Iranian Journal of Pathology最新文献

Background & objective: Inflammatory bowel diseases (IBD) is described by increased coagulability and prothrombotic state and can be associated with coagulopathies. Although many causes of increased coagulability and thrombosis have been reported in IBD, there is no definitive evidence for most of them. This study aimed to define the changes in Blood Coagulation Factors in patients with IBD compared to healthy controls.

Methods: In this case-control study, serum levels of protein C, protein S, antithrombin III, fibrinogen, and Homocysteine were evaluated in 59 patients with a confirmed IBD, (23 with Crohn disease and 36 with ulcerative colitis) (case group) and 29 healthy individuals (control group) matched for age and gender.

Results & conclusion: Significant differences were found in all five studied markers between IBD and non-IBD patients (protein C (P=0.033), protein S (P=0.006), antithrombin III (P<0.001), fibrinogen (P=0.016) and Homocysteine ​​(P<0.001)), however, multivariate analysis showed a significant role for only Homocysteine (OR=0.957, 95%CI: 0.93-0.986, P=0.003) in predicting IBD. Regarding the results, it can be alleged that despite the significant difference in the level of Blood Coagulation Factors between the IBD and non-IBD patients, only the serum level of Homocysteine has a predictive role for IBD.

Background & objective: COVID-19 infection is known to affect the kidneys, potentially resulting in Acute Kidney Injury (AKI). In some patients, however, renal failure may necessitate hemodialysis following a COVID-19 infection. Pneumothorax, hemothorax, cardiac arrhythmias, and endocarditis are some complications associated with Permcath insertion, a type of vascular access used in hemodialysis.

Case presentation: In this report, we present a 29-year-old man who suffered from endocarditis following hemodialysis treatments through a Permcath because of acute renal failure following COVID-19. Removing the large masses (3×3 cm) inside the right atrium (RA) and taking out the Permcath was completed surgically.

Conclusion: A suitable Permcath and its accurate insertion are recommended to provide prompt AKI treatment and prevent further complications, such as endocarditis and thrombosis.

Background & objective: Plasmacytoma is a rare plasma cell dyscrasia marked by localized monoclonal plasma cell proliferation, distinct from multiple myeloma by its lack of systemic symptoms. Extramedullary plasmacytoma (EMP), the rarest form, typically occurs in the upper respiratory tract. Cervical involvement is rare. Chronic inflammation may play a role in the development of cervical plasmacytoma, though this remains unproven for cervical cases.

Case presentation: We present a unique case of a 74-year-old woman who presented with vaginal bleeding linked to a neglected pessary inserted 15 years earlier. Upon examination, we discovered overgrown tissue with active bleeding. The biopsy revealed a monomorphic plasma cell infiltration, and immunohistochemistry confirmed CD138-positive, BCL2-negative cervical plasmacytoma, a rare occurrence in the cervix.

Conclusion: This case highlights the importance of considering cervical EMP in atypical cytology and suggests a possible link to chronic pessary-induced inflammation. Early diagnosis through histopathology and immunohistochemistry is essential.

Background & objective: Gastric cancer (GC) is a lethal disease with poor prognosis. Long non-coding RNAs (lncRNAs) involved in the development of cancer through changes in their expression levels. In present study, we aimed to evaluate HOXA10-AS gene expression and its potential as a biomarker in GC.

Methods: In this study 60 subjects (30 gastric carcinoma tissues and 30 adjacent non-carcinoma tissues) were examined. The expression level of the HOXA10-AS gene was evaluated using quantitative PCR. Furthermore, clinicopathological characteristicswere taken into consideration. Diagnostic value of the HOXA10-AS was examined by ROC curve analysis. Bioinformatics analysis was performed using different databases.

Results: Expression of HOXA10-AS was significantly upregulated in GC tumoral tissues. Roc curve analysis revealed that the diagnostic power of HOXA10-AS was high (AUC = 0.64) in the tumor compared to the normal GC tissues.

Conclusion: Our findings show that HOXA10-AS expression level is higher in the GC tumor compared to the adjacent non-carcinoma tissues and can act as a strong diagnostic biomarker in GC patients.

Background & objective: Septic arthritis is an emergent condition caused by an infection of the joint synovial fluid. If left untreated, it can lead to irreversible damage to the affected joint. Our study focused on providing a concise profile of the Iranian population and the diagnostic roles of synovial pan-PCR and culture.

Methods: In an observational study, we evaluated the characteristics of all patients diagnosed with septic arthritis and admitted to a teaching center hospital complex. We extracted and analyzed the study of population's demographics and laboratory values.

Results: This study included 50 patients diagnosed with septic arthritis. 56% of our study population were male, and the mean age was 50.48. There were significant associations between synovial WBC counts and positive synovial culture results. Further comparison of the two diagnostic methods revealed higher pan-PCR accuracy than synovial culture.

Conclusion: Pan-PCR may have higher diagnostic accuracy than synovial culture in hospitalized patients with septic arthritis.

Background & objective: Adrenal tumors present a notable prevalence of 4-7% in individuals above 40 years old. Current guidelines recommend adrenalectomy for hormone-secreting, potentially malignant, or large (>4 cm) lesions. However, the outcomes of adrenalectomy and their clinical-pathological associations remain poorly defined. This study assessed adrenalectomy outcomes and explored its clinical, demographic, and pathologic correlates.

