An unusual association of pyoderma gangrenosum with ulcerative colitis and thyrotoxicosis successfully treated with infliximab: a case report

Pyoderma Gangrenosum (PG) is a rare chronic immune-mediated inflammatory dermatosis manifested as painful skin ulceration, commonly affecting the lower limbs. The pathogenesis of the disease is complex. Abnormalities in neutrophil function, dysregulation of the innate immune system, and Tumor Necrosis Factor (TNF) were postulated. An underlying associated systemic disease was reported in more than 50% of PG patients, including inflammatory bowel disease, rheumatoid arthritis, and malignancies, with few cases reported an associated thyroid disease. Authors report a case of extensive PG associated with both ulcerative colitis and thyrotoxicosis co-morbidities not mentioned before in one patient. The patient was successfully treated with the anti-TNF alpha infliximab.

Seroprevalence of Anti-Human Metapneumovirus Antibodies in Hospitalized Children in Suleimani City/Iraq.

Background: Human Metapneumovirus (hMPV) is an important respiratory viral pathogen among children, and it is one of the causes of pediatric hospital admissions due to acute respiratory tract infections. Objective: This study was done to predict the seroprevalence of anti-hMPV antibodies among hospitalized children presenting with acute respiratory tract infections in Suleimani Governorate, Kurdistan Region/Iraq. Place and Duration: This study was done at the department of microbiology, school of medicine, suleimani University, between April 2011 and March 2012. Methods: Indirect immunofluorescent assay (IIFA) was performed to detect serum antihMPV antibodies (IgM and IgG antibodies) from three hundred hospitalized children less than 5 years old with acute respiratory tract infections. Results: IgM anti-hMPV antibodies were positive in thirty six (12%) out of three hundred children. The highest seroprevalence was found in the age group <1 year old, while the lowest in the age group 4 to <5 years old. No significant gender difference was found among seropositive children. The IgM anti – hMPV seropositive children were suffering from pneumonia, bronchiolitis, or other less severe acute respiratory tract infections like acute bronchitis and croup in frequencies of sixteen (44%), 10 (28%), and 10 (28%). The IgG anti-hMPV antibodies were positive in two hundred and twenty five (75%) out of the three hundred children, and there was a gradual increase in percentage of seropositivity with increasing age. Conclusion: hMPV is an important viral respiratory pathogen among hospitalized children in Suleimani Governorate/Kurdistan/Iraq, and most of the children had experienced hMPV infection by the age of five years.