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Objective To investigate the significance of ultrasonography in the examination of rheumatoid arthritis(RA). Methods The wrist joints of activated RA and wrist, metacarpophalangeal, proximal interphalangeal joints of remission of RA were determined, and the imaging features were analyzed. Results Patients with activated RA were divided into two groups. The bone erosion and sheath lesions were lower in the group of duration less than 1 year than those in the group of duration over 1 year (P < 0.01). The positive rate of ultrasound was higher than that of X-ray in bone erosion (P < 0.05). To patients with the remission of RA, the positive rate of ultrasound was higher than that of the physical examination in synovitis ( P < 0 . 05 ) . Conclusions For bone erosion, ultrasound is better than X-ray for patients with early RA. For synovitis, the sensitivity of ultrasonography is higher than the physical examination in remission for RA patients.
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Objective To discuss the diagnosis and treatment of systemic lupus erythematosus(SLE)patients associated with pancreatic pleural effusion and pancreatic:panniculitis.Methods Retrospectively analyzed the clinical data,therapy and experiences.Results A 40-year-old female SLE patient associated with pancreatitis,huge pancreatic pseudocysts,pancreatic pleural effusion,pancreatic panniculitis.Abdominal computed tomography(CT)showed an edematous swelling of the pancreas and several pseudocysts,the biggest one measuring 230 mm×95 am.Markedly elevated amylase (11 327 U/L)was contained in the massive pleural effusion.Erythema nodosum tissue pathology revealed the pancreatic panniculitis.The pscudocyst did not completely resolve with high-dose steroid.Growth hormone release inhibiting hormone (GIH),ulinastatin,nasojejunal feeding,and it was later complicated by infection and rupture.After a surgical percutaneous drainage for the complicated pseudocyst,the clinical symptoms and signs were markedly improved.Conclusion This case shows the importance of performing eady drainage rather than conservative treatment for pancreatic pseudocyst in patients with lupus-associated pancreatitis.
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Objective To enhance the understanding of systemic lupus erythematosus (SLE) associated with intestinal pseudo-obstruction (IPO) and ureterohydronephrosis. Methods Ten cases of SLE with IPO and ureterohydronephrosis were analyzed retrospectively. Results IPO was the initial manifestation of SLE in three patients. Seven cases (7/9) had concurrent bilateral ureterohydronephrosis, 5 (5/9) had thickened bladder wall, and 6 cases (6/8) were associated with thickened gallbladder wall simultaneously. All cases were ANA positive and hypocomplementemia, 6 had positive anti-dsDNA, 5 had positive anti-SSA, 6 had positive anti-RNP, and 4 were ACA-IgG positive (4/7). IPO responded readily to high dose steroid therapy within one week in all patients. Conclusions The pathogenic mechanism of IPO is not fully understood. The coexistence of IPO, ureterohydronephrosis and thickened gallbladder wall probably suggests a visceral smooth muscle dysmotility. Early recognition of the syndrome is necessary for the initiation of the appropriate medical treatment and prevention of inappropriate surgical intervention.
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Objective To explore the significance of antinucleosome and anti-dsDNA antibodies on the disease flare and organ damage in patients with systemic lupus erythematosus(SLE).Methods Sixty-nine SLE patients were divided into disease flare group,stable group,lupus nephritis group and non-lupus nephritis group.Serum levels of anti-nucleosome antibody and anti-dsDNA antibody were measured with enzyme linked immunosorbent assay(ELISA) and indirect immunofluorescence(IIF),respectively.Results The positive rates of serum anti-nucleosome and anti-dsDNA antibodies were 55.10% and 47.82% respectively and the rates were significantly higher in disease flare group than those in disease stable group(P
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0.05 ). The adverse reaction rate was 4.4 % (2 case) in the ACT group and 10% (7cases) in MTX group. The adverse reactions were more tolerable in ATC group than that in MTX group (P
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0.05).The adverse reaction rate was 14.0% (7 case) in the treated group and 15.6%(7 cases) in the controlled group. There was no significance difference between the two groups (P=0.83). But the adverse reactions were more tolerable in LEF group than in MTX group. Conclusion This study suggests that LEF is an effective and more safe drug for active rheumatoid arthritis in our country.