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Introduction. Type 1 diabetes is one of the most common serious metabolic diseases, with an onset in childhood and it may have a fatal evolution if the appropriate treatment is not administered. The pathogenic substrate of this condition is included in the spectrum of autoimmune diseases, a fact that predicts an accelerated evolution of symptoms. Materials and method. The aim of this paper is to bring to focus the clinical presentation of pediatric patients, whether through a classic symptomatology or a complicated form whose incidence is increasing worldwide. Results. The study was based on the descriptive analysis of clinical data from a group of 77 pediatric patients diagnosed with type 1 diabetes. Thus, data were obtained regarding the prevalence according to age and gender, the prevalence of autoantibodies in the diagnosis of the disease, the incidence of the symptomatology at admission, the presence of dehydration syndrome and diabetic ketoacidosis at the onset of the pathology. Conclusions. All these clinical data are extremely important in the diagnosis of the disease, but the follow-up of the child’s development parameters done by the family physician can suggest the existence of this disease, especially when predisposing factors are present, therefore the diagnosis of diabetes is possible before complications appear. The family doctor has a particularly important role, not only in the early diagnosis of patients with diabetes, but also in their multidisciplinary orientation throughout their lives. [ABSTRACT FROM AUTHOR]

For the environment, the human society progress has gradually turned into a factor of destruction, with disastrous effects on nature. With the advent of human civilization, also came its brutal intervention through the irrational exploitation of resources and the alteration of the environment through pollution caused by industrial, agricultural and household activities. There are toxins, pollutants and heavy metals everywhere in the environment. A proper diet and supplementation with standardized products can help eliminate heavy metals from the body (bioaccumulated), but their source must also be known to limit the body’s exposure and the impact of pollution on the pregnancy, fertility and health of future babies. Heavy metals can be chelated by selenium. Recent studies also show that most people with thyroiditis have a selenium deficiency, often triggering autoimmune diseases (Hashimoto’s thyroiditis). [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is the most common systemic autoimmune disease that can be associated with ocular complications – keratoconjunctivitis sicca, episcleritis, scleritis, corneal changes and retinal vasculitis. The purpose of the review is to illustrate the ocular manifestations of RA, focusing on pathogenesis, clinical examination and therapeutic management. Eye manifestations in RA benefit from the use of artificial tears, eye gels, ointments or topical nonsteroidal anti-inflammatory drugs or corticosteroids. Nonresponsive or severe forms should benefit from topical drops containing the supply of immunosuppressants or cyclosporine A. Rheumatic disease-modifying medication (DMARDs) has been reported to be effective in patients with refractory or corticosteroid-dependent cases. Biological substances – infliximab, adalimumab and rituximab – can be used successfully in patients considered nonresponders to synthetic therapy. Surgical treatment is reserved for severe cases, which are associated with local complications. In conclusion, collaborative efforts between ophthalmologists and rheumatologists in the assessment and treatment of patients with RA are essential for the effective management of any ocular complications that may occur. [ABSTRACT FROM AUTHOR]

The strong emphasis on the treatment of autoimmune diseases through allopathic medicine has led to the limitation of treatments based on diet and healthy lifestyle. Funding for drug use studies far exceeded the number of studies that could prove the reliability and success rate in treating these diseases through dietary changes, which is why clinicians currently do not have a sound basis for making recommendations and interventions of nutritional care. With the alarming increase in global chronic diseases, including autoimmune diseases, cardiovascular diseases, diabetes and cancer, and in line with the rising cost of allopathic treatments for these diseases, there has been a crisis in the management of autoimmune diseases, requiring the identification of more effective treatments, both in terms of results and related costs. [ABSTRACT FROM AUTHOR]

At the thyroid level, the fluctuations in hormone secretion primarily affect the patient's metabolism. Therefore, thyroid disorders cause diseases of the cardiovascular system (hypertension, atherosclerosis) and increase the risk of cardiovascular accident. Bipolar mental disorders are also associated with endocrine diseases. Currently, there are no ways to stop the autoimmune process in chronic thyroiditis, but given the state of research, selenium therapy remains the only therapeutic alternative. Current national and international studies focus on assessing the status of selenium in patients with autoimmune thyroiditis and the role of selenium supplementation in the disease evolution. [ABSTRACT FROM AUTHOR]

