Helicobacter pylori infection in sjögren�s syndrome: Co-incidence or causality?

Background and Aim: Lymphoid cell infiltration and destruction of exocrine glands, specifically lacrimal and salivary glands are characteristics of Sjogren�s syndrome (SS). An etiological role has been proposed for Helicobacter pylori (H. pylori), interacting in the clinical course and complications of SS (including gastric cancer and lymphoma). The aim of this study was to identify the probable correlation between H. pylori infection and Sjogren�s syndrome (SS). Methods: In this case-control study, ELISA method was used to determine serum level of IgA and IgM anti H. pylori antibody in 43 subjects with SS according to the international criteria and 95 healthy subjects as control. SPSS-17 was used to analyze data with t-test. P value <0.05 were considered significant. Results: Serum level of IgM (34.9 vs. 10.5, p-value= 0.001) and IgA (67.4 vs. 46.3 p value= 0.021) anti H. pylori antibody were significantly higher in SS patients compared to the control group. There was a positive correlation between age and H. pylori infection (r=0.2, P-value=0.05). Conclusion: Patients with SS had a higher prevalence of H. pylori infection compared to the normal population. Eradication of H. pylori is recommended particularly in older patients with SS. © 2019 Bentham Science Publishers

A rare case report of acute necrotizing encephalopathy of childhood

Objective Acute necrotizing encephalopathy of childhood (ANEC) is a fast growing disease, accompanied by progressive encephalopathy. The aim of this study was to report a rare case of ANEC in a four-year-old boy with bilateral thalamic necrosis and non-fatal outcomes. Case Report The patient was a four-year-old Iranian boy, without any history of health problems or hospitalization, except for jaundice and phototherapy in the neonatal period. He had no neurological signs or symptoms during admission, and he was admitted only with chief complaints of acute onset of fever, coryza, and icterus. In the neurological consultation, brain MRI was requested to analyze the possibility of brain damage. The results indicated the involvement of cerebellum, thalamus, and basal ganglia, which led to the diagnosis of ANEC. Conclusion Based on our findings, although ANEC is a rare disease, it should not be underestimated. © 2020, Iranian Child Neurology Society. All rights reserved

Ventricular endomyocardial fibrosis in a pregnant female with Behçet’s disease

A 32-year-old pregnant woman, diagnosed with Behçet’s disease 6 months earlier, presented with recent mild hemoptysis and exertional dyspnea. Transthoracic echocardiography showed an enlarged dysfunctional right ventricle. A large hypoechoic triangular-shaped mass was seen attached to the inner right ventricular wall, filling the cavity. No change in the size of the mass was noted after anticoagulant administration, and right heart failure progressed. Surgery was performed to remove the mass and repair the tricuspid valve. This was a very rare presentation of Behçet’s disease in pregnancy, which resulted in delivery of a completely healthy baby despite corticosteroid pulse therapy and cyclophosphamide. © The Author(s) 2017

New manifestations of electrophysiological remodeling of heart during experimental model of atrial fibrillation in cirrhotic rat isolated heart

Introduction: The present study is aimed to evaluate electrophysiological remodeling of atrioventricular (AV) node and ventricular conduction during experimental atrial fibrillation (AF) model in isolated heart of cirrhotic rats. Methods: Cirrhosis-induced electrophysiological remodeling was evaluated in 24 isolated retrogradely perfused rat hearts in 2 groups (control and cirrhotic). Cirrhosis was induced after 6 weeks of c ommon bile duct ligation in rats. Extracellular filed potential was recorded from upper atrium and right ventricle. The conduction time, refractoriness and frequency-dependent properties of AV node were characterized by specific stimulation protocols. Experimental AF was simulated by high-rate atrial pacing with random coupling intervals (range 75-125 ms). Results: Nodal conduction time and ventricular responsiveness were significantly increased in the cirrhotic rats compared to the control (95.8 ± 4.2 ms vs. 78.8 ± 3.3 ms) (P< 0.05). Nodal protective function during AF was potentiated with increased R-R interval, concealed beats, ventricular refractoriness and zone of concealment in the cirrhotic group. Cirrhosis evoked rate-dependent ventricular conduction time shortening with different patterns during arrhythmia. Conclusion: Cirrhosis-induced electrophysiological remodeling was shown by increased AV nodal conduction and shortened ventricular conduction. This electrophysiological remodeling may be considered as a new manifestation of cirrhotic cardiomyopathy in the heart, which can change ventricular rhythm during arrhythmia