Enhanced complement activation is part of the unfavourable cardiovascular risk profile in South Asians

South Asian immigrants in western societies exhibit a high burden of diabetes and subsequent vascular complications. Diabetic vascular complications are associated with vascular inflammation. We hypothesize that enhanced complement activation is involved. Therefore, levels of complement C3 and SC5b-9 - the soluble end product of complement activation - in a group of 200 South Asians were compared with an age- and sex-matched control group of native Caucasians. In addition, the association between complement levels and albuminuria, an indicator of renal damage and a cardiovascular risk marker, was assessed in the diabetic South Asian group. Compared with native Caucasians, South Asians had significantly higher levels of both serum C3 and plasma SC5b-9, even when only non-diabetic South Asians were considered. Diabetic South Asians had significantly higher C3 levels compared with non-diabetic South Asians. In diabetic South Asians, higher levels of SC5b-9 were associated with an increased prevalence of albuminuria (odds ratio 5.4, 95% confidence interval 1.8-15.8). These results suggest that enhanced complement activation is part of the unfavourable cardiovascular risk profile in South Asians.

[Acute occlusion of the renal artery treated by means of rheolytic thrombectomy]

A 64-year-old woman presented with recurrent infarction of the right kidney. Because of suspected dysfunction of the contralateral kidney, revascularisation of the occluded right renal artery was attempted. Local thrombolysis with urokinase was unrewarding. So-called rheolytic thrombectomy by means of a Hydrolyser was successful in opening the right main renal artery. Although recovery of right renal function was not complete, renal scintigraphy confirmed salvage of most of the right kidney parenchyma.

Testing families with HFE-related hereditary haemochromatosis

HFE-related hereditary haemochromatosis is the most common autosomal recessive disorder in the Caucasian population. In 1996 the responsible gene (called HFE) was identified. Two mutations (C282Y and H63D) are considered most important and occur frequently in the Caucasian population. We describe a family of an affected proband in which first- and second-degree relatives were tested phenotypically and genotypically. In second-degree relatives both C282Y homozygosity as well as compound heterozygosity were found. Family testing can be useful to detect persons who will possibly develop iron overload. We must be aware that testing first-degree relatives only carries a 2.5% chance that persons at risk of developing iron loading will not be detected. Cascade screening of second-degree relatives might be cost-effective.