Antiphospholipid antibodies in patients with bilharzial pulmonary hypertension

This study was conducted on 21 patients having bilharzial pulmonary hypertension [BPH], 15 patients with BHS without pulmonary hypertension and 10 healthy subjects as a control group. The patients and controls were subjected to full clinical examination, abdominal ultrasound, plain chest X-ray electrocardiogram, echocardiography with Doppler and analytic methods including some liver function tests, CBC, ESR, coagulation profile, serum creatinine, urine and stool analysis, immunological tests for schistosomiasis [IHA], rectal snip, liver biopsy for pathological diagnosis of bilharziasis for most cases, ACL [IgG and IgM] and ANA. It was found that there was significant increased numbers and percentage age of positive cases of [both IgG and IgM] ACL and ANA in the group of BPH versus control and BPH versus BHS. There was significant correlation between ACL, ANA and ESR in the studied groups. It was concluded that there is an association between both ACL and ANA and the presence of pulmonary hypertension in the patients suggesting a possibility of an autoimmune process contributing to the development of pulmonary hypertension in bilharzial patients

role of parasitic infections in fever of undetermined origin among Egyptians in Dakahlia, epidemiological, clinical and diagnostic evaluation

This study investigated the role of parasitic infections as possible etiologic agents in prolonged fever of undetermined origin [FUO]. The value of some diagnostic serological tests was also proved. 43 patients who fulfilled the international criteria for prolonged fever were studied. All cases were exposed to urine examination and culture, stools examinations, hemogram, liver and renal function tests, chest X-ray, tuberculin test, bone marrow, liver biopsy, blood films, serological tests including ELISA, IHA and IFA for detection of schistosomiasis, leishmaniasis, toxoplasmosis and malaria. The majority of cases with positive parasitic etiology were coming from rural areas. The pattern of fever was predominantly intermittent especially with malarial and schistosomal cases. Lymphadenopathy was detected in one third of cases, 60% of which were visceral leishmaniasis. The IHA test for leishmaniasis detected all cases at a titer of 256, 512 and 1024 reciprocally. The dot-ELISA detected 8 out of the 10 cases diagnosed by the IHA test. The detection of seropositive cases of visceral leishmaniasis in the studied area suggests the existence of reservoir or a focus and warrants epidemiological study to establish the actual situation