ABSTRACT
To investigate the clinical manifestations and risk factors in patients with systemic lupus erythematosus (SLE) and cancers. From October 2010 to February 2019, 5 566 SLE patients hospitalized in the First Affiliated Hospital of Zhengzhou University were enrolled. A total of 69 cancer patients were identified, and the clinical characteristics and previous treatment were analyzed. Cervical carcinoma (21.74%, 15/69) and thyroid cancer (21.74%, 15/69) were the most common types of cancer. Most cancers were diagnosed in SLE patients with an age 40~50 years. The disease duration of SLE was from 60~120 months. SLE patients without cancers were usually diagnosed between 20~30 years with duration of symptoms less than 12 months. As to the previous treatment of SLE, the uses of glucocorticoid, cyclophosphamide, methotrexate and azathioprine were comparable between patients with cancers and without ( P>0.05). However, the use of hydroxychloroquine was more frequent in SLE patients than in patients with cancers ( P<0.01). Correlation analysis revealed significant correlation between disease course of SLE ( OR=4.25, 95% CI 1.79~10.01, P<0.001), hydroxychloroquine ( OR=0.26, 95% CI 0.12~0.59, P<0.001) and cancer risk. Long disease course may be a risk factor for SLE patients to develop cancer, whereas hydroxychloroquine could be a protective factor.
ABSTRACT
To investigate the clinical manifestations and risk factors in patients with systemic lupus erythematosus (SLE) and cancers. From October 2010 to February 2019, 5 566 SLE patients hospitalized in the First Affiliated Hospital of Zhengzhou University were enrolled. A total of 69 cancer patients were identified, and the clinical characteristics and previous treatment were analyzed. Cervical carcinoma (21.74%, 15/69) and thyroid cancer (21.74%, 15/69) were the most common types of cancer. Most cancers were diagnosed in SLE patients with an age 40~50 years. The disease duration of SLE was from 60~120 months. SLE patients without cancers were usually diagnosed between 20~30 years with duration of symptoms less than 12 months. As to the previous treatment of SLE, the uses of glucocorticoid, cyclophosphamide, methotrexate and azathioprine were comparable between patients with cancers and without (P>0.05). However, the use of hydroxychloroquine was more frequent in SLE patients than in patients with cancers (P<0.01). Correlation analysis revealed significant correlation between disease course of SLE (OR=4.25, 95%CI 1.79~10.01,P<0.001), hydroxychloroquine (OR=0.26, 95%CI 0.12~0.59,P<0.001) and cancer risk. Long disease course may be a risk factor for SLE patients to develop cancer, whereas hydroxychloroquine could be a protective factor.
ABSTRACT
Objective To investigate the clinical features of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) associated hypertrophic pachymeningitis (HP).Methods Clinical data of 4 casesdiagnosed with MPO-ANCA vasculitis complicated with HP in our hospital were analyzed retrospectively and the related literaturewere reviewed.Results Four male patients with an age range from 44 to 66 years were diagnosed with ANCA-associated HP.The main clinical manifestations included headache and withvarious degree ofmultiple cranial paralysis.During active phase of the disease,all patients showed perinuclear(p)-ANCA positive,elevated levels of inflammatory biomarkers and titers of MPO-ANCA,whereas renal function,cytoplasmic (c)-ANCA and protease 3 (PR3)-ANCA were negative.Contrast-enhanced cranial magnetic resonance imaging (MRI) scan showed obviously thickened dura mater and sinusitis or mass in paranasal sinus.Four patients were sensitive to glucocorticoid.Three patients had a relapse during glucocorticoid tapering and were undercontrol when the dosage of glucocorticoid was increased and immunosuppressive agents were added.Levels of inflammatory biomarkers,titers of MPO-ANCA and p-ANCA recovered to normal,and the dural thickness on MRI was reduced in the remission stage.Conclusion MPO-ANCA associated HP is a type of central nervous system involvement in ANCA associated vasculitis (AAV).It involves the upper respiratory tract more frequently,and less frequently progresses to systemic AAV.This should be taken into consideration when middle-aged and elderly patients presented with headache and multiple cranial neuropathies.Enhanced MRI is the preferred examination for diagnosis,and dural biopsy should be done when necessary.
ABSTRACT
Objective To compare the disease activity score (DSA) 28-CRP and DAS28-ESR in patients with rheumatoid arthritis.Methods Two hundred and twenty-two patients were enrolled,and their sex,age,disease duration,swollen joint count,tender joint count,CRP,ESR,visual analogue scale were recorded.DAS28-ESR and DAS28-CRP were calculated and then analyzed by t test and Pearson's correlation test.Results There was a significant linear correlation between DAS28-ESR and DAS28-CRP (P＜0.05),with correlation coefficient of 0.968.Both DAS28-CRP (3.3±1.7) and DAS28-ESR (3.9±1.8) scores presented with normal distribution (P＞0.05),with the peak of the DAS28-CRP left to that of the DAS28-ESR.There was statistically significant difference between these two (P＜0.05).The difference between DAS28-CRP and DAS28-ESR was much higher in female (0.59±0.43) than in male (0.24±0.45,P＜0.05).The difference between DAS28-CRP and DAS28-ESR was not related to age and disease duration.Conclusion Attention should be paid to the assessment score when making the plan of treating to target since there is difference between DAS-28-ESR and DAS-28-CRP.
ABSTRACT
Objective To investigate the incidence and correlative factors of metabolic syndrome (MS) in patients with systemic lupus erythematosus (SLE).Methods A total of 116 SLE patients and 115 controls were enrolled into the study.The incidence of MS,SLE disease activity index(SLEDAI) of patients with SLE combined with MS (MS-SLE) and patients without MS (n-MS-SLE),lupus characteristics,cumulative glucocorticoids,administration dose of glucocorticoids and hydroxychloroquine were compared between SLE group and the control group.Results The incidence of MS of SLE group was obviously higher than that of the control ( 34.48％ vs 14.78％,P ＜ 0.05 ).The ratios of patients with lower HDL-C,higher TG and higher blood pressure in SLE group ( 50.86％,56.03％,46.55％ ) were higher than those in the controls ( 34.78％,16.52％,20.00％,all P ＜ 0.05 ).MS-SLE group had significantly higher mean waist circumference,BMI,systolic blood pressure and diastolic blood pressure and lower HDL-C than n-MS-SLE group (all P ＜0.05 ).No significant difference was found regarding duration of disease,renal involvement,ESR,C-reactive protein,high-sensitivity C-reactive protein,SLEDAI,cumulative and current glucocorticoids use in MS-SLE group and n-MS-SLE group.The ratio of patients taking hydroxychloroquine in n-MS-SLE group was higher than that of MS-SLE group (46.05％ vs 15.00％,P＜0.05).Conclusions Patients with SLE has a higher incidence rate of MS.Hydroxychloroquine may reduce their MS incidence.