ABSTRACT
Objective: The aim of this work was to establish human leukocyte antigen [HLA] class I and hereditary hemochromatosis gene [HFE] mutation associations with recurrent aphthous oral ulcers [RAOU] and Behcet disease [BD] in a cohort of Southern Tunisian patients
Subjects and Methods: A total of 232 patients with RAOU and 123 healthy controls [HCs] were enrolled in this study. The patients were divided into 2 groups based on the presence [BD+: n = 62] or absence of BD [BD - , n = 170]. In the BD+ group, 28 patients had severe manifestations of BD. In the BD- group, RAOU was isolated in 81 patients, associated with mucocutaneous manifestations in 58 and with joint symptoms in 25. Complement-dependent microlymphocytotoxicity assay and polymerase chain reaction-restriction fragment length polymorphism were used to study HLA class I polymorphism and HFE mutations, respectively
Results: HLA-B51 was positively associated with BD, particularly in those with severe manifestations. No association was detected with HLA class I polymorphism among the BD group. Based on stratification to clinical manifestations, the isolated RAOU was negatively associated with HLA-A1 with a difference close to significance [12 [14.81%] vs. 32 [26.02%] in HCs; p = 0.06]. Furthermore, patients with mucocutaneous features had a higher frequency of HLA-B51 [14, 24.14%] than patients without mucocutaneous involvement [11, 11.37%]. Considering HFE mutations, patients with isolated RAOU had a higher frequency of H63D when compared with other subgroups, especially after limiting the comparison to 27 patients of at least 5 years of follow up
Conclusion: This study showed that, unlike BD, RAOU were not associated with HLA-B51. Moreover, we suggest that H63D mutation was positively associated with isolated RAOU
ABSTRACT
Optic neuritis (ON) may be associated to a range of autoimmune or infectious diseases. We report herein a case of ON induced by Rickettsia conorii. A 53-year-old woman presented with a recent decrease in visual acuity and headache. ON was diagnosed on the basis of ophthalmologic examination and flash visual evoked potentials. Etiological investigation made in our department eliminated first autoimmune disorders (vasculitis and connective tissue diseases). Rickettsial optic neuritis was confirmed by detection of specific antibodies in serum and the negativity of other serologic tests. An association between corticosteroids and cyclines was prescribed with improvement of visual acuity.
ABSTRACT
To determine the incidence of pregnancies during the inflammatory myopathy [IM], its influence on this disease and the influence of IM on the pregnancy's outcome. From 1979 to 2007 we have collected retrospectively 67 cases of IM [53 women and 14 men] in the department of internal medicine CHU Hedi Chaker of Sfax [Tunisia]. Diagnosis criteria were those and Peter. We have included pregnancies occurring after diagnosis of DM or PM and cases of IM occurring during pregnancy or postpartum. Five women [4DM and PM], average age 30.6 years [range 26 - 41 years] concluded 10 pregnancies [9.4%]. The fertility rate is 2 pregnancies per patient. Nine pregnancies occurred after the diagnosis of myositis in 4 women. IM was inactive at conception in all this case. No flare-up in IM has been noted during these pregnancies. The DM was revealed to the 10th day post-partum in one patient. Therapeutic interruption of pregnancy was needed in 3 cases. 4 pregnancies were completed without incident and resulted in the birth of healthy newborns. Foetal complication were observed in the other two pregnancies occurring in one patient who also presents an APS associated with DM. it was a foetal death in utero and premature delivery of a newborn who died in 3rd day after birth. Pregnancy in the MI is rare. Its influence on the activity of the disease is variable, both during the pregnancy than post-partum. The foetal prognosis is good when the disease is in remission. However foetal complications are important in case of active IM