Methods: In this retrospective cohort study, the medical records of all patients who underwent adrenalectomy from March 2016 to March 2021 at a referral center in Tehran were reviewed. Also, a clinical follow-up via telephone was conducted. The chi-square test, independent t-test, and analysis of variance were utilized for statistical analysis.

Results: Data from a total of 75 patients (55 females) were reviewed. The mean age of the participants was 42.67 years. Of them, 60%, 22.7%, 14.7%, and 1.3% had pheochromocytoma, Cushing's syndrome, Conn's syndrome, and insulinoma, respectively. Malignancy was associated with greater tumor size (p<0.000) and mitotic rate (p=0.046), and the presence of necrosis (p=0.001), and capsular and vascular invasion (p<0.000). Clinical follow-up visits of 45 patients indicated 84.4% showed a complete response to the treatment (surgical ± medical). Treatment response was significantly influenced by approach (laparoscopic favored; p=0.001), surgery duration (<150 minutes better; p=0.017), mass pathology (adenoma favored; p=0.034), and capsular invasion (absence better; p=0.012).

Conclusion: Adrenalectomy outcomes were significantly affected by surgical approach and tumor pathology, notably capsular invasion. Larger studies are needed to determine the predictive values of clinical and pathologic variables in adrenalectomy for adrenal tumors.

Background & objective: Iron deficiency anemia is the most prevalent form of anemia worldwide and can cause complications in children and adolescents. This study investigates the correlation between serum and urinary ferritin and evaluates the feasibility of using urinary ferritin to diagnose iron deficiency.

Methods: In this case-control study, 45 patients with iron deficiency anemia were included in the case group and 45 healthy children in the control group. From each participant, 1.5 mL blood and 5 mL of urine were collected, and serum and urinary ferritin levels were measured using the chemiluminescent immunoassay (CLIA) method with Mindray kits. The results were analyzed and compared using SPSS software, version 16 (IBM Corp).

Results: The mean age of patients was 7.95 years, and that of controls was 7.26 years. Female patients constituted 62.2% of the case group, and female controls represented 46.7% of the control group. In patients, the mean serum ferritin level was 13.39 ng/mL (SD = 6.37), and the mean urinary ferritin level was 3.50 ng/mL (SD = 2.65). In controls, the mean serum ferritin level was 63.7 ng/mL (SD = 41.8), and the mean urinary ferritin level was 3.98 ng/mL (SD = 2.89). Urinary ferritin demonstrated lower diagnostic accuracy for iron deficiency anemia compared with serum ferritin. The Spearman correlation coefficient between serum and urinary ferritin was 0.155, indicating a weak positive correlation.

Conclusion: The findings of this study demonstrate an insignificant relationship between urine and serum ferritin levels. These findings indicate that urinary ferritin is not a reliable non-invasive alternative for diagnosing iron deficiency.

Background & objective: Mucopolysaccharidosis (MPS) type III, or Sanfilippo syndrome, is an autosomal recessive lysosomal storage disorder caused by mutations in genes encoding enzymes responsible for glycosaminoglycan (GAG) degradation. This case report describes two siblings with MPS type IIIB who exhibit a rare compound heterozygous mutation in the NAGLU gene.

Case presentation: A 7-year-old girl and her 4-year-old brother were referred for evaluation due to learning disabilities, aggressiveness, and coarse facial features. Enzyme assay using tandem mass spectrometry on dried blood spots in both siblings revealed absent N-acetyl-α-glucosaminidase activity.

Conclusion: Targeted sequencing confirmed the diagnosis, identifying two heterozygous mutations-an in-frame insertion and a missense mutation-in exon 3 of the NAGLU gene: c.214_237dup (p.Ala72_Gly79dup) and c.625A>C (p.Thr209Pro). This rare genetic finding in two siblings with Sanfilippo syndrome type B underscores the importance of precise mutation identification. Accurate characterization of defective gene variants may provide insights into potential targets for gene therapy in monogenic disorders.

Background & objective: Hashimoto's thyroiditis (HT) is one of the most common thyroid disorders and is characterized by manifestations attributed to thyroid gland damage and inflammatory conditions. Disturbances in thyroid hormones have physiological effects on lipoprotein metabolism and liver enzymes. CTRP family: C1q/TNF-related protein (CTRP) is an adipokine superfamily of proteins. Its essential role is anti-inflammatory activation, insulin sensitization, and regulation of blood lipids. In this study, we investigated the levels of CTRP-4 and CTRP-12 in the serum of HT patients and determined their association with biochemical factors.

Methods: The study included 60 participants, divided into HT patients and control groups. Diagnostic criteria for HT patients included anti-thyroid peroxidase antibodies (anti-TPO)>50 IU/mL. Serum levels of CTRP-4, CTRP-12, and anti-TPO were measured using an Enzyme-Linked Immunosorbent Assay.

Results: Our findings showed that the CTRP-4 and CTRP-12 levels in HT patients were higher than in the control groups (P=0.012 and P=0.003, respectively). HT patients also exhibited higher fasting blood glucose (FBG), cholesterol, TG, HDL, and LDL serum levels. Spearman's correlation analysis revealed a positive association between serum levels of CTRP-4 and CTRP-12 and anti-TPO (respectively, r= 0.295, P=0.022 and r = 0.346, P=0.007).

Conclusion: Our findings showed that the CTRP-4 and CTRP-12 levels in HT patients were higher than those in the control groups. These factors probably play a role in the pathogenesis of Hashimoto's thyroiditis. The clinical significance of these factors should be evaluated in future studies.