Interferon-beta-1b induced autoimmune hemolytic anemia in a patient with MS: a case report

A 26-year-old lady with the diagnosis of multiple sclerosis who had received interferon beta1-b for eleven months was visited in MS clinic of our hospital because of icter and fatigue. Laboratory tests showed anemia, indirect hyperbillirubinemia, increased LDH, positive direct and indirect coomb's tests, and increased reticulocyte count and percentage. Other causes of autoimmune hemolytic anemia [AHA] and pre-existing AHA in the patient were ruled out. After INF discontinuation, symptoms disappeared, hemoglobin increased, and indirect coomb's test became negative. We concluded that autoimmune hemolytic anemia should be considered in all MS patients who receive interferon beta 1-b and present with symptoms and signs of anemia

Neuropsychiatric manifestations in patients with systemic lupus erythematosus

Systemic Lupus Erythematosus [SLE] is an autoimmune disease with unknown etiology. It can cause diverse clinical manifestations. Neuropsychiatric [NP] features may appear as the main signs and symptoms of the disease while they can be extremely severe in nature. Since the NP conditions are almost always very important, early diagnosis and aggressive treatment is mandatory. This study was aimed to evaluate the NP manifestations of SLE. This was a descriptive prospective study conducted from 2002 to 2004 at Ghaeni Hospital, Mashhad University of Medical Sciences. Patients, involved in SLE according to American College of Rheumatology [ACR] criteria, entered the study. A neurologist examined all the patients clinically while paraclinical assessments were carried out in parallel when required. All the data were gathered in prepared questionnaires and analyzed statistically. From 88 examined SLE patients, 27 had NP-SLE [30.6%]. The mean age in this group was 25 years. The mean time between the beginning of the disease and the occurrence of the NP manifestations was 2.1 years. Central Nervous System [CNS] and Peripheral Nervous System [PNS] involvements were seen in 88.9% and 29.6% respectively. Cognitive dysfunction [55.5%], among all other NP features, was the most prevalent, and seizure with 37% was the second common manifestation. NP involvement of SLE patients usually occurs in young individuals. CNS involvement [most frequently seizure and psychosis] was more common than the PNS involvement. In our study, cognitive disorders were the most widespread features, which is compatible to the results of other similar studies. The vast variety of neuropsychiatric manifestations and their effects on the prognosis of the underlying disease, necessitate routine complete neurologic examinations as soon as the diagnosis is confirmed