ABSTRACT
Background:During the last five years the proportion of living unrelated kidney transplants has increased and DNA tissue-typing methods have become popular in India. This study was carried out to compare the results of tissue - typing by serology and sequence specific primers (SSP) and study the usefulness of 'episode' allograft biopsies for diagnosis of acute graft dysfunction . Materials and Methods:DNA was extracted from whole blood using Qiagen kit. Samples from 60 individuals including thirty patients and their donors were typed by serology and SSP. Fifteen allograft biopsies were performed for suspected acute rejection (AR) cases. Results: Both alleles of HLA - A, B and DR antigen could be determined in 86, 65 and 90% of samples by SSP respectively. There was a discrepancy of 16-40% between SSP and serology. Acute rejection was confirmed in 8/15 biopsies. Graft survival rates were 83 and 76% at one and two years respectively. Neither the graft survival nor the number of AR episodes showed any correlation with the extent of HLA mismatch. SSP was useful in defining A*68, A*66, A*69 and A*33 alleles at private level and A*36, A*74 and A*03 alleles which were blank on serology. Conclusions: SSP has become popular in India due to its simplicity, superior results especially for class II HLA alleles: and episode allograft biopsy is adequate for follow-up of kidney recipients.
ABSTRACT
Autoimmune diseases are commonly encountered in dermatology practice. While the association of two autoimmune diseases in the same individual is not unknown, it is relatively rare for the second disease to be suspected based on cutaneous manifestations. We present two such cases wherein cutaneous manifestations were the first clue to the development of lupus erythematosus in a setting of autoimmune thyroiditis. Further, we have reviewed literature on this uncommon occurrence and discuss various aspects of this association.