Displaying publications 201 - 220 of 485 in total

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  1. Suria AA, Nurasyikin Y, Adibah AG, Cheah FC, Leong CF
    Clin Ter, 2014;165(3):151-4.
    PMID: 24999569 DOI: 10.7417/CT.2014.1714
    ABO incompatibility and glucose-6-phosphate dehydrogenase deficiency G6PD are common haematological problems affecting the newborn. The resulting haemolytic disease of foetus and newborn (HDFN) caused by either of these pathologies generally follows a benign course. It is typically characterized by mild jaundice without significant anaemia. ABO incompatibility alone as a cause of foetal hydrops is extremely rare. We report a case of a newborn baby girl with an anti-B isoimmunisation and G6PD deficiency manifesting with hydrops foetalis, anaemia and hyperbilirubinaemia, born to a mother with blood group O.
    Matched MeSH terms: Glucosephosphate Dehydrogenase Deficiency
  2. Chuah KH, Mansor M, Rajen G, Wang CY, Chan YK
    Med J Malaysia, 2006 Mar;61(1):114-6.
    PMID: 16708749 MyJurnal
    Pulmonary hypertension in pregnancy is a rare condition but is associated with a high mortality. We report the case of a 29 year old female in early pregnancy with Protein C and S deficiency with recurrent deep venous thrombosis and pulmonary embolism and subsequent secondary pulmonary hypertension. The patient was counselled and consented for termination of pregnancy with tubal sterilization. She was administered continuous spinal anaesthesia with invasive monitoring. The successful anaesthetic management of this condition is described.
    Matched MeSH terms: Protein S Deficiency/physiopathology; Protein C Deficiency/physiopathology
  3. Ainoon O, Boo NY, Yu YH, Cheong SK, Hamidah HN, Lim JH
    Malays J Pathol, 2004 Dec;26(2):89-98.
    PMID: 16329560
    We performed DNA analysis on cord blood samples of 128 Chinese male neonates diagnosed as G6PD deficiency in Hospital Universiti Kebangsaan Malaysia by a combination PCR-restriction enzyme digest technique, Single Stranded Conformation Polymorphism analysis and DNA sequencing. We found 10 different G6PD-deficient mutations exist. The two commonest alleles were G6PD Canton 1376 G>T (42.3%) and Kaiping 1388 G>A (39.4%) followed by G6PD Gaohe 592 G>A (7.0%), Chinese-5 1024 C>T, Nankang 517 T>C (1.5%), Mahidol 487 G>A (1.6%), Chatham 1003 G>T (0.8%), Union 1360 C>T (0.8%), Viangchan 871 G>A (0.8%) and Quing Yang 392 G>T (0.8%). Sixty eight percent (88/125) neonates in this study had neonatal jaundice and 29.7% developed hyperbilirubinemia >250 micromol/l. The incidence of hyperbilirubinemia >250 micromol/l was higher in G6PD Kaiping (43.8%) than G6PD Canton (22%) (p< 0.05). There was no significant difference in the incidence of neonatal jaundice, mean serum bilirubin, mean age for peak serum bilirubin, percentage of babies requiring phototherapy and mean duration of phototherapy between the two major variants. None of the 88 neonates required exchange transfusion. In conclusion we have completely characterized the molecular defects of a group of Chinese G6PD deficiency in Malaysia. The mutation distribution reflects the original genetic pool and limited ethnic admixture with indigenous Malays.
    Matched MeSH terms: Glucosephosphate Dehydrogenase Deficiency/diagnosis; Glucosephosphate Dehydrogenase Deficiency/ethnology; Glucosephosphate Dehydrogenase Deficiency/genetics*
  4. Rahman SA, Chee WS, Yassin Z, Chan SP
    Asia Pac J Clin Nutr, 2004;13(3):255-60.
    PMID: 15331337
