Role of DNA-associated autoantibodies to cell membrane in the diagnosis of juvenile systemic lupus erythematosus / 中华儿科杂志

<p><b>OBJECTIVE</b>To establish a method of indirect immunofluorescence (IIF) to measure DNA (mDNA)-associated autoantibodies to cell membrane, and to evaluate diagnostic value of the anti-mDNA antibodies in patients with juvenile systemic lupus erythematosus (SLE) in comparison with anti-dsDNA antibody.</p><p><b>METHODS</b>Forty-four children with SLE were enrolled in this study. As a control group, 30 children with other rheumatic diseases were also enrolled. Anti-mDNA and anti-dsDNA antibodies were measured by IIF. Anti-smooth muscle (Sm) antibodies were measured by immuno-double diffusion (ID) and IIF.</p><p><b>RESULTS</b>Out of 44 juvenile SLE patients, 34 (77.27%) were seropositive for anti-mDNA, which was significantly higher than that of patients with other rheumatic diseases (20.00%, P<0.05). The sensitivity and specificity of anti-mDNA for juvenile SLE diagnosis were 77.27% and 80.00%, respectively. The positive predictive value and negative predictive value were 85.00% and 70.59%, respectively. The positive rate of anti-mDNA in SLE lacking of anti-dsDNA and anti-Sm antibodies were 68.00% (17/25) and 79.49% (31/39), respectively.</p><p><b>CONCLUSION</b>The detection of anti-mDNA antibodies is useful for diagnosis of juvenile SLE, especially in patients who are negative for anti-dsDNA antibodies and anti-Sm antibodies.</p>

Analysis of the characteristics of juvenile primary Sj(?)gren's syndrome with renal damage / 中华风湿病学杂志

Objective To study the renal damage of patients with juvenile primary Sjgren's syndrome (pSS)and its clinical manifestations,pathologic characteristics with biopsy,treatment and prognosis.Methods Ten patients with juvenile pSS complicated with renal impairments were retrospectively analyzed.Data of these 10 patients were compared with those without renal impairments.Results Ten patients complicated with renal impairments in 24 patients with juvenile pSS,9 of them presented with type I renal tubular acidosis(RTA), 5 with hypokalemia paralysis,3 with calcification of the renal tissue,3 with positive urine protein.1 with dia- betes insipidus.There was no significant difference between patients with renal impairments and those without. Three patients underwent kidney biopsy that showed chronic interstitial nephritis(CIN)with extensive lymp- hoplasmie cell infiltration.Two patients had glomerular lesions and one of them was diagnosed as pSS over- laped with systemic lupus erythematosus(SLE).Steroid and immunosuppressive agents had significantly alle- viated symptoms and the hypergammaglobulinemia was significantly improved.Conclusion Renal impairment may be the major complication in juvenile pSS.The major clinical manifestations are RTA and the glomeruli are involved occasionally.Treatment with steroid anti immunnsuppressive agents should be given to those who have evidence of systemic involvement.

Diagnostic significance of detection of anti-citrullinated peptide antibodies in juvenile rheumatoid arthritis / 中华风湿病学杂志

Objective To assess the diagnostic value of anti-cyclic citrullinated peptide antibody(an- ti-CCP),rheumatoid factor,anti-perinuclear factor(APF)and anti-keratin antibody(AKA)for juvenile rheumatoid arthritis(JRA)and compare it with rheumatoid arthritis(RA).Methods Anti-CCP was determined by ELISA in 54 serum samples of JRA patients,31 from patients with other rheumatic diseases and 116 RA patients.RF was determined in the same samples by latex agglutination test.APF and AKA were determined by indirect immunofluorescent assay.Results The sensitivity of anti-CCP,RF,APF and AKA was 61.1%, 57.4%,37.0% and 18.5% and their specificity was 96.8%,93.6%,96.8% and 100%,respectively for the diag- nosis of JRA.The sensitivity of anti-CCP resembleed that of RF,Anti-CCP was more sensitivity than APF and AKA in JRA.The sensitivity of anti-CCP,RF,APF and AKA was 82.3%,78.3%,48.7% and 25.4% and their specificity was 95.7%,73.7%,91.6%,94.0% respectively,for the diagnosis of RA.Anti-CCP,RF,APF and AKA were less sensitive in JRA than in RA.There was no statistical significance in specificity of these anti- bodies for the diagnosis of JRA and RA.Conclusion The detection of anti-CCP,RF,APF and AKA are use- ful for the diagnosis of JRA,but are less sensitive than in adults RA.