Immunology and Genetics Journal

Comparison of the Therapeutic Effect of Erythropoietin Alone and with the Combination of L-Carnitine on Hemoglobin Levels in Hemodialysis Patients

Vahid Sheikhi — 2024-10-13

Objective: L-carnitine deficiency causes various pathological conditions such as muscle weakness and erythropoietin-resistant anemia in hemodialysis patients. The present study was conducted to compare the therapeutic effect of erythropoietin alone and with the combination of L-carnitine on anemia in hemodialysis patients.

Materials and methods: In this clinical trial study, 24 hemodialysis patients were admitted to the dialysis department of Imam Ali Hospital in 2019. Eligible patients were divided into two equal groups of treatment with erythropoietin alone and the combination of L-carnitine and erythropoietin. A complete blood count (CBC) sample was taken from the patients and the hemoglobin level was measured before and after the treatment.

Results: The mean age of the patients in the erythropoietin treatment group and erythropoietin and L-carnitine combination treatment group was 18.66 ± 3.70 and 23.83 ± 5.70 years, respectively, and a significant difference was observed between the two groups (P=0.015). There was no significant difference between the two groups in the amount of hemoglobin before the treatment (P=0.327). The mean hemoglobin of hemodialysis patients after treatment, in the group treated with erythropoietin and the group receiving erythropoietin with L-carnitine, were 9.8±1.6 and 10.6±3.9 g/dL, respectively, and there was no significant difference between the two groups in terms of hemoglobulin (P=0.324).

Conclusion: Our results showed that receiving erythropoietin alone and erythropoietin together with L-carnitine did not have a significant effect in improving blood parameters in patients with anemia undergoing hemodialysis.

Clinical Characteristics, and Antibiotic Effectiveness in the First 48 Hours in Children Under 5 Years of Age with Bacterial Dysentery

Aghil Miri — 2024-10-16

Background: Bacterial dysentery is diarrhea with blood (plus or minus mucus), indicating an invasive infection. With effective antibiotic treatment, clinical improvement occurs within 48 hours, which leads to a reduction in the risk of serious complications and death, a shorter duration of illness, and a reduction in transmission. This study was conducted to investigate the clinical features, risk factors, and effectiveness of antibiotics in the first 48 hours in children under 5 years old with bacterial dysentery.

Methods: In this cross-sectional descriptive-analytical study, children less than 5 years old with bacterial dysentery hospitalized in Ali Ibn Abitaleb and Ali Asghar Hospital in Zahedan, Iran in 2014-2016 were enrolled. After obtaining the necessary permits from the ethics committee, the researcher extracted the information on 85 cases of patients diagnosed with bacterial dysentery, taking into account the entry and exit criteria in an accessible way. The information was entered into the questionnaire

Results: The mean age of the patients was 31.17±16.04 months. 52.9% of patients were girls (n=45). Fever was observed in 100% of patients(n=85). The severity of mild, moderate, and severe dehydration was observed in 36.47%, 40%, and 25.53% of the patients, respectively. The most injected antibiotic was ceftriaxone. White blood cell (WBC) levels decreased significantly after receiving treatment (antibiotic). (before treatment: 13.22±9.91 and after treatment: 8.57±2.71 cells/microliter, P-value=0.001).

Conclusion: Our study showed that antibiotic treatment in bacterial dysentery effectively reduces the serum level of WBC. It is suggested that educational programs for mothers in the field of child nutrition be provided and that the effectiveness of different types of antibiotics be compared in future studies.

The RAG1 Mutation Presenting as Early Onset SLE in an Iranian Patient

Taher Cheraghi — 2024-10-13

It has been established that Recombinase Activating Genes (RAG1 and RAG2) mutations are responsible for classic T-B-NK+ severe combined immunodeficiency (SCID). On the other hand, it has now become evident that certain mutations within these genes can also lead to other forms of combined immunodeficiency, antibody deficiency, and even autoimmunity.

In this report, we present a case involving a 9-month-old female patient who presents with clinical and laboratory findings indicative of systemic lupus erythematosus (SLE). Following the diagnosis of early-onset SLE and considering the presence of concurrent infections, it was considered necessary to investigate potential underlying monogenic disorders associated with inborn errors of immunity. Immunological evaluations demonstrated a combined immunodeficiency and whole exome sequencing confirmed that the patient has a mutation in the RAG1 gene.

Asthma-Related Plastic Bronchitis: A Challenging Diagnosis

Mohammad Reza Modaresi — 2024-10-16

Both adults and children could be affected by PB, but most described cases in the literature are children. Its prevalence of PB is unknown due to its non-specific signs and symptoms and difficult-to-diagnose nature. It could be a complication of some medical conditions, such as asthma, cystic fibrosis, sickle cell anemia, lymphatic abnormalities, infections, and congenital heart surgery (Fontan procedure). PB was associated with the history of Fontan procedure in most patients; its association with asthma is rare. One recent study in the pediatric population with PB showed that 70.5% of the patients had a history of Fontan procedure, 26.5% had previous respiratory diseases and 3% had idiopathic PB; the prevalence of asthma-related PB was 17.6% in their study. Based on the previous studies, 28%-60% of cardiac-related PB and 6%-7% of non-cardiac-related PB died as a result of this condition; therefore, its prompt diagnosis and management are crucial.