Papular purpuric gloves and socks syndrome in a 72-year old woman.

A 72-year-old woman presented with fever, rash and limb pain. Physical examination revealed systemic non-pitting edema, and painful edematous erythema on both forearms and thighs, and non-palpable petechia on her legs. These manifestations were suggestive of papular purpuric gloves and socks syndrome (PPGSS). Her serum anti-parvovirus B19 immunoglobulin M (IgM) was positive. To our knowledge, this is the oldest individual with typical parvovirus 19-associated PPGSS reported to date.

Loss of maternal annexin A5 increases the likelihood of placental platelet thrombosis and foetal loss.

Antiphospholipid syndrome is associated with an increased risk of thrombosis and pregnancy loss. Annexin A5 (Anxa5) is a candidate autoantigen. It is not known, however, whether endogenous Anxa5 prevents foetal loss during normal pregnancy. We found significant reductions in litter size and foetal weight in Anxa5-null mice (Anxa5-KO). These changes occurred even when only the mother was Anxa5-KO. A small amount of placental fibrin deposition was observed in the decidual tissues, but did not noticeably differ between wild-type and Anxa5-KO mice. However, immunoreactivity for integrin beta 3/CD61, a platelet marker, was demonstrated within thrombi in the arterial canals only in Anxa5-KO mothers. Subcutaneous administration of the anticoagulant heparin to pregnant Anxa5-KO mice significantly reduced pregnancy loss, suggesting that maternal Anxa5 is crucial for maintaining intact placental circulation. Hence, the presence of maternal Anxa5 minimises the risk of thrombosis in the placental circulation and reduces the risk of foetal loss.

[Examination of HCV infection in hemodialysis patients with HCV-RNA assay using a magnetic extraction method (AmpliCap GT HCV MONITOR Test Kit v2.0 and AmpliCap GT HCV Specimen Preparation Kit v2.0)].

Hemodialysis(HD) patients are a high-risk group for hepatitis C virus(HCV) infection. Detection of HCV-RNA is important for safety and environmental protection in HD units. PCR-based methods are unsuitable for analyzing large samples of HD patients, because conventional centrifugal extraction method fails to eliminate heparin, a potent inhibitor of PCR. We have reported the usefulness of a new HCV-RNA extraction method using specific capture probes and magnetic particles in comparison with conventional centrifugal extraction method in hemodialysis patients. In this study, we evaluated the rate of HCV infection and HCV-RNA positivity by using a magnetic extraction method. As a result, the rate of HCV infection in dialysis patients was significantly higher than that of healthy people, and positivity for HCV infection was found to be related to the duration of hemodialysis. It has been assumed that the rate of new HCV infection is decreased as the result of improvement in dialysis equipment, a decrease in the need for blood transfusion due to the availability of erythropoietin for renal anemia, and the introduction of anti-HCV screening for blood donors. Hospital infection was strongly suggested from the evidence that the correlation with the rate of HCV infection and duration of dialysis was not significantly changed. HCV-RNA positivity was observed in two among 435 HCV antibody-negative patients. Since HCV-RNA positivity has been observed in HCV antibody-negative patients in HD units, combination with HCV-RNA by the magnetic extraction method and anti-HCV antibodies should be useful for the treatment of HCV infection. In this study, the effectiveness of IFN therapy was expected in 56.7%(38/67) that were genotype2 and/or had a low viral load. A precise diagnosis using HCV-RNA assay by the magnetic extraction method and precise medication including IFN therapy is desired for improving the long-term prognosis of dialysis patients.