association of human leukocytic antigens class II with systemic lupus erythematosus in Upper Egypt

In this study 46 patients' suffering from SLE and 39 control groups the patients divided into disease with remission [11] and in active state [35] with age below 20 year or above all patients had complete clinical examination together with laboratory investigation. In this study females [41] more affected than male [5] in a ratio 8.1 and at age onset from [9:35] with malar rash [38]' photosensitivity [29], alopecia [31], mucosal ulcers [I I], arthritis [3 I], sororities [lo], renal disease [25] hepatic disease [18] and CNS [6], for the haemogram findings, anemias [35], leucopenia [24], lymphopenia [22] and thrombocytopenia [8]. Auto antibodies showed ANA in [43], anti-ds DNA [dl], anti-RO [28] and antism [23] Patients. The value of anti-ds DNA, anti-RO and anti-SM were significantly higher in patients with activity than control and remission. Peripheral pattern of ANA by IF was found in activity while homogenous in remission. In this study there was a significantly increased frequency of HLA -DRBl*03 and significantly decrease frequency of HLA-DRBI *7 in SLE patients than control. The frequency of HLA-DRBI * 11, I3 increased in SLE patients than control also HLA-DRBI *3, 11 with age onset less than 20 year while HLA-DRBI* 13 in age more than 20 years old. Regarding HLA-DRBI gene association with different clinical and laboratory findings, positive association of different clinical signs, also between certain clinical signs of SLE and auto antibodies. This study suggested that the presence of HLA-DRBl*03 may predispose to SLE or its clinical manifestation, while the presence of HLA DRBI *07 may have a protective effect from SLE. Also the presence of HLA-DRBI *03 or 11 predispose to early SLE in age less than 20 year while HLA-DRBI *I3 to late SLE development at age more than 20 years old

Role of coxsackie-B4 virus in newly diagnosed type I diabetic cases in children

Background: Coxsackie B4 virus [CVB4] is one of the enteroviruses that play a major role in type I Diabetes Mellitus. It has been found that the virus has a selective tropism to ? cells of islets of Langerhans, causing selective autoimmune destruction of pancreatic islet cells. However many factors contribute to the pathogenesis of this disease, so this work tried to approve the role of CVB4 in the newly diagnosed type one Diabetes Mellitus cases in Pediatric Department in Assiut University Hospitals

Methodology: Fifty three cases with recent onset type I Diabetes Mellitus and 25 matched controls were enrolled in this study to detect the role of CVB4. Tissue Culture confirmed by micro-neutralization technique, semi nested RT-PCR and ELISA to detect IgM to CVB4 virus in sera of patients and controls were used to detect the presence or absence of CVB4

Results: It was found that 58.49% of cases were positive for CVB4 by tissue culture, while 67.92% and 54.7% were positive by microneutralization technique and semi nested RT-PCR respectively, corresponding to only 15.09% positive cases only by ELISA. While, in controls there were 44% positive for CVB4 by tissue culture and only 23% by microneutralization and 4% by PCR and ELISA

Conclusion: Coxsackie B4 virus is one of the major causes of newly diagnosed cases of type I Diabetes Mellitus and should be searched for during management of these cases

Hepatitis E virus antibodies in multiply transfused patients

Hepatitis E virus [HEW infection is the leading cause of enterically transmitted hepatitis worldwide. Transmission of infection is via fecal route but the possibility of transmission by blood has been suggested, Data concerning anti-HEV prevalence among children who are exposed to risk of parenteral transmission are few and giving conflicting results. The present work studied the presence of anti-HEV antibodies [IgG and IgM], HBsAg, anti-HCV IgG, anti-HIV antibodies, serum ALT, prothrombin concentration and albumin level in 30 hemodialyzed, 20 thalassemic, 20 hemophilic patients as well as 25 matched age and sex healthy children as controls. The rate of anti-HEVIgG in hemodialyzed, thalassemic and hemophilic patients was significantly higher [43.3%, 35%, 25% respectively] than controls [8%] p>0.001, [0.003, [0.02 respectively. There was a significant positive correlation between the duration of hernodialysis and the number of patients with positive anti-HEV IgG [r = 0.87, pc0.001]. The rate of anti- HEV IgM in the patients groups was significantly higher [20%, 10%, 5% respectively] than controls [0%] p>0.004, >0.001, [0.05 respectively. There was no significant correlation between the frequency of blood transfusion and HEV reactivity in the studied patients groups. The rates of HBV and HCV infections in the different groups of patients were significantly higher [20%, 10%, 5% and 26.6%, 20%, 15% respectively] than controls [0% and 5% respectively] p<0.001, [0.007, [0.05 and <0.001, [0.03, [0.03 respectively. There was no significant correlation between HEV infection and neither HBV nor HCV infections in the studied patients groups

Conclusion: this study indicates a high prevalence of anti-HEV antibodies in multiply transfused children, carrying a possibility of parenteral transmission in endemic areas. However further larger scale technically supported studies are needed to exclude other possibilities