Difficulties of hypocomplementemic urticaria vasculitis diagnostics

Urticaria vasculitis is a multisystem disease with cutaneous lesions which resemble urticaria and histologic signs of leukocytoclastic vasculitis. The article highlights the main aspects of etiology, pathogenesis, clinical and histopathological disease manifestations, and also methods of treatment. Difficulties of a diagnostic process are demonstrated by means of an example of our own follow-up of a patient with Urticaria vasculitis having a history of solar urticaria. The main trigger of episodes relapse of urticarial rash in the form of coldinduced urticaria and urticaria resulting from blood pressure, was a stress factor and hemorrhage from the duodenal bulb ulcer. The analysis of clinical data and peculiarities of disease progression was conducted for the purpose of diff erential diagnostic procedure of urticaria and urticaria vasculitis. The patient’s urticaria lasted longer than 24 hours; haemosideric staining was observed in the course of rash resolving, local oedemata resembling Quincke’s edema ailed, general symptoms were present (arthralgia, fever, abdominal pains, neurological disorders, etc.). Low effi ciency of antihistamines was reported. Laboratory examination revealed the increase in the blood sedimentation rate, lowering of the complement component 3, raise of anti-C1q and cryoglobulinemia. The essential component of the diagnostic search was biopsy of the skin which allowed to reveal signs of leukocytoclastic vasculitis. On the basis of the clinical evidence (fixed urticarial eruption), laboratory data (hypocomplementemia), histological examination of skin (leukocytoclastic vasculitis) and multisystemic pathology found (of joints, heart, GIT, nervous system), the patient has been diagnosed with a hypocomplementary urticaria vasculitis. Moreover, the article includes recommendations on sampling of pathological material due to primary importance of skin biopsy results in diagnostics of the urticarial vasculitis. Medical professionals no matter of their speciality, should know peculiarities of Urticaria vasculitis progression to reduce the likelihood of its error diagnosis as recurrent urticaria or other immunological disease.

Morphological and Biochemical Parameters of Pigs’ Blood with Enzootic Pneumonia

One of the most common diseases of pigs in large pig enterprises is enzootic pneumonia. The main etiological agent causing enzootic pneumonia is Mycoplasma hyopneumoniae. Mycoplasmas have minimal virulence, but they increase the susceptibility of pigs to secondary infections. In association with other microorganisms, Mycoplasma hyopneumoniae enhances its pathogenic effect, which makes the course of the disease more severe, often leading to the death of animals. Blood tests were performed to study the changes in morphological and biochemical parameters during the development of infection caused by Mycoplasma hyopneumoniae. Experimental groups of animals were formed, consisting of healthy as well as infected and ill pigs of different ages (2, 3, and 4 months), in which the pathogen M. hyopneumoniae was detected by polymerase chain reaction. The following hematological changes were revealed in the piglets suffering from respiratory mycoplasmosis: erythropenia, leukopenia, increased blood sedimentation rate (BSR), hypoproteinemia, hypoalbuminemia, increased activity of alanine aminotransferase and alkaline phosphatase, increased urea, and hyperglycemia. Keywords: pigs breeding; pneumonia; biochemical parameters; morphological parameters

Deskripsi Jumlah Leukosit dan Laju Endap Darah pada Pasien Tuberkulosis di Rumah Sakit Paru Dungus Madiun

