Introduction: Pediatric immune thrombocytopenia (ITP) is a potentially life threating autoimmune disorder with different responses to therapy and different bleeding phenotypes in critical organs. The molecular basis for the variable response has not yet been fully elucidated. This study was designed to address the predictive value of regulatory B-cell (B reg ) count and interleukin-10 (IL-10) serum levels for acute ITP patients who progress to chronic phase. The present study included 80 children with acute ITP )38 males and 42 females (with median age of 8 years and 40 matched healthy controls. Assessment of B reg (CD19 + CD24 hi CD38 hi ) was carried out by a multicolor flowcytometry, however, IL-10 serum levels were evaluated by enzyme-linked immunosorbent assay. A significant reduction of B reg percentage and a significant increase in serum IL-10 levels were identified in children with acute ITP as compared with controls (P < 0.001 for both). Fourteen ITP patients passed to chronic phase, while 66 patients achieved remission within 6 months. The absolute B reg was significantly lower, while IL-10 was significantly higher in patients with acute ITP who progressed to chronic phase in comparison with acute ITP patients who achieved complete remission. Cox proportional hazards for ITP chronicity revealed that IL-10 OR was 2.46 (confidence interval: 1.42-4.27; P = 0.001) and absolute B reg OR was 0.147 (confidence interval: 0.128-0.624; P = 0.005) in the peripheral blood. Therefore, they could predict chronicity in ITP cases. Conclusion:Reduced B reg count and elevated IL-10 levels in patients with acute ITP at diagnosis can predict chronicity.

Background Hepatitis C virus infection is one of the main causes of chronic liver disease worldwide. Both chronic hepatitis C and chronic kidney disease are common and serious diseases; this work aimed to determine the clinical impact of HCV infection on malnutrition inflammation index score in chronic kidney disease patients. This study was conducted on 96 patients on haemodialysis. They were divided into two groups. The first group was composed of 46 patients who were on maintenance haemodialysis and had chronic hepatitis C. The second group was composed of 50 patients on haemodialysis who were negative for hepatitis C. Results HCV-infected patients were associated with higher malnutrition inflammation score values (10% had MIS 16–20) compared to non-infected patients (2% only had MIS 16–20). Conclusion The prevalence of malnutrition was higher in the HCV-positive than the HCV-negative group.

This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited.