Open Access Case Study

Henoch-Schonlein Purpura Successfully Treated with Oral Steroids: A Case Report

Mohamed Eltaieb Ali, Ashraf Alakkad, Naglaa Mohamed Hamed

Asian Journal of Immunology, Page 15-19

A 38-years old male patient, documented case of Irritable Bowel Syndrome (IBS), presented to the clinic with complaints of severe central abdominal pain and severe rash. The day before presenting to the clinic, the patient went to the Emergency Department for the same complaints.

According to the patient, the abdominal pain was colicky in nature. There were no associated complaints of nausea, vomiting, or GI bleeding, but did have an upper respiratory tract infection three weeks ago, after which he had started experiencing these symptoms. His infection was treated with oral antibiotics and was soon got resolved. The staff at the ED had investigated the cause, including a CT abdomen with contrast, but the reports had been all clear. He had mildly raised serum creatinine at that time.

On clinical examination, the patient had severe tenderness in his abdominal region. The rash was extensive, reddish, raised, and purpuric in nature and had spread all over his lower limbs and hips on both sides. The upper limbs were also involved up to the forearms.

All the lab investigations conducted on the patient were normal, including CBC, Creatinine, Serum C3, C4, and the rheumatoid factor. CRP was found to be elevated and positive occult blood was seen in the stool of the patient.

The combination of the above medical symptoms and investigations revealed that the patient was suffering from abdominal angina. The symptoms had a classic presentation pattern: positive occult blood in stool, a purpuric rash, abdominal pain, and renal involvement that was preceded by a documented case of upper respiratory tract infection (URTI).

Later, the patient was found to have all findings consistent with immune-mediated IgA vasculitis (Henoch Schonlein Purpura) and was then treated accordingly.

The above-mentioned case was an interesting presentation: the condition is not often presented to the hospital with such clear manifestations, leading to an absolute diagnosis. The following sections of this case study will explore how the patient was diagnosed, treated, and managed accordingly to save his life.

Open Access Original Research Article

Overweight and Obesity in Saudi Patients with Schizophrenia Affects Cholesterol Concentration and Some Immune System Cells

Sawsan Hassan Mahassni, Razan Ahmed Alyoubi

Asian Journal of Immunology, Page 1-14

Introduction: Schizophrenia (SZ), a prevalent and highly debilitating mental disease, is associated with high rates of overweight and obesity and effects on different systems of the body including the immune system. There are very few studies worldwide on weight measured by the body mass index (BMI) in patients with SZ and its effect on blood parameters, while there are no such studies in Saudi Arabia.

Aims: This study is the first to determine the effects of weight, measured by the BMI, on the differential complete blood count in patients with SZ. Additionally, the serum lipid profile was determined.

Methodology: Blood samples were collected from 45 randomly chosen male inpatients with SZ with an age range of 28-47 years and a mean age of 37 years.

Results: BMI categorization of the patients showed that 6.7% were underweight, 53.3% were healthy, 24.4% were overweight, and 15.6% were obese. Compared with the healthy BMI, significantly lower cholesterol levels and neutrophil counts were found for the overweight BMI group, while significantly higher cholesterol levels and monocyte percents were found for the obese BMI group.

Conclusion: Most subjects had a healthy BMI while overweight and obese subjects showed effects on cholesterol levels and counts of innate immune system cells.

Open Access Original Research Article

Fresh Raffia Palm Wine, Fermented Soya Bean Milk Supplementation, Enzymatic Antioxidant and Lipid Peroxidation Biomarkers in Lactating Female Wistar Rats

Forwah Jacques Ndeh, Ebot Walter Ojong, Uwem Okon Akpan, Immaculate Ihuoma Ekeagba

Asian Journal of Immunology, Page 20-29

Aim: Lactation is the most crucial period characterized by intensive caloric requirements to boast up female’s nutritive system and breastfeeding life. Current study evaluated the effects of fermented soya bean milk (FSBM) and fresh palm wine (FPW) supplements on endogenous antioxidant enzymes activities and lipid peroxidation biomarker in thirty five (35) lactating Wistars rats.  

Methods: Animals were obtained from the Experimental Research Animal House of University of Calabar, Nigeria. At parturition, the animals were randomly divided into five groups containing five (5) rats (n=5). Oral treatment done as follow: Group I: Control group, was given normal feed of protein content 20mg/kg and distilled water (1 ml/kg), Group II: Metoclopramide (5 mg/kg), Group III: 10ml /kg of FPW. Group IV: Three (3) sub-groups of group four (4) received 10%, 20% and 40% of FSBM respectively, Group V: Co-administration of 40% FSBM plus FPW (10ml /kg) supplements .Treatment was done every six hour daily for a duration of ten (10) days.

Results: Serum malondialdehyde concentration, a biomarker of Lipid peroxidation was significantly increased (P < 0.05) in metoclopramide treated group than control group, FSBM and FPW supplemented groups. There was a significant decrease (P < 0.05) in serum activities of four endogenous antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase) in metoclopramide treated group when compared to control group, FSBM and FPW supplemented groups.