Drugs with an effect on the immune system, such as corticosteroids, antihistamines and immunosuppressants, have been and are widely used in the treatment of inflammatory, allergic and autoimmune diseases. Recent advances in immunopharmacological research have provided new classes of clinically relevant drugs. These include protein kinase and biological inhibitors, such as monoclonal antibodies, used not only in the treatment of cancer and autoimmune diseases, but also in a number of other human pathologies. In this article, certain elements of immunobiology and laboratory immunology are brought back to attention, meant to highlight their indispensable role in immunopharmacological research. There are also presented the main classes of drugs used in the treatment of allergic, inflammatory and autoimmune diseases, as well as in the treatment of associated diseases. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus is a chronic and multisystemic autoimmune disease that can occur in members of the same family. Genetic factors are still unidentified and not all relatives with these risk factors are predestined to develop the disease, but are more likely(1). Relatives of systemic lupus erythematosus (SLE) patients appear to be at higher risk of SLE and other autoimmune diseases, but individual family risk estimates are largely unavailable or unsafe. Moreover, the relative contribution of genetic factors, shared and divided into the susceptibility of SLE, remains unclear(2,3). The presence of antinuclear antibodies (ANA) is mainly associated with connective tissue diseases. In addition, their presence can also be found in healthy people. These antibodies are more common in women and in elderly people(4,5). It is known that subjects who are in the preclinical stages of SLE are represented in the healthy population with positive ANA autoimmunity, and the early detection of these antibodies often allows a rapid diagnosis of this disease(3). [ABSTRACT FROM AUTHOR]

Vitamin D is increasingly being studied globally, especially since its deficiency is very common. The role of vitamin D and its importance have been demonstrated in many studies, vitamin D being involved in bone formation, brain, cardiac, muscular, immune system and skin. Deficiency of vitamin D has attracted attention in many diseases, such as cancers, autoimmune diseases, cardiovascular and neurological disorders, infections. From a dermatological point of view, vitamin D deficiency is associated with multiple disorders, becoming a concern in dermatological practice. [ABSTRACT FROM AUTHOR]

Vitamin D is required to maintain normal blood levels of calcium and phosphate, which are in turn needed for the normal mineralization of bone, also play a role in muscle function, nerve conduction, the immune system and general cellular function in all cells of the body. Populations at risk for vitamin D deficiency are infants, adolescents, eldery, pregnant and lactating women. The actions of the vitamin D hormone 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) are mediated by the vitamin D receptor (VDR), a ligand-activated transcription factor that functions to control gene expression. Epidemiological data underline a strong correlation between vitamin D deficiency and higher risk for chronic inflammatory illnesses or autoimmune diseases. Evidence is not sufficiently to draw conclusions regarding the benefits of vitamin D supplementation for the prevention of cancer. Literature increasingly supports the inverse relationship of vitamin D level and diabetes, metabolic syndrome, cardiovascular disease mortality. [ABSTRACT FROM AUTHOR]

Autoimmune diseases etiology is hard to be determined. It implies the interrelation between genetic and environmental factors. Reactive arthritis is an autoimmune disease that develops in response to an infection, usually with Chlamydia spp., Salmonella spp., Yersinia spp., Shigella spp., Campylobacter spp. Postinfection persistence of bacterial antigens (DNA, RNA, lipopolysaccharide) was demonstrated. Nevertheless, the complete mechanism of reactive arthritis etiopathogenesis remains to be clarified. It seems that gut microbiota plays a key role, its perturbation leading to increased intestinal permeability which results in translocation of the microbial antigens to the joints. Uncovering the mechanisms underlying the pathogenesis of the disease would help conceive novel therapeutic targets for the treatment of reactive arthritis. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a multisystem major collagenosis of unknown etiology with autoimmune pathogenesis and unpredictable evolution. The prevalence of neuropsychiatric manifestations as a complication of SLE is reported in the literature of 14-95% in pediatric patients. The study presents the case of a patient with SLE, whom after a month of the onset, the illness is complicated with an impairment of the nervous system. Clinical manifestations were: headache syndrome, memory impairment, hemianopsia, hemiplegia. The brain MRI was found multiple areas of ischemia. Aimd immunosuppressive treatment, there was clinical and laboratory improvement. Although the lupus prognosis has improved significantly in recent years, the neuropsychiatric involvement represents one of the main causes of major disabilities, morbidity and mortality in SLE. Introduction. Systemic lupus erythematosus (SLE) is a multisystem inflammatory disorder of unknown etiology with various clinical and laboratory manifestations due to an imperfect genetically determined immunoregulation, associated with autoantibody hyperproduction and unpredictable evolution. The prevalence of neuropsychiatric manifestations as a complication of SLE is reported in the literature of 14-95% in pediatric patients. The neuropsychiatric involvement represents one of the main causes of morbidity and mortality in SLE. Aim: to study the particularities of clinical manifestations of the neurolupus in children. Material and Method: is presented a clinical case of a patient with SLE with clinical and laboratory signs of neuropsychiatric impairment and the methodology of investigations. Results and Conclusions: The patient, aged 14, is a primary diagnosed with SLE. One month after onset of illness appears one of the major complications of this disease- the impairment of the nervous system. Clinical manifestations were: headache syndrome, memory impairment, hemianopsia, hemiplegia. The brain MRI found multiple areas of ischemia. There was clinical and laboratory improvement amid an immunosuppressive treatment, though the prognosis remains reserved one. [ABSTRACT FROM AUTHOR]

The diagnostic and treatment of autoimmune diseases which also involve a chronic HVC became a very important concern for specialists, taking into consideration the grim prognosis of the patients. Though the purpose of the antiviral therapy is targeted on primary liver disease, there are enough reasons regarding the efficiency and safety of using these therapies in patients with associated extra-hepatic manifestations. [ABSTRACT FROM AUTHOR]

