Splenic myeloid metaplasia in warm autoimmune hemolytic anemia (wAIHA): a retrospective study.

BACKGROUND: Splenic myeloid metaplasia (SMM) is a kind of extramedullary hematopoiesis, whereas its clinical significance in wAIHA remains unclear. The aim of this study is evaluating the frequency and clinical characteristics of SMM, compared with splenic-congestion (SC). METHODS: We included patients with wAIHA treated in a Mexican tertiary hospital between January 1992 and December 2015. All patients received steroids as first-line treatment and splenectomy as second-line treatment. RESULTS: Among the thirty-six splenectomized patients, 15 (41.6%) and 21 (58.4%) were diagnosed as SMM and SC, respectively. No differences were found in clinical characteristics between two groups. SMM patients showed lower platelet count (147×109/L vs. 240×109/L, P=0.02) and higher presence of anti-dsDNA antibodies (40% vs. 4.7%, P=0.01) than SC patients. Although the complete response (CR) rate with first-line treatment was lower in SMM patients (13.3% vs. 47.6%; P=0.04), post-splenectomy median disease-free-survival (DFS) was longer (16.2 mo vs. 5.1 mo; P=0.19). Univariate/multivariate analysis showed that achieving CR during first-line treatment (OR 0.3, 95% CI: 0.03-0.94, P=0.03) and higher platelet count (OR 0.99, 95% CI: 0.98-0.99, P=0.03) were protective factors for SMM; and anti-dsDNA titer higher than 9.6 IU/dL was a risk factor for SMM (OR 2.76, 95% CI: 1.48-5.14, P<0.001). CONCLUSION: The wAIHA patients with SMM have different biological profiles with those without SMM. This study is the first trial evaluating the significance of histopathological spleen findings and their association with rheumatologic profile.

Splenic myeloid metaplasia in warm autoimmune hemolytic anemia (wAIHA): a retrospective study

BACKGROUND: Splenic myeloid metaplasia (SMM) is a kind of extramedullary hematopoiesis, whereas its clinical significance in wAIHA remains unclear. The aim of this study is evaluating the frequency and clinical characteristics of SMM, compared with splenic-congestion (SC). METHODS: We included patients with wAIHA treated in a Mexican tertiary hospital between January 1992 and December 2015. All patients received steroids as first-line treatment and splenectomy as second-line treatment. RESULTS: Among the thirty-six splenectomized patients, 15 (41.6%) and 21 (58.4%) were diagnosed as SMM and SC, respectively. No differences were found in clinical characteristics between two groups. SMM patients showed lower platelet count (147×109/L vs. 240×109/L, P=0.02) and higher presence of anti-dsDNA antibodies (40% vs. 4.7%, P=0.01) than SC patients. Although the complete response (CR) rate with first-line treatment was lower in SMM patients (13.3% vs. 47.6%; P=0.04), post-splenectomy median disease-free-survival (DFS) was longer (16.2 mo vs. 5.1 mo; P=0.19). Univariate/multivariate analysis showed that achieving CR during first-line treatment (OR 0.3, 95% CI: 0.03–0.94, P=0.03) and higher platelet count (OR 0.99, 95% CI: 0.98–0.99, P=0.03) were protective factors for SMM; and anti-dsDNA titer higher than 9.6 IU/dL was a risk factor for SMM (OR 2.76, 95% CI: 1.48–5.14, P < 0.001). CONCLUSION: The wAIHA patients with SMM have different biological profiles with those without SMM. This study is the first trial evaluating the significance of histopathological spleen findings and their association with rheumatologic profile.

Methylmercury increases glutamate extracellular levels in frontal cortex of awake rats.

A current hypothesis about methylmercury (MeHg) neurotoxicity proposes that neuronal damage is due to excitotoxicity following glutamate uptake alterations in the astrocyte. By sampling from a microdialysis probe implanted in the frontal cortex of adult Wistar rats, we measured the effects of acute exposure to either 10 or 100 microM MeHg through the microdialysis probe, on glutamate extracellular levels in 15 awake animals. After baseline measurements, the perfusion of MeHg during 90 min induced immediate and significant elevations in extracellular glutamate at 10 microM (9.8-fold, P<.001) and at 100 microM (2.4-fold, P=.001). This in vivo demonstration of increments of extracellular glutamate supports the hypothesis that dysfunction of glutamate neurotransmission plays a key role in MeHg-induced neural damage.

Behavioral effects of exposure to endosulfan and methyl parathion in adult rats.

