga Khan University Hospital, Karachi and from the Community Clinics in Karachi. METHODOLOGY: A total number of 90 subjects were enrolled and divided in three groups consisting of 30 patients each. Group 1 comprised of patients with diagnosis of chronic urticaria, Group 2 of diagnosed cases of hypothyroidism with/without urticaria, and Group 3 of normal age and gender-matched healthy volunteers. In all patients, serum antithyroid autoantibodies (antithyroglobulin and antimicrosomal) and thyroid profile (serum T3, T4 and TSH levels) was carried out. Chi-square test was used to determine significance of proportion of variables at p < 0.05. RESULTS: Elevated titres of antithyroglobulin antibodies were found to be present in 9 (30%) patients in Group 1 (chronic urticaria), 24 (80%) patients in Group 2 (known cases of hypothyroidism) compared to control. Elevated titres of antimicrosomal antibodies were found to be present in 13 (43.3%) patients in Group 1, 27 (90%) patients in Group 2 (known cases of hypothyroidism) compared to control. The association between hypothyroidism and chronic urticaria with regard to autoantibodies titres was highly significance (p <0.001). CONCLUSION: A highly statistically significant association was found between chronic urticaria and hypothyroidism with special regard to antithyroglobulin and antimicrosomal autoantibodies. Therefore, assays of these two autoantibodies are justified for the early diagnosis of autoimmune thyroiditis in combination with chronic urticaria for better treatment options.

Cutaneous leishmaniasis: an emerging childhood infection.

BACKGROUND: Cutaneous Leishmaniasis (CL) has been an endemic parasitic infection in certain areas of Pakistan. New outbreaks have occurred in many areas not identified previously especially in the province of Sindh. The object of this study was to see the prevalence of CL as a childhood disease. METHODS: It was a cross sectional study in which 400 cases coming to various skin disease clinics were included for confirmation of CL by microscopy, culture and PCR. RESULTS: Out of 400 cases, 185 cases of ages from 1-14 years were diagnosed clinically and confirmed by Lab. Tests for CL. Both dry and wet types of lesions were observed that indicated presence of more than one strain of the parasite. CONCLUSION: Cutaneous Leishmaniasis was found to be significantly prevalent in children. The strains were found to be L. tropica and L. major as was indicated by the nature of lesions and confirmed by PCR.

Levels of non-high density lipoprotein cholesterol (non-HDL-C) in patients with ischaemic heart disease.

BACKGROUND: Ischaemic heart disease (IHD) is influenced by elevated cholesterol, low density lipoproteins-C (LDL-C), triglycerides and low blood levels of high density lipoproteins (HDL-C). Recently, non-HDL-C has also been suggested as one of the factors involved in IHD. Non-HDL-C is the difference between total cholesterol and HDL-C. Assuming that non-HDL-C levels are raised in IHD, a cross sectional study was designed to evaluate the levels of non-HDL-C in patients of IHD. METHODS: Thirty adult non-smoking male (age 50 +/- 0.51 years) patients of IHD were compared with 30 adult non-smoking males (47.27 +/- 1.15 years) controls without IHD. A 12 hours fasting blood sample was analysed to determine serum cholesterol and HDL on autoanalyzer. RESULTS: Non-HDL-C was significantly raised (p < 0.001) in patients of IHD when compared to controls. Values of non-HDL-C were 158.00 +/- 4.79 and 127.63 +/- 2.82 (Mean +/- SEM) in patients and controls respectively. CONCLUSION: Non-HDL-C contains all known potentially atherogenic lipid particles including LDL-C, intermediate density lipoproteins and very low density lipoproteins cholesterol remnants. Results of this study suggest its possible involvement in IHD. Non-HDL-C is an emerging coronary risk factor. It is a cost effective screening test that may be included in coronary risk profile.

Frequency of cryptosporidium in childhood diarrhoea--importance of modified acid fast technique.

BACKGROUND: One of the important causes of childhood diarrhoea is cryptosporidium, a parasitic pathogen which is usually overlooked. This study was therefore designed to show the importance of modified acid fast stain in the diagnosis of cryptosporidium in childhood diarrhoea. METHODS: Stool samples from 300 children with prolonged diarrhoea were examined by modified acid fast staining a long with wet mounts in saline and iodine. RESULTS: Out of 300 samples five (1.7%) were diagnosed as positive for cryptosporidium. CONCLUSION: Results indicate that Cryptosporidiosis exists as a cause of diarrhoeal illness in our society. It was also noted that modified acid fast staining of stool samples is an important, non-invasive and useful diagnostic technique in identification of cryptosporidium.