Eritema elevatum et diutinum (EED) is a rare form of leukocytoclastic vasculitis, with unknown etiology, whose onset could involve infections, autoimmune diseases or monoclonal gammopathy. We present the case of a female patient, who came with the recent onset of a rash that consisted of erytematous papules and nodules localized on the interphalangian joints and thenar eminence, associated with local burn, pain and arthralgia in the small joints of the hands. Clinically, the lesions had a particular aspect, with inflammatory characteristics and abcedation tendency, which oriented the diagnosis towards EED. There were some differential diagnosis problems with other vasculitis. The histophatological exam confirmed the diagnosis of EED. In our case, there were multiple trigger factors such as bacterial and fungal infections, hepatitis with C virus and tuberculinic hiperergy. [ABSTRACT FROM AUTHOR]

The auto-immune diseases of thyroid represent a variant and challenging field with an increasing interest during the last years. We present some aspects related to the autoimmune underlying mechanism, but also the clinical implications in pathogeny and current clinical practice not only in endocrinology, but also in internal medicine, rheumatology, or gynecology. [ABSTRACT FROM AUTHOR]

Patients with active rheumatoid arthritis (RA) have a significantly higher incidence of gum disease compared with healthy subjects, in RA patients the correlation with tooth and alveolar bone loss being demonstrated. It is interesting to study the relationship between the rheumatoid factor (RF), anticyclic citrullinated peptide antibodies (anti CCP), and Porphinomonas gingivalis (Pg), RF and anti CCP, present in RA, these being identified in the gum and in the subgingival plaque as well. The presence of gum disease increases the chance of developing heart disease, and mortality from cardiovascular damage in patients with RA, is 2 times higher compared to the general population. Based on these observations the question, whether oral infections play an important role in the pathogenesis of rheumatoid arthritis, and whether cardiovascular disease increases the risk in these patients, arises. [ABSTRACT FROM AUTHOR]

The risk of active tuberculosis (TB) is increased in patients with systemic autoimmune diseases, the more so in those with severe organ/system involvement and high disease activity, requiring aggressive immunosuppressive treatment. In the following paper we are presenting the case of a female systemic lupus erythematosus (SLE) patient with WHO class IV lupus nephritis and a history of completely healed miliary TB, who developed tuberculous arthritis of the knee. Promptly diagnosed and treated by associating chemotherapy for TB with a large synovectomy, the outcome of the arthritis was favorable. To present, this patient's SLE has been in remission for 3 years, with minimal renal impairment, while the TB arthritis is cured without any significant disability. [ABSTRACT FROM AUTHOR]

Objectives: to evaluate the prevalence of anti-CCP antibodies in chronic inflammatory diseases, others than rheumatoid arthritis (RA); to evaluate their usefulness in the differential with RA. Methods: cross-sectional design; 3 test groups: 41 psoriatic arthritis (PsA) patients, 45 systemic lupus erythematosus (SLE) patients, 37 peripheral spondylarthritis (SpA) patients; 2 control groups: 148 RA patients; 147 normal subjects. Results: 3 SLE patients (6.7%), 2 SpA patients (5.4%) and 5 PsA patients (12.2%) were anti-CCP positive; an anti- CCP titer below 1.25 U/mL in a SLE patients confirms this diagnosis with 90.5% specificity; it is highly likely that a predominantly peripheric AS patient with an anti-CCP titer > 7.8 U/mL has actually RA; it is highly likely that a PsA patient with an anti-CCP titer > 11.6 U/mL has actually RA associated with psoriasis. Conclusions: while classically associated with RA, anti-CCP antibodies have a relatively smaller prevalence in populations with other auto-immune diseases; their quantification represents a very good test in differentiating the aforementioned nosological entities from RA. [ABSTRACT FROM AUTHOR]

Background. Systemic sclerosis (SSc) is a complex autoimmune disease that involves various organs and systems and is associated with high mortality and morbidity rates. Objectives. To identify even from the first visit to the physician clinical and non-clinical parameters with predictive value for death, in patients with SSc. Methods. Demographic, clinical and non-clinical data were assessed (at each visit, according to EUSTAR recommendations) for all patients with SSc that visited our clinic between 2004-2012. Statistical analysis was done through SPSS 20.0, using chi-square and uni- and multivariate logistic regression. Results. 96 patients with SSc were included in the study, with a mean follow-up of 4.2±1.6 years. Throughout the follow-up period, there were 13 (13.5%) deaths, of whom 6 (6.2%) were of SSc cause and 7 (7.2%) of non-SSc cause. Sex- and age-adjusted univariate analysis identified the diffuse subset, a modified Rodnan score (mRSS) >14, digital ulcers, restrictive ventilatory syndrome, proteinuria, heart rhythm and conduction anomalies and hypo/ hyperpygmentation of the skin to be associated with increased mortality in all patients. Sex- and age-adjusted multivariate model identified a mRSS >14 and proteinuria as predictors of death. With regard to deaths that can be attributed to SSc, univariate analysis identified a mRSS >14, digital ulcers and proteinuria as predictive factors. Conclusions. The survival rate of patients included in the study was over 86% during a mean follow-up period of 5 years. Several clinical and non-clinical parameters which can be deemed predictive factors for death in patients with SSc were identified. Moreover, these can be detected early, from the patient's first visit to the physician, and can have an important role in developing a management strategy for the patient with SSc. [ABSTRACT FROM AUTHOR]

