The co-occurrence of anti-CCP positive RA with IgA nephropathy

Very few studies have explored the renal involvement in RA. This co-occurrence could be attributed to the disease itself ordrug induced. The present case study discussing the co-occurrence of anti-CCP positive RA and IgA nephropathy highlightsthe need for having a collaborative treatment approach for managing the patients.

A rare co-occurrence of anti CCP-positive rheumatoid arthritis with sacroiliitis

Sacroiliitis is considered as the most important sign of spondyloarthropathy. Rheumatoid arthritis mainly affects peripheraljoints and the involvement of sacroiliac joint is very rare. The present case study discusses the rare existence of RA andconcurrent chronic bilateral sacroiliitis.

Heparin in haemorrhagic infarction in cerebral venous sinus thrombosis.

Morbidity and mortality in puerperal cerebral venous thrombosis (CVT) can be reduced by arresting the progression of thrombosis using heparin. However, conventional dose of heparin requires monitoring of coagulation parameters and carries a risk of haemorrhage. The present study involved 56 patients of puerperal CVT with CT evidence of haemorrhagic infarction. Twenty nine of these patients received low dose heparin till 30th post-partum day or symptomatic relief. Their clinical features and severity were similar to 27 patients who did not receive heparin. The mortality and morbidity at discharge was significantly less (P < 0.001) in heparin treated group. There were no haemorrhagic complications. Low dose heparin is safe and effective in cerebral venous thrombosis, even with haemorrhagic infarction.

Effect of gamma interferon on the expression of class I MHC antigens on fresh leukemic cells and their susceptibility to lysis by lymphokine activated killer cells.

Relationship between MHC class I antigen expression on PBLs from leukemia patients and their susceptibility to lysis by LAK cells was investigated. LAK cells induced small yet significant lysis of leukemic cells. In nine out of 14 cases studied, treatment with Interferon gamma (200 U/ml for 48 hours) resulted in a decrease in the LAK susceptibility of leukemic cells. In six of these cases, there was a concomitant increase in the expression of class I MHC antigen expression. In three samples, the increase in MHC class I antigen expression was not accompanied by a decrease in LAK susceptibility. IFN treatment had no effect on the binding of leukemic cells to LAK effector cells.

Evaluation of particle agglutination test for detection of HIV-I antibodies.

A commercially available particle agglutination test (PA) was evaluated for its specificity and sensitivity as compared to ELISA currently used in our laboratory to detect HIV-I antibodies. A total of 463 sera from blood donors and clinical referrals were screened by PA, 45 were found to be positive (9.7%). Out of 463, 258 sera were simultaneously screened by ELISA; 28 were found to be positive (10.8%). Twelve samples showing positive results by both ELISA & PA were tested by Western blot and were confirmed to be positive. We found sensitivity of PA as compared to ELISA as 100% and specificity to be 88.44%. Readings of PA taken at 2 hrs should be reconfirmed at 24 hrs as it eliminates a number of false positives. Overall, we feel PA is fairly comparable with ELISA. It can be used in the set up where equipment and trained personnel for ELISA are not available for primary screening purposes.

Immune response to hepatitis B viral antigens in chronic infection & its relationship with liver necrosis.

Markers of hepatitis B virus (HBV) and immune response against them were studied in 18 chronic asymptomatic carriers, 8 patients of the virus induced chronic liver disease (CLD), and 7 patients of chronic alcoholic liver cirrhosis, who were also chronic HBV carriers (CALC). The LMI responses to HBeAg were elevated in HBeAg and/or HBV-DNA positive chronic asymptomatic carriers, (median response 31.5%), along with elevation of serum alanine aminotransferase (sALT) levels (59-150 IU/l). On the other hand the LMI responses to this antigen, in HBeAg and HBV-DNA negative chronic carriers were in the normal range (median response 12%) and their sALT levels were also normal (7-50 IU/l). The CLD and CALC patients did not show any relation between their LMI to HBeAg and sALT levels. In contrast no relation between LMI to HBsAg and sALT levels was observed in any group. The LMI responses to HBsAg in CLD patients were elevated (median response 38%) and the responses of chronic asymptomatic carriers and CALC patients were either in the normal range or poor (median responses, 18 and 7% respectively), irrespective of their sALT levels. These results suggest that T cell responses to both the antigens may be involved in liver cell damage.