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Background: Alloimmunization is an immune response against foreign antigens which introduced into the body through transfusion, pregnancy, or transplantation. This phenomenon is a big challenge in patients, which require regular transfusions. In the current study, we tried to have a comprehensive review on the status of alloimmunization in Iran. For this purpose, we searched for papers investigating alloimmunization in transfusion-dependent patients and also in patients with no regular transfusions who are candidate for surgery or who need blood. Methods: We searched PubMed, Google Scholar, SID, and MAGIRAN databases using the following keywords: "blood transfusion," "alloimmunization," "alloantibodies," "irregular antibodies," "red cell antibodies," and "Iran." No limitation for the date of publication and language of the papers was defined. All the identified records were then screened for the relevance and duplication. Results: A total of 22 papers were included in this study. All of the studies were conducted from 1999 to 2016 and providing alloimmunization data from different cities all over of Iran. In general, the results showed that the most prevalent alloantibodies are anti-Kell (anti-K antigen) and anti-Rh system, mainly anti-E, anti-D, anti-C, and anti-c. Conclusion: Anti-Kell and anti-Rh antibodies are the most prevalent antibodies responsible for alloimmunization in Iranian population. [ABSTRACT FROM AUTHOR]

Parvovirus B19 has been identified to infect pregnant women and cause anemia, spontaneous abortion, and fetal death. Given the significance of parvovirus B19 complications, this study aims to determine the seroprevalence and geographical distribution of parvovirus B19 antibodies in pregnant women to improve health control policies in the community. Online international databases and national Persian databases were used to define appropriate studies published between 2000 and January 2021. The quality of all papers was determined by a Newcastle-Ottawa Scale (NOS) checklist. The statistical analyses were performed using the Stata version 11 package (StataCorp, College Station, TX, USA) software. Heterogeneity among the primary studies was calculated using Cochran's Q-test and I2 index. The Egger test and the funnel plot chart with a significance level of less than 0.1 were used to evaluate the publishing bias. The seroprevalence of parvovirus B19 IgG antibodies among pregnant and non-pregnant women in Iran was assessed in 12 primary studies. Our finding showed that the seroprevalence of parvovirus B19 IgG antibodies among pregnant women varies from 21% to 76%. Combining the results of 5 primary studies based on the random effect model, the seroprevalence of parvovirus B19 IgG antibody among pregnant women in Iran was estimated to be 54% (95% CI:33–76). The seroprevalence of parvovirus B19 IgM antibodies has been reported in 9 studies. By combining the results of these studies using a random effect model, the seroprevalence of parvovirus B19 IgM antibody among pregnant women was estimated to be 3% (95% CI: 1–6). Generally, it is suggested that appropriate screening programs should be performed for the treatment and prevention of diseases. According to this point, the prevalence of parvovirus B19 is low among pregnant women, but it can cause serious manifestations such as hydrops fetalis and severe anemia, therefore, antibody determination using ELISA can be recommended for all pregnant women. [ABSTRACT FROM AUTHOR]

Background: Seroprevalence of Cytomegalovirus infection varies between 40% and 100% worldwide. Different studies carried out in Iran indicate this variation in this country. It is important to estimate the total infection prevalence using a reliable method such as meta- analysis in order to be applied by policymakers. This study aims to estimate the IgG and IgM seroprevalences of CMV infection among Iranian women and neonates. Method: We selected eligible articles for final meta- analysis by searching the national and international databases, excluding duplicates and irrelevant papers from primarily identified studies after abstract/full text review, implementing exclusion/inclusion criteria and quality assessment. Standard error of the prevalence was calculated according to binomial distribution formula. Based on the degree of heterogeneity, fixed or random effects models were applied for estimating the pooled prevalences. Results: In this study, 16 papers providing 20 evidences of CMV prevalence in Iran entered in the meta-analysis. CMV IgG and IgM seroprevalences as well as primary infection rate (95% confidence interval) among pregnant women were 92.8% (90.6 - 94.9), 6.4% (2.8 - 9.9) and 1.1% (0.7 - 1.5) respectively. CMV IgM seroprevalence among neonates were 0.6% (0.09 - 1.2), while CMV IgG and CMV IgM seroprevalences among non-pregnant women were 78.4% (70 - 86.8) and 4.6% (1.5 - 7.6) respectively. Conclusions: This meta- analysis showed that the prevalence of CMV infection among studied population is relatively high. Therefore, mortality, complications, anomalies and injuriesamongfetuses, neonates and immunocompromized patients can be partially related to the CMV infection. [ABSTRACT FROM AUTHOR]

Objectives: To generate synthesized information on the epidemiology of VZV infection, as well as an estimation of prevalence of age-specific antibody in Iranian less than 40. Material and Methods: After exclusion of irrelevant and overlapping reports, 15 papers were included (from nine major cities). Studies were pooled according to the heterogeneity test results. Random effect model methods were used for metaanalysis where significant heterogeneity was observed (age 1-16years ).For other age groups, fixed model were used. Results: Significant heterogeneity was observed in prevalence rates of all childhood age-groups. The seropositivity prevalence increased steeply from the age of 1-5 to 6-10 [from 21.9% (95% CI; 10.8-33.1) to 42.1 %(95% CI; 33.6-50.6)]. At the age of 11-15, 59.4% (95% CI; 46.1-72.8) of children showed to be infected. The rate of seropositivity was more than 87% in individuals of 40 and older. Conclusion: The varicella seroeprevalence in Iran is in accordance with average tropical and temperate areas. Comparison of conducted studies during 2003 to 2011 didn't show any alteration in VZV seroprovalence in Iran. [ABSTRACT FROM AUTHOR]

