Familial multiple myeloma. Two more families

The authors report on two multiple myeloma sibling pairs. In the absence of a known disease-specific marker one can only speculate on an explanation: is it because of inherited errors or is it related to the same environmental exposure, or both? In this study HLA typing and metabolizing enzyme polymorphism studies have been carried out with the aim of finding inherited similarities in the siblings or characteristics that might differ from the average population. Sibling pair 1 shared an HLA haplotype. Sibling pair 2 shared only HLA-B51, DR4, DRw53, DQ3. Sibling 1/1 was GSTT1/GSTM1 null and GSTP1 Ile105Val; sibling 1/2 was a GSTT1/GSTM1 heterozygote and GSTP1 Ile105Val; sibling 2/1 and 2/2 were GSTT1 heterozygotes and shared GSTM1 null/GSTP1 Ile105Ile. The siblings had identical light chain or heavy chain secretion, or both. The similarities found in the inherited factors together with the same environmental exposure in the siblings' first 20 years of life imply that the development of the same disease cannot be a coincidence

Effective humoral immunity against diphtheria and tetanus in patients with systemic lupus erythematosus or myasthenia gravis

INTRODUCTION: Controversy exists about the effectiveness of vaccine-induced immune response in patients with immunoregulatory disorders. Our aim was to determine the antibody titers to diphtheria and tetanus in patients with either of two autoimmune diseases. METHODS: 279 patients with SLE (205 females, aged 45.0+/-13.8 years), 158 patients with myasthenia gravis (MG) (101 females, aged 55+/-18.7 years) and 208 healthy subjects (122 females, aged 48+/-14.6 years) were enrolled. Serum concentrations of diphtheria-antitoxin-IgG (A-DIPHTH) and tetanus-antitoxoid-IgG (A-TET) were determined with ELISA. RESULTS: Equal proportions of healthy subjects, as well as patients with SLE or MG exhibited proper antibody responses and immune protection against diphtheria and tetanus. In all three test groups, serum concentration of A-DIPHTH decreased significantly (p60-years-old) subjects. There were no significant differences among the groups in the age-related changes of A-TET and A-DIPHTH except that in <40-years-old subjects, A-DIPHTH level was significantly (p=0.029) lower in SLE patients than in controls. CONCLUSIONS: Our findings suggest that the level of vaccine-induced immunity against diphtheria and tetanus infections in patients with SLE or MG is comparable to the healthy population

Gerundium: A Comprehensive Public Educational Program on Organ Donation and Transplantation and Civil Law in Hungary

Background. Organ transplantation has become an organized, routine, widely usedmethod in the treatment of several end-stage diseases. Kidney transplantation means thebest life-quality and longest life expectancy for patients with end-stage renal diseases.Transplantation is the only available long-term medical treatment for patients with endstageliver, heart, and lung diseases. Despite the number of transplantations increasingworldwide, the needs of the waiting lists remain below expectations.Methods. One of the few methods to increase the number of transplantations is publiceducation. In cooperation with theUniversity of Debrecen Institute for SurgeryDepartmentof Transplantation, the Hungarian National Blood Transfusion Service Organ CoordinationOffice, and the Local Committee Debrecen of Hungarian Medical Students’ InternationalRelations Committee (HuMSIRC), the Gerundium, a new educational program, has beenestablished to serve this target. Gerundiumis a special program designed especially for youtheducation. Peer education means that age-related medical student volunteers educate theirpeers during interactive unofficial sessions.Results. Volunteers were trained during specially designed training. Medical studentswere honored by HuMSIRC, depending on their activity on the basis of their own regulations.Uniform slides and brochures to share were designed. Every Hungarian secondaryschool was informed. The Local Committee Budapest of HuMSIRC also joined the program,which helps to expand our activity throughout Hungary. The aim of the program ispublic education to help disperse disapproval, if presented.Conclusions. As a multiple effect, our program promotes medical students to have betterskills in the field of transplantation, presentation, and communication skills. Our programis a voluntary program with strong professional support and is free of charge for thecommunity

Gerundium: A Comprehensive Public Educational Program on Organ Donation and Transplantation and Civil Law in Hungary

ABSTRACTBackground. Organ transplantation has become an organized, routine, widely usedmethod in the treatment of several end-stage diseases. Kidney transplantation means thebest life-quality and longest life expectancy for patients with end-stage renal diseases.Transplantation is the only available long-term medical treatment for patients with endstageliver, heart, and lung diseases. Despite the number of transplantations increasingworldwide, the needs of the waiting lists remain below expectations.Methods. One of the few methods to increase the number of transplantations is publiceducation. In cooperation with theUniversity of Debrecen Institute for SurgeryDepartmentof Transplantation, the Hungarian National Blood Transfusion Service Organ CoordinationOffice, and the Local Committee Debrecen of Hungarian Medical Students’ InternationalRelations Committee (HuMSIRC), the Gerundium, a new educational program, has beenestablished to serve this target. Gerundiumis a special program designed especially for youtheducation. Peer education means that age-related medical student volunteers educate theirpeers during interactive unofficial sessions.Results. Volunteers were trained during specially designed training. Medical studentswere honored by HuMSIRC, depending on their activity on the basis of their own regulations.Uniform slides and brochures to share were designed. Every Hungarian secondaryschool was informed. The Local Committee Budapest of HuMSIRC also joined the program,which helps to expand our activity throughout Hungary. The aim of the program ispublic education to help disperse disapproval, if presented.Conclusions. As a multiple effect, our program promotes medical students to have betterskills in the field of transplantation, presentation, and communication skills. Our programis a voluntary program with strong professional support and is free of charge for thecommunity

Differences in the genetic background of latent autoimmune diabetes in adults (LADA) and type 1 diabetes mellitus

Objectives: According to the recent classification of diabetes mellitus the Latent Autoimmune Diabetes in Adults (LADA) belongs to the group of type 1 autoimmune diabetes, as a slowly progressive form. Our aim was to determine (i) the prevalence of HLA-DRB1 and DQB1 genotypes, and (ii) to determine the tumor necrosis factor (TNF) α promoter polymorphism at position -308 (the G→A substitution, designated the TNF2 allele) in patients with type 1 diabetes and with LADA compared with the healthy population. Methods: The major histocompatibility complex (MHC) II genotypes and the TNF α promoter polymorphism were determined by PCR method. We examined 69 type 1 diabetic and 42 LADA patients. As control samples of 336 cadaver kidney donors and 138 volunteers were used. Results: Both type 1 diabetes mellitus and LADA were positively associated with the DRB1*04-DQB1*0302 (DR4/DQ8) haplotype (P=0.00001, and P=0.0005, respectively), and negatively associated with the DRB1*11-DQB1*0301 (DR11/DQ7) haplotype (P=0.00006, and P=0.007, respectively) compared with control population. There were differences between the two disease entities in the frequency of the DRB1*03-DQB1*02 (DR3/DQ2) haplotype (P=0.00008 vs. P=0.177) compared with control group. The presence of the TNF2 allele was significantly lower in LADA than type I diabetes (P=0.022) or control group (P=0.017). Conclusion: Our findings indicate that there are marked differences in the genetic background of type 1 diabetes and LADA. The low presence of TNF2 allele (known to be associated with high amount of TNF α production) in LADA could be one of the factors responsible for the relatively slow progression. © 2002 Elsevier Science B.V. All rights reserved