ABSTRACT
The management of prolonged fever in low-socioeconomic-status areas by primary care providers such as general practitioners is challenging. Given the endemic nature of many infectious diseases, physicians typically start empirical antibiotic therapy following a limited diagnostic workup including serologic examinations. Herein, we report the case of a young male patient with prolonged fever and arthralgia initially diagnosed with and treated for brucellosis but with a confirmed diagnosis of systemic lupus erythematosus on follow-up. This unique case shows that close follow-up is the best practice for managing prolonged fever in cases with non-specific laboratory findings.
Subject(s)
Humans , Male , Arthralgia , Brucellosis , Communicable Diseases , Diagnosis , Fever , Follow-Up Studies , General Practitioners , Lupus Erythematosus, Systemic , Practice Guidelines as Topic , Primary Health CareABSTRACT
Systemic lupus erythematosus [SLE] is an autoimmune disease with unknown etiology. Interleukin-1 receptor antagonist [IL-1Ra] is naturally occurring cytokine that inhibits interleukin-1 [IL-1] activity by binding to the IL-1 receptors without signal transduction. The aim of this study was to investigate the association between IL-1Ra gene 86bp VNTR polymorphism and systemic lupus erythematosus in the South- East of Iran. In this case control study, genetic polymorphism was analyzed in 163 SLE patients and 183 healthy controls. Genotyping of IL-1Ra VNTR polymorphism was determined by gel electrophoresis after PCR amplification. IL-1Ra VNTR alleles have different copies of 86bp tandem repeats: allele 1[four repeats], allele 2 [two repeats], allele 3 [five repeats], allele 4 [three repeats] and allele 5 [six repeats]. We found an increased frequency of IL-1Ra allele 4 and 1/4 genotype in SLE patients compared to healthy controls [p=0.001 and p=0.002 respectively]. Whereas, the frequency of IL-1Ra allele 3 was higher in controls than SLE patients [p=0.01]. There was no any association between the IL-1Ra allele 2 and SLE. We did not observe any association between IL-1Ra polymorphism and SLE manifestations. We concluded that IL-1Ra allele 4 was involved in the pathogenesis of SLE. However, there was no association between the IL-1Ra allele 2 and SLE in South East of Iran
ABSTRACT
Systemic lupus erythematosus [SLE] is a multisystem disease with unknown etiology. We hypothesized that insertion/deletion [I/D] polymorphism of angiotensin-converting enzyme [ACE] gene may influence the development and/or progression of SLE and lupus nephritis. In a crass sectional case-control study, genomic DNA from 106 SLE patients and 103 healthy controls matched for sex, age, and ethnicity, were genotyped for the [I/D] polymorphism of ACE gene by polymerase chain reaction [PCR]. Comparison of quantitative variants between two groups was assessed by student t-test and association between qualitative variables was analyzed by the chi-square or Fisher exact tests. The frequency of DD genotype in SLE patients was significantly higher than control group [25.5% vs. 14%], and the risk of SLE was 2.2 times greater in subjects with DD genotype than the individual by DI and II genotypes [OR, 2.2 [95% CI, 1.1 to 4.4]; p=0.023]. The distribution of D allele in SLE patients was significantly higher [p=0.021] compare to controls [47 and 36.4, respectively]. The Risk of nephropathy in SLE patients with DD genotype was three times more than other genotypes [OR], 3 [95% CI, 1.1 to 8]; p=0.027]. This study demonstrated that ACE DD genotype acts as a risk factor on SLE and Lupus nephropathy in an Iranian population
ABSTRACT
Analysis of the role of different alleles of human leukocyte antigen [HLA] in rheumatoid arthritis [RA] patients is necessary in many populations and geographical areas. The aim of the present study was to investigate the frequency of HLA-DRB1 alleles in RA patients, comparing with that in control group in southeast Iran. Case-control study of rheumatoid arthritis patients referred to rheumatology clinic at university hospital. The frequency of HLA-DRB1 alleles was determined in 79 RA patients and 93 healthy subjects in Zahedan, southeast Iran. HLA-DRB1 allele types were identified by polymerase chain reaction with sequence-specific primer [PCR-SSP]. The HLA-DRB1*10 allele showed a significantly higher frequency in patients with RA [OR=2.698, 95% CI=1.087-6.699, P=.045], while the frequency of DRB1*03 allele in these subjects was significantly lower than that in the control group [OR=0.447, 95% CI=0.2285-0.8729, P=.021]. The frequencies of DRB1*01, DRB1*04, DRB1*07, DRB1*09, DRB1*11, DRB1*13, DRB1*14, DRB1*15, DRB1*16 were not significantly different between RA subjects and the control group. The data suggest that the DRB1*10 allele is a risk factor and DRB1*03 is protective for RA in this population