Background: Sharing of injecting paraphernalia is known to contribute to hepatitis C virus (HCV) transmission amongst people who inject drugs. Objectives: In this paper, we identify the variables correlated with paraphernalia sharing among male drug injectors in Kermanshah city, western Iran. Methods: We enrolled 606 male drug injectors using snowball sampling in a cross-sectional study. Serological testing for HCV, HIV and HBV infections were performed after the completion of a bio-behavioral questionnaire. To identify variables associated with paraphernalia sharing, logistic regression analysis was completed. Results: The respondents were aged 18–65 years (mean±SD age of 36.7 ± 8.5). Approximately half of those surveyed (55.3% 335 individuals) reported sharing of injecting paraphernalia in the month prior to interview. Serological testing showed 54.8% (CI 50.8–58.7%), 6.4% (4.4–8.3%) and 2.9% (1.6–4.3%) positive result for HCV antibody, HIV antibody and HBs-Antigen, respectively. Being unemployed P <.001, single P <.001, having a history of drug overdose P <.001, having a previous positive HCV test P <.001, less than weekly attendance to needle/syringe programs P <.001and alcohol consumption P <.001 were all significant in the final model. Conclusions: With over half the participants reporting injecting paraphernalia sharing, providing more accessible harm reduction programs together with HCV testing and treatment programs may help to reduce the transmission of HCV among networks of drug injectors in Kermanshah city. [ABSTRACT FROM AUTHOR]

Background: Q fever is endemic in Iran, thus, we conducted a systematic review and meta-analysis on epidemiology of Coxiella burnetii among humans and animals in Iran. Materials and Methods: A systematic search was performed to identify all articles reporting C. burnetii prevalence in Iranian humans or animals, published from January 2000 to January 2015. Data from articles were extracted, and a pooled estimate of prevalence with corresponding 95% confidence interval (CI) was calculated using random effect method. Results: In this review, 27 papers were identified. The pooled seroprevalence of Q fever in animals was 27% (CI 95%: 23%-32%). The prevalence was 33% (CI 95%: 22%-45%) in goats, 27% (CI 95%: 21%-32%) in sheep, and 17% (CI 95%: 5%-28%) in cattle. The bacterial DNA was detected in 5% (95% CI: 3%-9%) of milk samples, and it was higher in cattle (10%; 95% CI: 6%-16%) than sheep (2%; 95% CI: 0-7%) and goats (4%; 95% CI: 0-12%). Conclusion: C. burnetii DNA or its antibody has been frequently detected among ruminants. Since these animals can transmit the infection to humans, Q fever could be a potential health problem in Iran. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is prone to opportunistic infections, including toxoplasmosis, due to an immunodeficiency system. This study aimed to evaluate the serum of people with T2DM to determine the titer of anti-toxoplasma antibodies in patients and compare it with the control group. Materials and Methods: 720 blood samples have been carried out between October and the end of January 2017 in Sistan, and Baluchestan provinces in southeastern Iran, of these, 360 samples were related to healthy individuals (control), and 360 samples were related to T2DM individuals. The immunoglobulin (Ig) M and IgG enzyme-linked immunosorbent assay methods have been used to detect toxoplasmosis. The data were analyzed using SPSS-19, Chi-square, and Fisher's exact test to compare statistical parameters. Results: In this cross-sectional study, out of 360 samples of T2DM by ELISA method, 60% samples in diabetic patients and 48.1% in control group were IgG positive (P < 0.05). Nearly 2.5% samples in diabetic patients and 0.3% in control group were IgM positive (P < 0.05). Conclusion: Anti-toxoplasma antibodies including IgG and IgM were higher in diabetic patient in comparison to control group. [ABSTRACT FROM AUTHOR]

Background: Rubella and measles are two highly contagious viral childhood diseases. However, the high possibility of brutal effects of both microorganisms during pregnancy has kept them emerging as a major public health issue. The current study aimed to investigate the seroprevalence of rubella and measles among 15–25‐year‐old females in southwest Iran. Method: This descriptive study was performed in Jahrom, southern west Iran during 2012. Serum samples from female individuals with an age of 15–25 years visiting main laboratories in our study location were collected and evaluated by a commercial ELISA kit for anti‐rubella and measles IgG antibodies. Results: Among the 179 participants, regarding anti‐rubella antibodies, 171 (95.0%) were positive, 3 (1.7%) were negative, and 6 (3.3%) were borderline. Regarding anti‐measles antibodies, 166 (92.2%) of the subjects were positive, 1 (5.6%) was negative, and 13 (17.2%) were borderline. By assuming a positive value for the borderline cases, the ultimate findings demonstrated that 98.3% and 99.4% of the participants were immune against rubella and measles, respectively. There was no statistically significant association between measles and rubella immunity with age or the use of immunosuppressor medication. Conclusion: Implementation of vaccine program has obtained significant immunity level in inhabitants, particularly women of childbearing age who play a more important role in herd immunity. Therefore, maintaining the national immune screening against rubella and measles is needed to take into consideration to maintain the current satisfactory level of immunization. [ABSTRACT FROM AUTHOR]

Background: Gluten sensitivity (GS) is one of the gluten-related disorders (GRDs). Patients with GS may have serum antibodies against tissue transglutaminase (tTG) (IgA and IgG) without any evidence of enteropathy. We aimed to evaluate both tTG-6 and tTG-2 antibodies to determine the prevalence of seropositive tTG-2 and tTG-6 antibodies in patients with multiple sclerosis (MS). Methods: In this cross-sectional study, we carried out serological tests (IgA & IgG anti-tTG-6 and tTG-2 antibodies) in patients with MS. Results: Seventy-two patients with MS were included in this study. Of them, seropositive patients for total (IgA + IgG) of tTG-6 and tTG-2 autoantibodies were 9.7% (95% CI, 4.2-18) and 5.6% (95% CI, 1.4-12.5), respectively. Conclusion: Anti-tTG-6 antibody testing may be necessary for early diagnosis of GS in patients with MS. More studies with larger sample sizes are warranted to confirm these data. [ABSTRACT FROM AUTHOR]

Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor-associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet's and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry. [ABSTRACT FROM AUTHOR]

