Plasmacytic Pleural Effusion as a Major Presentation of Angioimmunoblastic T-Cell Lymphoma: A Case Report.

Angioimmunoblastic T-cell lymphoma is one of the peripheral T-cell lymphomas. Reactive plasma cells can occasionally be observed in AITL patients' peripheral blood and bone marrow. Plasmacytic pleural effusion as the presentation of AITL has not been reported before. The mechanisms of plasmacytic pleural effusion are not fully understood. Here we present an 82-year-old male with exuberant plasma cells in his pleural effusion in addition to his peripheral blood and bone marrow aspiration. By presenting this case, we would like to expand the spectrum of disease presentations in AITL and discuss the significance of flow cytometry in the differential diagnosis of pleural effusion. To our knowledge, this is the first case report in the literature, which will be crucial to assist the hematopathologist in accurate diagnosis and treatment.

[Expression of T-bet and GATA3 in children with acute idiopathic thrombocytopenic purpura].

OBJECTIVE: To study the expression of transcriptional factors T-bet and GATA3 mRNA and the levels of IFN-gamma and IL-4 in blood in children with acute idiopathic thrombocytopenic purpura (ITP) and investigate the tendency of polarization of Th1/Th2 in children with ITP. METHODS: Blood T-bet and GATA3 mRNA expression were examined using RT-PCR and plasma IFN-gamma and IL-4 levels were measured using EIASA in children with acute ITP in acute (n=30) and remission stages (n=28). Twenty healthy children served as the controls. RESULTS: Blood T-bet mRNA expression and IFN-gamma levels in children with ITP in the acute stage were markedly higher than those in the remission stage and controls (p<0.01). In contrast, blood GATA3 mRNA expression and IL-4 levels in children with ITP in the acute stage were significantly lower than those in the remmission stage and controls (p<0.01). CONCLUSIONS: The high expression of T-bet and IFN-gamma and the low expression of GATA3 and IL-4 indicate the existence of Th1 polarization in children with acute ITP. This might be related to the regulation of T-bet and GATA3.

[Correlation between HLA-DQA1 allele and anaphylactoid purpura in juvenile Hans residing in Inner Mongolia].

OBJECTIVE: To analyze the genetic susceptibility of HLA-DQA1 allele to anaphylactoid purpura(AP)and its association with the clinical features in juvenile Hans residing in Inner Mongolia. METHODS: Seventy children with AP and ninety normal controls of Hans in Inner Mongolia were subjected to HLA-DQA1 genotyping with the use of polymerase chain reaction-sequence specific primer (PCR-SSP) technique. RESULTS: (1) The gene frequency of HLA-DQA1*0301 of AP group (33.4%) was significantly higher than that (10.6%) of control group (chi square=21.899, P<0.01). On the other hand, the gene frequencies of HLA-DQA1*0302 were 6.7% and 19% in the AP group and the control group respectively; a significant difference between them was seen (chi square=9.786, P<0.01); (2)The gene frequencies of both DQA1*0301 and DQA1*0302 in the cutaneous purpura simplex cases and the controls were not significantly different (P>0.05). The gene frequencies of DQA1*0301 of the cutaneous purpura cases associated with gastrointestinal, joint and renal impairment were 26.7%, 28.5% and 29.3% respectively, which were higher than that of the control group (10.6%); the differences were statistically significant (P<0.01, 0.01, 0.01; respectively). The gene frequencies of HLA-DQA1*0302(3.9%, 5.7% and 9.6%) for the cutaneous purpura cases associated with gastrointestinal, joint and renal impairment were significantly lower than that (19%) of the controls except renal impairment(P<0.01, 0.01, respectively). CONCLUSION: The allele of HLA-DQA1*0301 was probably a susceptible gene while HLA-DQA1*0302 was the protective one in AP of the children who were Han inhabitants in Inner Mongolia. The results of this study also revealed that patients with the allele of HLA-DQA1*0301 tended to involve gastrointestinal, joint and renal impairment.