No abstract

The emerging renal complications in beta-thalassemia patients have raised the global exchange of views. Despite better survival due to blood transfusion and iron chelation therapy, the previously unrecognized renal complication remain a burden of disease affecting this population -the primary concern on how iron overload and chelation therapy correlated with renal impairment is still controversial. Early detection and diagnosis is crucial in preventing further kidney damage. Therefore, a systematic review was performed to identify markers of kidney complications in beta thalassemia patients with iron overload receiving chelation therapy. Methods: Searches of PubMed, Scopus, Science Direct, and Web of Science were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify studies of literature reporting renal outcome in β-TM patients with iron overload and receiving chelation therapy. The eligible 17 studies were obtained. Results: uNGAL/NGAL, uNAG/NAG, uKIM-1 are markers that can be used as predictor of renal tubular damage in early renal complications, while Cystatin C and uβ2MG showed further damage at the glomerular level. Discussion and Conclusion:The renal complication in beta-thalassemia patients with iron overload receiving chelating agent therapy may progress to kidney disease. Early detection using accurate biological markers is a substantial issue that deserves further evaluation to determine prevention and management.

Anti-dense fine speckled 70 (DFS70) dikenal sebagai penanda autoimun nonsistemik. Hanya 1% pasien gangguan autoimun sistemik ditemukan anti-DFS70 dan 2-22% positif pada populasi sehat. Dari penelusuran kami belum pernah dilaporkan anti-DFS70 positif pada pasien systemic lupus erythematosus (SLE) dengan komorbid primary billiary cholangitis (PBC). Artikel ini menyajikan sebuah kasus pada seorang wanita 40 tahun dengan SLE sejak satu bulan, datang dengan keluhan lemas, nafsu makan berkurang, ikterik, atralgia, rambut rontok, dan demam tanpa sebab yang jelas sejak tujuh hari sebelumnya. Total bilirubin 9,46 mg/dl, direk bilirubin 7,73 mg/dl, gamma-glutamyl transferase (GGT) 503 U/L, alkali fosfatase (ALP) 520 U/L, ANA-IF 1:1000, ANA-profile borderline pada anti-centromer B, dan positif tiga pada DFS70. Gambaran magnetic resonance cholangiopancreatography (MRCP) mendukung primary billiar cholangitis (PBC). Setelah dua bulan mendapat terapi ursodeoxycholic acid (UDCA) 2 x 250 mg, ALP dan GGT kembali dalam batas normal. Hal ini mengingatkan klinisi bahwa penemuan anti-DFS70 pada SLE memerlukan evaluasi mendalam apakah juga terdapat kejadian autoimun nonsistemik. Primary billiar cholangitis (PBC) yang muncul bersama dengan SLE bisa membaik dengan terapi UDCA standar.

association between IQGAP3 expression and the clinical characters and prognosis. The relationship between IQGAP3 expression and sensitivity to radiation therapy was determined by subgroup analysis. Results: There was significant upregulation of IQGAP3 in breast cancer cell lines and human tumor tissues at both the mRNA and protein level compared to the normal ones. In addition, 110/257 (42.8%) of archived paraffin embedded breast cancer specimens had high protein expression of IQGAP3. High expression of IQGAP3 was significantly related to clinical stage (P ¼ 0.001), T category (P ¼ 0.002), N category (P ¼ 0.001), locoregional recurrence(P ¼ 0.002), distant metastasis (P ¼ 0.001), and vital status (P ¼ 0.001). Univariate and multivariate statistical analysis showed that IQGAP3 was an independent prognostic factor of the whole cohort breast cancer patients (P ¼ 0.003, P ¼ 0.001). Subgroup analysis revealed IQGAP3 expression correlates with radiation therapy resistance and was also an independent predictor for radiation therapy outcome. Conclusions: Our findings suggest that high IQGAP3 expression predicts poor prognosis and radiation therapy resistance in breast cancer. In addition, IQGAP3 may be a reliable novel biomarker to provide personalized prognostication and identify patients who can profit from more aggressive RT regimen for improving the survival of breast cancer patients.

Background: Obesity and metabolic syndrome (MetS) have been linked to the risk of developing certain cancers. This study aimed to analyze the association between obesity markers, MetS and survival outcomes of patients with breast cancer. Methods: This study retrospectively investigated patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-), nonmetastatic breast cancer diagnosed between January 2010 and December 2019. Data on clinical conditions, body mass index (BMI), waist-to-hip ratio (WHR), MetS, time of metastasis and death were collected. Results: A total of 223 breast cancer patient records were eligible for analysis. Obesity (BMI ≥ 25) was found in 38.1% of cases. Abdominal obesity measured as WHR ≥ 0.85 was found in 48.9%. Metabolic syndrome was detected in 56.1% of patients and was associated with older age (OR = 2.196, p = 0.005), postmenopausal status (OR = 2.585, p = 0.001), obesity (OR = 5.684, p = 0.001) and abdominal obesity (OR = 2.612, p = 0.001). Obesity was not associated with poor disease-free survival (DFS) or overall survival (OS), while abdominal obesity was modestly associated with poor DFS (HR = 1.539, p = 0.083) and OS (HR = 3.117; p = 0.019). Multivariate analysis revealed that WHR ≥ 0.85 was independently associated with unfavorable DFS (HR = 1.907, p = 0.027). Patients with MetS had a similar survival rate to those with normal metabolism. Conclusion: In Indonesian women with HR+/HER2-breast cancers, obesity and MetS were not associated with poor survival outcomes. The abdominal obesity marker (WHR) was more accurate in predicting unfavorable DFS.