Background: Despite a lot of efforts made in the rabies health care system, Iran is still in an endemic region and millions are spent annually to prevent rabies. Materials and Methods: Searching in national and international databases has been performed. The preferred reporting items for systematic reviews and meta analyses protocol were followed. To assess heterogeneity, the I index was calculated. In addition, sensitivity analysis was performed by the remove one method. The publication bias was also investigated by Egger's regression test, and the trim and fill method. To perform a meta analysis, CMA version 2 software was used. Results: Totally, 33 studies with 250,980 animal bite cases were meta analyzed. A summary estimate of the incidence of 1200 per 100,000 population (95% CI 1000, 1500) with a mean age of 29.97±15.13years (95%CI: 29.33, 30.61) was estimated. The rate in men was higher 76.7% (95%CI 74.7%, 78.8%) than in women and in the rural 49.7% (95%CI: 42.8%, 58.6%) was equal in the urban. Most bites occurred in the spring and summer 20.5% (95%CI: 16.1%, 25.9%). The highest of job related bites was in students 20.1% (95%CI: 19%, 23%). The highest rate of bite location and the animal type were estimated in the order of lower limbs and by dogs respectively. The rate of complete vaccination 61% (95%CI: 43%, 76%) and immunoglobulin injection 39% (95%CI: 22%, 59%), were estimated respectively. Conclusion: Estimates reveal that there has been little change in the animal bites over the years. It is necessary to take special actions to control the disease at the national and international levels. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate the association between acute cardiac injury (ACI) and outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19) in Iran. Methods: The current cohort study enrolled all consecutive hospitalized patients with COVID-19 (≥ 18 y) who had serum high-sensitivity cardiac troponin-I (hs-cTnT) measurements on admission between March 2020 and March 2021. ACI was determined as hs-cTnT levels exceeding the 99th percentile of normal values. Data on demographics, comorbidities, clinical and laboratory characteristics, and outcomes were collected from Web-based electronic health records. Results: The study population consisted of 1413 hospitalized patients with COVID-19, of whom 319 patients (22.58%) presented with ACI. The patients with ACI had a significantly higher mortality rate than those without ACI (48.28% vs 15.63%; P<0.001) within a mean follow-up of 218.86 days from symptom onset. ACI on admission was independently associated with mortality (HR, 1.44; P=0.018). In multivariable logistic regression, age (OR, 1.034; P<0.001), preexisting cardiac disease (OR, 1.49; P=0.035), preexisting malignancy (OR, 2.01; P=0.030), oxygen saturation reduced to less than 90% (OR, 2.15; P<0.001), leukocytosis (OR, 1.45; P=0.043), lymphopenia (OR, 1.49; P=0.020), reduced estimated glomerular filtration rates (eGFRs) (OR, 0.99; P=0.008), and treatment with intravenous immunoglobulin during hospitalization (OR, 4.03; P=0.006) were independently associated with ACI development. Conclusion: ACI occurrence on admission was associated with long-term mortality in our hospitalized patients with COVID-19. The finding further underscores the significance of evaluating ACI occurrence on admission, particularly in individuals more prone to ACI, including older individuals and those with preexisting comorbidities, reduced oxygen saturation, and increased inflammatory responses. [ABSTRACT FROM AUTHOR]

Background: Some evidence reveled that chronic infection with Toxoplasma gondii (T. gondii) has recently been associated with infertility in human and experimental model. This baseline study aimed to investigate serological evidence of Toxoplasma infection among infertile women who admitted to the in vitro fertilization (IVF) clinic at Imam Khomeini Hospital, Mazandaran province, Sari, northern Iran. Subjects and Methods: In this retrospective (descriptive-analytical) study, all infertile women referred to the IVF clinic during 2010–2019 (10 years), constitute the study population. All data including demographic and some related characteristics were collected into a questionnaire and registered at the Iranian National Registry Center for Toxoplasmosis (INRCT) at the Mazandaran University of Medical Sciences, northern Iran. The existence of anti-Toxoplasma antibodies (IgG and IgM) was explored using a commercially available enzyme-linked immune sorbent assay (ELISA) kit (PishtazTeb, Iran), based on the manufacturer's protocol. Results: Of 520 infertile women, anti-T. gondii IgG, IgM and both IgG and IgM antibodies were detected among 342/520 (65.77%), 1/520 (0.19) and 4/520 (0.77) infertile women, respectively. Primary and secondary infertility was detected in 74.56% and 25.44% of IgG seropositive infertile women, respectively. Also, most of the IgG seropositive subjects had no history of abortion, polycystic ovary syndrome (PCO), fibroma, contraceptive use and varicocele in spouse as primary cause of infertility. Furthermore, serum levels of prolactin and antimullerian (AMH) hormones were normal in 81.29 and 80.12% of infertile women with anti- T. gondii IgG, respectively. There was also a statistically significant difference between the seroprevalence of Toxoplasma infection and these variables associated to primary infertility (P < 0.05). Conclusion: According to the high prevalence (about two thirds) of chronic T. gondii infection among infertile women, particularly those with a history of abortion and primary infertility, it can be concluded that latent Toxoplasma infection pose a risk to infertile woman in the study area. Therefore, we advise that screening and treatment of Toxoplasma infection among infertile women must be favorably considered. [ABSTRACT FROM AUTHOR]

Background: Maternally derived antibodies (MDA) have protection against canine distemper virus (CDV) in the first weeks of puppies' life. However, MDA decreases with age. The most important and effective factor on immunization is timely vaccination. But in recent years, there were some outbreaks of CDV among puppies in Iran and this problem could be related to vaccine failure. Objectives: The aim of this study is to evaluate the possible effect of MDA titre on vaccines against CDV and the efficacy of two commercial vaccines by using the enzyme‐linked immunosorbent assay (ELISA). Methods: In this regard, 24 healthy 8‐week old terrier puppies were selected and divided into three identical groups based on a randomized, double‐blind comparative trial. The control group was injected normal saline, and group A was vaccinated by the vaccine namely Biocan L (Bioveta, Czech Republic), and the group B was vaccinated by the other vaccine called Duramune Max 5 + LCI/GP (Fort Dodge Animal Health, USA). The vaccines were used for the puppies between 8 and 16 weeks of age and in every 4 weeks. Results: The results showed that the response of both vaccines was satisfactory, and no significant difference was observed between them. Moreover, the MDA in the control group reached an unprotective level in all puppies prior to their 14 weeks of age. In the vaccinated groups, after the second vaccine, all puppies in both groups reached protective levels. Discussion: This is the first study on evaluation of two commercial vaccines in changes of serum antibody titres against distemper in puppies in Iran. Conclusion: It is recommended that veterinarians during consulting use the ELISA to measure antibody titres to optimize the vaccination schedule and reduce the cost of vaccination failure. This is of paramount importance for puppies. [ABSTRACT FROM AUTHOR]

Background: The present study was designed to determine the prevalence of Toxoplasma gondii seronegative pregnant women, estimate the frequency of fetuses at risk of congenital toxoplasmosis in the study area, and also to investigate the awareness of the studied mothers about T. gondii disease. Methods: A total of 740 pregnant women referred to two health centers in Qazvin province were surveyed voluntarily for anti-T. gondii IgG and IgM antibodies by enzyme-linked immunosorbent assay (ELISA). IgG avidity test was used as a confirmatory test for samples showing positive or borderline results for IgM antibodies. Data on socioeconomic, demographic, and knowledge of participants about toxoplasmosis were collected using questionnaires and through face-to-face interviews. Multivariable logistic regression modeling was used to identify the potential predictor variables for T. gondii infection. Results: Overall, 21.2% (157/740) and 0.27% (2/740) of pregnant women were positive for T. gondii IgG and IgM antibodies, respectively. Only 1.7% (13/740) of expectant mothers had prior information on toxoplasmosis. Among socioeconomic and demographic variables, contact with soil was the merely cause of a significant association with T. gondii infection. Other variables including age, occupation, education level, residential area, source of drinking water, abortion history, number of delivery, consumption of raw/undercooked meat, having home cat and and consumption of raw vegetables failed to establish significant associations. Conclusion: Our results clarified that the prevalence of T. gondii has remarkably reduced in the study area. This finding indicates a low risk of congenital toxoplasmosis in this region. [ABSTRACT FROM AUTHOR]

Background: Detection of Leishmania RNA virus (LRV) in Old World Leishmania species and their possible role in the disease prognosis requires sensitive and specific methods, preferably independent of the viral genome. We aimed to develop an indirect immunofluorescence antibody (IFA) assay to detect LRV in the Old World Leishmania parasites. Methods: Clinical samples were collected from 86 cutaneous leishmaniasis (CL) patients in different endemic areas of CL in Iran, during 2017-2019. For antibody preparation, the viruses were obtained from sediment of an LRV-infected L. major culture-using freeze and thaw cycles followed by gradient cesium chloride centrifugation. The purified viruses were used to immunize a male 3-4 months rabbit. Various dilutions of the LRV-immunized rabbit's serum and a conjugated antibody were deployed to detect LRV in 48 isolates by IFA assay. Results: LRV virus was detected in four of the 48 CL cases using IFA method. Amplification of a partial fragment of RNA-dependent RNA polymerase (RdRp) gene from the isolates confirmed the IFA results. In phylogeny, the generated RdRp sequences from four isolates were grouped with the other Old World LRVs, but separate from L. aethiopica LRVs, which appeared as a highly supported distinct clade. Conclusion: Further optimization of this approach to detect the LRV directly in lesion scrapings can make it a more reliable tool for field studies and disclosing the virus's possible role in disseminating and unusual clinical features. [ABSTRACT FROM AUTHOR]

Early diagnosis of primary immunodeficiencies is crucial for timely treatment and preventing unwanted complications. Next-generation sequencing (NGS) and detailed clinical and immunological evaluation can help early detect such disorders. This study aimed to confirm the diagnosis of two cases of autosomal recessive hyper-immunoglobulin E (IgE) syndrome (AR-HIES), presenting with irreversible eye involvement. Two unrelated patients with suspected AR-HIES were referred to the Immunology, Asthma and Allergy Research Institute (IAARI), Tehran, Iran. Immunological screening tests were performed for AR-HIES, which showed elevated serum IgE levels, eosinophilia, and low T-lymphocyte responses. NGS was performed, and the results were confirmed by Sanger sequencing. Sequence analysis showed a mutation in intron 17 of the dedicator of cytokinesis 8 (DOCK8) gene in the first patient, and a homozygous three base-pair deletion in exon 45 of DOCK8 in the second patient. This is the first time such mutations are reported and these variants are predicted to be damaging. Both patients suffered from persistent viral infections along with cytomegalovirus (CMV) retinitis. Suspicion of these two novel DOCK8 mutations can benefit patients presenting with recalcitrant ophthalmic viral involvements and relevant immunological test results. This would lead to earlier referrals for immunologic and genetic confirmation and thus, a more timely intervention with hematopoietic stem cell transplantation (HSCT). [ABSTRACT FROM AUTHOR]

Patients with cancer are at significantly greater risk of COVID-19 and its complications than the general population. Since IgG antibodies remain detectable well after infection with the SARS-CoV-2 virus, seroprevalence can be used to estimate the proportion of the cancer population previously infected and potentially immune to SARS-CoV-2. The current study is a multi-center, prospective observational study to assess the seroprevalence of SARS-CoV-2 IgG antibody in a cancer population referred for vaccination between April and June 2021. Of a total of 270 adult patients with cancer accrued, 16% reported a history of COVID-19 more than four weeks previously confirmed by PCR. At the same time, serologic positivity for SARSCoV2 IgG was found in 29% of patients prior to vaccination including nearly 20% of patients without a history of confirmed COVID-19. Seropositivity was significantly greater in females consistent with higher rates in patients with breast cancer and gynecologic cancers. A seroconversion rate of 79.5% was observed in cancer patients with a history of PCR confirmed COVID-19, less than observed in the general population. In multivariable analysis, gender and prior history of COVID-19 were both independently associated with seropositivity prior to vaccination. Follow-up is continuing of this cohort of patients with cancer following vaccination to assess antibody and clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests a connection between celiac disease and dilated cardiomyopathy. Herein, we serologically screened for celiac in dilated cardiomyopathy patients and investigated its correlation with ejection fraction. Methods: We selected 123 cardiomyopathy patients. Patients were screened for celiac, using anti-tissue transglutaminase (ATA), antigliadin (AGA), and anti-endomysial (EMA) immunoglobulin type A (IgA) antibodies. Total IgA levels were also measured. Results: Of 123 patients, 3 were EMA positive (2.4%), 4 were AGA positive (3.3%) and 5 were ATA positive (4.1%). EMA positive patients had significantly lower EF values compared to EMA negative patients (35±5 vs. 46.52±9.21, p-value: 0.034). Similar results were observed for AGA (32.5±14.34 vs. 46.7±8.8, p-value: 0.002), but not for either ATA positivity (40±10 vs. 46.5±9.21, p-value: 0.126) or IgA deficiency (50±5 vs. 46.14±9.37, p-value: 0.480). No significant difference was observed in the age and gender of seropositive patients compared to seronegative. Conclusion: We observed a higher prevalence of celiac seropositivity among dilated cardiomyopathy patients compared to the general population. EMA and AGA positive patients had significantly lower ejection fractions compared to their negative counterparts. [ABSTRACT FROM AUTHOR]

