Clustering cases of Chlamydia psittaci pneumonia mimicking COVID-19 pneumonia.

BACKGROUND: The onset symptoms of people infected by Chlamydia psittaci can mimic the coronavirus disease 2019 (COVID-19). However, the differences in laboratory tests and imaging features between psittacosis and COVID-19 remain unknown. AIM: To better understand the two diseases and then make an early diagnosis and treatment. METHODS: Six patients from two institutions confirmed as psittacosis by high-throughput genetic testing and 31 patients confirmed as COVID-19 were retrospectively included. The epidemiology, clinical characteristics, laboratory tests and computed tomography (CT) imaging features were collected and compared between the two groups. The follow-up CT imaging findings of patients with psittacosis were also investigated. RESULTS: The white blood cell count (WBC), neutrophil count and calcium were more likely to be decreased in patients with COVID-19 but were increased in patients with psittacosis (all P = 0.000). Lymphocyte count and platelet count were higher in patients with psittacosis than in those with COVID-19 (P = 0.044, P = 0.035, respectively). Lesions in patients with psittacosis were more likely to be unilateral (P = 0.001), involve fewer lung lobes (P = 0.006) and have pleural effusions (P = 0.002). Vascular enlargement was more common in patients with COVID-19 (P = 0.003). Consolidation in lung CT images was absorbed in all 6 patients. CONCLUSION: Psittacosis has the potential for human-to-human transmission. Patients with psittacosis present increased WBC count and neutrophil count and have specific CT imaging findings, including unilateral distribution, less involvement of lung lobes and pleural effusions, which might help us to differentiate it from COVID-19.

[Direct sequencing and analysis of exons of Wilson' disease gene with the most mutations: a study in Hunan Han patients].

OBJECTIVE: To detect hot point mutations of ATP7B gene in Hunan Han patients with Wilson' disease (WD). METHODS: The genomic DNA of 22 WD patients was extracted and exons 5, 8, 12, 13 were amplified by PCR. Screening for the mutations was done by direct sequencing and analysed by BLAST. RESULTS: Fifteen of the 22 patients were found with mutations. Ten heterozygous Arg778Leu (2273G --> T) mutations were found in exon 8, all of them were accompanied with 2250C --> G polymorphism (Leu770Leu). Seven patients were found with 2855G --> A (Arg952Lys) polymorphism (4 heterozygous and 3 homozygous), 3 of them had Arg778Leu mutation in exon 8 and one with heterozygous mutation Gly943Asp (2828G --> A) in exon 12 simultaneously. Only one patient was found with heterozygous Pro992Leu (2975C --> T) mutation in exon 13. No mutations were found in exon 5. CONCLUSION: Arg778Leu is the hot point mutation of ATP7B gene in Hunan Han patients with Wilson' disease while exon 5 is not.

[Ceruloplasmin level of patients with liver disease in China].

OBJECTIVE: To find out the degree of overlap of ceruloplasmin concentration in patients presenting with liver disease, providing scientific evidences for the diagnosis and differential diagnosis of Wilson's disease (WD). METHODS: Measuring the serum ceruloplasmin concentration of patients presenting with liver diseases, all data were statistically analyzed with SPSS12 for Windows. RESULTS: The average serum ceruloplasmin concentration of patients with WD was (93.9 +/- 98.1) mg/L, which was significantly lower than patients with non WD. The ceruloplasmin concentration of 72.7% of patients with WD was less than 100 mg/L, and that of 42.9% of patients with WD was less than 50 mg/L, but the ceruloplasmin concentration of 9.1% of patients with WD was more than 210 mg/L. The average serum ceruloplasmin concentration of patients with acute hepatitis was (398.4 +/- 151.3) mg/L, which was significantly higher than other group. The average serum ceruloplasmin concentration of patients with severe hepatitis was (296.5 +/- 106.5) mg/L, which was significantly lower than other group. The ceruloplasmin concentration of 6.8% of patients with non WD was less than 210 mg/L, the lowest was 28 mg/L. CONCLUSIONS: There is some degree overlap in ceruloplasmin concentration between WD and other liver disease, WD could not be confirmed or excluded according to ceruloplasmin concentration only.