Tuberculosis is an infectious disease of global concern caused of bacterium Mycobacterium tuberculosis. It can attack lung, liver, kidneys, bones or skin. If a person infected by tuberculosis, the body will begin the mechanism of inflammation as a form of haematological manifestation. The purpose of this study was to describe the number of leukocytes and Blood Sedimentation Rate (BSR) in tuberculosis patients. The research design used is non-analytic descriptive. The population in this study were all tuberculosis patients at the Dungus Madiun Lung Hospital in 2018Using the Quota Sampling technique, the sample in this study was 30 respondents. This research was conducted on May 2018. The results of the study on tuberculosis patients showed that the number of leukocytes in TB patients was 9120 cells/�L blood, 11 (37%) patients had leukocytosis and 19 (63%) sufferers have a nominal leukocyte count. The lowest leukocyte count was 4100 cells/�L of blood and the highest was 24700 cells/�L of blood. The average value of BSR in TB patients was 71 mm/hour I, 29 (96.6%) patients experienced an increase in BSR values and 1 (3.4%) patients had normal BSR values. The lowest value of BSR is 11 mm/hour I and the highest value of BSR is 106 mm/hour I. Prevention of tuberculosis infection can be done by conducting laboratory diagnosis to find out how far the disease goes and choose the right OAT for patients. With intensive treatment, it will reduce the number of leukocytes and reduce the risk for MDR TB

Оптическая цифровая регистрация седиментации эритроцитов и ее моделирование в форме коллективного процесса

The dependence of the sedimentation rate of donor blood on its percentage in the sample (the degree of its dilution with physiologic saline) ranging from 0.25 to 100% (whole undiluted blood) is investigated with digital video equipment. The ratio of the value of displacement of the sediment–supernatant boundary per time unit was taken as the blood sedimentation rate. In case of registration of different speeds of movement of this boundary in a given volume of the cuvette, their spatial averaging was performed. A substantial increase in the blood sedimentation rate was found experimentally at high levels of its dilution, and, conversely, at blood concentrations in physiologic saline solutions that are close to whole blood. At the same time, the rate of blood sedimentation decreased several times with blood content in the range of 30–50%. It was experimentally shown that variation of blood content in the physiologic saline solution over a wide range did not affect the evenness of sedimentation occurring for almost any blood concentration in the mixture. In other words, in the process of sedimentation of a single blood sample of a given dilution in the physiologic saline solution, the sedimentation rate does not change with time. The experimentally obtained results allowed to build a theoretical model of blood sedimentation for two cases: 1) sedimentation of free erythrocytes (highly diluted blood) and 2) sedimentation of erythrocyte aggregates (almost undiluted blood, up to whole blood). The originality of the model comes from the proposition to consider the sedimentation of cells and/or their aggregates as a collective effect, and not in the traditional form of sedimentation of individual particles or particles interacting with each other. This model gives a satisfactory agreement with experimental laws with the use of certain empirical constants. The study is useful for understanding the process of erythrocyte sedimentation.

STUDY ABOUT THE PROGNOSIS VALUE OF HS-CRP, FIBRINOGEN, WHITE BLOOD CELL, BLOOD SEDIMENTATION RATE IN ACUTE STROKE PATIENTS

Background: The relationship between the concentration of hs-CRP, fibrinogen, white blood cells, blood sedimentation rate with prognosis in acute stroke patients. Subjects and Methods: Case-control study, cross-sectional description, over 110 cases including 66 stroke patients (44 cerebral infarction, 22 cerebral hemorrhage) and 44 cases of asthma at Hue University Hospital. Data were processing by conventional statistics methods and SPSS 15.0. Results: (i) The concentration of hs-CRP, fibrinogen in stroke patients during the acute phase was 6.74±6.61 mg/l and 4.47±0.98 g/l, higher than the control group (p<0.001). WBC was 7729±1549x109/l and VSS (K) 2455±1412 is not different from the control group with p>0.05. There was no difference between 2 groups, cerebral infarction and cerebral hemorrhage; (ii) There was a correlation between inflammatory factors on the severity of stroke patients: Positive correlation between hs-CRP levels with size of brain lesion (p=0.002; r=0.370). Inverse correlation between hs-CRP levels with glasgow scale (p=0.001; r=-0.423), inverse correlation between fibrinogen with size of brain lesion (p=0.043; r=0.250). Inverse correlation between fibrinogen concentration with glasgow scale (p=0.043; r=-0.250). Conclusion: Serum concentration of hs-CRP, fibrinogen has correlation with the severity in stroke patients during the acute phase. Key words: acute stroke, hs-CRP, fibrinogen