    Serum levels of 25-hydroxyvitamin D (25 (OH) D) were determined in 276 (103 Malays and 173 Chinese) postmenopausal women, aged 50 to 65 years. The level of 25 (OH) D was significantly lower in the postmenopausal Malay women (44.4 +/-10.6 nmol/L) compared to the Chinese women (68.8 +/- 15.7 nmol/L) (P<0.05). There were 27% Malay women with serum 25 (OH) D in the range of 50 - 100 nmol/L (defined as lowered vitamin D status, or hypovitaminosis D) and 71% with levels in the range of 25 - 50 nmol/L (defined as vitamin D insufficiency) compared to 87% and 11% Chinese women respectively. Serum 25 (OH) D was found to significantly correlate with BMI, fat mass and PTH level. Multivariate analyses showed that race has a strong association with vitamin D status. The high prevalence of inadequate levels of serum vitamin D found in our study may have important public health consequences and warrants the development of a strategy to correct this problem in the older adult Malaysian population.
    Matched MeSH terms: Vitamin D Deficiency/blood; Vitamin D Deficiency/ethnology; Vitamin D Deficiency/epidemiology*
  5. Chin KY, Ima-Nirwana S, Ibrahim S, Mohamed IN, Wan Ngah WZ
    Nutrients, 2014 Nov 26;6(12):5419-33.
    PMID: 25431881 DOI: 10.3390/nu6125419
    Vitamin D insufficiency is a global health problem. The data on vitamin D status in Malaysian men is insufficient. This study aimed to investigate vitamin D status among Chinese and Malay men in Malaysia and its associating factors. A cross-sectional study was conducted on 383 men aged 20 years and above, residing in Klang Valley, Malaysia. Their age, ethnicity, body anthropometry and calcaneal speed of sound (SOS) were recorded. Their fasting blood was collected for serum 25-hydroxyvitamin D (25(OH)D), intact parathyroid (PTH), total calcium and inorganic phosphate assays. Vitamin D deficiency was defined as a serum 25(OH)D level <30 nmol/L and insufficiency as a serum 25(OH)D level between 30 and 50 nmol/L. The overall prevalence of vitamin D deficiency was 0.5%, and insufficiency was 22.7%. Vitamin D deficiency and insufficiency were more prevalent in the Malays compared to the Chinese. Being Chinese, older in age, having lower body mass index (BMI) and a high physical activity status were associated significantly with a higher serum 25(OH)D level (p < 0.05). The serum PTH level was inversely associated with the serum 25(OH)D level (p < 0.05). As a conclusion, a significant proportion of Malaysian men have vitamin D insufficiency, although deficiency is uncommon. Steps should be taken to correct the vitamin D status of these men.
    Matched MeSH terms: Vitamin D Deficiency/blood*; Vitamin D Deficiency/diagnosis; Vitamin D Deficiency/ethnology
  6. Mohaghegh Z, Abedi P, Dilgouni T, Namvar F, Ruzafza S
    Horm Metab Res, 2015 Apr;47(4):284-8.
    PMID: 25611206 DOI: 10.1055/s-0034-1395607
    The predisposing factors of preeclampsia may endanger the mother's heath as well as her neonate. One hypothesis related to preeclampsia is vitamin D deficiency or insufficiency. This study was conducted to evaluate the relationship between preeclampsia and the serum level of 25-hydroxyvitamin D (25-OH-D) in mothers and their neonates. In this case-control study, we recruited 41 preeclamptic and 50 healthy women from the Imam Khomeini Hospital in Ahvaz, Iran. Venous blood (2 ml) from mothers (in time of labor) and 2 ml of blood from the umbilical cord were taken, centrifuged, stored at -30°C and sent to a laboratory for analysis of 25-OH-D by ELISA. Vitamin D levels<20 ng/ml were regarded as deficiency, levels between 21-29 ng/ml were regarded as insufficiency, and if levels were higher than 30 ng/ml, these were considered normal. Independent t-test, chi-square, Spearman correlation coefficient and logistic regression were used to analyze data. Mean levels of 25-OH-D were significantly lower in preeclamptic women (15.2±13.6 vs. 23.3±15.3 ng/ml, p=0.001) and in their neonates (15.2±13.1 vs. 21.6±12.6 ng/ml, p=0.01) compared to normal pregnant women and their neonates. There was a significant relationship between the levels of vitamin D in preeclamptic women with levels of this vitamin in their neonates (r=0.901, p=0.0001). 25-OH-D deficiency that exist in preeclamptic mothers, may be a health risk for their infants, therefore, early use of vitamin D supplement with higher dose than 400 IU in Iranian women is recommended.
