COVID-19 et maladies auto-immunes dans un centre de traitement des épidémies à Dakar / COVID 19 and autoimmune diseases in an outbreak treatment center in Dakar

Introduction : Les patients présentant une affection systémique ont un risque accru d'infections. Leur prise en charge au cours de la pandémie au COVID19 constitue un défi qui doit prendre en considération plusieurs aspects. Nous rapportons les caractéristiques épidémiologiques, cliniques, et évolutives des patients COVID positifs suivis pour une maladie auto-immune (MAI). Patients et méthode : étude rétrospective, descriptive et analytique menée au centre de traitement des épidémies du centre hospitalier universitaire (CHU) Le Dantec de Dakar durant les périodes du 30 Avril au 30 Octobre 2020 puis du 30 Décembre 2020 au 30 Avril 2021. Etaient inclus tous les dossiers des patients suivis pour une maladie systémique hospitalisés pour COVID-19 confirmée à la RT-PCR. Résultats : treize patients étaient inclus dans l'étude, composés de 8 femmes et de 5 hommes. L'âge moyen était de 59 ans [16 à 74 ans]. Il s'agissait de 8 cas de maladies auto-immunes systémiques (MAIS) : polyarthrite rhumatoïde (n=3 ; 37,5%), Sjögren primitif (n=2 ; 25%), lupus systémique, dermatomyosite, arthrite à cellules géantes chacun 1 cas (12,5%) et 5 cas de maladies auto-immunes spécifiques d'organes (MASO) : maladie de Basedow (n=1 ; 20% de MASO), thyroïdite de Hashimoto (n=1 ; 20%), myasthénie (n=1 ; 20%), diabète de type 1 (n=1 ; 20%) et maladie de Biermer (n=1 ; 20%). Les formes cliniques étaient modérées (6 cas ; 46,1%), sévères (2cas ; 15,4%) et critiques (2cas ; 15,4%). Huit patients (8/13) avaient au moins une comorbidité associée. Deux décès (2/13) étaient notés. Conclusion : il n'a pas été trouvé une augmentation des complications sévères dues au COVID-19 chez les patients suivis pour une maladie auto-immune. Leur pronostic n'est pas différent de celui de la population générale.

Clinical significance of IgG4 related Hashimoto thyroiditis / 中国免疫学杂志

Objective:To explore the serum IgG4 level in patients with IgG4-related Hashimoto thyroiditis(IgG4 HT),and its clinical implications.Methods:The serum IgG4 was determined in 129 patients with HT using enzyme-linked immunosorbent assays and classified into two subgroups based on IgG4 level:IgG4 HT group(IgG4≥135 mg/dl)and non-IgG4 HT group(IgG4<135 mg/dl).And the levels of serum thyroid hormone and thyroid peroxidase antibodies(TPOAb)and thyroglobulin antibodies(TgAb)were measured by electro-chemiluminescence immunoassay.Ultrasonic imaging of the thyroid gland were detected.Results:The TPOAb levels correlated significantly with both serum IgG4 levels(r=0.437 1,P=0.012 7)and IgG4/IgG ratios(r=0.396 2,P=0.023 5)in the patients with HT.Compared with that of non-IgG4 HT group(n=97),IgG4 HT group(n=32):①The mean age was lower(P=0.029 3);②Higher levels of serum TPOAb(P=0.002 1)and TgAb(P=0.012 8);③Ultrasound imaging:the more obvious thyroid nodule(P=0.022 6);④Logistic regression analysis showed that serum IgG4 and TPOAb were the risk factor for thyroid nodules(OR=1.672,P=0.021;2.549,P=0.014 ).Conclusion: IgG4 HT patients existed corresponding clinical characteristics.For the HT-patients with elevated serum IgG4,thyroid function and morphology should were more closely monitored.

Detection of APRIL mRNA in peripheral blood of auto-immune diseases using a quantitative real-time PCR method / 临床检验杂志

Objective To establish a SYBR Green Ⅰ quantitative real-time PCR method for detecting the expression of APRIL gene(a proliferation-inducing ligand,APRIL) in peripheral blood of patients with auto-immune diseases,e.g.,systemic lupus erythematosus(SLE) and rheumatoid arthritis(RA),and investigate the relationship of APRIL mRNA expression with pathogenesis and prognosis of auto-immune diseases.Methods Plasmid PGEM-T easy-APRIL was cloned as the standard template.SYBR Green Ⅰ quantitative real-time PCR was set up to examine the expression of APRIL mRNA in peripheral blood of 58 patients with auto-immune diseases and 20 healthy controls using Line Gene FQD-33A Detection System.Results The obtained data were normalized by dividing the copy number of target cDNA by those of GAPDH(glyceraldehycle-3-phosphate dehydrogenase,GAPDH).APRIL expression levels ranges from 3.95 to 192 and mean value was 29.68?4.5.APRIL expression of twenty healthy controls showed range from 3.1 to 18.7 and mean value of 10.56?2.0.APRIL expression levels in patients with auto-immune diseases were higher than those in healthy controls.In auto-immune diseases group APRIL expression levels of untreated patients were higher than those of the other patients,and a statistical significance was found.Conclusions APRIL mRNA was successfully detected by SYBR Green Ⅰ quantitative real-time PCR and the method was accurate and reliable.The expression of APRIL mRNA of auto-immune disease patients was higher than those of healthy controls,and the expression of untreated patients was the highest.This method may be used for further study on the high-level expression of APRIL mRNA in mechanism of auto-immune diseases as well as the development and prognosis of diseases.