ABSTRACT
Respiratory manifestations related to the intake of non-steroidal anti-inflammatory drugs (NSAIDs) during the treatment of the painful vaso-occlusive crisis of sickle cell disease are either a type I hypersensitivity mechanism of the Gell and Coombs classification, or a pharmacological mechanism of NSAIDs. The use of NSAIDs is essential in the Abidjan school because of the absence of therapeutic alternatives in the management of the inflammatory crisis of this disease. The induction of tolerance to NSAIDs initiated by the authors has had clear clinical success. The basic biological reasons for this tolerance were evaluated in this study. A group of 11 sickle cell patients aged 12 to 39 years in whom post-NSAID respiratory manifestations disappeared for at least 6 months following a short tolerance induction protocol with ibuprofen, was assayed by ELISA for TNFα, INFï§ (Th1 cytokines), IL-4 (Th2 cytokine), IL-10, TGF-ß (immunosuppressive cytokines) and total IgE, before induction or pre-induction (D-1) and at day one (D1), D2- 3, one month (M1), and M6 after induction. A repolarization of the Th1/Th2 balance was noted during the post induction period. The high concentration of IL-4 observed at D-1 gradually decreased in favor of the cytokines TNFα, INFï§. The decrease in cytokine IL-4 with the level of total IgE was accompanied by the increase of IL-10 and TGF-ß demonstrating the regulatory role of these cytokines in the control of allergic diseases. In conclusion, the induction of immuno-tolerance to NSAIDs through a short protocol is well supported by immune regulation. The medium-term effects are real, unlike the results of allergen desensitization or specific immunotherapy. However, this protocol could be used in certain circumstances such as in the case of intolerance to trimethoprim-sulfamethoxazole, used as the treatment of choice for the prevention of opportunistic diseases in people living with human immunodeficiency virus.
Subject(s)
Anemia, Sickle Cell , Interleukin-10 , Humans , Tumor Necrosis Factor-alpha , Interleukin-4 , Cote d'Ivoire , Anemia, Sickle Cell/drug therapy , Anemia, Sickle Cell/complications , Cytokines , Immune Tolerance , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Transforming Growth Factor beta , Immunoglobulin EABSTRACT
Discovered in China in December 2019, coronavirus disease-19 (COVID-19) has confronted the world with an unprecedented crisis. Healthcare workers, the first line of defense against this pandemic, have been severely affected. Clinical trial results of the emergency vaccines showed that they all produced IgG antibodies against severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) with high rates of seroconversion. While immunization against natural challenge (COVID-19 infection) and artificial challenge (vaccination) in health care workers is relatively well described in the West, the issue is not well understood in Sub-Saharan Africa, particularly in Côte d'Ivoire, where populations are genetically distinct from Caucasians. Our aim was to investigate the magnitude of post-vaccination IgG responses to SARS-CoV-2 in healthcare workers in our African epigenetic context. A cross-sectional, multicenter, analytical study was conducted from March to May 2022 among health workers employed at the University Hospital of Abidjan and vaccinated against COVID-19. The study included 77 health workers. IgG immunoassays were performed with an enzyme-linked fluorescent assays. Data were analyzed using SPSS version 22.0 software, with a p-value Ë 0.05 considered as a significant difference. All enrolled subjects developed anti-SRAS-Cov-2 IgG, of which 88.3% had a strong response (titer ≥ 250 Binding Antibody Units/ml). IgG titers varied significantly by gender (p=0.04). Vaccine type and number of doses did not affect IgG titers. However, a history of COVID-19 infection was associated with a 5-fold greater likelihood of developing a strong IgG response after vaccination. In conclusion, humoral IgG responses developed after vaccination against SARS-CoV-2 were robust and would be influenced by a variety of factors..
