Medical conditions associated with a positive anti-double-stranded deoxyribonucleic acid

To explore the associated diseases with positive anti-double stranded [ds] DNA other than systemic lupus erythematosus [SLE], and to determine an association if any, between its level in non-SLE causes. This is a retrospective review of all patients with positive anti-dsDNA assay [more than 200 IU/ml] tested for any underlying etiology from January to December 2007 at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Two hundred and twelve patients with anti-dsDNA antibody testing were evaluated. Of these, 124 patients had SLE [58.5%], while 88 patients [41.5%] had other diseases. Representing non-SLE diseases were: rheumatological disorders in 29 patients [33%], infections in 11 [12%], and malignancy in 6 patients [7%]. Strong positive results [>800 IU/ml] were found in only 8 patients [4%] with diagnoses of antiphospholipid antibody syndrome, tuberculosis, osteomylitis, thymoma, lymphoma, sarcoidosis, and 2 autoimmune hepatitis patients. There was a statistically significant association between highly positive anti-dsDNA testing and rheumatological disorders. Although positive anti-dsDNA test is common in SLE patients, other diseases should be considered when the anti-dsDNA level is equivocal, and the clinical criteria are not in favor of SLE

Diseases associated with the different patterns of antinuclear antibodies detected by immunofluorescence

immunofluorescent antinuclear antibody [ANA] patterns are variable and may indicate specificity towards certain diagnosis. to explore the spectrum of diseases associated with the common different ANA patterns seen at King Abdulaziz University Hospital [KAUH]. ANA tests were performed by indirect immunofluorescent assay [IIFA] in the clinical immunology laboratory. Cases with positive ANA cases were selected sequentially. Their IIFA patterns and patient files were reviewed. 211 positive ANA cases were studied. The ages ranged between 3-70 years [mean age 31.4 +/- 15] females predominated [83%]. Rheumatological disorders were the predominant illnesses; they were diagnosed in 148 cases [70.1%]. These included systemic lupus erythematosus [SLE] 71 [33.6%], rheumatoid arthritis 18 [8.5%], others 26 [12.3%], and undiagnosed 33 [15.6%]. Other autoimmune disorders followed with 34 [16.1%]. There were also 23 [10.9%] cases with recurrent abortion and 6 [2.8%] with miscellaneous illnesses. The different ANA patterns on IIFA were: homogeneous 107 [50.7%], speckled 68 [32.2%], nuclear 18 [8.5%], peripheral 7 [3.3%], centromere 1 [0.5%], and mixed 10 [4.7%]. A highly significant association was detected between the peripheral ANA pattern and SLE cases [P<0.01]. autoimmune disorders, particularly rheumatological, were the commonest diseases associated with positive ANA test. The predominant ANA pattern was the homogeneous, followed by the speckled which is compatible with reports in the literature. ANA staining pattern have limited value in the clinical assessment of autoimmune diseases; however, ANA has very high sensitivity for SLE especially in cases with peripheral ANA pattern

Incidence of bronchial asthma in a children hospital, Jeddah

To study epidemiological and management pattern of asthmatic children attending the emergency room of the main children hospital at Jeddah and to determine the relation of temperature changes in the city to the rate of their attendance. A retrospective review of all emergency room records in 2 years. Yearly and monthly rates of acute asthma cases required medical intervention were calculated. Monthly ratios were correlated to mean grades of temperature in the city. A sample of 2504 cases were drawn randomly to reveal factors associated with presentation and management of asthmatic children. A total of 13802 acute asthmatic children presented to the emergency room [7.2% of all emergencies]. Saudis formed 61.2% and males formed 65.5% of asthmatics. Younger ages [< 2 years] showed a significant predominance and family history of bronchial asthma was recorded in 74% of the sample while previous use of prophylactic therapy was very low. Dyspnea was the most frequent presenting symptom followed by cough and wheezing. Most of the cases were managed primarily by nebulized Salbutamol and only 21% required systemic steroid. Months of low temperature grades were strongly associated with more presentation of asthmatics in the emergency room. Asthmatic children are forming a sizable portion of emergency attendances in Jeddah. An inadequate use of standard prophylactic therapies with a subsequent high impact on the utilization of health resources was noted. Efforts are needed by the medical community to adhere to national and international protocols for the diagnosis and management of bronchial asthma and promote the use of prophylactic drugs