    Matched MeSH terms: Vitamin D Deficiency/blood; Vitamin D Deficiency/complications*; Vitamin D Deficiency/epidemiology
  7. Al-Mekhlafi HM, Al-Zabedi EM, Al-Maktari MT, Atroosh WM, Al-Delaimy AK, Moktar N, et al.
    Nutrients, 2014 Jan;6(1):190-206.
    PMID: 24384995 DOI: 10.3390/nu6010190
    Iron deficiency anaemia (IDA) is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI=42.3, 54.8). Moreover, 34% (95% CI=28.3, 40.2) of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (p<0.01). Moreover, a significant reduction in the prevalence of IDA by almost 22% than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3% reduction among children in the placebo group. In conclusion, vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities.
    Matched MeSH terms: Anemia, Iron-Deficiency/blood; Anemia, Iron-Deficiency/drug therapy*; Anemia, Iron-Deficiency/epidemiology
  8. Poh BK, Ng BK, Siti Haslinda MD, Nik Shanita S, Wong JE, Budin SB, et al.
    Br J Nutr, 2013 Sep;110 Suppl 3:S21-35.
    PMID: 24016764 DOI: 10.1017/S0007114513002092
    The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.
    Matched MeSH terms: Calcium/deficiency; Vitamin D Deficiency/epidemiology
  9. Chandyo RK, Henjum S, Ulak M, Thorne-Lyman AL, Ulvik RJ, Shrestha PS, et al.
    Eur J Clin Nutr, 2016 Apr;70(4):456-62.
    PMID: 26626049 DOI: 10.1038/ejcn.2015.199
    INTRODUCTION: Iron deficiency anemia is a widespread public health problem, particularly in low- and middle-income countries. Maternal iron status around and during pregnancy may influence infant iron status. We examined multiple biomarkers to determine the prevalence of iron deficiency and anemia among breastfed infants and explored its relationship with maternal and infant characteristics in Bhaktapur, Nepal.
    SUBJECTS/METHODS: In a cross-sectional survey, we randomly selected 500 mother-infant pairs from Bhaktapur municipality. Blood was analyzed for hemoglobin, ferritin, total iron-binding capacity, transferrin receptors and C-reactive protein.
    RESULTS: The altitude-adjusted prevalence of anemia was 49% among infants 2-6-month-old (hemaglobin (Hb) <10.8 g/dl) and 72% among infants 7-12-month-old (Hb <11.3 g/dl). Iron deficiency anemia, defined as anemia and serum ferritin <20 or <12 μg/l, affected 9 and 26% of infants of these same age groups. Twenty percent of mothers had anemia (Hb <12.3 g/dl), but only one-fifth was explained by depletion of iron stores. Significant predictors of infant iron status and anemia were infant age, sex and duration of exclusive breastfeeding and maternal ferritin concentrations.
    CONCLUSIONS: Our findings suggest that iron supplementation in pregnancy is likely to have resulted in a low prevalence of postpartum anemia. The higher prevalence of anemia and iron deficiency among breastfed infants compared with their mothers suggests calls for intervention targeting newborns and infants.
    Matched MeSH terms: Anemia, Iron-Deficiency
  10. Lim KK, Chan YY, Teh CH, Ismail H, Yusof R, Muhi J, et al.
    Asia Pac J Clin Nutr, 2017 8 15;26(5):861-866.
    PMID: 28802296 DOI: 10.6133/apjcn.092016.06
    BACKGROUND AND OBJECTIVES: In 2000, legislation on mandatory universal salt iodisation was enacted in Sabah, Malaysia, to reduce the incidence of iodine deficiency disorders among its population. To evaluate the iodine levels among pregnant women from selected rural divisions in Sabah 13 years after the enactment of the universal salt iodisation programme.

