Clinical characteristics analysis and literature review of 55 cases with panniculitis / 中华风湿病学杂志

Objective To improve the clinical understanding of the disease by retrospective analysing 55 cases of patients with panniculitis. Methods The hospitalized patients with panniculitis were collected from December 2011 to October 2018 in the Shanxi Dayi Hospital Affiliated to Shanxi Medical University. The demographics, clinical manifestations, laboratory examinations and treatments were analyzed and summarized, rate or composition ratio were applied for statistical description of the counting data. Results The proportion of males and females in the 55 patients was 1:2.23, with an average of (53±15) years (18-82 years). A total of 52 cases of nodular panniculitis (including 14 cases of mesenteric involvement) and 3 cases of special type of panniculitis were collected. Patients with nodular panniculitis were often presented with subcutaneous nodules or masses. According to the affected parts, they cowld be divided into skin sub-type and systemic sub-type. Among them, 32 cases were skin sub-type and 20 cases are systemic sub-type. The most frequently involved organs were mesenteric and kidney involvement. Nine of 55 patients was complicated with tumor. Patients with mesenteric panniculitis mainly presented with abdominal pain and bloating, which were mainly diagnosed according to CT findings. Patients with systemic panniculitis could be significantly relieved after treatment with coricosteroids and immunosuppressive agents. Conclusion Panniculitis is an inflammatory disease of unknown etiology. It is frequent in middle-aged and elderly people. It presents with various clinical manifestations and lacks specificity. The diagnosis is mainly based on pathological results. It is easy to be complicated with tumors. When subcutaneous nodules are found, pathological examination should be performed in order to avoid misdiagnosis.

Value of anti-mutated citrullinated vimentin antibody and anti-cyclic citrullinated peptide antibody in the prediction of bone erosion and disease activity of rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate the relationship between anti mutated citrullinated vimentin (MCV) antibody, anti-cyclic citrullinated peptide (CCP) antibody with disease activity and bone erosion in patients with rheumatoid arthritis (RA), so as to provide evidence for clinical diagnosis and treatment. Methods The anti-CCP antibody and anti-MCV antibody were detected using the enzyme-linked immune adsorption method (ELISA) for 634 patients with RA. At the same time, the clinical and laboratory data were collected, and the X-ray images of hands or feet were taken. Disease activity score (DAS)28 score was calculated, and all patients were divided into high disease activity group, moderatedisease activity group, low disease activity group and stable disease group on the basis of the DAS28 score. We analyzed the relationship between the degree of anti MCV, anti CCP antibodies, and disease activity of patients by Spearman correlation. And anti CCP, anti MCV antibodies, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) of these patients were compared at different period of bone erosion and disease activity by the Wilcoxon rank sum test and nemenyi. Results ① Positive correlation could be detected between anti-MCV antibody and ESR, CRP, number of tender joint, DAS28 score (r=0.115, P=0.004; r=0.120, P=0.003; r=0.124, P=0.002; r=0.085, P=0.032), and anti CCP antibody had no correlation with these index. The anti MCV antibodies in high disease activity group [694 (156, 1 000)] U/ml, and moderate activity group [911 (190, 1 000)] U/ml were higher than that of the low disease activity [248(150, 731)] U/ml or stable group [275(62, 928)] U/ml (U=2.29, P=0.023;U=2.25, P=0.024; U=2.45, P=0.014; U=2.4, P=0.018), and anti CCP antibody in the moderate disease activity group [499(180, 1 370)] U/ml was higher than low disease activity group [297(83, 574)] U/ml and stable group [187(67, 1 153)] U/ml (U=2.53, P=0.012; U=2.22, P=0.026). ②The anti MCV, anti CCP antibody in the bone erosion group were higher than those without bone erosion group (U=4.64, P<0.01;U=2.69, P=0.007). The anti MCV antibodies in stage Ⅱ[722(259, 1 000)] U/ml and Ⅲ group [714 (216, 1 000)] U/ml was significantly higher than that in stage Ⅰ [316(98, 1 000)] U/ml(U=3.46, P<0.01; U=4.28, P<0.01). The anti CCP antibody level in stage Ⅱ [394(180, 1 000)] U/ml and Ⅲ[391(181,1305)] U/ml was higher compared with stage Ⅰ[277 (98,898)] U/ml (U=1.99, P=0.046; U=2.92, P=0.004), and that in phase Ⅲ was higher than Ⅳ [218(71, 911)] U/ml (U=2.06, P=0.041). Conclusion Compared with anti-CCP antibody, anti-MCV antibody is closely related with disease activity, and has a better predictive value for bone erosion. Patients with higher ESR and CRP are more susceptible to bone erosion.