Biological therapies improved significantly the prognosis of autoimmune diseases. However, there are patients who do not reach the expected therapeutic response. One of the causes of non-responsiveness is the presence of anti-drug antibodies(ADA). Immunogenicity of biological therapies can be induced by different factors, many of them still unknown. We consider associated disease modifying anti rheumatic drugs (DMARD), dose escaladation and increased frequency of administration, as strategies that can decrease imunogenicity. It should be kept in mind that each biological therapy has a different pharmacokinetic mechanism, variable risk of developing ADA and that a standardized method for detecting serum active substance and ADA would be useful for monitoring biological treatment. [ABSTRACT FROM AUTHOR]

Introduction. Raynaud's phenomenon (RP) can be idiopathic, benign, or associated with a series of causes among which the most reserved prognosis have the systemic autoimmune diseases. Autoimmune Raynaud's is frequently an early sign of scleroderma spectrum diseases (SSD), associated with a high morbidity. Nailfold capillaroscopy (NC) can identify a specific pattern in SSD, reflecting the early microvascular involvement. Objectives. To evaluate the ability of NC to differentiate non-immune RP from immune-associated RP (immune RP) and to reveal the role of NC in the early etiological diagnosis of RP. Materials and methods. This transversal descriptive study included all the patients with unclassified RP who visited the clinic between October 2009 -- May 2011. The etiology of RP was established through clinical, paraclinical assessment and NC. The statistical analysis used the chi-square test and logistic regression. Sensitivity (Se), specificity (Sp), negative predictive value (NPV) and positive predictive value (PPV) for immune RP were calculated for each capillaroscopic parameter studied, as well as for the exam itself. Results. 49 patients were included, 41 women (83,7%) and 8 men (16,3%), aged 18-71 years (mean±SD 41.46 ± 15.02 years); 11 patients with non-immune RP and 29 with immune RP were identified. The etiology was diverse: overlap syndromes (n = 10; 20.4%), early systemic sclerosis (n = 7; 14.3%), undifferentiated connective tissue disease (n = 5; 10.2%), systemic lupus erythematosus and rheumatoid arthritis (2 cases each, 4.1%), dermatomyositis, Sjogren's syndrome and other autoimmune diseases (1 case each, 2%). Pathologic NC, megacapillaries and microhaemorrhages were significantly associated with immune RP. Logistic regression showed the association between the same parameters and immune RP (odds ratio, p): pathologic NC (5.75; 0.014), megacapillaries (8; 0.039) and microhaemorrhages (8; 0.039). NC exam had Se = 79.3%, Sp = 63.6%, PPV = 85% and NPV = 53.8% in the diagnosis of immune RP. The parameters with the highest specificity and PPV were architectural derangement, reduced capillary density and ramified capillaries, followed by megacapillaries and microhaemorrhages. Conclusions. NC can efficiently discriminate between non-immune RP and immune RP, facilitating the early diagnosis of underlying systemic conditions. The capillaroscopic examination of RP patients identified not only early scleroderma cases, but also a significant number of other connective tissue diseases. [ABSTRACT FROM AUTHOR]

Background. Rheumatoid arthritis (RA), the most common chronic autoimmune disease, that can be defined not only by its debilitating phenotype, but also by its major economic impact, and affects approximately 1% of the population worldwide. Osteoporosis is a major extra-articular involvement, marked by an increased fracture risk. Quantifying this absolute risk becomes therefore essential in identifying the correct patient subset in whom the correct therapeutical measures are highly needed. The aim of our study. was to determine the possible correlation between disease activity score and the presence of osteoporosis and the fracture risk, in patients with rheumatoid arthritis. Methods: our study included 125 patients diagnosed with AR. Bone mineral density was measured using DXA technology, using the same densitometer and the fracture risk by FRAX online calculator, introduced in 2008 by WHO. Results. 115 of the 125 patients were women, with a mean age of 56.75± 7.69 years. The mean spine T score was -1.63±1.31 and the mean total hip T score -1.49±1.18. Osteoporosis was identified in 21.6% patients, both for lumbar spine and total hip, in 38.5% for one site; 32% of the patients had osteopenia. Using FRAX algorithm, the major osteoporotic fracture risk was 11,96±8.18% and 4.71±6.03% for a hip fracture. T score, both in lumbar spine and total hip, was significantly higher (p<0.0001) in patients with a high disease activity score, compared with the group with a moderate activity score (-2.41±0.79/-2.31±0.78 vs -1.30±0.90/-1.11±0.99). Using FRAX algorithm, the hip fracture risk was 8.34% in the first group vs 2.69%., for the second one, statistically significant (p<0.0001). The major osteoportic fracture risk was also significantly higher (p<0.0001) in the first group (16.53%) compared with the second one (9.5%). There was a significant correlation between DAS28(4v) and lumbar spine Tscore (r=0.67; 95%CI 0.7594 -0.5647; P<0.0001) and between DAS28(4v) and total hip T score (-0.61; 95%CI -0.71 -0.48; p<0.0001). The correlation coefficient between DAS28(4v) and the risk of a major osteoporotic fracture was 0.459 (95%CI 0.308-0.587, p<0.0001) and 0.451 for a hip fracture. Conclusion. In summary, our data suggest that the patient diagnosed with reheumatoid arthritis is at high risk for a fragility fracture, directly related to disease activity and thus establishing the crucial role of the FRAX algorithm in our clinical routine. [ABSTRACT FROM AUTHOR]

