[Delay in diagnosis of common variable immunodeficiency: a paradigmatic case report]. / Ritardo di diagnosi di immunodeficienza comune variabile: un caso clinico emblematico.

This case report highlights the frequent delay in diagnosis of common variable immunodeficiency. The patient, 84 years old, had over 30 years of recurrent infections. At the first visit serum IgG were less than 134 mg/dl. From the review of previous examinations strong hypogammaglobulinemia was present for over 14 years.

[Genetic and environmental contribution to rheumatoid arthritis: a family study]. / Studio di una famiglia con elevata concordanza per artrite reumatoide: ruolo dei fattori genetici, ambientali e costituzionali.

We report on the HLA typing of three brothers (A, B, C) with rheumatoid arthritis (RA) and their six sons. This family is interesting for the full concordance for RA between parents. The aim of this study was the discovery of genetic and/or enviromental cofactors determining this absolute concordance.

Case report: safety and efficacy of tocilizumab in a patient with rheumatoid arthritis and chronic hepatitis C.

Tocilizumab is a monoclonal humanized anti-IL-6-receptor antibody used for the treatment of rheumatoid arthritis. The safety of tocilizumab in HCV patients is an open question. We report on safety and efficacy of tocilizumab in a 71-year-old female with rheumatoid arthritis and chronic hepatitis C. Monotherapy with tocilizumab (8 mg/kg every 4 weeks, i.v.) was prescribed after the discontinuation, determined by clinical inefficacy, of anti-TNF-alfa agents (adalimumab and, subsequently, etanercept). We have registered an optimal and rapid clinical response to tocilizumab with early remission (SDAI <3.3 since 4 weeks). The safety was good with no adverse events and maintenance, during a six-month followup, of normal liver enzymes. These data suggest a good safety profile of tocilizumab in patients with rheumatoid arthritis and chronic hepatitis C virus pathology.