ABSTRACT
Autoantibodies are an integral part of the process of classifying, detecting, and, at least in some cases, mediating autoimmune diseases. The antinuclear antibody is not just one antibody but, actually, many different antibodies associated with a variety of diseases and disease manifestations. Antinuclear antibodies [ANA], anti-Sm, or anti-dsDNA antibodies are part of the American College of Rheumatology criteria [ACR] for SLE. Specific reactivities are associated with distinct clinical features of SLE. To study associations between antinuclear antibodies [ANA] detected by Line Immunoassay and signs/symptoms in patients with systemic lupus erythematosus [SLE]. A total of 38 unselected consecutive patients, diagnosed as having SLE and attending the rheumatology and nephrology units, Suez Canal University Hospital, were included in this study. The patients met the American College of Rheumatology [ACR] revised criteria for classification of SLE. ANA profiles were determined by line immunoassay and by indirect immunofluorescence on Crithidia luciliae. An extensive list of signs/symptoms was evaluated. ANA were found by indirect immunofluorescence [IIF] in 36/38 [95%] patients. The frequencies of the specific reactivities were: anti-dsDNA 60%, anti-SmB 35%, anti-SmD 25%, anti-RNP-C 25%, anti-Ro60 15%, anti-SSB 15%, anti-RNP-A 10%, antiRibosomal P 10%, anti-Ro52 5%, anti Cenp-B 5%, anti Scl-70 2.6%, and anti-Histones 60%. Cutaneous manifestations were associated with anti-SSB, Ro52, Ribosomal P, anti-dsDNA and histones. Raynaud's phenomenon was associated with Ro52 and 60, histones and RNP-C. Xerostomia was associated with Ro52 and 60 as well as Cenp-B. Renal manifestations were associated with RNP-A, Ro52, Ro60 and dsDNA. By using a sensitive and specific multiparameter assay like LIA for identifying antinuclear reactivities, we could confirm some of the previously reported associations of antibodies with clinical symptoms of SLE. We also found several new associations meriting further study
ABSTRACT
Background: Diabetes is a common cause of peripheral neuropathy. Phrenic neuropathy may be an important, albeit rare, complication of diabetes. Diaphragmatic function should be considered in any patient with unexplained breathlessness and orthopnea. Neurological problems of the diaphragmatic muscle occur when a disease process decreases or terminates the impulse of respiratory stimuli originating in the brain. The diaphragm receives its role muscular neurologic impulse of the respiratory impulse from the phrenic nerve. Phrenic neuropathy may impair respiratory function. Aim of the work: To compare respiratory functions and phrenic nerve electrophysiological activity in diabetics and non-diabetics
Methods: An electrophysiological study of phrenic nerve was performed, using motor nerve conduction velocity study to determine its possible involvement in 30 diabetic patients and 30 non-diabetics. Respiratory functions [FVC,FEV1, FEV1/FVCratio, and FEF25-75]were also measured
Reuslts: Most of diabetics showed impaired respiratory function. Twelve patients of all diabetics showed pathological phrenic nerve latency. Phrenic nerve conduction velocity is significantly lower in those diabetics who have impaired respiratory functions than those without respiratory function impairment. Delayed phrenic nerve latency correlated clearly with impaired respiratory functions, fasting blood sugar and glycosylated hemoglobin
Conclusion: Diabetes is correlated with delayed phrenic nerve conduction velocity and respiratory function impairment