Search

Purpose: Anorexia nervosa (AN) is a serious and complex mental disorder affecting mainly young adult women. AN patients are characterized by low body weight in combination with self-induced starvation, intense fear of gaining weight, and distortion of body image. AN is a multifactorial disease, linked by recent evidence to a dysregulation of the immune system., Methods: In this pilot study, 22 blood serums from AN patients were tested for the presence of autoantibodies against primate hypothalamic periventricular neurons by immunofluorescence and by a home-made ELISA assay. Cellular fluorescence suggests the presence of autoantibodies which are able to recognize these neurons (both to body cell and fiber levels). By means of ELISA, these autoantibodies are quantitatively evaluated. In addition, orexigenic and anorexigenic molecules were measured by ELISA. As control, 18 blood serums from healthy age matched woman were analysed., Results: All AN patients showed a reactivity against hypothalamic neurons both by immunofluorescence and ELISA. In addition, ghrelin, pro-opiomelanocortin (POMC), and agouti-related peptide (AGRP) were significantly higher than in control serums (p < 0.0001). In contrast, leptin was significantly lower in AN patients than controls (p < 0.0001)., Conclusions: Immunoreaction and ELISA assays on AN blood serum suggest the presence of autoantibodies AN related. However, it is not easy to determine the action of these antibodies in vivo: they could interact with specific ligands expressed by hypothalamic cells preventing their physiological role, however, it is also possible that they could induce an aspecific stimulation in the target cells leading to an increased secretion of anorexigenic molecules. Further studies are needed to fully understand the involvement of the immune system in AN pathogenesis., Level of Evidence: V, descriptive study., (© 2022. The Author(s).)

Background: Adverse cutaneous drug reactions (ACDR) are unexpected cutaneous changes occurring at drug dosages that are normally used for disease prophylaxis, diagnosis or treatment., Objective: The aim of the study was to determine the clinical types of ACDR, the causative agents, the latency time between drug intake and onset of ACDR and the recovery time in an outpatient population., Method: Ninety-five patients diagnosed with ACDR at the Department of Dermatology of the University of Genoa between 2003 and 2012 were retrospectively studied., Results: Antimicrobials, especially cephalosporins, were the most responsible for ACDR, followed by non-steroidal anti-inflammatory drugs and antihypertensives. The most common clinical manifestations were exanthema (42.1%), erythema multiforme (10.53%) and vasculitis (9.53%). Patients with peripheral eosinophilia showed a more severe clinical manifestation, they were treated with systemic therapies and their recovery time was longer., Conclusion: It is important to have an appropriate clinical approach according to the ACDR severity degree. We think that eosinophilia may characterise severe cutaneous eruptions and that it should always be investigated when ACDR is suspected in order to manage the patient with the appropriate treatment.