Evaluation of the serum levels of immunoglobulin and complement factors in beta thalassemia major patients in Southern Iran

Beta-thalassemia major is one of the major health problems in our country. Many studies have confirmed the fact that, these patients have an increased susceptibility to bacterial infections. In this study, we have assessed the humoral immune system in 68 thalassemic patients by measuring their serum concentration of Immunoglobulin G [IgG], IgM, IgA, C3 and C4 in order to find out a responsible immune defect. Sixty eight beta-thalassemia major patients were enrolled randomly from referrals to Dastgheib clinic of thalassemia. The same number of case controls with matched age and sex were selected from healthy people without any history of recent or recurrent infections. Serum IgG, IgM, IgA, C3 and C4 levels were assessed using Single Radial Immunodiffusion [SRID]. Serum levels of IgG, IgM and IgA were significantly higher [P<0.01] and those of C3 and C4 were significantly lower [P<0.01] in thalassemic patients than the controls. Considering the result of analytic tests, it was revealed that, thalassemia patients show much more increase in serum immunoglobulin levels as they get older. Splenectomized patients had higher serum IgG and IgA levels than non-splenectomized patients but had no difference in serum IgM, C3 and C4. Serum ferritin level had no correlation with the changes of humoral immunity; however, patients with serum ferritin level >2500ng/ml had higher serum IgM level. These results can be due to continuous exposure to antigens, repeated infections, chronic liver disease and splenectomy but not iron overload. The only probable cause of humoral immune deficiency found in these patients is a defect in serum complement levels

Renal ultrasonography systemic lupus erythematosus

Renal sonography was done in 30 cases with systemic lupus and was correlated with serum creatinine, creatinine clearance and 24-hour urinary protein excretion. Pathological findings in sonography was found to be sensitive by 90% in detection of lupus nephritis. Cortical echogenicity and renal length together correlate well with the degree of renal impairment. Significant relation exists between the cortical echogenicity and the degree of sclerosis, tubular atrophy and interstial infiltration. However, it is not feasible to distinguish different classes using diagnostic ultrasound

Determination of serum immunoglobulin and complement levels during acute asthmatic attack

Seventy five patients with acute asthma and 160 apparently healthy individuals as a control group were studied for the first time in Mosul in order to determine their total serum level of IgE, IgG, IgA, IgM, C3c and C4, and specific IgE against 21 allergens. The geometric mean of total serum IgE level of patients was 173.6 lU/ml, while that of the control was 76.9 lU/ml. These two levels were significantly different [P<0.001]. The total serum IgE levels of the tested subjects in relation to their age, sex, specific IgE and treatment of asthma were also determined. Specific IgE antibodies against the allergens were detected by RAST in 36% of patients and 16% of control. Explanations were put forward for this relatively low percentage of RAST positivity in our patients; the most important of which may be related to the exhaustion of specific IgE from the circulation during asthmatic attack. The most commonly detected specific IgE antibodies were those against grass [g2] and weed [WII] pollens in patients and wheat [f4] in control. Elevated serum levels of IgG, IgA and IgM, and normal levels of C3c and C4 were detected in acute asthma

Acute rheumatic fever: an immunological profile

Serum immunoglobulins [IgG, IgM and IgA] and complement components [C3 and C4] were assessed in 111 patients with acute rheumatic fever "RF", 30 patients with acute streptococcal tonsillitis "ST", 20 patients with poststreptococcal glomerulonephntis "PSGN", and 50 healthy control group. All immunoglobulins were significantly increased in patients with acute RF, compared to the significant increase of IgG and IgM in those with PSGN, and IgG in those with acute ST. Complement component C3 and C4 were significantly increased in patients with acute RF, while they were significantly decreased in patients with PSGN. Maximum rise of IgG, IgM, C3 and C4 was observed in patients with pure arthritis, while maximum rise in IgA was observed in those with pure carditis. A discussion was made in this study to verify the sgnificance of the above mentioned data and their role in the pathogenesis of acute RF and individual rheumatic manifestations

Rheumatic heart disease: a profile of serum immunoglobulins and complements

Sera [From 72 patients with rheumatic heart disease [RHD], 20 patients with non rheumatic heart disease [NRHD], and 30 healthy individuals were examined for estimation of immunoglobulins [IgG, IgM, and IgA] together with com plement components [C3 and C4] levels. AII serum immunoglobulins and C3 component were significantly elevated in patients with RHD compared with healthy individuals. More significant rise of immunoglobulins and C3 component [levels was observed in patients with recurrence of rheumatic activity [RR] compared with RHD patients and healthy individuals. No statistically significant difference in C4 complement component level was observed between RHD, NRHD, and RR patients as compared with healthy individuals. Although, there was no statistically significant difference in any of the serum immunoglobuhns nor complement components between patients with subacute bacterial endocarditis [SBE] and healthy individuals, yet those patients had significantly reduced lgG and C3 levels as compared with RHD patients