    METHODS AND STUDY DESIGN: This cross-sectional study was conducted from 1 May to 30 June, 2013, in three rural divisions of Sabah (the Interior, the West Coast, and Kudat). Data regarding domestic iodised salt use and iodine-containing supplement consumption were obtained from respondents through face-to-face interviews; goitre enlargement was examined through palpation and graded according to the World Health Organization classification. Spot urine samples were also obtained to assess urinary iodine levels by using an in-house modified micromethod.

    RESULTS: In total, 534 pregnant women participated. The prevalence of goitre was 1.0% (n=5), noted only in the West Coast and Kudat divisions. Although all pregnant women consumed iodised salt, overall median urinary iodine concentration was only 106 μg/L, indicating insufficient iodine intake, with nearly two-thirds of the women (60%) having a median urinary iodine concentrations of <150 μg/L.

    CONCLUSIONS: Pregnant women from the rural divisions in Sabah still exhibit iodine deficiency disorder despite the mandatory universal salt iodisation programme. Iodine supplementation programmes targeting pregnant women are warranted.

    Matched MeSH terms: Iodine/deficiency
  11. Rahmadhani R, Zaharan NL, Mohamed Z, Moy FM, Jalaludin MY
    PLoS One, 2017;12(6):e0178695.
    PMID: 28617856 DOI: 10.1371/journal.pone.0178695
    BACKGROUND: The vitamin D receptor (VDR) gene is expressed abundantly in different tissues; including adipocytes and pancreatic beta cells. The rs1544410 or BsmI single nucleotide polymorphism (SNP) in the intronic region of the VDR gene has been previously associated with vitamin D levels, obesity and insulin resistance.

    AIMS: This study was aimed to examine the association between BsmI polymorphism and risk of vitamin D deficiency, obesity and insulin resistance in adolescents living in a tropical country.

    METHODS: Thirteen-year-old adolescents were recruited via multistage sampling from twenty-three randomly selected schools across the city of Kuala Lumpur, Malaysia (n = 941). Anthropometric measurements were obtained. Obesity was defined as body mass index higher than the 95th percentile of the WHO chart. Levels of fasting serum vitamin D (25-hydroxyvitamin D (25(OH)D)), glucose and insulin were measured. HOMA-IR was calculated as an indicator for insulin resistance. Genotyping was performed using the Sequenom MassARRAY platform (n = 807). The associations between BsmI and vitamin D, anthropometric parameters and HOMA-IR were examined using analysis of covariance and logistic regression.

    RESULT: Those with AA genotype of BsmI had significantly lower levels of 25(OH)D (p = 0.001) compared to other genotypes. No significant differences was found across genotypes for obesity parameters. The AA genotype was associated with higher risk of vitamin D deficiency (p = 0.03) and insulin resistance (p = 0.03) compared to GG. The A allele was significantly associated with increased risk of vitamin D deficiency compared to G allele (adjusted odds ratio (OR) = 1.63 (95% Confidence Interval (CI) 1.03-2.59, p = 0.04). In those with concurrent vitamin D deficiency, having an A allele significantly increased their risk of having insulin resistance compared to G allele (adjusted OR = 2.66 (95% CI 1.36-5.19, p = 0.004).

    CONCLUSION: VDR BsmI polymorphism was significantly associated with vitamin D deficiency and insulin resistance, but not with obesity in this population.

    Matched MeSH terms: Vitamin D Deficiency/genetics*
  12. Moey LH, Abdul Azize NA, Yakob Y, Leong HY, Keng WT, Chen BC, et al.
    Pediatr Neonatol, 2018 08;59(4):397-403.
    PMID: 29203193 DOI: 10.1016/j.pedneo.2017.11.006
    BACKGROUND: Fructose-1,6-bisphosphatase (FBPase) deficiency is a rare autosomal recessive inborn error of gluconeogenesis. We reported the clinical findings and molecular genetic data in seven Malaysian patients with FBPase deficiency.