STUDY ON THE VALUE OF C-REACTIVE PROTEIN IN CHILDREN WITH ACUTE GLOMERULONEPHRITIS

Background: We had assessed the value of C-reactive protein (CRP) in children with Glomerulonephritis Acute (GNA). Study on the interrelation between CRP and the signs of clinic, paraclinic. Population and Methods: Patients : 35 patients with GNA age 1 – 15 years old in Pediatric Department of Hue Central Hospital from 4 / 2008 to 4 / 2009. Methods: Prospective, descriptive study. Results: No fever (74.30%); White blood cells>7000/mm3 (60%); Blood sedimentation rate>10mm (74.30%); ASLO>200UI/L (37.14%); normal CRP≤ 8mg/l (60%); CRP>8mg/l - 300mg/l (40%). CRP is no related to the fever sign (r = 0,162; p>0,05). CRP is positive tightly correlated with White blood (r = 0.680; p<0.05), with ASLO (r = 0,660; p<0,05) and CRP is positive moderate correlated with Blood sedimentation rate (r = 0,392; p<0,05). Conclusions: The CRP increased in GNA of children is 40%. Before treating, the average concentration of CRP is 12,88 ± 30,93 mg/l . After treating, the concentration of CRP is≤8mg/l (97.10%). Key words: CRP; Glomerulonephritis Acute

THE CLINICAL DISPLAYS AND THE FUNCTIONAL ACTIVITYOF RIBOSOMAL GENES IN ASTHMATIC CHILDREN

Background. To analyze the interrelations between the parameters of the functional activity of ribosomal genes and some clinical features in asthmatic children. Material and methods. 78 asthmatic patients were included in the study. Standard methods of production and colouring of cytogenetic preparations were used. The functional activity of ribosomal genes was defined on five-point system in arbitrary units. Statistical data processing was spent with the help of applied programs Statistica 6.0. Results. The data about the level of the functional activity of ribosomal genes of asthmatic children (18,57 arbitrary units) were obtained. In all patients the general functional activity of ribosomal genes parameters were correlated with the number of leukocytes and the functional activity of ribosomal genes localized in GHchromosomes parameter -with the level of immunoglobulin E. We constructed the discrimination model according to the disease severity index which included 4 significant parameters: bands number, disease manifestation age, blood sedimentation rate and active ribosomal genes copies number. Conclusion. Our data give evidence about the interrelations between the functional activity of ribosomal genes parameters and some clinical features in asthmatic children. The number of active ribosomal genes copies is considered to be one of the significant features of disease activity.

EARLY MUSCLE AFFECTION IN CHURG–STRAUSS SYNDROME

Purpose: Skeletal muscle affection already in the eosinophilic stage of Churg–Strauss syndrome (CSS) is unusual. Case report: In a 36-year-old woman with a history of recurrent bronchial infections since childhood, recurrent poly-sinusitis and nasal polyps, and bronchial asthma, easy fatigability, weakness of the lower arms and lower legs, generalized myalgias with predominance of the lower arms, recurrent vertigo and falls developed. There was recurrently elevated creatine-kinase, glutamate-oxalate-transaminase, aldolase, lactate-dehydrogenase, eosinophilic granulocyte-count, thrombocyte-count, cholesterol, and blood sedimentation rate. Histologically polyps showed diffuse infiltrations of eosinophils exclusively. Muscle biopsy revealed grouped atrophic fibers, necrotic fibers, rarely regenerating fibers, epitheloid cells and rarely perimysial eosinophilic granulozytes. According to established criteria, CSS was diagnosed. Conclusions: This case shows that affection of the skeletal muscle in CSS, may manifest as easy fatigability, myalgias, and recurrently elevated CK, and that skeletal muscle involvement may be a dominant feature not only of the vasculitic but also of the eosinophilic stage of CSS.