Ligustrum vulgare (Privet) pollen proteins are responsible for allergies in susceptible individuals in many regions of the world. This study investigated the immunochemical characterization of Privet pollen extract and the occurrence of skin prick test reactivity to Privet and other allergenic pollen grains in allergic rhinitis patients. All subjects experienced a skin prick test with twenty-two allergen extracts. sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) separated Privet pollen extract, IgE-immunoblotting, and specific ELISA procedures determined the allergenic profile on forty-five Privet allergic patients. A positive allergic reaction to L. vulgare pollen extract was observed in forty-five (31.4%) out of 145 patients. Ten resolved protein fractions were found on SDS-PAGE, ranging from 10 to 80 kDa. IgE-specific antibodies interacted with several allergenic protein bands from Privet-allergic patients in the immunoblotting assay. The most significant interaction was observed in proteins with molecular weights of approximately 15, 18, 43, and 66 kDa. Privet pollen is regarded as a potent allergen composed of IgE-binding constituents. Considering the high allergenicity of Privet pollen grains and since many countries are rich in this plant, identification and production of recombinant forms of common allergens in this species can be used for developing more efficient diagnostic, therapeutic, and preventive approaches. [ABSTRACT FROM AUTHOR]

Aim: Bluetongue is a non-contagious, infectious viral disease of domestic and wild ruminants; which is believed to have originated in Africa. The epidemiology of Bluetongue virus infection is poorly defined in many parts of the world, including a wide range of Asia and the Middle East. This paper reports the results of a Bluetongue serological survey in sheep from some provinces of Iran during 2007-2008. Material and Methods: A total of 996 sheep sera were collected from 8 provinces in Iran and tested for Bluetongue virus specific using c-ELISA. Results: The results showed that the Bluetongue virus seroprevalence of sheep over the entire study areas was 34.93%, with the highest and lowest prevalence seen in West-Azerbaijan (64.86%) and Qom (12.1%) areas respectively. Conclusion: The results demonstrated a high prevalence of Bluetongue antibodies in Iranian sheep, giving serological evidence of extensive exposure to Bluetongue virus infection in some provinces of the country. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Hepatitis B (HB) vaccine response in hemodialysis patients is less than healthy individuals. Different strategies have been taken into account to improve the response rate. This study aimed to evaluate the effect of tetanus and diphtheria (Td) vaccine as an adjuvant therapy to HB vaccination. METHODS: Sixty three end-stage renal disease patients were recruited on dialysis that were older than 18 years and had passed at least 3 doses of HB vaccination schedule, and had HBS antibody (Ab) with titer less than 10 IU/L. The patients were divided into two groups; A (30 patients) and B (33 patients). Both of the groups received a 3-dose HB vaccination schedule of 40 μg intramuscularly in the left deltoid muscle at 0, 1 and 6 months. Group A also received Td vaccine intramuscularly simultaneous with the first dose of HB vaccine. HBS Ab was measured in periods of 1 and 6 months after completion of the vaccination. RESULTS: One month after completion of the vaccination, group A had better but not significant response rate (96%) than group B (83.9%) (p > 0.05); in addition, after 6 month there was no difference between the two groups (87.5% vs. 83.3%) (p > 0.05). Patients with HCV infection had lower response rate than patients who did not have HCV infection (33.3% vs. 92.5%) (p < 0.05). Age had negative effect on immune response to HB vaccination (r = -0.339; p = 0.005). CONCLUSIONS: The use of Td vaccine concurrent with HB vaccination may increase the response rate in non-responder individuals; however, it seems it does not have any role in the persistence of immune response. Age and HCV infection negatively affected the response to HB vaccination in dialysis patients. [ABSTRACT FROM AUTHOR]

Background: The role of carcinogenic viruses in developing breast cancer has not yet been identified. Many studies have examined the association between breast cancer and human cytomegalovirus (HCMV), but conflicting results have been reported. Objectives: The aim of this study was to evaluate the levels of IgM & IgG antibodies against HCMV by identifying the viral genome in the breast tissue of women with breast cancer. Methods: A total of 60 patients with breast cancer and 60 healthy individuals (40 cases with fibroadenoma and 20 healthy samples) were selected. Serum levels of IgM& IgG antibodies againstHCMVwere measured by ELISA, and afterDNAextraction from the breast tissue, the presence of the cytomegaloviruses (CMV) genome was assessed by Real-Time PCR. Results: Real-time PCR results showed that 20 samples of breast cancer tissue and 5 samples of fibroadenoma were positive forCMV genome (P = 0.001, OR: 5.50, CI 95%: 1.90 - 15.89). All samples had CMV-IgG antibody in their serum, but their mean serum level was higher in the cancer group (48.27-15.99 U/mL) than the control group (40.11-18.01 U/mL) (P = 0.004). However, CMV-IgM anti-viral antibody was positive in 5 cases with cancer and 3 cases in the control group. The mean serum concentration of this antibody was higher in the cancer group (6.60-6.75 U/mL) than the control group (4.92-3.03 U/mL) (P = 0.099). Conclusions: Increased serum levels of anti-CMV antibodies in patients with cancer, as well as the presence of viral genomes in some cases, indicate the carcinogenesis effect of the virus. [ABSTRACT FROM AUTHOR]

