Elevation of B-type natriuretic peptide level in asymptomatic Hepatitis B virus-positive patients is not associated with abnormalities of cardiac function

To compare B-type natriuretic peptide [BNP] and echocardiographic parameters in patients with hepatitis B virus [HBV] and healthy control subjects. 52 consecutive patients with HBV and 47 healthy controls were examined. All subjects underwent transthoracic echocardiography after a complete medical history and laboratory examination including BNP, C-reactive protein [CRP] and high-sensitivity CRP [hsCRP]. Demographic characteristics were similar in patients with HBV and the control group. No significant difference was found in conventional Doppler and tissue Doppler parameters between the two groups. BNP levels were significantly higher in patients with HBV [6.5 ng/l [range 0.5-85.2]] than controls [4.3 ng/l [range 0.5-18.3]], p = 0.039. hsCRP [3.25 mg/l [0.02-40.2] vs. 0.5 mg/l [0.02-8.0]] levels were significantly higher in patients with HBV than control subjects [p < 0.001]. Patients with HBV had higher BNP, CRP, and hsCRP levels than controls. Echocardiographic findings were similar in both groups. This slight BNP elevation in HBV patients may be related to chronic inflammation due to HBV

49, xxxxy syndrome with autoimmune diabetes and ocular manifestations

We report a rare case of 49,XXXXY syndrome with autoimmune diabetes [requiring insulin therapy], bilateral cataracts and unilateral glaucoma. A 25-year-old man with mental retardation presented with multiple skeletal abnormalities, polyuria and polydipsia. He had high glucose concentrations, without ketonuria, and hypergonadotropichypogonadism. Ophthalmic examination revealed a polar cataract in both eyes and increased intraocular pressure in the left eye. The anti-islet cell antibody test was positive, and antiglutamic acid decarboxylase autoantibody levels were elevated. Karyotype analysis revealed 49,XXXXY. Intensive insulin therapy and testosterone replacements were started. The autoimmune nature of diabetes that we observed in our patient seems to be predisposed by hypogonadism. Cataract and glaucoma in this case seem to be the result of diabetes, and an association of these ocular manifestations with the syndrome 49,XXXXY seems unlikely