Sjogren's Syndrome is a chronic, inflammatory autoimmune disorder that primarly involves the exocrine glands and in 25-50% of cases it has a broad clinical spectrum of extraglandular, systemic manifestations affecting the eye, gastrointestinal tract, kidney, skin, nervous system and joints. The development of non-Hodgkin's lymphoma as well as some extraglandular (gastrointestinal, kidney, pulmonary, neurological, cutaneous) involvement are associated with a poor outcome in patients with Sjogren's Syndrome. Thus, the recognition and close monitoring of the extraglandular manifestations are very important since they have prognostic implications and a strong impact on the quality of life of these patients. [ABSTRACT FROM AUTHOR]

Termenul „sindrom de overlap descrie, în hepatologie, forme diferite de afecţiuni hepatobiliare autoimune: hepatită autoimună (HAI), ciroză biliară primitivă (CBP), colangită sclerozantă primitivă (CSP), colangită autoimună. Pacienţii cu sindrom hepatic de overlap prezintă caractere comune biochimice şi histopatologice pentru cel puţin două din afecţiunile autoimune hepatice. Evoluţia hepatitelor autoimune sau sindroamelor de overlap este adesea către ciroză şi insuficienţă hepatică fără terapie adecvată. Rămâne încă neclar dacă aceste „sindroame de overlap sunt entităţi distincte sau doar variante ale hepatopatiilor majore autoimune. Stadializarea şi criteriile de diagnostic, scorurile de prognostic sau de predicţie pentru apariţia sindroamelor de overlap nu sunt încă pe deplin stabilite, ceea ce face a termenul să fie folosit frecvent dar, nu totdeauna corect în practica medicală. Sindroamele de overlap sunt afecţiuni hepatice rare, dar cu prognostic sever. Tratamentul medical empiric al sindroamelor de overlap hepatic include: terapie imunosupresivă cu corticosteroizi şi azathioprină, terapie anticolestatică cu acid ursodeoxicholic, strict personalizată ca asociere [ABSTRACT FROM AUTHOR]

Despite therapy options for rheumatoid arthritis, obtaining clinical remission remains a challenge. Several prognostic factors for response to synthetic and biological DMARDs treatment were found, but their applicability remains controversial (1). A biomarker test that predicts response shortly after initiating a treatment, as well as an algorithm for choosing a suitable biologic DMARD were recently approved. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease affecting women at childbearing age. More than 30 years ago, pregnancy was an absolute contraindication in SLE patients, out of concern for fatality and genetic inheritance. Pregnancy in SLE still remains a high-risk condition, due to increased risk for fetal loss and medical and obstetrical complications. Golden rules to maximize the success of a pregnancy in lupus include advanced planning, close surveillance, a well-defined management plan, coordinated care and a good neonatal unit. [ABSTRACT FROM AUTHOR]

Introduction: KIR receptors (killer cell Ig-like receptors) play a major role in the regulation of NK cell activity and hence their importance in development of many diseases (autoimmune diseases, cancers, transplantation). The aim of our study is KIR genotype analysis in patients with multiple myeloma and its impact on disease progression and response to treatment. Material and methods: the study was performed on 80 patients with multiple myeloma diagnosed in Center of Hematology, Fundeni Clinical Institute, between 2007-2011. As a control group were used 50 healthy blood donors. KIR genotyping was performed by molecular biology methods (SSP method). Results: the AA genotype has a higher frequency in the control group (42% vs. 33.75%), while BB genotype is more common among patients with multiple myeloma (10% vs. 4%) and it is associated with aggressive forms of disease. Conclusions: KIR genotype analysis may be considered as a prognostic factor in the outcome in multiple myeloma patients, among other genetic parameters already consecrated as del13q14, t(4,14) or t (11,14). [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to identify predictive factors for early menopause (EM) to autoimmune thyroid diseases patients (AITD). Materials and methods: The study included 162 patients with AITD diagnosed before 45 years. We performed univariate analysis of several independent factors by multivariate logistic regression analysis of the factors with statistical significance (p <0.01), with a score of predictive modeling. Results: Score EM prediction = -2.2022 x Age <35 years at diagnosis of AITD (1 / 0) + 1.9328 x Infertility (1 / 0) -0.3792 x Antiovarian antibodies (IU / ml), the criterion ≤ -1.8359, sensitivity 90%, specificity 88 %, AUC - 0.91. Conclusions: Two predictors are linked AITD at diagnosis: age <35 years wich decreases the risk and infertility which increase the risk, and may have a correlation with ovarian aging and occult ovarian failure [ABSTRACT FROM AUTHOR]