Rubella infection within the first trimester of pregnancy may lead to adverse pregnancy outcomes. The present study was conducted to evaluate the immunity against rubella among the pregnant Iranian women. The steps of meta-analyses were conducted based on the MOOSE protocol and results were reported according to the PRISMA guideline. To review the associated English and Persian literature, a comprehensive search was conducted among the international databases such as Scopus, PubMed/Medline, Science Direct, Embase, Cochrane library, Web of Science and Google Scholar search engine as well as Iranian databases, until April 1, 2018 using the following medical subject headings (MeSH) keywords: 'Pregnant', 'Gestational', 'Prenatal care', 'Complications of pregnancy', 'Pregnancy', 'Rubella infection', 'Prevalence, 'Epidemiology', 'Immunity', 'Immunization', 'Antibody', 'Immunogenicity' and 'Iran'. Cochran's Q test and I2 index were used to investigate heterogeneity in the studies. Random effects model was used to estimate the rate of rubella immunity. The obtained data were analyzed using Comprehensive Meta-Analysis Ver.2. Fifteen studies constituting 7,601 pregnant Iranian women met the inclusion criteria. The overall pooled rubella immunity rate was 90.1% [95% confidence interval (CI): 86.1-93.1]. Rubella immunity rates were respectively 88.6% (95% CI: 80.6-93.6) and 91.5% (95% CI: 88.1-93.9) before and after national vaccine program. Rubella immunity rates were 91.4% (95% CI: 87.8-94.0) and 87.2% (95% CI: 74.3-94.1) based on the enzyme-linked immunosorbent assay (ELISA) and haemagglutination-inhibition (HAI) methods, respectively. There was no significant association between rubella immunity and vaccination program (P=0.398), diagnostic methods (P=0.355), geographic regions (P=0.286), quality of the studies (P=0.751), occupation (P=0.639), residence (P=0.801), and year of the studies (P=0.164), but it was significantly associated with age (P<0.001). Despite high rubella immunity among the pregnant Iranian women, anti-rubella antibody screening is recommended for all women of childbearing age. [ABSTRACT FROM AUTHOR]

Background: Sulfur mustard (SM) is a powerful blistering chemical warfare agent that has genotoxic effects. Cells with excessive proliferation such as lymphocytes may inherit this cellular toxicity which can lead to their malfunctions in the long-term. This study was designed to evaluate the status of acquired immunity among SM poisoned veterans around three decades after exposure. Methods: Thirty five male Iranian veterans having at least 25% disability due to SM poisoning with long-term complications in the respiratory system, skin or eyes were investigated. Non-functional/functional tests including hematological parameters, immunostaining analysis, lymphocyte proliferation assay, cytokine profile, and levels of total serum IgM, IgG and IgA were performed. Results: The results showed that most of the parameters of adaptive immune system of the veterans were currently within the normal ranges. However, changes in the proliferation index (PI) of lymphocytes showed problems with the lymphocytes which cannot be proliferated appropriately. PI values for PBMCs (peripheral blood mononuclear cells) in presence of PHA (Phytohemagglutinin-A) and LPS (lipopolysaccharide) mitogens were 1.16 ± 0.14 and 1.13 ± 0.07, respectively which are less than expected. Conclusions: Based on the results gathered in this study, most of the parameters of acquired immunity were normal. However, the observed failure of lymphocyte functions may disrupt physiological activity of whole immune system leading to long-term complications; including recurrent respiratory tract infections. Indeed, further cellular and molecular studies with regard to lymphocytes function are required to better understand the status of adaptive immunity in these patients. [ABSTRACT FROM AUTHOR]

A conference paper on the relation between schizophrenia and toxoplasma gondii in Iranian patients is presented. Serum samples of 230 cases of schizophrenia and 230 of a matched control group were examined for Toxoplasma antibodies by enzyme-linked immunosorbent assay method. Results reveal that 41 of the patient cases and 17 of the control cases were antibody positive. There were no differences between age groups and both genders.

Background: Cytomegalovirus (CMV) is a common cause of congenital infection worldwide and infants with symptomatic congenital CMV (cCMV) infection are at significantly increased risk of developing adverse long-term outcomes. This study aimed to determine the prevalence of cCMV infections in symptomatic infants under 3 weeks in Tehran, IRAN and to evaluate the usefulness of serologic markers in these neonates.Methods: Urine and serum samples of 100 symptomatic infants, under 3 weeks old, with clinical signs referred to Tehran medical centers from June 2013 to December 2014, were collected and tested for CMV-DNA and IgG/IgM antibody titers by PCR and ELISA, respectively.Results: CMV-DNA was detected in urine of 58 cases, whereas only 20 cases had detectable CMV-IgM titers. All CMV-IgM positive cases excreted CMV-DNA through their urine. Of the 100 patients, only 59 had CMV-IgG antibody and CMV-DNA was found in the urine of only 40 of them.Conclusions: We conclude that CMV is an important etiologic agent of congenital infections in symptomatic infants in Tehran, IRAN (prevalence: 58%) and CMV-DNA detection immediately after delivery is recommended for early treatment and reduction of post infection problems. Furthermore, our study showed that the serologic markers are unreliable for diagnosis of cCMV infection in infants. This is the first report of cCMV prevalence in symptomatic congenital infections in Iran showing similarity with the world averages. [ABSTRACT FROM AUTHOR]

Background: Immunoglobulin (Ig) replacement therapy is used for treating a variety of primary immunodeficiency diseases (PIDs). Ig replacement therapy is the most important therapy for these diseases, since it protects the body against infections and reduces autoimmune disease symptoms. The purpose of this research was to estimate the cost of subcutaneous and intravenous Ig therapy in Iran. Methods: This study is carried out from the perspective of Iran’s healthcare system and all the medical costs are calculated. Cost variables include personnel, equipment, and supplies. The data required for cost estimation are obtained from the records of children’s Medical center of Tehran for 2015. Personnel and medical treatment costs are calculated based on relative value units. For SCIg, cost items are extracted from the literature. Results: The total cost of IVIg and SCIg for the health system in the first year of treatment is $1370 and $121 respectively. The results indicate that SCIg reduces costs and is the preferred treatment for PID patients. Conclusions: SCIg therapy significantly reduces the costs of the healthcare system compared to IVIg therapy, and this is enough economic justification for introduction of this treatment in the Iranian healthcare system. SCIg is also critical in reducing the direct costs of patients. [ABSTRACT FROM AUTHOR]

