Anticardiolipin antibodies in young Iraqi adults with deep venous thrombosis

To determine the prevalence and clinical significance of anticardiolipin antibodies [ACA] in young Iraqis with Deep venous thrombosis [DVT]. A total of 50 unselected young Iraqi adults [<45 years] with Doppler confirmed DVT were evaluated. The evaluation included full relevant history, Prothrombin Time, Partial Thromboplastin Time, Kaolin Clotting time [KCT], KCT index [to screen for Lupus Anticoagulant [LA] in patients not on oral anticoagulants], and lgG and IgM ACA titres [by ELISA]. The median age of the DVT patients was 32.5 years with a M:F ratio of 1:2.6. The overall prevalence of Antiphopholipid Antibodies [APA] [those with elevated ACA and/or LA] was 16%, while it was 9.5% in the subcategory with single DVT attack. The subcategory of patients with recurrent DVT [8 patients] had significantly higher frequency of APA [OR 9.5] and lgG ACA titres compared to those with a single episode [p=0.01583 and 0.01 respectively]. Higher frequencies of APA were also encountered in the subcategories with history of Pulmonary embolism, Stroke and recurrent fetal loss, compared to those without such histories [OR of 3.2, 6.7 and 7.7 respectively]. The findings of this study are consistent with worldwide reports on prevalence and significance of APA. The high frequency of these antibodies in young Iraqi patients and their association with recurrent thrombotic events, in addition to the bulk of the literature suggesting higher recurrence rates and mortality in those with the antibodies on cessations of therapy, warrants pursuing the policy of evaluating all Iraqi young adults at diagnosis or just prior stopping therapy for APA, and considering long term appropriate anticoagulation in those with the antibodies, to reduce recurrence and mortality

Antiphospholipid antibodies in rheumatoid arthritis: clinical and laboratory orrelations in fifty Iraqi patients

Background: studies on prevalence and correlations of antiphospholipid antibodies[APA] in Rheumatoid Arthritis [RA] are infrequent from developing and Asian countries and the current study is to address this issue

Materials And Methods: fifty unselected Iraqi Rheumatoid Arthritis patients managed at the Baghdad teaching hospital[Baghdad, Iraq], in the period between Nov 1998 and Sept 1999, were evaluated for the presence of Antiphospholipid antibodies [Lupus anticoagulant [LA] and Anticardiolipin antibodies [aCL]], and their clinical and laboratory correlations

Results: anticardiolipin antibodies were detected in 11 [22%] and LA in 4 [8%]patients, including two who had both antibodies concomitantly. The presence of aCL was significantly associated with a lower haemoglobin [p=0.024] and higher ESR [p=0.015], indicating a positive correlation with disease activity, while there were no significant associations of APA with any of the articular or extra-articular manifestations of the disease, or with history of thrombosis, fetal loss, or thrombocytopenia

Conclusions: antiphospholipid antibodies in RA are significantly correlated with disease activity, but not with their classical associations [thrombosis, fetal loss and thrombocytopenia] as seen in SLE and primary Antiphospholipid Syndrome, suggesting heterogeneity of these antibodies

Bleomycin doxorubicine and prednisolone combination for induction therapy for high risk acute lymphoblastic leukaemia

In the period between September 1993 and January 1994, Vincristine was not available in Iraq. During this period, ten patients [aged 13-40 years] were admitted to one of the medical units at Baghdad Teaching Hospital - Baghdad with the diagnosis of high risk Acute Lymphoblastic Leukaemia [ALL] [seven were newly diagnosed cases, while three were relapsed ALLs]. These patients received an induction therapy consisting of Bleomycin, Doxorubicine and Prednisolone. Of the seven newly diagnosed ALL so treated, six obtained complete remission, 2 of whom were still in remission at their last follow up 110 weeks of their initial diagnosis. The remaining 4 patients relapsed 2-80 w after diagnosis due to non-compliance with maintenance therapy. None of the three relapsed ALLs cases achieved complete remission. This regimen was not a trial and was stopped as soon as Vincristine became available again, however the encouraging results noted warrant in our opinion reconsidering the role of Bleomycin in induction protocols for newly diagnosed high risk ALLs