Objective: To reassess the antiovarian antibodies test performance in the diagnosis of premature ovarian failure of the patients with autoimmune thyroid disease. Material and method: The study involved 70 patients with autoimmune thyroid disease, from which ten cases (10/70, 14.4%) were associated with premature ovarian failure and were found to have serum antiovarian antibodies, using as reagent a mixture of ovarian proteins; the values greater than 10 IU/mL were considered positive. Results: Antiovarian antibodies were positive in one case (1,4%, 1/70) and was not a case of premature ovarian failure; in the same case antinuclear antibodies were positive. Conclusions: Determination of the circulating antiovarian antibodies as a possible predictive factor for premature ovarian failure is not really sustained, especially because it doesn't exist a recognized specific marker of the ovarian autoimmunity, and the study results are statistically insignificant. [ABSTRACT FROM AUTHOR]

Scleroderma is a rare, chronic autoimmune disease, with a high mortality, characterized by a mixture of vasculopathy and fibrosis, responsible for the heterogeneity of this disease. This paper reviews some recent data, as relevant for the clinical practice, highlighting data from registries and large patient cohorts. It also briefly summarizes the diagnostic and evaluation methods recommended for the monitoring of the most prevalent visceral involvement, outlining the molecules and clinical parameters suitable as biomarkers. [ABSTRACT FROM AUTHOR]

High values of blood pressure in spite of optimal treatment could have many explanations: lifestyle deviations, incomplete medical treatment, drugs interactions or associated pathologies. Material and method: Clinical case is presented to determine the expression of intricate increases tense; first cardiovascular risk factors that classified essential component and second emergence of diseases associated (endocrinopathy) determining secondary hypertension. Case analysis presents polymorphic symptoms. Clinical and Para clinical exams showed a hyperkinetic syndrome with a thyroid showing an increase in volume of the gland which has been shown to be of autoimmune etiology. Concomitantly, allergic phenomena appeared. Final diagnosis is: Acute urticaria, Hyperlipoproteinemia, Hypertension grade II, stage II, medium risk, Autoimmune thyroid. Conclusions: The intricate pathology raises many differential diagnostic problems. Blood pressure imbalance can have many causes that should not be ignored, such as the appearance of a disthyroidies. [ABSTRACT FROM AUTHOR]

Juvenile idiopathic arthritis (JIA) shares the same clinical and pathological features with rheumatoid arthritis (RA) în adults. Both are autoimmune diseases characterized by destructive arthropaty and by complex genetic traits, auto antibodies and cytokine profile în affected tissues. în order to help the practitioners to do a better distinction between these two entities, the author outlines the differences, first of all în clinical aspect. RA is a homogenous entity, whereas JIA is characterized by 7 or even 8 subtypes (categories, forms) according to the newest ILAR classification. The outcome is also quite different. în JIA the outcome is more variable and it can be predicted based on phenotype at presentation, whereas the patients with RA may have a poorer outcome. Although both diseases have an increased frequency of family history of other autoimmune diseases, patients with RA have a stronger family history of RP. The genetic markers present to variable degrees în the subtypes of JIA differ considerably from those of RA, particularly concerning HLA. [ABSTRACT FROM AUTHOR]

Common variable immunodeficiency (CVID) refers to a heterogeneous group of diseases, which have in common an insufficient antibody production. The main clinical feature of CVID is an increased susceptibility to infections (especially microbial infections). Also, these patients may present diseases with autoimmune or inflammatory pathogeny, a typical aspect for this group of primary immunodeficiencies. Recent discoveries in the field of molecular biology have contributed to the individualization of some entities, for which the determining genetic/molecular defect was found. There has also been progress in defining the immune phenotype of these patients, with the description of numerous cellular (B cells, T cells, dendritic cells) and cytokine (interleukins 2, 4, 5, 7, 12, interferon-γ) changes. The basic treatment of CVID is substitutive, with the aim of raising the seric immunoglobulin level. It still remains the objective of a more precise diagnosis of these patients and of identifying specific therapeutic modalities. [ABSTRACT FROM AUTHOR]