BACKGROUND In some studies inflammatory bowel disease (IBD) and celiac disease were considered to be associated and some believe that this association may influence the prognosis of IBD. However, there is a considerable controversy regarding this association. Therefore,we aimed to assess the association of these two common digestive diseases and evaluate the complications of this association. METHODS In this comparative study, 200 patients with ulceritive colitis (UC) and 206 patients with Crohn's disease (CD) were evaluated for celiac disease using relevant diagnostic tests and pathologic studies. Total IgA, IgA tissue transgulaminase antibody and specific IgA anti endomysial antibody were asseyed. In cases of IgA deficiency, total IgG and IgG tissue TG and IgG anti endomyseal Ab were measured. Patients with increased specific IgA and IgG antibodies for celiac disease, underwent endoscopy and 4 standard samples were obtained. Our results were compared with the results of the prevalence study of celiac disease in the general population. Data were analyzed using analytic and descriptive statistics at a significance level of 5%. RESULTS Among the studied patients, 1 patient with UC had elevated IgA anti tTG antibody and IgA anti-endomysial antibody who underwent endoscopy and celiac was confirmed on pathology. Hence, of the 200 patients with UC, the diagnosis of celiac disease was confirmed in 1 patient (1:200) with no significant difference with the prevalence of celiac disease in the general population (1:166). However, none of our patients with Crohn's disease had celiac disease (0:206). CONCLUSION We found no significant difference in the prevalence of celiac disease between patients with UC and the general population. Since most of our participants had a mild level of Crohn's activation, none of those with Crohn's disease had celiac disease. Complications of IBD including sclerosing cholangitis, may be more common in patients with concurrent celiac disease. Therefore, it is recommended that celiac disease be considered in patients with severe and complicated IBD. [ABSTRACT FROM AUTHOR]

Objective(s): Helicobacter pylori infection occurs worldwide, but the prevalence of this infection varies greatly among different countries and population groups. The aim of this study was to determine the seroprevalence of anti-Helicobacter pylori and anti-cytotoxin-associated gene A (CagA) antibodies in asymptomatic healthy population in the center of Iran and to investigate the relation with different parameters. Materials and Methods: Totally, 525 individuals aged 17-60 years were enrolled in study. The serum samples of participants were tested for anti-H. pylori IgG and anti-CagA IgG by enzymelinked immunosorbent method (ELISA). ABO blood grouping was also done by hemagglutination test. Results: The seroprevalence of anti-H. pylori IgG was 74.2% and their rates increased with age. The seroprevalence of anti-H. pylori IgG was higher in males (74.6%) than in females (71.6%). There was statistically inverse association between H. pylori infection and education level (P=0.04) and marital status (P=0.000). The most prevalent blood group was type AB with positive Rhphenotype (82.4%). In H. pylori infected individuals the seroprevalence of anti-CagA antibody was 46.9%. The seroprevalence of anti-CagA IgG was in males 48.6% and in females 31.6%. There was no statistically significant association between anti-CagA IgG positivity and age, occupation, socioeconomic status, ABO blood groups and Rh status. Conclusion: These results showed that H. pylori infection was common in the asymptomatic individuals. Almost half of the infected individuals acquire CagA-positive strains of H. pylori. Moreover, it seems that males are more susceptible to infection with CagA-positive strains compared to females. [ABSTRACT FROM AUTHOR]

Background : Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease that results in segmental stenosis of the bile ducts, cholestasis and fibrosis. During the previous two decades, patients with steroid responsive PSC have been presented in a few case reports and studies. This study aims to evaluate and compare IgG4 levels in patients with ulcerative colitis (UC), with and without PSC. Materials and Methods: This cross-sectional study enrolled 116 patients with UC who referred to the Gastrointestinal Clinic of Imam Khomeini Hospital, Tehran, Iran. Patients with allergic diseases such as asthma and atopic dermatitis as well as those with autoimmune disorders such as vasculitis and systemic lupus erythmatosus were excluded. After signing an informed consent form, 5cc blood sample was taken for serum IgG4 evaluation. Patients with clinical or laboratory signs of PSC underwent Magnetic resonance cholangiopancreatography (MRCP) after which patients were divided into two groups (with and without PSC) according to the results of their MRCP findings. IgG levels more than 157 mg/dl were considered elevated. SPSS software package version 16 was used for data analysis. A significance level of 0.05 was considered statistically significant. Results: There were 57(49.1%) male participants, of which 24 (20.7%) had evidence of PSC. Among these, 7 (29.1%) had elevated IgG4 titers. Of participants, 92 did not have PSC. From this group, 9 (9.7%) had elevated IgG4 levels. This difference was statistically significant (p =0.012). The odds ratio was 3.9 (CI: 1.28-12. l) and the area under the curve for IgG4 in predicting PSC in the ROC curve was 0.65. There was a significant relationship between IgG4 titer and colitis extension in both groups. However there was no significant relationship regarding the severity of colitis (p=0.247). Conclusion: It is necessary to evaluate IgG4 titers in all patients with PSC because of its treatable nature. Determining IgG4 levels in all UC patients can be a predicting factor for PSC. Thus additional cohort studies with larger numbers of participants are recommended. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis (VL) is a life-threatening vector-borne parasitic disease is distributed in some parts of the new world and old world. The disease is endemic in different parts of Iran. This review article has been focused on major topics of epidemiological aspects and clinical features of VL in Iran for the period of 2002 through 2012. For the detection of VL in humans as well as animal reservoir hosts, anti-Leishmania antibodies were detected using direct agglutination test (DAT) as a validated serological test. Parasitological examinations were performed on suspected VL patients as well as canines and rodents. Different molecular methods were used for identification of species and genotype/ or strain of Leishmania spp. isolated from infected humans, animal reservoir hosts and vectors. Altogether, 1698 out of 36081 (4.7%) human serum samples collected from 5 distinct geographical zones showed anti-Leishmania antibodies at titers≥1:3200 using DAT. The majority of VL cases in the endemic areas were found among children up to 12 years old. Almost 75% of DAT-positive cases (≥1:3200) in endemic areas showed clinical signs and symptoms. Predominant signs and symptoms in 217 hospitalized patients with DAT positive (≥1:3200) results included paleness (99.5%), fever (96.9%), splenomegaly (91.5%), hepatomegaly (53.6%) and lymphadenopathy (21.1%). Integrated VL surveillance system in primary care using DAT, could decrease mortality and morbidity of the disease in the VL endemic areas of the northwestern Iran. Out of 7204 serum samples collected from domestic dogs in various geographical locations of Iran, 879 (12.2%) were DAT sero-positive at titers≥1:320. L. infantum as the principal causative agent of the disease was isolated from infected humans, domestic and wild canines and rodents. The principal animal reservoir hosts of the infection are domestic and wild canines. Ph. kandelakii, Ph. perfiliewi transcaucasicus, Ph. tobbi in northwestern Iran; Ph. major s.l. (=Ph. neglectus), Ph. keshishiani, and Ph. alexandri in southern parts of Iran were molecularly and/or parasitologically positive for L. infantum infections. The zoonotic form of VL (ZVL) caused by L. infantum occurs sporadically in all geographical zones of Iran but in northwestern and southern parts of the country the disease is endemic. DAT as an appropriate and potential tool has been used for sero-diagnosis and sero- epidemiological of VL among humans as well as domestic and wild canines. [ABSTRACT FROM AUTHOR]