Subject(s)
COVID-19 , Humans , COVID-19/prevention & control , SARS-CoV-2 , Cote d'Ivoire , Cross-Sectional Studies , Hospitals, University , Vaccination , Health Personnel , Immunoglobulin G , Antibodies, ViralABSTRACT
OBJECTIVE: the goal of this clinical case is to report a case of ophthalmic zoster in children and to insist on the relevance of early antiviral treatment so as to minimize corneal affection and preserve visual function. OBSERVATION: we report an eleven-years-old-girl case, with a history of varicella infection at 5 years old, who came for consultation for a painful eruption affecting the forehead, the upper eyelid, the nose, and the upper lips. The clinical examination showed many vesicles erythematous affecting the left hemi face. The diagnosis of ophthalmic zoster has been retained. The biological checkup was done namely blood count, and glycemia in empty stomach and a HIV serology. This checkup was normal. The treatment was a local antiseptic based and systemic with acyclovir and antalgic (tramadol) during 8 days. The evolution was favorable. Zoster is rare in children. The ophthalmic form is exceptional. The diagnosis is clinical and should mention some bladdery lesions grouped in bunch with a disposition which follows a metamere. It can be responsible of serious ocular complications which can compromise the visual function. CONCLUSION: the particularity of our observation is the presence of zoster in immunocompetent child and the ophthalmic localization remaining an exceptional form in children.
OBJECTIF: le but de ce cas clinique était de rapporter un cas de zona ophtalmique chez l'enfant et d'insister sur l'intérêt d'un traitement antiviral précoce afin de limiter l'atteinte cornéenne et de préserver la fonction visuelle. OBSERVATION: nous rapportons le cas d'une fillette de 11 ans, avec un antécédent de varicelle à l'âge de 5 ans qui a consulté pour une éruption douloureuse, prenant le front, la paupière supérieure, le nez et les lèvres supérieures. L'examen clinique a mis en évidence de multiples vésicules érythémateuses, intéressant l'hémiface gauche. Le diagnostic de zona ophtalmique a été retenu. Un bilan biologique a été effectué, notamment une numération formule sanguine, une glycémie à jeun et une sérologie VIH. Ledit bilan s'est révélé normal. Le traitement a été local à base d'antiseptique et systémique fait d'aciclovir et d'antalgique (tramadol) pendant 8 jours. L'évolution a été favorable. Le zona est rare chez l'enfant. La forme ophtalmique est exceptionnelle. Le diagnostic est clinique et doit être évoqué devant des lésions vésiculeuses groupées en bouquet et dont la disposition suit un métamère. Il peut être responsable de complications oculaires graves pouvant compromettre la fonction visuelle. CONCLUSION: la particularité de notre observation est la survenue de zona chez un enfant immunocompétent et la localisation ophtalmique qui reste une forme exceptionnelle chez l'enfant.
ABSTRACT
Objectif : le but de ce cas clinique était de rapporter un cas de zona ophtalmique chez l'enfant et d'insister sur l'intérêt d'un traitement antiviral précoce afin de limiter l'atteinte cornéenne et de préserver la fonction visuelle. Observation : nous rapportons le cas d'une fillette de 11 ans, avec un antécédent de varicelle à l'âge de 5 ans qui a consulté pour une éruption douloureuse, prenant le front, la paupière supérieure, le nez et les lèvres supérieures. L'examen clinique a mis en évidence de multiples vésicules érythémateuses, intéressant l'hémiface gauche. Le diagnostic de zona ophtalmique a été retenu. Un bilan biologique a été effectué, notamment une numération formule sanguine, une glycémie à jeun et une sérologie VIH. Ledit bilan s'est révélé normal. Le traitement a été local à base d'antiseptique et systémique fait d'aciclovir et d'antalgique (tramadol) pendant 8 jours L'évolution a été favorable. Le zona est rare chez l'enfant. La forme ophtalmique est exceptionnelle. Le diagnostic est clinique et doit être évoqué devant des lésions vésiculeuses groupées en bouquet et dont la disposition suit un métamère. Il peut être responsable de complications oculaires graves pouvant compromettre la fonction visuelle. Conclusion : la particularité de notre observation est la survenue de zona chez un enfant immunocompétent et la localisation ophtalmique qui reste une forme exceptionnelle chez l'enfant