Conclusion: while fermented soya bean milk and fresh palm wine supplementation increased lactation and endogenous enzymatic antioxidant activities without lipid peroxidation, Metoclopramide at 5 mg/kg concentration increased lactation with lipid peroxidation.

Open Access Original Research Article

Molecular Detection and Sequencing of Rotavirus VP4 among Children Aged 0-5 Years with Gastroenteritis in 2 Selected Healthcare Centres in Keffi, Nigeria

I. Ibrahim, R. U. Usman, H. I. Mohammed, D. Ishaleku, A. B. Shuaibu

Asian Journal of Immunology, Page 30-40

Aims: This study was conducted to detect and sequence Rotavirus VP4 among children aged 0-5 years with gastroenteritis in 2 selected healthcare centres in Keffi, Nigeria.

Study Design: The study was a cross sectional study.

Place and Duration of Study: Keffi, Nasarawa State, between March and June 2019.

Methodology: Stool samples were collected from 303 (203 from FMC Keffi and 100 from PHC Angwan Waje, Keffi) children with gastroenteritis and information about them were obtained by structured questionnaires. All collected samples were screened for the presence of Rotavirus antigen using Aria Rotavirus antigen detection test kit (CTK Biotech, Inc, San Diego, USA). VP4 was detected from Rotavirus positive samples by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) using specific primers. The sequences of the amplified VP4 genes were verified using MEGA software version 7 and Rotavirus strains were determined by pasting the FASTA (Text based format for representing nucleotide sequence) format into the Basic Local alignment Search Tool (BLAST) from the National Center for Biotechnology Information (NCBI). Data collected were analysed using Smith’s Statistical Package (version 2.8, California, USA) and P value of ≤ 0.05 was considered statistically significant.

Results: Of the 303 children screened, 54(17.8%) were positive for Rotavirus infection. Highest prevalence of the viral infection was recorded among males (19.7%) aged 0-12 months (24.8%). Gender was found to be associated with rate of Rotavirus infection in this study (P<0.05). However, age was not significantly associated with the viral infection (P>0.05). Furthermore, based on the RT-PCR carried out, 3(5.6%) out of the 54 Rotavirus positive samples were positive for the VP4 gene and sequences of this gene were all found to be of type P [11] Strain N115.

Conclusion: This study reveals the presence of infection with type P [11] Strain N115 (5.6%) of Rotavirus in the study population. The detection of this rare rotavirus strain in this study is a cause for concern and hence there is an urgent need for the Nigerian health authorities to implement a nationwide surveillance system for monitoring rotavirus molecular epidemiology.

Open Access Original Research Article

Prevalence and Classes of SARS-CoV-2 Antibodies among COVID-19 Suspected Patients who Attended a Health Care Setting in Sana’a, Yemen

Talal A. Sallam, Mokhtar Al-Youssefi, Amen A Bawazir

Asian Journal of Immunology, Page 41-48

Aims: This study investigates SARSCoV-2 antibody prevalence and classes among COVID-19 suspected patients in Sana’a, Yemen. Antibody response to SARS-CoV-2 infection remains to be fully elucidated. Currently, no reports on SARS-CoV-2 antibody response from Yemen are available. Study Design: This cross-sectional study investigates SARS-CoV-2 antibody prevalence and classes among COVID-19 suspected patients. Place and Duration of Study: This study was conducted in Sana’a the capital of the Republic of Yemen from June 2020 through January 2021. Methodology: Serological investigation for Anti-SARS-CoV-2 antibody tests was conducted for 259 suspected COVID-19 patients who attended a health care facility for antibody testing to confirm the diagnosis on C. Results: The mean age was 40.8 ±16.6 years. Of all subjects, 180 (69.5%) were males and 79 (30.5%) were females, 73% were < 50 years of age. A total of 133 (51.4%) had at least one anti-SARS-CoV-2 antibody class, 6 (2.3%) had isolated IgM, 80 (30.9%) had concomitant IgM and IgG and 49 (18.9%) had isolated IgG. Only the seropositivity of isolated anti-SARS-CoV-2 IgG significantly (p=0.002) differs among various age groups. There was a significantly higher (p=0.017) IgM seropositivity among females than among males. Conclusions: Among subjects with suspected COVID-19, > 30% had concomitant IgM and IgG with a minority having isolated IgM or IgG suggesting concurrent or close seroconversion time of both antibody classes. In addition, around 50% of subjects were SARS-CoV-2 seropositive suggestion low SARS-CoV-2 seroconversion and consequently low community seroprevalence. An antibody dynamic study based on will characteristics of COVID-19 patients is required. Also, a community-based seroprevalence study based on the detection of a combination of IgM, IgG, and IgA remains essential to determine the prevalence of SARS-CoV-2 infection in Yemen.