To investigate anti- Neospora caninum antibodies in stray dogs living in Urmia city, 135 blood samples were collected. Serum samples were screened for detection of anti- N. caninum IgG antibodies using indirect fluorescent antibody test (IFAT; ≥50). Antibodies were seen in 36 (27%) of 135 dogs. The IFAT antibody titers were as follows: 1:50 in 16 dogs, 1:100 in ten dogs, 1:200 in six dogs, 1:400 in one dog, 1:800 in two dogs, and 1:1,600 in one dog. There were no significant differences in seroprevalence of Neospora infection between different genders ( p > 0.05). The seropositive results were increased with age and the differences were statistically significant ( p < 0.05). The results confirm the presence and exposure of stray dogs to N. caninum in Urmia city and the importance of this protozoan as a cause of disease in dogs of the region. [ABSTRACT FROM AUTHOR]

Background: High prevalence rates of celiac disease (CD) in patients with type-1 diabetes mellitus (T1DM) have been reported in several countries. However, the data regarding this association are scarce in Iran. In this study, we report the prevalence of CD in patients with T1DM in northwest of Iran using tissue transglutaminase antibodies (tTGA) as a screening test.Methodology: One hundred patients with T1DM (58 women and 42 men) aged 21.8 +/- 8.86 years (age range: 7-50 years) were compared with 150 healthy people (82 women and 68 men) aged 28.9 +/- 9.07 years (age range: 4-50 years). All subjects were serologically screened for the presence of tTGA. Total immunoglobin A (IgA) was obtained to investigate IgA deficiency. Subjects positive for tTGA and deficient for IgA were submitted to upper gastrointestinal endoscopy.Results: Eight patients with T1DM (8%) and three of the controls (2%) were positive for tTGA (P = 0.023), while only 3% of the tTGA positive T1DM patients underwent duodenal biopsy and all of them showed partial or total villous atrophy. The mean age of tTGA positive cases was significantly lower than tTGA negative ones (mean difference 7.17; 95% CI: 0.82-13.52). None of the tTGA positive T1DM patients had a history of chronic diarrhea, but one out of eight tTGA positives reported history of dermatitis (P = 0.001). Also, none of the tTGA positive subjects presented IgA deficiency. There was a significant difference in history of chronic diarrhea (P = 0.006) and autoimmune diseases (P = 0.001) between patients with T1DM and controls.Conclusion: This study showed higher prevalence of CD in patients with T1DM than in general population of northwest Iran and the data lend support to recommend regular screening for CD in all patients with T1DM. [ABSTRACT FROM AUTHOR]

Background: Congenital rubella syndrome (CRS) can be prevented with appropriate vaccination programs. The prevalence rates of rubella and CRS in Iran are unknown; therefore, the risk of exposure in pregnant women is not clear. The prevalence of CRS in the pre-vaccine period can be estimated by evaluating the proportion of children in the population with sensorineural hearing loss attributable to rubella. Methods: This was a case-control study to estimate prevalence of CRS in Tehran (Iran) by evaluating the proportion of children with sensorineural hearing loss attributable to rubella. The study used rubella antibody titer as an indicator, and compared the prevalence of rubella antibody between children with and without sensorineural hearing loss. Using these findings, the proportion of cases of sensorineural hearing loss attributable to rubella was estimated. Results: A total of 225 children aged 1 to 4 years were entered into the study (113 cases and 112 controls). There was a significant difference between cases and controls with regard to rubella antibody seropositivity (19.5% vs. 8.9%, respectively, odds ratio = 2.47, 95% CI = 1.04—5.97). The proportion of sensorineural hearing loss cases attributable to rubella was found to be 12%, corresponding to a CRS prevalence of 0.2/1000. Conclusion: The prevalence of CRS was approximately 0.2/1000 before rubella vaccination in Iran, Moreover; the results suggest that implementation of appropriate rubella vaccination programs could potentially prevent about 12% of cases of sensorineural hearing loss in Iranian children. This data could potentially be used as baseline data, which in conjunction with an appropriate method, to establish a surveillance system for rubella vaccination in Iran. An appropriate surveillance system is needed, because the introduction of a rubella vaccine without epidemiological data and an adequate monitoring program could result in the shifting of rubella cases to higher ages, and increasing the incidence of CRS. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the efficacy and safety of interferon beta-1a (Avonex) and intravenous immunoglobulin (IVIG) in clinical practice for the treatment of relapsing-remitting multiple sclerosis. Avonex is the most common disease-modifying therapy used in Iran due to its ease of administration. IVIG is also frequently used due to its alleged effectiveness and fewer side effects. Eighty patients were selected and prospectively monitored according to a predefined protocol. They were then randomized to receive either weekly intramuscular injections of Avonex or 0.4 g/kg monthly IVIG in a single blind fashion and following an attack of exacerbation which was treated with steroids. Basal relapse rate and Expanded Disability Status Scale (EDSS) were similar in both groups of patients (p > 0.4). Seventy-two patients remained in the study. The annual relapse rate consistently decreased from 0.95 ± 0.41 to 0.60 ± 0.67 (∼32%, p < 0.001) for 34 patients treated with Avonex and from 1.05 ± 0.34 to 0.55 ± 0.46 for 38 patients in the IVIG group (∼47%, p < 0.001). EDSS decreased by 0.4 units in IVIG-treated patients (p < 0.001) and remained stable (0.2 < p < 0.3) in the Avonex arm. This study confirms the relative efficacy of both treatments with better safety profile for IVIG in the studied Iranian population. However, the results are very preliminary ones, due to limited numbers of patients and only 12 months of treatment. Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Celiac disease has been shown to be associated with type 1 diabetes mellitus. We conducted this study to determine the frequency of celiac disease in a group of Iranian diabetic children. Ninety-six patients with type 1 diabetes mellitus were tested for anti-tissue transglutaminase antibodies. Six patients (6.25%) were seropositive, and histopathological changes were compatible with celiac disease in intestinal biopsy. [ABSTRACT FROM AUTHOR]