Association between an angiotensin-converting enzyme gene polymorphism and Alzheimer’s disease in a Tunisian population

Abstract Background The angiotensin-converting enzyme gene (ACE) insertion/deletion (I/D or indel) polymorphism has long been linked to Alzheimer’s disease (AD), but the interpretation of established data remains controversial. The aim of this study was to determine whether the angiotensin-converting enzyme is associated with the risk of Alzheimer’s disease in Tunisian patients. Methods We analyzed the genotype and allele frequency distribution of the ACE I/D gene polymorphism in 60 Tunisian AD patients and 120 healthy controls. Results There is a significantly increased risk of AD in carriers of the D/D genotype (51.67% in patients vs. 31.67% in controls; p = .008, OR = 2.32). The D allele was also more frequently found in patients compared with controls (71.67% vs. 56.25%; p = .003, OR = 2.0). Moreover, as assessed by the Mini-Mental State Examination, patient D/D carriers were more frequently found to score in the severe category of dementia (65%) as compared to the moderate category (32%) or mild category (3%). Conclusions The D/D genotype and D allele of the ACE I/D polymorphism were associated with an increased risk in the development of AD in a Tunisian population. Furthermore, at the time of patient evaluation (average age 75 years), patients suffering with severe dementia were found predominantly in D/D carriers and, conversely, the D/D genotype and D allele were more frequently found in AD patients with severe dementia. These preliminary exploratory results should be confirmed in larger studies and further work is required to explore and interpret possible alternative findings in diverse populations

HLA class II alleles and multiple sclerosis in Tunisian patients

International audienceObjective The aim of our study was to investigate the association of HLA-DRB1 and -DQB1 alleles with multiple sclerosis (MS) in a Tunisian population and their effect on age at onset and disease severity Methods 58 MS patients and 105 healthy controls were genotyped for HLA class II alleles by PCR-SSP technique Results An association of MS with HLA-DRB1*15 was found (147% vs 3 8%, OR (95% CI) = 4 34 (1 69-11 39) P(c) = 2 5 x 10(-3)) after Bonferroni's correction Moreover the DRB1*15-DQB1*06 (138% vs 28%, OR (95% CI) = 5 44 (1 92-17 41) p(c) = 1 1 x 10(-3)) and DRB1*04-DQB1*04 (86% vs 19% OR (95% CI)- 4 86 (1 36-21 62) p(c) = 0 028) haplotypes were found to confer a susceptibility to multiple sclerosis Conclusion To our knowledge this is the first study performed to analyze the association of HLA-DRB1/DQB1 alleles on MS susceptibility in Tunisia The modern Tunisian gene pool shows some degree of heterogeneity and reflects a significant gene flow from Mediterranean regions (C) 2010 Elsevier B V All rights reserve

Parsonage–Turner syndrome of the brachial plexus secondary to COVID‐19 vaccine: A case report

Abstract Parsonage–Turner syndrome (PTS) is a peripheral inflammatory neuropathy of unknown etiology. We present a rare case of a 50‐year‐old male patient with PTS post‐COVID‐19 BNT162b2 mRNA vaccine. Symptoms occurred 15 days after the second dose. He was treated with corticosteroids, analgesics, and physical rehabilitation with a partial recovery

La coagulation intravasculaire disséminée: intérêt du score de la société internationale sur la thrombose et l´hémostase

La coagulation intravasculaire disséminée (CIVD) est une cause de mortalité redoutable en milieu de réanimation. L´utilisation du système de score de la société internationale sur la thrombose et l´hémostase (ISTH) permet de faciliter le diagnostic précoce de la CIVD. Nous présentons trois observations cliniques de CIVD d´étiologies différentes: un adénocarcinome prostatique, un choc septique et un hématome rétro-placentaire. Les tests d´hémostase nécessaires au calcul du score de la Société Internationale sur la Thrombose et l´Hémostase (ISTH) (numération plaquettaire, taux de prothrombine, fibrinogène et D-dimères) ont été régulièrement réalisés. D´autres tests complémentaires (recherche de complexes solubles, test de lyse des euglobulines, dosage des taux d´antithrombine, de protéine C activée et du facteur V) ont été également réalisés. L´utilisation du score ISTH permet de faciliter le diagnostic précoce de la CIVD

Neuro-meningeal cryptococcal infection revealing a multiple myeloma

Rare cases of Cryptococcus have been documented in patients living with multiple myeloma. To date there has been no documented evidence of cryptococcosis revealing multiple myeloma. We reported a 63-year-old man who had a 2-months history continuous holocranial headaches, morning vomiting, complaining of blurred vision and fever. The biologic and the imaging showed a Cryptococcus meningoencephalitis. The search for a cause of immunodeficiency revealed a multiple myeloma. The diagnosis for Cryptococcus was confirmed according to an India ink stain, blood and cerebrospinal fluid culture. The patient's treatment for multiple myeloma was initiated with a chemotherapy regimen. The evolution was good without complication. Cryptococcosis, especially in the neuro-meningeal form, is a serious, deadly opportunistic infection. The search of an underlining immunodeficiency must be systematic. In this case, it was associated with early stage multiple myeloma