Children and adolescents with type 1 diabetes mellitus have an increased risk to develop other autoimmune manifestations; the most frequent is Hashimoto's thyroiditis that is the common cause of acquired hypothyroidism in children, with negative consequences on glycemic control, somatic and pubertar development. Our objective was to define the prevalence of autoimmune thyroiditis and the presence of thyroid dysfunction in these patients. Material was represented by 47 children with type 1 diabetes mellitus. Methods: clinical examination, chemiluminiscent assay of the serum level of thyroid peroxidase antibody (ATPO), thyroid-stimulating hormone, thyroid hormone levels, measurement of glycated haemoglobin and thyroid ultrasonography. Results. The prevalence of autoimmune thyroiditis was 23,4% with high predominance of female (81,8%) and the thyroid dysfunction was present in 4 patients (8,5%) who required treatment with L-thyroxin. We didn't find a relation between age at the beginning of diabetes or duration of illness and the presence of positive ATPO. Conclusions. The screening for autoimmune thyroiditis and thyroid dysfunction is necessary in all children and adolescents with type 1 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Some of the pathologic aspects of the eye can raise the suspicion of a systemic or local disease in the human body. The investigation of these aspects is important, because of the existing connection between the pathology of the immune system and the systemic clinical features. Objective. The detection of the eye complications in the autoimmune diseases and the investigation of their connection to the presence of immune markers. The study consists of a group of 83 patients, with immune disorders, hospitalized at the Rheumatology Clinic. 34 patients were extracted for the second separate study; they had been diagnosed with the rheumatoid polyarthritis. These patients had a positive rheumatoid factor and the presence of auto antibodies correlated to the presence of ocular pathology. Results. 37 patients had eye pathology and 46 had no eye pathology. Out of the 46 without eye pathology, 23 had no immune markers. Out of the 37 with eye complications, 19 had immune markers in their serum. The group of patients with rheumatoid arthritis was also examined. 17 patients had eye pathology, 17 did not present any disorders within the eye. Immune markers were found in 14 out of the 17 patients with associated eye pathology. Among the group of 17 patients without associated eye pathology, 9 had no immune markers in their serum. Discussions. χ² test - p was under 0.05 in both groups of patients, therefore, the connection between the occurent eye pathology and the presence of immune markers is statistically true. Also, odds ratio is relevant for both groups of patients (2 - for all immunitary diseases, and 5 for rheumatoid polyarthritis). Conclusions. 41 % of all the patients with rheumatic diseases were associated with eye pathology, as referred in medical literature. The monitoring of the immune markers can be used as a screening test for the appearance of the associated eye pathology. [ABSTRACT FROM AUTHOR]

Because every person is different, they'r response to aggresion is diversified, generating unidentified pathologies as ‟The fatigue sindrom„, polyalergies, autoimmune disease. At the oral's cavity level the aggresion can form because of 3 tipes of alloy: mercury, chromium, nikel, ball, cadmium, titanium which can start gingival methalosis as well as the growth of concentracion of the metal in blood. To counteract this symthoms Prof.Sami Sandhaus replaced metals with zirconium, which proved to have real qulities of immunologic biocompatibility. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) correlated with HBV infection is the 2nd cancerous death cause, after smoking. HBV increases HCC risk 200 times. Hepatocellular carcinoma associated with hepatic cirrhosis appears with an annual risk of 2-5%, but the HBV infected persons may also evolve towards HCC with an anual risk of 0,5%. (47, 48) Extrahepatic chronic diseases associated with HBV and HCV infection belong mainly to the autoimmune diseases and chronic lymphoproliferative syndromes. HBV infection prevalence to the patients with malignant non-Hodgkinian lymphoma (MNHL) ranges between 3-30%. HCV infection prevalence in patients with NHML B cell or other cronical limfoprolifertions ranges between 8-32%. [ABSTRACT FROM AUTHOR]

Background: Systemic lupus erythematosus (LES) is a multisystemic disease involving a large number of viscera. Aim: Assessment of the involvement of gastric mucos in LES patients suffering from nephropathy and renal insufficiency. Material and methods: Ten female LES patients aged 38,7±6,12 years with renal fuctional deficiency were examined. Blood ureea nitrogen (BUN), serum creatinine and gastroscopy were performed in all cases. The fragments of gastric mucosa were examined in light microscopy using hematoxiline-eosine staining. Results: Six patients were identified as having moderate renal insufficiency (BUN = 94,66±20,46 mg/dl and serum creatinine = 3,1±0,63 mg/dl) and 4 severe renal functional impairment (BUN = 161,25±17,87 mg/dl and serum creatinine = 5,65±0,42 mg/dl). All of them complained of some dyspeptic symptoms. Erosive gastritis was identified in all patients suffering from moderate renal functional defect whereas hemorrahic gastritis has been observed only in those with severe renal functional impairment. Helycobacter pylon was present in all patients. Conclusion: gastritis and Helycobacter pylon infection is a common feature of patients with lupus nephropathy. [ABSTRACT FROM AUTHOR]

