[Reynolds syndrome: the combination of scleroderma and primary biliary cirrhosis. Case report]. / Pierwotna marskosc zólciowa wspólistniejaca z twardzina ukladowa (zespól Reynoldsa). Opis przypadku.

A 57-year--woman with Reynolds syndrome (primary biliary cirrhosis and scleroderma) is reported. Diagnosis of primary biliary cirrhosis is based on clinical findings, laboratory tests results and histological result of liver biopsy. Scleroderma was confirmed by anticentromere antibodies presence, and typical skin lesions. Although, antimitochondrial antibodies are very typical for PBC (primary biliary cirrhosis), in this case the were not found.

Aspirin-induced asthma and HLA-DRB1 and HLA-DPB1 genotypes.

BACKGROUND: Aspirin-induced asthma (AIA) affects one in 10 individuals with adult-onset asthma. It is not known if aspirin sensitivity is due to immune mechanisms or to interference with biochemical pathways. OBJECTIVE: The study aimed to test for possible involvement of the genes of the Major Histocompatibility Complex (MHC) in AIA. METHODS: HLA-DPB1 and HLA-DRB1 genotyping was carried out by DNA methods in 59 patients with positive challenge tests for AIA and in 48 normal and 57 asthmatic controls. RESULTS: The DPB1*0301 frequency was increased in AIA patients when compared with normal controls (19.5% vs 5.2%, Odds Ratio = 4.4, 95% Confidence Interval (CI) 1.6-12.1, P = 0.002), and compared with asthmatic controls (4.4%, OR = 5.3, 95% CI = 1.9-14.4, P = 0.0001). The frequency of DPB1*0401 in AIA subjects was decreased when compared with normal controls (28.8% vs 49.0%, OR = 0.42, 95% CI = 0.24-0.74, P = 0.003) and asthmatic controls (45.6%, OR = 0.48, 95% CI = 0.28-0.83, P = 0.008). The results remained significant when corrected for multiple comparisons. There were no significant HLA-DRB1 associations with AIA. CONCLUSION: The presence of an HLA association suggests that immune recognition of an unknown antigen may be part of the aetiology of AIA.

[Laboratory diagnosis of lupus anticoagulant]. / Diagnostyka laboratoryjna antykoagulantu toczniowego.

Lupus anticoagulant (LA) prolongs clotting times in vitro, but in vivo leads to an increased risk of thromboembolic complications. LA is detected in many patients with lupus erythematosus but also in subjects without any autoimmune disease (primary antiphospholipid syndrome). We determined LA in 133 patients, mostly with lupus erythematosus and other autoimmune diseases. Three screening and two confirmatory tests based on different mechanisms of clotting system activation were used. LA was found in 34 patients. DRVVT was the most useful test in detecting LA while kaolin clotting time was the least sensitive. Anticardiolipin antibodies (ACL) of IgG class were found in 41 patients studied (31%). They were most often detected in patient positive for LA (64%). ACL IgM were not associated with prolonged clotting times. Laboratory diagnosis of antiphospholipid syndrome is easy when the presence of LA is confirmed by two independent tests and in addition ACL would be detected. In other cases, when only single tests are positive, it is suggested to repeat diagnostic procedure at least once.

[Immunologic tests in patients with idiopathic uveitis--preliminary reports]. / Badania immunologiczne u chorych z samoistnym zapaleniem tylnego odcinka blony naczyniowej--doniesienie wstepne.

AIM: This study aimed to evaluate the immune system function in patients with uveitis of unknown aetiology. METHODS: The clinical material comprised 19 patients with endogenous uveitis. In all cases the following immunological tests were performed: serum immunoglobulins A, G, M, total IgE, circulating immune complexes, complement components C3c and C4-all determined by laser nephelometry; antinuclear antibodies assessed with indirect immunofluorescence method using HEp-2 cell lines; and antineutrophil cytoplasmic antibodies using indirect immunofluorescence test. In 4 cases lupus anticoagulant was measured with APTT and dRVVT assays. RESULTS: Among our 19 examined patients immunological abnormalities were found in 12 cases. Changes in immunoglobulin concentrations were found in 8 cases. In 4 patients abnormalities of the complement system were observed. Antinuclear antibodies with speckled pattern in indirect immunofluorescence were present in 7 cases. CONCLUSION: In a proportion of patients with endogenous uveitis mild immunological abnormalities were present, suggesting an autoimmune background of the disease. Studies of the immunological profile can therefore help in better evaluation of the patients. It remains to be determined whether the observed immunological alterations are of any importance in the pathogenesis of the studied disease.

Autoimmune phenomena in bronchial asthma with special reference to aspirin intolerance.

We assessed the autoimmune status of 185 adult patients with bronchial asthma and 46 healthy subjects of similar sex and age. The patients were divided into groups with: (1) aspirin-induced asthma (AIA) (n = 80); (2) intrinsic asthma with good aspirin tolerance (n = 46); and (3) atopic asthma (n = 59). Antinuclear antibodies (ANA) at a titer of > or = 1:40 were present in the serum of 55% of the patients with AIA, 41% of those with intrinsic asthma, 39% of those with atopic asthma, and 11% of the healthy subjects, with the difference between each patient group and the healthy subjects being statistically significant (p < 0.05). The fluorescence staining pattern of ANA on Hep-2 cells was mainly speckled, but the precise antigen specificity of the antibodies could not be identified with reference sera against extractable nuclear antigens. None of the subjects exhibited anti-double stranded deoxyribonucleic acid (anti-ds-DNA) or anti-neurtrophil cytoplasmic antibodies (ANCA). Positive ANA were associated with signs of complement activation, the presence of rheumatoid factor, and circulating immune complexes. Clinical signs of autoimmunity, evidenced by rheumatic symptoms, cold sensitivity, and Raynaud's phenomenon, were more common among the patients who tested positively for ANA. The assessment of autoimmunity may help in better characterizing patients with asthma and understanding various symptoms of the disease. Any causal relationship between asthma and autoimmunity remains to be established.

Autoimmune vasculitis preceding aspirin-induced asthma.

Two female patients have been described in whom peripheral vasculitis with cold sensitivity preceded by about 5 years typical symptoms of aspirin-induced asthma. Vasculitis was immunologically mediated and took the form of either limited cutaneous scleroderma or perniosis. Antinuclear autoantibodies of SS-B specificity were present in the serum. Challenge with aspirin provoked asthma and distinct blood circulation disturbance in the hands. It is speculated that in these patients vasculitis and asthma were causally linked, and leukotrienes mediated bronchial and vascular reactions that occurred simultaneously following aspirin administration.

[Catalet--vaccine against hay fever]. / Catalet--szczepionka pylkowa.

Catalet is the Polish vaccine against pollinosis. It contains pollens of 13 species (mainly grass) and is used in the treatment of pollinosis. It is standardized in protein units. Allergen adsorption on aluminium hydroxide prolongs its absorption and decreases a number of the necessary injections. A four-year investigations in 30 patients (including 5 children) showed that Catalet tolerability is comparable with that of foreign-made preparations such as Alavac P, Desalerga F, and Allpyral-5 Grass mix.