Résumé
The aim of this study in Tunisia was to classify ketosis-onset diabetes in adult patients. All patients aged >/= 30 years without known diabetes, presenting with ketosis and admitted to our department were studied. Patients with secondary or gestational diabetes and those on corticoid therapy or with coinciding infection were excluded. The data included clinical characteristics, immunological markers and beta-cell function. Of the 63 patients, islet-cell antibodies were present in 27.0%, glutamic acid decarboxylase antibodies in 25.4% and thyrosin phosphatase antibodies in 19.0%. beta-cell functional reserve was preserved in 54.0%. Our results confirm that patients with ketosis-onset diabetes mellitus in adulthood are a heterogeneous group
Sujets)
Humains , Adulte , Mâle , Femelle , Acidocétose diabétique , Ilots pancréatiques/immunologie , Marqueurs biologiquesRésumé
Sixty one Tunisian adult patients with bacterial meningitis were screened for complement deficiency. Functional activity of the classical and the alternative pathways of complement [CH50 and AP50 respectively] were measured according to standard haemolytic procedures. Serum concentrations of C3 and C4 were determined by nephelometry. Late complement component [C5-C9] and properdin concentrations were assessed by double-ligand ELISA. Complement deficiency was found in eight patients [13%]: Seven had late complement component deficiency [three C7 deficiency, two C5 deficiency, one C6 deficiency and one C8 deficiency] and one had partial properdin deficiency. Patients with late complement component deficiency had a mean age of 24 years [range 17-32 years]. All deficient patients had meningococcal meningitis. Recurrent meningitis was reported in half of the patients. Our findings demonstrated a high prevalence of complement deficiency in Tunisia suggesting that screening for hereditary complement deficiency should be performed in case of bacterial meningitides and meningococcal disease patients