Indirect immunofluorescence on different cell line in detection of cell membrane DNA antibody in juvenile systemic lupus erythematosus / 国际儿科学杂志

Objective To detect anti-cell membrane DNA ( cmDNA) antibody with human B lym-phocyte Raji cells and human promyelocytic leukemia HL60 cells as substrates and to compare the diagnostic value of anti-cmDNA antibody with that of anti-nucleosome antibody ( AnuA ) , anti-Sm antibody and anti-double-stranded DNA ( dsDNA) antibody in juvenile systemic lupus erythematosus ( JSLE) patients. Meth-ods We recruited 92 JSLE patients and 71 patients with other rheumatic diseases. Anti-cmDNA antibody an-dantinuclear antibody ( ANA ) was detected in patient serum by indirect immunofluorescence assays ( IIF ) . Anti-dsDNA antibody were detected by combining enzyme-linked immuno sorbent assay ( ELISA) and IIF. Anti-Sm antibody were detected by double immunodiffusion assay and immunoblotting, while anti-nucleosome antibody ( AnuA) were detected by ELISA. We collected concurrent clinical data. Results Anti-cmDNA antibody demonstrated stronger intensity of fluorescent patterns in using Raji cells as substrate than HL60 cells. JSLE patients had a significantly higher positive percentage of anti-cmDNA than patients with other rheu-matoid diseases. The sensitivity of anti-cmDNA on cell line Raji was higher than that of anti-dsDNA and anti-Sm (P0. 05) and was lower than anti-Sm and AnuA (P0. 05) and the specificity was lower than AnuA (P<0. 01). The sensitivities of anti-dsDNA, anti-Sm and AnuA by combining with an-ti-cmDNA were much higher than that of the above antibody detected respectively ( P<0. 05 ) . Anti-cmDNA had no correlation with SLE disease activity index ( P=0. 907 ) . Conclusion The high sensitivity and speci-ficity of anti-cmDNA antibody make it a valuable diagnostic tool for JSLE. Combined detection of anti-cmDNA and other autoantibody might further improve the sensitivity in JSLE. Anti-cmDNA detected with IIF on cell line Raji was better than cell line HL60.

Antibodies to mutated citrullinated vimentin and some associated autoantibodies in juvenile idiopathic arthritis / 中华儿科杂志

<p><b>OBJECTIVE</b>To compare the diagnostic value of antibodies to mutated citrullinated vimentin (MCV) and some associated autoantibodies in juvenile idiopathic arthritis and to further analyze the relation between antibodies and inflammatory markers.</p><p><b>METHOD</b>Antibodies to cyclic citrullinated peptides (CCP) and anti-MCV antibodies were detected by enzyme-linked immunosorbent assay (ELISA), antiperinuclear factor (APF) and antikeratin antibody (AKA) by indirect immunofluorescent assay, as well as rheumatoid factor (RF) by latex agglutination test in serum samples from 113 patients with JIA and 56 children without rheumatoid arthritis.</p><p><b>RESULT</b>(1) The positive rate of anti-MCV antibodies, anti-CCP antibodies, and RF was 16.8%, 14.2%, and 21.2% in the JIA. In the other group, the positive rate was 2.2%, 2.2%, and 6.5%. There was a significant difference between the two groups (χ(2)=8.105, 6.337, 7.036, P<0.05). The positive rate of AKA and APF were not significantly different. The area under the ROC curve of anti-MCV antibodies, anti-CCP antibodies, RF, AKA, APF was 0.579, 0.561, 0.578, 0.539, 0.505. (2) The positive rate of anti-MCV antibodies and anti-CCP antibodies were higher than other antibodies. In the RF-positive polyarticular disease patients, they were higher than those in the other subtypes (P<0.05). Antibody levels were not significantly different (P>0.05) from other subtypes. (3) The swollen joint counts and tender joint counts had a low correlation to anti-MCV antibodies, anti-CCP antibodies, RF, AKA and APF. No correlation was found between ESR, CRP and anti-MCV antibodies, anti-CCP antibodies, RF, AKA and APF.</p><p><b>CONCLUSION</b>The diagnostic value of anti-MCV antibodies is low for JIA. The positive rate of anti-MCV antibodies was higher than the other antibodies in the classification of JIA. There was a low correlation between anti-MCV antibodies, anti-CCP antibodies, RF, AKA, APF and swollen joint counts, tender joint counts.</p>

Analysis of a case of systemic sclerosis complicated by noncirrhotic portal hypertension and literature review / 中华风湿病学杂志

Objective To improve the rheumatologists' understanding of noncirrhotic portal hypertension.MethodsA case of systemic sclerosis complicated by noncirrhotic portal hypertension was reported and the related literatures were reviewed.Results A 51-year-old female who had been diagnosed as systemic sclerosis presented clinically with an chronic onset of portal hypertension.She also had pancytopenia,splenomegaly,and significant esophageal varices.Liver function tests were normal.Hepatitis viral serology was negative.Ultrasound scan of liver revealed no focal lesion.ACT scan confirmed the absence of portal vein thrombosis.Taking into account the above evaluation we concluded that the patient had systemic sclerosis and noncirrhotic portal hypertension.The patient was on prednisolone and immunosuppressant and the condition was well.Conclusion Noncirrhotic portal hypertension complicated by autoimmune disease,especially SSC,is very poor,characteriged by significant portal hypertension as well as histological evidence that cirrhosis is absent.Rheumatilogist should pay attention to it.