Predicting genetic risk factors for AA amyloidosis in Algerian patients with familial Mediterranean fever

Renal amyloid-associated (AA) amyloidosis is a harmful complication of familial Mediterranean fever (FMF). Its occurrence involves polymorphisms and mutations in the Serum Amyloid A1 (SAA1) and Mediterranean Fever (MEFV) genes, respectively. In Algeria, the association between SAA1 variants and FMF-related amyloidosis was not investigated, hence the aim of this case-control study. It included 60 healthy controls and 60 unrelated FMF patients (39 with amyloidosis, and 21 without amyloidosis). All were genotyped for the SAA1 alleles (SAA1.1, SAA1.5, and SAA1.3), and a subset of them for the - 13 C/T polymorphism by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Comparisons between genotype and allele frequencies were performed using Chi-square and Fisher tests. The SAA1.1/1.1 genotype was predominant in amyloid FMF patients, compared to non-amyloid FMF patients (p = 0.001) and controls (p < 0.0001). SAA1.1/1.5 was higher in non-amyloid patients (p = 0.0069) and in controls (p = 0.0082) than in patients with amyloidosis. Bivariate logistic regression revealed an increased risk of AA amyloidosis with three genotypes, SAA1.1/1.1 [odds ratio 7.589 (OR); 95% confidence interval (CI): 2.130-27.041] (p = 0.0018), SAA1.1/1.3 [OR 5.700; 95% CI: 1.435-22.644] (p = 0.0134), and M694I/M694I [OR 4.6; 95% CI: 1.400-15.117] (p = 0.0119). The SAA1.1/1.5 genotype [OR 0.152; 95% CI: 0.040-0.587] (p = 0.0062) was protective against amyloidosis. In all groups, the - 13 C/C genotype predominated, and was not related to renal complication [OR 0.88; 95% CI: 0.07-10.43] (p = 0.915). In conclusion, in contrast to the - 13 C/T polymorphism, the SAA1.1/1.1, SAA1.1/1.3 and M694I/M694I genotypes may increase the risk of developing renal AA amyloidosis in the Algerian population.

Renal involvement in familial Mediterranean fever in an Algerian population

The objectives of this study were to investigate the clinical biological and histological renal involvement secondary to familial Mediterranean fever (FMF), the epidemiological data, genetics of our patients and their evolution under treatment. We prospectively studied 58 Algerian patients admitted in our nephrology department from January 2012 to January 2021. The diagnosis of nephropathy was suspected clinically and biologically and confirmed histologically. All our patients were tested for MEFV mutations. Results: 58 patients, 30 males and 28 females, mean age 31.68 ± 12.71; 3 (5.17%) chronic dialysis patients and 55 (94.82%) referred to the nephrology department for renal biopsy with renal symptomatology consisting of nephrotic syndrome in 50 (94. 73%), associated with renal failure 27 (47.36%), mainly primary in 23 (34.5%), secondary to seronegative lupus 13 (22.4%), Crohn's disease 9 (14.5%), sarcoidosis 3 (5.26%), and lymphoma 1 (1.7%); 29 (50%) were from consangineous marriages, the histological study found AA amyloidosis in 52 (89.6%); the genetic study confirmed the diagnosis of FMF in 58 (100%). The evolution of the patients: 20 (34.48%) followed in consultation, 25 (43.10%) in hemodialysis and 13 (22.41%) deceased. Conclusion: Renal involvement was the revealing complication in the diagnosis of FMF which exists in our country, and is still underdiagnosed.

The Autoinflammatory Diseases Alliance Registry of monogenic autoinflammatory diseases

Objective

The present manuscript aims to describe an international, electronic-based, user-friendly and interoperable patient registry for monogenic autoinflammatory diseases (mAIDs), developed in the contest of the Autoinflammatory Diseases Alliance (AIDA) Network.

Methods

This is an electronic platform, based on the Research Electronic Data Capture (REDCap) tool, used for real-world data collection of demographics, clinical, laboratory, instrumental and socioeconomic data of mAIDs patients. The instrument has flexibility, may change over time based on new scientific acquisitions, and communicate potentially with other similar registries; security, data quality and data governance are corner stones of the platform.

Results

AIDA project will share knowledge and expertise on mAIDs. Since its start, 118 centers from 24 countries and 4 continents have joined the AIDA project. Fifty-nine centers have already obtained the approval from their local Ethics Committees. Currently, the platform counts 337 users (122 Principal Investigators, 210 Site Investigators, 2 Lead Investigators, and 3 data managers). The Registry collects baseline and follow-up data using 3,748 fields organized into 21 instruments, which include demographics, patient history, symptoms, trigger/risk factors, therapies, and healthcare information for mAIDs patients.

Conclusions

The AIDA mAIDs Registry, acts both as a research tool for future collaborative real-life studies on mAIDs and as a service to connect all the figures called to participate. On this basis, the registry is expected to play a pivotal role in generating new scientific evidence on this group of rare diseases, substantially improving the management of patients, and optimizing the impact on the healthcare system. NCT 05200715 available at https://clinicaltrials.gov.

Acute Cellular Rejection in A Kidney Transplant Recipient Following Vaccination with Inactivated SARS-CoV-2 Vaccine

SARS-CoV-2 vaccines are being administered worldwide. Most of the reported side effects are mild and self-limiting with few reported cases of severe adverse reactions. Here we report a case of acute cellular rejection in a kidney transplant recipient following vaccination with an inactivated SARS-CoV-2 vaccine. fifty- one years old man with autosomal dominant polycystic kidney disease, who had received a kidney transplantation from a living related donor, 3 years ago, presented with an impaired kidney function seven days after receiving the first dose of Sinovac's COVID-19 vaccine. Kidney transplant biopsy revealed acute cellular rejection. The allograft function completely recovered after treatment with steroids. The analysis and investigation of the complications and adverse reactions induced by anti-COVID-19 vaccines, could increase our understanding of the underlying pathogenesis.  DOI: 10.52547/ijkd.6915.

[Leukocytoclastic vasculitis and acute renal failure following inactivated SARS-CoV-2 vaccine]

Les vaccins contre le SRAS-CoV-2 sont administrés dans le monde entier. La plupart des effets secondaires sont légers et spontanément résolutifs, avec peu de cas signalés de réactions graves. Nous rapportons un cas de vascularite leucocytoclasique avec insuffisance rénale aiguë à la suite d’un vaccin à SARS-CoV-2 inactivé, unique pour sa présentation visuelle spectaculaire et sa réponse rapide au traitement. Il s’agit d’un homme âgé de 58 ans présentant de la fièvre, des arthralgies et un purpura vasculaire au niveau des quatre membres, le tout associé à une insuffisance rénale aiguë nécessitant une hémodialyse neuf jours après la vaccination anti-COVID-19. La biopsie cutanée a révélé une vascularite leucocytoclasique et la biopsie rénale une néphrite tubulo-interstitielle aiguë. Le purpura vasculaire s’est résolu 7 jours après le début du traitement par prednisone, mais le patient a conservé une insuffisance rénale chronique modérée. L’analyse et les enquêtes sur les complications et les événements indésirables induits par les vaccins anti-COVID-19 pourraient améliorer notre compréhension de la pathogenèse sous-jacente.