ABSTRACT
OBJECTIVE: Dehydroepiandrosterone sulphate (DHEAS), the major steroidal product of the human adrenal, is abnormally low in patients with SLE. Moreover, a recent study confirms a positive effect of the precursor DHEA on the disease course in SLE, which supports an etiologically important role of the hormone on SLE. The aim of this study is to search for an interrelation between clinical manifestations, laboratory findings, and disease activities and DHEAS in patients with SLE. METHOD: DHEAS were measured by radioimmunoassay kit using 125I-labeled DHEA-SO4 antibody-coated tube in the serum of 48 patients with SLE and in 46 control subjects. Laboratory findings, clinical symptoms, signs and SLE disease activity index (SLEDAI) in SLE patients were evaluated at blood sampling time. RESULTS: DHEAS was lower in patients with SLE compared to controls (45.60+/-42.62 mug/dL vs 101.55+/-56.54 mug/dL, p<0.005). The serum DHEAS levels were significantly negative correlation with SLEDAI (r=-0.333, p<0.05). There were significantly negative correlations between daily steroid dose and DHEAS (r=-0.384, p=0.012), and the amount of steroid used during previous 2 months and DHEAS (r=-0.011, p=0.011). CONCLUSIONS: Patients with SLE have low levels of DHEAS and significant negative correlation between SLEDAI, steroid dose and DHEAS.
Subject(s)
Female , Humans , Dehydroepiandrosterone , Lupus Erythematosus, Systemic , RadioimmunoassayABSTRACT
Rheumatoid arthritis (RA) is though to be a collagen disease induced by auto-immune mechanism of unknown etiology. Chronic myelogenous leukemia (CML) is a disease characterized by overproduction of cells of the granulocytic, especially the neutrophilic series and occasionally the monocytic series, leading to marked splenomegaly and very high white blood cell counts. There's no consensus on the risk of leukemia in RA. There are some reports ragarding the relationship between low dose of methotrexate (<20 mg weekly) and the development of leukemia in RA. Although RA is a complex process, it can be considered initially as a stem cell disorder requiring treatment similar to that administered to transplant patient. We experienced a case of CML associated with RA. A 60-year-old woman with RA was treated with low dose methotrexate (7.5 mg weekly), hydroxychloroquine (HCQ), non-steroidal anti- inflammatory drug (NSAID) and low dose steroid. This therapy was continued for 3 years. She was diagnosed CML after 3 years of therapy. CML was confirmed by bone marrow biopsy and the presence of the Philadelphia chromosome.
Subject(s)
Female , Humans , Middle Aged , Arthritis, Rheumatoid , Biopsy , Bone Marrow , Collagen Diseases , Consensus , Hydroxychloroquine , Leukemia , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Leukocyte Count , Methotrexate , Neutrophils , Philadelphia Chromosome , Splenomegaly , Stem CellsABSTRACT
Cryoglobulins are cold-precipitable monoclonal or polyclonal immunoglobulins,which can occur without an identifiable underlying disease condition or in association with underlying disorders.Cryoglobulinemic vasculitis is immune complex-mediated vasculitis that predominantly affect small vessels.Less often,medium-sized or even large vessels can be affected.Cryoglobulinemic vasculitis is a rare one of the cutaneous manifestations of multiple myeloma.We experienced a patient with cryoglobulinemic vasculitis developed in multiple myeloma who presented with Raynaud's phenomenon,purpuric patch and skin ulcer.