Role of HLA-B27 in high grade atrioventricular block and sick sinus syndrome

There has been an association between HLA-B27 and cardiovascular affection. Furthermore, a significantly increased prevalence of HLA-B27 was found in men with pacemakers who had no clinical or radiological signs of HLA-B27 associated disease. This study was planned to obtain more insight into the association between HLA-B27 and high grade AV block [HG-AVB] and sick sinus syndrome [SSS], and the possible role of HLA-B27 in causing this block. HLA tissue typing was preformed on 200 normal Egyptians [control] and 75 Egyptian pts who had permanent pacemakers implanted for HG-AVB and SSS who had no clinical or radiological signs of HLA-B27 associated disease. The pacemaker pts were classified into 3 groups according to the aetiology of AVB and SSS, group 1 included 5 pts with acquired HG-AVB, group II included 10 pts with congenital complete heart block and group III included 60 pts with idiopathic HG-AVB or SSS. HLA-B27 was present in 5/200 [2.5%] normal healthy Egyptians, in 6/60 [10%] pts with idiopathic HG-AVB and SSS [group III]. However, HLA-B27 was negative in both groups I and II. There was a statistically significant higher prevalence of HLA-B27 in pts with idiopathic HG-AVB/SSS than in both normal Egyptians and pts with acquired or congenital AVB [p < 0.05]. HLA-B27 might have a role in the aetiology of idiopathic AVB however, further research is needed to obtain more insight into its role and the role of other factors in idiopathic AVB

Measurement of non-specific antibodies in renal transplant patients and the incidence of certain postoperative viral infections

In this study we assess the level and incidence of panel reactive antibodies which are the main cause of hyperacute rejection in renal transplant. The patients sera were tested against the lymphocytes of standard individuals. The lymphocytes panel had adequate representation of most of known antigens. 11 out of 20 patients [55%] gave positive standard panel test utilizing the microlymphocytotoxic assay. The positivity was recorded at 20°C suggesting that those patients were sensitized. When the recipient sera were treated with Dithiothreitol [DTT] 2 cases showed false cytotoxic antibodies as shown in thee-negative panel obtained after the DTT treatment. The other nine positive cases showed true cytotoxic by not reacting with DTT. 80% of active CMV infections occurred concomitantly to acute rejection episodes and/or its treatment suggest a chronologic, possibly causal link between rejection and CMV infection