    METHODS: All patients diagnosed with FBPase deficiency from 2010 to 2015 were included in this study. Their clinical and laboratory data were collected retrospectively.

    RESULTS: All the patients presented with recurrent episodes of hypoglycemia, metabolic acidosis, hyperlactacidemia and hepatomegaly. All of them had the first metabolic decompensation prior to 2 years old. The common triggering factors were vomiting and infection. Biallelic mutations in FBP1 gene (MIM*611570) were identified in all seven patients confirming the diagnosis of FBPase deficiency. In four patients, genetic study was prompted by detection of glycerol or glycerol-3-phosphate in urine organic acids analysis. One patient also had pseudo-hypertriglyceridemia. Seven different mutations were identified in FBP1, among them four mutations were new: three point deletions (c.392delT, c.603delG and c.704delC) and one splice site mutation (c.568-2A > C). All four new mutations were predicted to be damaging by in silico analysis. One patient presented in the neonatal period and succumbed due to sepsis and multi-organ failure. Among six survivors (current age ranged from 4 to 27 years), four have normal growth and cognitive development. One patient had short stature and another had neurological deficit following status epilepticus due to profound hypoglycemia.

    CONCLUSION: FBPase deficiency needs to be considered in any children with recurrent hypoglycemia and metabolic acidosis. Our study expands the spectrum of FBP1 gene mutations.

    Matched MeSH terms: Fructose-1,6-Diphosphatase Deficiency/complications*
  13. Tan YL, Voon HY, Ngeh N
    Med J Malaysia, 2018 06;73(3):170-171.
    PMID: 29962501
    We report the peculiar case of a patient who consumed raw rice daily and had iron-deficiency anaemia secondary to menorrhagia with underlying polycystic ovarian syndrome. A 32-year-old lady of Asian descent presented with symptoms of fatigue, lethargy and prolonged, irregular periods for the last two months. There was noticeable increase in body weight, male pattern alopecia and facial acne. In addition, she experienced sudden, unexplained predilection towards consumption of raw rice (up to 300- 400g/day). The patient was treated with oral iron and cyclical progestin. After three weeks, her haemoglobin improved and her ryzophagia subsided. Gynaecologists should be vigilant of pica, which can occur outside of the context of pregnancy and also poses potential health risks including tooth attrition, electrolyte imbalance, intestinal obstruction and poisoning.
    Matched MeSH terms: Anemia, Iron-Deficiency/etiology
  14. Lee WS, Jalaludin MY, Wong SY, Ong SY, Foo HW, Ng RT
    Pediatr Neonatol, 2019 02;60(1):12-18.
    PMID: 29680189 DOI: 10.1016/j.pedneo.2018.03.011
    BACKGROUND: To determine vitamin D status in children with chronic liver disease (CLD) in a tropical country.

    METHODS: Cross-sectional study in Malaysian children with CLD. Factors affecting serum vitamin D level (definition: deficient 

