ABSTRACT
We analyzed the incidence and risk factors for ocular GVHD in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) in Korea. In this retrospective, noncomparative, observational study, 635 subjects were included who had at least 2 years of follow-up ophthalmological examinations after allo-HSCT from 2009 to 2012 at Seoul St Mary's Hospital, Seoul, Korea. The mean duration between allo-HSCT and onset of ocular GVHD was 225.5±194.3 days. The adjusted incidence for acute ocular GVHD was 1.33% and that for chronic GVHD was 33.33%. In the multivariate analysis, preexisting diabetes mellitus (odds ratio (OR): 4.22, 95% confidence interval (CI): 1.66-10.72), repeated allo-HSCT (OR: 29.10, 95% CI: 1.02-8.28) and the number of organs that chronically developed GVHD by stage I (OR: 14.63, 95% CI: 9.81-21.84) increased risk of ocular GVHD. Careful monitoring of ocular GVHD is needed in patients with chronic GVHD in multiple organs and preexisting diabetes.
Subject(s)
Graft vs Host Disease/epidemiology , Hematopoietic Stem Cell Transplantation/adverse effects , Keratoconjunctivitis Sicca/epidemiology , Adult , Allografts , Comorbidity , Diabetes Mellitus/epidemiology , Female , Follow-Up Studies , Graft vs Host Disease/drug therapy , Graft vs Host Disease/etiology , Hematologic Diseases/therapy , Humans , Immunosuppressive Agents/therapeutic use , Incidence , Keratoconjunctivitis Sicca/drug therapy , Keratoconjunctivitis Sicca/etiology , Male , Middle Aged , Multiple Myeloma/therapy , Organ Specificity , Republic of Korea/epidemiology , Retrospective Studies , Risk Factors , Severity of Illness IndexABSTRACT
OBJECTIVE: There is an established association between the development of ankylosing spondylitis (AS) and the HLA-B27 allele, but whether or not homozygosity for HLA B27 has any additional effects on the clinical manifestations of AS is unclear. The aim of this study was to determine the influence of HLA-B27 homozygosity on the clinical manifestations of AS in Korea. METHODS: A total of 490 patients were enrolled in this study. Genotyping was carried out using polymerase chain reaction-sequence specific primers (PCR-SSP) to assess HLA-B27 homozygosity or heterozygosity. One PCR reaction was undertaken to determine the HLA-B27 carrier status, and 5 group-specific PCR reactions were carried out to determine all of the other HLA-B alleles. Clinical manifestations of AS and BASFI were also evaluated according to homozygosity or heterozygosity for HLA-B27. RESULTS: HLA-B27 positive patients had a significantly younger age at symptom onset, more uveitis, and a higher frequency of hip joint involvement than HLA-B27 negative patients. One hundred and forty-six (29.8%) patients were homozygous for HLA-B27. No significant association between HLA-B27 homozygosity or heterozygosity and a history of peripheral arthritis, acute anterior uveitis, age at onset, or the Bath Ankylosing Spondylitis Functional Index (BASFI) was found. CONCLUSIONS: Homozygosity for HLA-B27 does not affect the clinical manifestations of AS in Korean patients.
Subject(s)
Genetic Predisposition to Disease , HLA-B27 Antigen/genetics , Spondylitis, Ankylosing/genetics , Adult , Age of Onset , Female , Homozygote , Humans , Korea/epidemiology , Male , Polymerase Chain Reaction , Polymorphism, Single-Stranded Conformational , Spondylitis, Ankylosing/epidemiology , Spondylitis, Ankylosing/physiopathologyABSTRACT
Macrophagic myofasciitis (MMF) is known to be closely associated to vaccination containing aluminium as an adjuvant. Here we describe a case of MMF unrelated to vaccination, and presented as focal tender muscle in a 59-year-old woman. Magnetic resonance imaging showed evidence of unilateral myofasciitis involving muscles and fascias of the vastus lateralis. Open biopsy showed a unique pathological pattern of MMF. Our case suggests that other causes unrelated to vaccination need to be investigated in the pathogenesis of MMF, and MMF could be considered in the differential diagnosis of patients with focal muscle tenderness.
