Iranian Journal of Allergy, Asthma and Immunology
Volume:5 Issue: 3, Sep 2006

Sulfur mustard has been employed in chemical warfare in certain regions including Iran. The short and long term biological effects of sulfur mustard contamination have been studied in both basic and clinical aspects. Sulfur mustard has been shown to induce a vast array of pathological effects in affected persons. In addition to skin, lung, eyes and gastrointestinal disturbances, sulfur mustard has been shown to induce hematological complications and a severe suppression of the immune system. The short and long term immunological (both cellular and humoral), hematological, genetic and biochemical consequences of persons exposed to sulfur mustard are extensively reviewed here. The long term complications of these patients indicate the need to develop effective preventive and therapeutic strategies in the clinic. These strategies may be based upon immunopotentiating intervention and therapy.

Idiopathic Chronic Urticaria (ICU), the most common form (70-80%) of chronic urticaria is supposed to have immune basis causes. It is speculated that the promoter polymorphism of TGF-β1 gene may be involved in ICU. This condition is thought to affect at least 0.1% of the population and often can be severe and difficult to treat.A total of 40 patients with ICU and 41 normal subjects were studied. DNA was extracted from whole blood and TGF-β1 promoter –509C>T polymorphism was determined by PCR-RFLP method.Out of the 40 patients with ICU, 11 (27.5%) had CC, 26 (65%) had CT and 3 (7.5%) had TT genotypes. A higher proportion of case subjects with the C allele (CT type or CC type) was found compared with the T allele.These results do suggest an influence of genetic variability at the promoter of TGF-β1 gene (-509C>T) on the occurrence of ICU. This polymorphism has been shown as a useful genetic change in our study. Further work is required to confirm this result.

Previous studies have demonstrated some significant differences in HLA allele frequencies in leukemic patients and normal subjects. We have analyzed HLA class II alleles and haplotypes in 60 Iranian patients with acute myelogenous leukemia (AML) and 180 unrelated normal subjects. Blood samples were collected after obtaining informed consents. From the patients and control DNA extraction and HLA typing were performed using PCR-SSP method. Significant positive association with the disease was found for HLA-DRB1*11 allele (35% vs. 24.7%, p=0.033). Two alleles including HLA-DRB4 and –DQB1*0303 were found to be significantly decreased in patients compared to controls. Regarding haplotype analysis, no significant association was found between case and control groups. It is suggested that HLA-DRB1*11 allele plays as a presumptive predisposing factor while the HLA-DRB4 and –DQB1*0303 alleles are suggested as protective genetic factors against acute myelogenous leukemia. Larger studies are needed to confirm and establish the role of these associations with acute myelogenous leukemia.

Primary immunodeficiency diseases (PIDs) are rare but include severe conditions found predominantly in children, Most PIDs have cutaneous manifestations that may be important as early diagnostic features.The purpose of this study was to determine the frequency and nature of cutaneous alterations associated with PIDs. This article is a cross-sectional study at the department of allergy and clinical immunology of children’s medical center conducted between December 5, 2001 and April 20, 2002. The subjects included pediatric patients with a diagnosis of PID and dermatological diagnoses were made by a dermatologist. Two hundred and ten patients were studied They consisted of 68 cases of humoral deficiency, 22 cases of cellular and combined deficiencies, 57 cases of phagocytic defects and 63 cases of other PIDs. In 67 cases (31.8%) the cutaneous alterations preceded and were the basis for clinical immunological diagnosis. Overall cutaneous alterations were infections in 99 cases and eczematous dermatitis in 27 cases. Our findings support the results of other studies that most PIDs have cutaneous features which being their typical aspects are highly suggestive for the diagnosis of PIDs.

Snoring can occur alone or it may be the presenting feature of Obstructive Sleep Apnea and other common chronic conditions. In our study, we aimed to estimate the prevalence and correlates of snoring in adolescent students in Tehran, Iran.A cross-sectional study was designed and students were selected from 20 secondary and high schools, in 5 different zones in Tehran in order to have a representative sample of the adolescent population. A total of 2900 students (1200 male and 1700 female students) 11-17 year-old who were attending secondary and high schools were investigated. Information was collected via a structured face-to-face interview, based on a questionnaire. In addition to snoring, nocturnal cough, asthma-related symptoms, and daytime symptoms were also questioned. BMI was measured by two trained physicians. The prevalence of snoring was 7.9% (4.8% in girls and 12.4% in boys). The prevalence of snoring was significantly higher among males (P< 0.05). Snoring was positively associated with asthma and nocturnal cough. Overweight/obese adolescents had significantly higher rates of snoring and asthma symptoms. Prevalence of daytime symptoms increased significantly in the snoring group.These results suggest that snoring is associated with multiple factors in adolescents. We conclude that the prevalence of snoring is relatively high in children of this region. This highlights the need for awareness among physicians about the problem of sleep-disordered breathing, especially in children with asthma and obesity, and also the need for further studies to measure the prevalence of sleep breathing disorders among Iranians.

The Calmette-Güerin vaccine (BCG) is administered to all the newborns in Iran in order to prevent tuberculosis. Complications of this vaccine are uncommon. We report disseminated BCG disease in 17 patients less than 10 years old.This is a retrospective study of total of 17 cases who were admitted in Children Medical Center Hospital with systemic syndrome compatible with Mycobacterium disease with evidence of histopathologic demonstration of acid-fast bacilli during 1995-2004.Fourteen cases occurred in children younger than 1 year old. Nine patients were female. Ten of the 17 total cases were associated with an immune deficiency including severe combined immunodeficiency, chronic granulomatous disease and cell mediated immune defect. Response to therapy was ineffective and 10 of them (58.8%) died.Disseminated BCG disease is an uncommon but devastating complication of vaccination that should be considered in the appropriate clinical setting. Immune-compromised infants are at greatest risk and they respond poorly to standard therapies.

Asthma and Cystic Fibrosis (CF) have some identical manifestations. In the present study, the frequency of positive sweat test was assessed in asthmatic children. This cross-sectional study was performed in asthmatic children, who were referred to Bahrami Children Hospital, Tehran, during July 2003 to July 2005. Sweat test was performed for all children. One hundred and thirty five (95 males and 40 females) asthmatic were studied. Sweat test was positive in 35 (26%) patients. Major signs and symptoms among these 35 patients were: Cough (35/35), Dyspnea (7/35), Chronic Diarrhea (6/35), and steatorrhea (1/35). Failure to thrive was found in 31 of 35 patients. The mean duration of asthma in patients with positive test was 49.3 months, which was significantly higher than 18.1 months in the group with negative test (P=0.001). Significant relations between recurrent respiratory tract infections (P=0.029), chronic diarrhea (P=0.001), failure to thrive (P=0.0001), and positive sweat test were found. Sweat test should be recommended in asthmatic children with recurrent upper respiratory tract infections, long duration of asthma, chronic diarrhea, and failure to thrive.

In this case report we will describe a rare association between anhyrotic ectodermal dysplasia (AED) and immunodeficiency and autoimmunity [in our case: Idiopathic Thrombocytopenic Purpura (ITP) and Crohn disease]. AED is a rare congenital disorder characterized by sparse hair, abnormal teeth and anhidrosis due to lack of eccrine glands. The survey of 87 cases with (AED) revealed only one Irritable Bowel Disease (IBD). AED has only two relevancies with immunodeficiency: (EDA-ID: Ectodermal Dysplasia Anhyrotic with Immunodeficiency) and APE-CED (Autoimmune polyendocrinopathy, Candidiasis and Ectodermal Dysplasia) that in our case EDA-ID is strongly suspected.