    Matched MeSH terms: Vitamin D Deficiency/epidemiology*
  15. Ishak R, Hallett MB
    Biochem Biophys Res Commun, 2018 12 02;506(4):1065-1070.
    PMID: 30409431 DOI: 10.1016/j.bbrc.2018.10.174
    It has been proposed that Ca2+ activation of calpain-1 is an important trigger for rapid cell spreading by neutrophils. In this paper, we have investigated this by assessing the ex vivo functioning of neutrophils from calpain-1 null mice, Calpain-1 null neutrophils failed to migrate through TNF-activated endothelial monolayers. The failure to transmigrate through endothelial monolayers was therefore unlikely to be due to a failure of chemotaxis as chemotaxis by adherent calpain-1 null neutrophils towards fMLP was unpaired. In contrast, the capacity of calpian-1 neutrophils to spontaneously spread was limited to smaller diameters than for wild type cells. Photolytic uncaging of IP3 with Individual wild type neutrophils resulted in a large Ca2+ signal and rapid cell spreading. In contrast, calpain-1 neutrophils failed to spread in response to the IP3-induced Ca2+ signal. This work has therefore demonstrated that the presence of calpain-1 was required for effective rapid cell spreading by neutrophils.
    Matched MeSH terms: Calpain/deficiency*
  16. Abdullah HR, Ang AL, Froessler B, Hofmann A, Jang JH, Kim YW, et al.
    Singapore Med J, 2020 Jun;61(6):287-296.
    PMID: 31044255 DOI: 10.11622/smedj.2019037
    Preoperative anaemia is common in the Asia-Pacific. Iron deficiency anaemia (IDA) is a risk factor that can be addressed under patient blood management (PBM) Pillar 1, leading to reduced morbidity and mortality. We examined PBM implementation under four different healthcare systems, identified challenges and proposed several measures: (a) Test for anaemia once patients are scheduled for surgery. (b) Inform patients about risks of preoperative anaemia and benefits of treatment. (c) Treat IDA and replenish iron stores before surgery, using intravenous iron when oral treatment is ineffective, not tolerated or when rapid iron replenishment is needed; transfusion should not be the default management. (d) Harness support from multiple medical disciplines and relevant bodies to promote PBM implementation. (e) Demonstrate better outcomes and cost savings from reduced mortality and morbidity. Although PBM implementation may seem complex and daunting, it is feasible to start small. Implementing PBM Pillar 1, particularly in preoperative patients, is a sensible first step regardless of the healthcare setting.
    Matched MeSH terms: Anemia, Iron-Deficiency/drug therapy*
  17. Aslam S, Yee VC, Narayanan S, Duraisamy G, Standen GR
    Br J Haematol, 1997 Aug;98(2):346-52.
    PMID: 9266932
    Molecular analysis has been performed on a Malaysian patient with a severe bleeding disorder due to factor XIII(A) subunit deficiency. Total mRNA was isolated from the patient's leucocytes and four overlapping segments corresponding to the entire coding region of the A subunit cDNA were amplified by RT-PCR. The cDNA segments amplified efficiently and were of expected size. Direct sequencing of the complete reading frame revealed a single homozygous base change (nt 1327G-T) in exon 10 corresponding to a missense mutation, Val414Phe, in the catalytic core domain of the A subunit monomer. The mutation eliminates a BsaJ1 restriction site and family screening showed that both parents were heterozygous for the defect. The base substitution was absent in 55 normal individuals. Val414 is a highly conserved residue in the calcium-dependent transglutaminase enzyme family. Computer modelling based on 3D crystallographic data predicts that the bulky aromatic side chain of the substituted phenylalanine residue distorts protein folding and destabilizes the molecule. In addition, conformation changes in the adjacent catalytic and calcium binding regions of the A subunit are likely to impair the enzymatic activity of any protein synthesized.
    Matched MeSH terms: Factor XIII Deficiency/genetics*
  18. Kerner G, Rosain J, Guérin A, Al-Khabaz A, Oleaga-Quintas C, Rapaport F, et al.
    J Clin Invest, 2020 Jun 01;130(6):3158-3171.
    PMID: 32163377 DOI: 10.1172/JCI135460