Endosulfan (ES) and methyl parathion (MP) are widely used in Latin America, and simultaneous exposure to both products is documented. This exposure may have effects on the nervous system because their targets include the GABAergic and cholinergic systems, which are main modulators of neuronal excitability in the cortex and hippocampus. We tested whether low-level, repeated exposure of adult rats to commercial formulations containing ES and MP disrupts spatial learning in the water maze. Five groups of eight animals received subcutaneously appropriate dilutions of the commercial formulations to yield the following treatments during 10 days: saline, 25 mg/kg ES, 2 mg/kg MP (MP(2)), 25 mg/kg ES plus 1 mg/kg MP (ES+MP(1)) and 25 mg/kg ES plus 2 mg/kg MP (ES+MP(2)). In addition, markers of neurological function, renal and hepatic damage were explored as potential consequences of exposure. In the absence of overt toxicity, the groups exposed to the ES plus MP showed significantly longer escape latencies, higher number of failures to reach the platform and more time in the periphery of the tank than the control and single-exposed groups. This finding shows that commercial formulations of ES and MP have marginal effects when administered individually but can produce behavioral alterations when given in combination.

Detection and characterization of antigens from Taenia solium cysticercus in cerebrospinal fluid.

Dot-ELISA and standard-ELISA were used to detect T. solium cysticercus antigens in cerebrospinal fluid for the diagnosis of neurocysticercosis. The results indicate that both assays are sensitive, specific and economically adequate for the diagnosis of this disease. Using SDS-PAGE, electroblotting and dot-ELISA we have found that the antigen is a protein with a molecular weight of 66,000 daltons.

Detection of Cysticercus cellulosae antigens in cerebrospinal fluid by dot enzyme-linked immunosorbent assay (Dot-ELISA) and standard ELISA.

The dot enzyme-linked immunoassay and standard enzyme-linked immunoassay were used to detect Cysticercus cellulosae antigens in cerebrospinal fluid of patients suffering with neurocysticercosis. Using the dot enzyme-linked immunoassay, 10 of 17 patients (59%) were positive at a reciprocal titer of 128 (range 128-1,024). In the standard assay, 13 of 17 (77%) were positive (range 128-512). Specificity was 100% in both assays using 48 cerebrospinal fluids from patients with various central nervous system infections. The quantification of antigens in cerebrospinal fluid using standard assay and photometric readings showed a range of 17 to 138 ng/ml. The results indicate that both assays are sensitive, specific, and economical for the diagnosis of neurocysticercosis.

Treatment of neurocysticercosis with flubendazole.

Thirteen patients with neurocysticercosis were studied and treated with flubendazole. Diagnostic procedures included computerized tomography (CT) and enzyme-linked immunosorbent assay. In 12 cases treatment with the drug led to clinical improvement. CT showed that some cysts regressed in size, and in two patients they disappeared. The treatment also lowered the antibody levels. The drug was well tolerated and no allergic reaction or other side effects were observed.

Aplicacion del metodo ELISA para el diagnostico de la cisticercosis. / Use of ELISA method for the diagnosis of cysticercosis

La frecuencia elevada de cisticersosis en paises en desarrollo y sus efectos patologicos y economicos senalan la necesidad de contar con una prueba satisfactoria para diagnosticar esta enfermedad. En el Hospital Central Ignacio Morones Prieto de San Luis Potosi, SLP, Mexico, se realizo un estudio en el que se comparo la sensibilidad del ensayo inmunosorbente enzima conjugada (ELISA) con la del metodo de hermaglutinacion indirecta (HI), para diagnosticar la cisticercosis. Por medio de ambos metodos se analizaron muestras de liquido cefalorraquideo y de suero de 120 pacientes neurologicos que se dividieron en dos grupos control y un grupo de 17 casos de cisticercosis cerebral confirmada. Las muestras de los grupos control resultaron negativas con ambos procedimientos, pero en el grupo de enfermos de cisticercosis con el metodo de HI se obtuvo 29% de resultados falsos negativos, en tanto que con ELISA no se obtuvo ninguno.Se concluye que el metodo ELISA es mas sensible que el de HI puesto que con el no se lograron resultados falsos negativos ni positivos sin embargo, en vista del pequeno numero de casos investigados no es posible llegar a una conclusion definitiva

Effect of flubendazole on Cysticercus cellulosae in pigs.

The effect of flubendazole on Cysticercus cellulosae was tested in 15 pigs. In doses o 8.3 mg/kg body weight or more daily for 10 days the drug was lethal to the cysticerci, causing both macroscopic and microscopic morphological alterations. An in vitro test showed 0% viability of cysticerci in most of the treated pigs, whereas in 90-100% of 11 control pigs they were viable.