ABSTRACT
Common variable immunodeficiency (CVID) is a heterogeneous group of primary immune deficiencies in adults characterized by hypogammaglobulinemia, recurrent bacterial infections, and a higher incidence of autoimmune diseases. More than 25% of CVID patients also have autoimmune diseases such as autoimmune hemolytic anemia, immune thrombocytopenic purpura, rheumatoid arthritis, and systemic lupus erythematosus. However, the pathogenesis of autoimmunity in CVID remains obscure. We report a 56-year-old woman with CVID and Sjogren's syndrome. In addition to a long history of recurrent upper respiratory infections, acute gastroenteritis, and cellulitis, she has also suffered from persistent xerostomia and xerophthalmia for the past 10 years. Serologic studies revealed hypogammaglobulinemia (low levels of IgG, IgA, and IgM in serum) and the presence of anti-Ro antibodies, and salivary scintigraphy indicated salivary gland involvement. These findings led to a diagnosis of CVID and Sjogren's syndrome, which was treated by monthly intravenous immunoglobulin therapy.
Subject(s)
Adult , Female , Humans , Middle Aged , Agammaglobulinemia , Anemia, Hemolytic, Autoimmune , Antibodies , Arthritis, Rheumatoid , Autoimmune Diseases , Autoimmunity , Bacterial Infections , Cellulitis , Common Variable Immunodeficiency , Diagnosis , Gastroenteritis , Immunization, Passive , Immunoglobulin A , Immunoglobulin G , Immunoglobulin M , Incidence , Lupus Erythematosus, Systemic , Purpura, Thrombocytopenic, Idiopathic , Radionuclide Imaging , Respiratory Tract Infections , Salivary Glands , Sjogren's Syndrome , Xerophthalmia , XerostomiaABSTRACT
OBJECTIVE: To assess the effect of fentanyl and midazolam on in vitro fertilization rate and early embryo development in a mouse IVF model. METHODS: Mouse oocytes were exposed in vitro to fentanyl at a concentration of 0(control), 50, 250, 500, 1000, 5000 pg/ml, and midazolam, 0(control), 2.5, 12.5, 25, 50, 250 ng/ml for 30 minutes, washed and inseminated. Thereafter fertilization was assessed. And subsequent in vitro development to the blastocyst stage was monitored daily. RESULTS: Where fertilization occurred, subsequent embryo cleavage and development up to the blastocyst stage was affected significantly by the presence of fentanyl and midazolam solution in the medium(i.e., 14% to 31%, 10% to 35%), in comparison with control group( 60%, 62%). CONCLUSION: It can be concluded from these experiments that even a brief exposure of cumulus enclosed oocytes to a low concentration of fentanyl, midazolam is deleterious to subsequent cleavage.