    Mendelian susceptibility to mycobacterial disease (MSMD) is characterized by a selective predisposition to clinical disease caused by the Bacille Calmette-Guérin (BCG) vaccine and environmental mycobacteria. The known genetic etiologies of MSMD are inborn errors of IFN-γ immunity due to mutations of 15 genes controlling the production of or response to IFN-γ. Since the first MSMD-causing mutations were reported in 1996, biallelic mutations in the genes encoding IFN-γ receptor 1 (IFN-γR1) and IFN-γR2 have been reported in many patients of diverse ancestries. Surprisingly, mutations of the gene encoding the IFN-γ cytokine itself have not been reported, raising the remote possibility that there might be other agonists of the IFN-γ receptor. We describe 2 Lebanese cousins with MSMD, living in Kuwait, who are both homozygous for a small deletion within the IFNG gene (c.354_357del), causing a frameshift that generates a premature stop codon (p.T119Ifs4*). The mutant allele is loss of expression and loss of function. We also show that the patients' herpesvirus Saimiri-immortalized T lymphocytes did not produce IFN-γ, a phenotype that can be rescued by retrotransduction with WT IFNG cDNA. The blood T and NK lymphocytes from these patients also failed to produce and secrete detectable amounts of IFN-γ. Finally, we show that human IFNG has evolved under stronger negative selection than IFNGR1 or IFNGR2, suggesting that it is less tolerant to heterozygous deleterious mutations than IFNGR1 or IFNGR2. This may account for the rarity of patients with autosomal-recessive, complete IFN-γ deficiency relative to patients with complete IFN-γR1 and IFN-γR2 deficiencies.
    Matched MeSH terms: Interferon-gamma/deficiency*
  19. Lee KT, Teoh CS, Chew TK, Goh AS
    J R Coll Physicians Edinb, 2020 Jun;50(2):144-147.
    PMID: 32568285 DOI: 10.4997/JRCPE.2020.213
    Vitamin B12 deficiency and folate deficiency are common causes of macrocytic anaemia and both are important for many cellular processes. These deficiencies could be due to inadequate dietary intake, impaired absorption or drug ingestion. We present a case of a 47-year-old male with a history of diffuse large B-cell lymphoma (DLBCL) who was admitted for fatigue, persistent frontal headache and left upper-quadrant abdominal pain. Further investigation showed that he had pancytopenia with microangiopathic haemolytic anaemia (MAHA) and intracranial bleeding (ICB). Serum vitamin B12 and folate were later found to be low and a diagnosis of combined vitamin B12 and folate deficiency mimicking thrombotic thrombocytopenic purpura (TTP) was made. The patient responded well to vitamin B12 and folate replacement.
    Matched MeSH terms: Folic Acid Deficiency; Vitamin B 12 Deficiency
  20. Khor BH, Sahathevan S, Sualeheen A, Ali MSM, Narayanan SS, Chinna K, et al.
    Sci Rep, 2021 01 14;11(1):1416.
    PMID: 33446880 DOI: 10.1038/s41598-020-80812-1
    The metabolic impact of circulating fatty acids (FAs) in patients requiring hemodialysis (HD) is unknown. We investigated the associations between plasma triglyceride (TG) FAs and markers of inflammation, insulin resistance, nutritional status and body composition. Plasma TG-FAs were measured using gas chromatography in 341 patients on HD (age = 55.2 ± 14.0 years and 54.3% males). Cross-sectional associations of TG-FAs with 13 markers were examined using multivariate linear regression adjusted for potential confounders. Higher levels of TG saturated fatty acids were associated with greater body mass index (BMI, r = 0.230), waist circumference (r = 0.203), triceps skinfold (r = 0.197), fat tissue index (r = 0.150), serum insulin (r = 0.280), and homeostatic model assessment of insulin resistance (r = 0.276), but lower malnutrition inflammation score (MIS, r =  - 0.160). Greater TG monounsaturated fatty acid levels were associated with lower lean tissue index (r =  - 0.197) and serum albumin (r =  - 0.188), but higher MIS (r = 0.176). Higher levels of TG n-3 polyunsaturated fatty acids (PUFAs) were associated with lower MIS (r =  - 0.168) and interleukin-6 concentrations (r =  - 0.115). Higher levels of TG n-6 PUFAs were associated with lower BMI (r =  - 0.149) but greater serum albumin (r = 0.112). In conclusion, TG monounsaturated fatty acids were associated with poor nutritional status, while TG n-3 PUFAs were associated with good nutritional status. On the other hand, TG saturated fatty acids and TG n-6 PUFAs had both favorable and unfavorable associations with nutritional parameters.
    Matched MeSH terms: Protein Deficiency/blood*
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