Antiphospholipid syndrome is a hypercoagulable autoimmune condition that predominantly affect the female and commonly manifest as arterio-venous thrombosis and recurrent miscarriage. Here, we present a unique case of a healthy young man who developed sudden onset of right leg swelling after exercise which was then found to be due to deep vein thrombosis via Doppler ultrasound. His blood investigations showed thrombocytopenia and prolonged coagulation profile. Therefore, antiphospholipid syndrome was suspected and later confirmed by positive autoim- mune antibodies. He was treated with long term moderate intensity oral warfarin. The objective of this case report is to share the uncommon occurrence of an unprovoked deep vein thrombosis secondary to antiphospholipid syn- drome in a healthy young man so that the possibility of deep vein thrombosis should be suspected in selected cases of non-resolving leg swelling after exercise as it can lead to fatal pulmonary embolism.
Introduction: Atopic dermatitis (AD) and its severity has been inconsistently associated with lower vitamin D levels as multiple other factors that influence vitamin D status were not always assessed. Methods: A case control study involving AD patients and controls 18 years old was performed. Exclusion criteria were systemic immunosuppres- sion 4 weeks prior to recruitment, renal or hepatic impairment, parathyroid diseases and vitamin D or calcium supplementation. Healthy controls were matched for age, gender, ethnicity, Fitzpatrick skin type and body mass index (BMI). Sun exposure, a 3-day, 24-hour dietary recall and serum 25-hydroxyvitamin D were measured. Re- sults: 38 AD patients and 38 controls participated. Majority had Fitzpatrick skin type IV. Vitamin D was lower in AD [15.9(9.9-24.0)ng/ml] than controls [17.3(14.4-27.2)ng/ml], p= 0.028. It was sufficient in 16(42.1%) AD and 15(39.5%) controls, insufficient in 7(18.4%) AD and 22(57.9%) controls and deficient in 15(39.5%) AD compared to 1(2.6%) control. Sun exposure was similar in both groups. AD had significantly higher dietary vitamin D intake [1.5(0.6-3.1) vs 0.6 (0.3-1.0)µg]. AD was an independant risk for vitamin D deficiency with OR 17.52; 95%CI:1.4-
212.7 and vitamin D insufficiency OR 0.26;95%CI:0.07-0.95. Vitamin D levels did not correlate with AD severity. Conclusion: AD is a risk for vitamin D deficiency despite higher dietary intake and similar skin type, BMI and sun exposure as controls.
Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide ß cross
link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high
levels of CTX- ß. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as