Anticardiolipin, autoantibodies, and cryoglobulin in patients with chronic hepatitis C and their relation to thrombocytopenia

Introduction: Chronic infection with hepatitis C virus [HCV] has been found to be associated with autoimmune phenomena and extra hepatic manifestations. HCV was implicated as a cause of the development of anti-phospholipid antibodies, leading to the suggestion that this virus may be involved in the aetiopathogenesis of the anti- phospholipid syndrome [APLS]. Aim: to study the association between anticardiolipin, autoantibodies and cryoglobulin with chronic hepatitis C infection and their relation to thrombocytopenia. Patients: Thirty three patients with chronic liver diseases of different stages were included in this study. Twenty seven of them were due to hepatitis C virus [HCV] and 6 were due to hepatitis B virus [HBV]. Their age ranged from 35 to 52 years. Twenty healthy subjects were included as controls In addition to clinical and ultrasonografic examination complete blood count, anticardiolipin [aCL] [IgG and 1gM isolypes], antinuclear antibody [ANA], antismooth muscle antibody [ASMA] antimitochondrial antibody [AMA] and cryoglobulin were done for both patient and control groups. The frequency of aCL antibodies of IgG and IgM isotypes were significantly more in patients with chronic HC infection [59.2% and 81.5 respectively] than that in controls [5% for each] [P < 0.001]. There was no significant relations between the presence of aCL antibodies and the presence of thrombocytopenia. There was no significant difference in the frequency of aCL between patients with chronic HC and chronic HB infection. The frequency of cryoglobidins was more in HC positive patients [63%] than HB positive patients [50%], but the difference was not significant. However ANA and AMA were significantly more in patients with chronic HC group than patients with chronic HB group [P < 0.05] for each. A significant proportion of HCV patients had detectable aCL However no significant association between aCL antibodies and thrombocytopenia was detected

Rheumatic chorea; clinical, neurophysiological, and laboratory study

Rheumatic Chorea [Rh.C.] is the only extrapyramidal syndrome presents with hypotonia. However the pathogenesis of this hypotonia is not known. Still it is not known whether it is due to peripheral or central lesion. This work was designed to study the neurophysiologic and laboratory correlates of hypotonia in Rh. C. patients. The study included 20 patients with Rheumatic Chorea [15 females and 5 males] with mean age 77.7 +/- 5.5, they were subjected to : complete neuropsychiatric examination with evaluation of the duration and severity of chorea, electrophysiologic studies including; Distal Latency [DL], Motor Conduction Velocity [MCV], Compound Muscle Action Potential [cMAP], F.wave, H.Reflex latencies; and laboratory studies including; detection of ESR, ASOT, and serum immunoglobulin IgG. Neurophysiologic parameters were matched to that of 30 control subjects with mean age [13.1 + 5.4], and serum immunoglobulin G was compared to that of 12 normal control subjects with mean age 14.2. The study revealed that 70% were experiencing their 1[st] choreic acute attack, 15% had history of recurrence. [2[nd] attack] and 15% had chronic persistent Rh.C. Neurological examination revealed that 80% of our patients had hypotonia. Choreic movement were generalized in 95% of cases, but mostly asymmetrical [55%]. Neurophysiologic studies revealed generalized disruption of peripheral nerve function in comparison to controls, mainly of mixed type [50%.]. In the demyelinating type; proximal involvement was more common than distal involvement. ESR was elevated in 65% and 95% of cases at the 1[st] and 2[nd] hour respectively, while positive ASOT was recorded in 30% of cases only. There was significant positive correlation between serum level of IgG and various studied neurophysiologic parameters [F-wave and H-Reflex latencies, DL, and MCV]. But there was no significant relation between the distribution of hypotonia and the studied neurophysiologic parameters, which may suggest a possible role of other contributing factors, not yet studied

Hepatitis B, C and D virus infections in patients and staff in Assiut dialysis unit

Thorough history was taken from 50 HD patients and 30 staff members with special stress on the risk factors that may contribute to hepatitis virus infection in addition to clinical examination, abdominal ultrasound, serological detection of viral markers and liver transaminase estimation. The high percentage of HCV-Ab [74%] and HBs Ag may be due to exposure of uremic patients to various risk factors for virus transmission prior or during HD. The percentage of HCV-Ab [13.3%] in dialysis staff matches that in the community and the absence of HBs Ag could be explained by staff vaccination against HBV