Vitamin D serum levels in allergic rhinitis: any difference from normal population?

BACKGROUND: Recently it has been suggested that, the worldwide increase in allergic diseases such as asthma, allergic rhinitis and food allergy is associated with low vitamin D intake. OBJECTIVE: This study measured the vitamin D levels in patients with allergic rhinitis and compared the results with the general population. METHODS: Vitamin D levels were assessed in 50 patients with allergic rhinitis diagnosed clinically by Allergic Rhinitis and its Impact on Asthma 2008 criteria and the result of skin prick test for aeroallergens. There was no control group, and the study results were compared with the results of another study evaluating vitamin D status in the 5,329 people of normal population of Iran. RESULTS: The prevalence of severe vitamin D deficiency was significantly higher in patients with allergic rhinitis than the normal population, 30% and 5.1% respectively (p = 0.03). Also women with allergic rhinitis had lower vitamin D levels. CONCLUSION: Measuring vitamin D serum levels could be helpful in the routine assessment of patients with allergic rhinitis in Iran.

[Study on the association of Toxocariasis with allergic rhinitis in individuals referred to Rasoul Akram Hospital, Tehran]

Toxocariasis is a common worldwide zoonotic parasite infection caused by the larvae of Toxocara catti and Toxocara canis. Allergic rhinitis is the most common chronic diseases in the upper respiratory tract. The main symptoms are sneezing, watery rhinorrhea, itching in the nose, eyes and palate. The purpose of this study was to investigate the association between toxocara seropositivity and allergic rhinitis compared with the control population. This cross-sectional study was carried out from September 2009 to February 2011 on 93 patients with allergic rhinitis and 87 control subjects. Confirmation of the diagnosis of allergic rhinitis was defined by history and positive epicutaneous prick test. Control subjects were healthy based on history and no signs of allergic rhinitis and other allergic diseases were seen. Blood and fecal samples were taken from both groups. Sera were separated, labeled and stored at -20°C until used. Stool samples were examined by a wet mount and formalin-ethyl acetate concentration technique. The diagnosis of toxocariasis was established by IgG anti Toxocara and IgE total by ELISA method. In case group [allergic rhinitis] from 93 patients, 50 patients [53.8%] were males and 43 [46.2%] were female. In the control group of 87 individuals studied, 56 [64.4%] were males and 31 [35.6%] were female. In cases and controls, 5 [5.4%] and 3 [3.4%] of sera were positive for IgG Toxocara, respectively. There was no statistical difference in Toxocara seropositivity in both groups [p =0.39]. It seems to be in contrast to worms and allergies several factors, including phase worm infections [acute and chronic], parasite load, parasite species and resistance genes are involved and this require further studies in different ages and populations

Co-administration of Chenopodium album allergens and CpG oligodeoxy- nucleotides effects on peripheral blood mononuclear cells of patients with allergic rhinitis treated with intranasal corticosteroids and antihistamines

Allergic Rhinitis [AR] is one of the most common chronic diseases in the developed countries. This study was performed to investigate the effect of CpG-ODN in alteration of T-helper [Th]l/Th2 balance of patients with AR treated with intranasal corticosteroids [INCs] and antihistamines. Peripheral blood mononuclear cells [PBMCs] of 20 patients with AR were isolated before and after 45 days therapy. Cytokine production [IL-4, IL-10, IL-13, IFN-gamma] and specific Ch.a IgE in response to CpG co-administration of natural chenopodium album [CpG/Ch.a] or recombinant Ch.a [CpG/rCh.a] allergen were investigated in supernatants.of cultured PBMCs using ELISA Intracellular IL-10 was also assessed in CD4[+] cells using flow cytometry. Significant increase in production of IFN-y and IL-10 and decrease in production of IL-4 were found in supernatants of cultured PBMCs activated with CPG/ch.a and CPG/rch.a. of both CpG/Ch.a and CpG/rCh.a compared to allergens alone, before and after therapy. After therapy, IFN-gamma production with CpG/Ch.a was significantly increased in comparison with before [237 vs. 44 pg/ml, p=0.001]. IFN-gamma and IL-10 production with CpG/rCh.a was significantly increased after therapy compared to before [407.6 vs. 109 pg/ml, p=0.0l for IFN- gamma; 171.7 vs. 52.6 pg/ml, p=0.008 for IL-10], whilst IL-4 was significantly decreased [2.1 vs. 5.8 pg/ml, p=0.02]. Intracellular IL-10 expression was also significantly increased in response to either CpG/Ch.a or CpG/rCh.a that showed intracellular assay could be more sensitive than ELISA. Also, treatment with intranasal corticosteroids and antihistamines could enhance this CpG effect, in vitro

Mortality in primary immunodeficient patients, registered in Iranian primary immunodeficiency registry

Primary immunodeficiencies [PID] are a group of disorders, characterized by an unusual susceptibility to infections. Delay in diagnosis results in increased morbidity and mortality in affected patients. The purpose of this study was to determine the mortality rate of Iranian immunodeficient patients referred to Children Medical Center Hospital affiliated to Tehran University of Medical Sciences over a period of 20 years. In this study, records of 235 [146 males, 89 females] patients with immunodeficiency who were diagnosed and followed in our center, during 22 years period [1979 2001] were reviewed. The diagnosis of immunodeficiency was based on the standard criteria. The cause of death was determined by review of death certificates. Antibody deficiency was the most common diagnosis made in our patients. The overall five-year survival rate was 22.7% in our studied patient group; this was greatest in antibody deficiency. During the 22 year period of study, 32 patients died. As some of the patients could not be located, the true mortality rate ranged between 13.6% and 17.5%. The main leading cause of death were lower respiratory tract involvement in 14 cases [44%]. The most common pathogenic microorganisms causing fatal infections were psudomonas and staphylococcus in 9 cases [28.1%] followed by E. coli in 7 [21.9%], tuberculosis in 13 [40.6%] and salmonella in 1 [3.1%]. Based on our study, delay in diagnosis in patients with PID results in tissue and organ damage and several complications. Mortality and morbidity are increased in undiagnosed patients

Gastrointestinal manifestations of patients with Chronic Granulomatous Disease

Chronic Granulomatous Disease [CGD] represents a group of inherited disorders of phagocytic system, manifesting recurrent infections at different sites. The present study was accomplished in order to determine the gastrointestinal manifestations of CGD patients. Fifty-seven patients [38 males and 19 females] with CGD, who had been referred to three immunodeficiency referral centers in Iran, were studied during a 24-year period [1980-2004]. The median age at the time of study was 14.5 years old [1-56 years]. The median onset age of symptoms was 5 months [1 month - 13.75 years], and that of diagnostic age was 5 years [2 months- 54.1 years], with a diagnostic delay of 33 months, on average. Seven patients were presented with acute diarrhea, 3 with oral candidiasis, and 2 with liver abscesses as the first chief complaints. Twenty-four cases [42.1%] had been complicated by gastrointestinal manifestations during their course of the disease. Of those, 12 cases [21.1%] had diarrhea, 7 [12.3%] oral candidiasis, 5 [8.8%] hepatitis, 4 [7.0%] hepatic abscess, and 2 cases [3.5%] gastric outlet obstruction. Also, failure to thrive was detected in 6 patients [10.5%]. Four patients died [7%]. CGD should be excluded in any patient with gastrointestinal manifestations especially chronic diarrhea, hepatic abscess, and gastric outlet obstruction