Introduction: It is generally accepted that one of the most important characteristics of pathological process implicated in rheumatoid arthritis (RA) is the excessive fibroblastic proliferation. Recently, different studies have shown the implication of ceramide in apoptotic signalization and in programmed death induction in cultured synoviocytes. It is also recognized the important role of citrullination of different peptides in the pathogenesis of the disease. Material and method: We have assessed the concentration of ceramide and citrulline in synovial fluid samples collected from RA and osteoarthritic patients, using magnetic resonance spectroscopy method in order to sustain these theories. Results: The quantitative analysis of synovial fluid has shown the statistically significant increased concentration of citrulline and ceramide în RA synovial samples. Conclusion: Identification of a specific increased concentration of citrulline and ceramide could be a diagnostic marker for RA and could offer explanations regarding the complex pathogenesis of the disease. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis (OP) is more common and premature associated with rheumatoid arthritis (RA). Excessive release of cytokines and growth factors due to inflammation associated with the effect of antirheumatic therapy (mainly corticosteroids) and immobilization significantly influence total bone mass. Purpose: To evaluate the bone mineral density (BMD) and some of the risk factors for osteoporosis in RA. Methods: We evaluated BMD using quantitative ultrasound technique in 153 patients with RA and we assessed the correlation between BMD and some risk factors: disease duration and activity (scored with DAS28), functional status, menopause, therapy (corticosteroids, methotrexate). For statistical analysis we used Statisti XL, Statcrunch R 2.0.1., T-test and Pearson's product moment correlation. Results: 83% of pts had a decrease in BMD (T score < -1,5), and 63% had a T score < -2,5. Statistical analysis revealed a significant correlation between the decrease in BMD and the disease duration, functional status, corticosteroid and methotrexate therapy as well as menopause. We couldn't find any correlation with the disease activity, rheumatoid factors concentration or menopause duration in our patients. Conclusion: RA pts have an increase incidence of OP, because they associate several risk factors. OP is a major source of both disability and costs in these patients, therefore an appropriate therapy must be associated. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is an autoimmune disease with a wide spectrum of clinical involvments. Skin manifestations are polymorph: specific or non-specific. Among them bullous system lupus erythematosus is a rare, distructive blistering disorder associated with autoimmunity to type VII colagen, an anchoring fibrile between derm and epiderm. We report on a female patient 29- years-old with SLE and pituitary adenoma who developed vesiculobullous eruption. We also discuss the relation between SLE and hyperprolactinaemia. [ABSTRACT FROM AUTHOR]

The cytomegalic virus (CMV) isn't considered an infectious agent relied to the etiology of the rheumatoid polyarthritis (PR), but it has the property to modulate the immune response. The aim of this case-control study was to investigate the prevalence of the infection with CMV in PR and to correlate IgG anti-CMV titres with the TNF-alfa and IL-6 values. There is no prevalence of the CMV infection over the PR patients more than over the arthrosic ones or the general population. The number of patients with very high IgG anti-CMV titres (>10 × N) was visibly higher in the PR group than in the A group, meaning that a reactivation of the viral infection had taken place to the PR patients. The semnificative correlation between the TNF-α, IL-6 values and the IgG anti CMV titres cannot sustain a pathogenic role of these antibodies in PR, but their important growth at the PR patients in a moderate or intense state of illness may have a pathogenic relevance. [ABSTRACT FROM AUTHOR]

Aging is accompanied by immune responsiveness alterations, which lead to an increase in susceptibility to infectious diseases, a decrease in response to immunizations, and an increase in autoimmune diseases incidence (1). In this study we have evaluated the immune response of the elderly and the aging associated-inflammation status and we correlate the results with other hematological parameters, clinical status and the existing chronic diseases. We have lead a prospective study on 49 elderly patients without clinical signs of acute infections or inflammation at the beginning of the study, which have been monitored at 1 month, 3 months and 6 months. [ABSTRACT FROM AUTHOR]

Intravenous immunoglobulins (IVIg) are highly purified gammaglobulin preparations made from pooled human plasma from 3,000 to 10,000 healthy blood donors. IVIg generally contains more than 95% unmodified IgG. The clinical utility of IVIg has been enlarged during the last years from the primary immunodefi ciency syndromes to a wide variety of clinical conditions, such as infectious processes (i.e., sepsis, parvovirus B19, or HIV infection), neuroimmunological diseases (i.e.: multiple sclerosis, chronic inflammatory demyelinating polyradiculoneuropathy, Guillain-Barré syndrome, or myasthenia gravis, and in different systemic autoimmune diseases (i.e., dermatomyositis, polymyositis, systemic lupus erythematosus, ANCA vasculitis, Sjogren syndrome, systemic sclerosis, Henoch-Schonlein purpura, Behcet's disease, antiphospholipid syndrome, rheumatoid arthritis, etc). The mechanism of action of IVIg is complex and may differ between diseases and even between patients. IVIg is usually well tolerated. [ABSTRACT FROM AUTHOR]

The authors present a very rare case of a bilateral cochleovestibular syndrome in a patient with autoimmune hemolytic anemia. Vestibular rehabilitation was possible by vasodilator drug therapy, hearing rehabilitation was possible only using lip lecture and mimic gesticulation. [ABSTRACT FROM AUTHOR]