Peripheral blood monocytes in multiple sclerosis exacerbations

Monocytes [MO], macrophages, and microglia have a central role in the central nervous system inflammation of multiple sclerosis [MS]. During clinical activity in MS, MO activation markers increase and some interleukins and tumor necrosis factor-alpha levels are elevated. Our aim was to determine levels of absolute MO count and percentage in peripheral blood of MS patients during the attacks. We assessed the percentage of MO by examining the blood smears in 28 patients with definite MS, in 20 patients with acute cerebrovascular disease [CVD] and in 20 healthy control subjects. The mean value of absolute MO count in MS patients, CVD and control groups were as 606.67 +/- 170.52, 746.50 +/- 414.76 and 360.00 +/- 109.54 respectively. The mean values of MO percentage in MS patients, CVD and control group were 8.34 +/- 2.61%, 5.56 +/- 2.48% and 5.36 +/- 1.50% respectively. The mean percentage of MO was significantly elevated in MS patients compared with the both groups of CVD and control [P<0.001]. Our results suggest a possible role of an increase in MO activation in the acute exacerbations of Multiple Sclerosis

Antiphospholipid antibodies syndrome in 'Stroke in young'.

Antiphospholipid antibodies syndrome has emerged as an important entity responsible for stroke in young. Seven cases of young stroke (< 40 years of age) with mean age of 30.1 years (age range 25-39 years, 2 males and 5 females), who tested positive for antiphospholipid antibodies are being reported. All subjects had completed strokes. Six had arterial ischaemic and one patient had venous stroke. One patient suffered from four episodes, three ischaemic and one intracerebral haemorrhage. Two patients suffered from foetal loss. Generalised tonic clonic seizures occurred in three patients. Deep vein thrombosis was observed in one case. Thrombocytopenia was not observed in any case. All the patients had elevated anticardiolipin antibodies (aCL) IgM or IgG, while Lupus anticoagulant (LA) was elevated in 4 cases. Six cases belonged to primary antiphospholipid antibodies syndrome and one to lupus like illness. Oral anticoagulants were administered to maintain a high intensity international normalized ratio (INR). No recurrences were observed during a follow up period of 6-18 months.