Angiotensin-converting enzyme gene insertion/deletion polymorphism in Saudi patients with rheumatic heart disease

To investigate the association between angiotensin-converting enzyme [ACE] insertion/deletion [I/D] polymorphism and rheumatic heart disease [RHD] in Saudi patients. A case-control study was conducted in Saudi RHD patients. Genomic DNA was isolated from 99 RHD patients attending the Pediatric Cardiology Clinic at the Maternity and Children Hospital, Al-Madinah, Saudi Arabia from March 2013 to June 2014, and from 145 age- and gender-matched controls. Patient clinical records were reviewed to report major and minor modified Jones' criteria for diagnosis. The diagnosis was confirmed by echocardiography. The ACE I/D polymorphism was identified by polymerase chain reaction. A significant difference in ACE D allele carriage [DD+ID] distribution between RHD cases and controls was identified [p=0.02, odds ratio = 3.6, 95% confidence interval: 1.2-10.8]. The D allele carriage was significantly associated with development of mitral valve lesions alone [p=0.03]. The ACE I/D polymorphism is associated with an increased risk of RHD in the Saudi population. Further studies are needed to confirm our findings and to understand the molecular mechanisms underlying this association

Kawasaki disease in western Saudi Arabia

To describe our experience on Kawasaki disease in the Madinah region, Kingdom of Saudi Arabia [KSA]. This is a retrospective hospital based study. The study was conducted in Maternity and Children Hospital, Madinah, Kingdom of Saudi Arabia during January 2007 to January 2010. The study included 51 patients' records as suspected cases of Kawasaki disease. The study was approved by the Ethical Committee. Twenty-four patients were proven to have Kawasaki disease in this study. The mean age of the patients at diagnosis was 3.1 +/- 2.4 years. Most patients were younger than 5 years [83.3%]. The male to female ratio was 1.7:1. Diagnosis was made 8.1 +/- 3.3 days after start of fever with a range from 4-15 days. All patients received intravenous immunoglobulin [IVIG] with 2 requiring another dose of IVIG. Echocardiography was performed 10.1 +/- 3.9 days from onset of fever with a range of 4-20 days. The duration of hospital stay was 7.9 +/- 5.8 days with a range from 3-25 days. Three patients had coronary artery abnormalities and still have coronary artery dilatation at last follow-up appointment. A high index of suspicion is mandatory for early diagnosis of Kawasaki disease as delayed diagnosis may lead to coronary lesions. A national awareness program on Kawasaki disease is recommended