Frequencies and results of anti-nuclear, anti-dsDNA and anti-ENA in a tertiary-care hospital in Karachi, Pakistan.

OBJECTIVE: To analyse frequencies and results of anti-nuclear antibodies, anti-double stranded deoxyribonucleic acid and anti-extractable nuclear antigens tests ordered in a tertiary-care hospital. METHODS: The retrospective study was conducted at a tertiary care hospital in Karachi, and comprised all tests ordered for anti-nuclear antibodies, anti-double stranded deoxyribonucleic acid and anti-extractable nuclear antigens from March 2017 to January 2018. Data was retrieved from the institutional electronic database. The frequencies and results of the tests were determined. Anti-nuclear antibodies test was determined by indirect immunofluorescence, while the other two tests were determined by enzyme-linked immunosorbent assay. Patterns emerging from anti-nuclear antibodies tests were also analysed. RESULTS: Of the 1053 cases studied, 1000(95%) were tested for for anti-nuclear antibodies. The test was positive in 260(26%) patients, and was repeated in 8(3%) of the positive and 9(1.2%) of the negative patients. Anti-double stranded deoxyribonucleic acid test was ordered in 300(40.5%) and anti-extractable nuclear antigens test in 125(17%) patients who had tested negative for anti-nuclear antibodies. Among those who tested positive for anti-nuclear antibodies, the commonly observed patterns were homogenous 109(41.9%) and speckled 103(39.6%). Rod and ring pattern was seen in 10(3.8%) patients, and none of them were on anti-viral treatment. CONCLUSIONS: There was injudicious and unjustified ordering of auto-antibodies testing, indicating the need for greater physician education and cost-effective protocols.

First reported case of hereditary bisalbuminaemia in Pakistan.

A 50 year old female patient demonstrated double peaks of albumin on serum protein electrophoresis (SPE). Patient's detailed medical history was taken and investigations were carried out to rule out systemic causes. Serum electrophoresis was also done on 5 of patient's children. Mixing studies were performed in gradually decreasing concentration of bisalbuminemic serum. Hereditary Bisalbuminaemia with the variant albumin showing slower mobility, was observed.

Apolipoprotein B in type 2 diabetics--a cross sectional study in a tertiary care set-up.

OBJECTIVE: To analyze the pattern of dyslipidaemias including apolipoprotein B in type 2 diabetes. METHODS: A total of 120 diabetics were studied for their lipid profile including serum triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol in fasting state, along with apolipoprotein B levels. RESULTS: Raised apolipoprotein B was the most frequent lipid disorder in type 2 diabetics, occurring in 56.7% of the studied patients. This was followed by high serum triglycerides levels in 55.8% and low HDL cholesterol levels in 55% of patients. Notably, 6% patients had normal triglyceride levels accompanied by raised LDL cholesterol, compared to 20% patients who had normal triglycerides with high apolipoprotein B levels. Overall, 36% of patients had normal LDL cholesterol values but elevated apolipoprotein B. CONCLUSION: Apolipoprotein B is the most frequently occurring dyslipidaemia in type 2 diabetes. It identifies individuals with high risk of coronary heart disease not otherwise detected on routine lipid profile.