ABSTRACT
Objective To investigate the clinical and laboratory features of autoimmune disease (AID) associated cryoglobulinaemia. Methods From April 2010 to May 2014, thirty threc patients with AID in Peking University Peopleˊs Hospital were tested positive for cryoglobulin. Their clinical and laboratory features were analyzed retrospectively. T test, Mann-Whitney U test, Chi-squaretest and Fisherˊs exact test were used for statistical analysis. Results Among the 33 patients, 26 were female, 7 were male, the average age was (47 ± 17) years old (range 12-75 years old). The spectrum of autoimmune diseases included, in order, systemic lupus erythematosus (SLE), Sj?grenˊs syndrome (SS), multiple myositis/dermatomyositis, rheumatoid arthritis (RA), systemic sclerosis (SSc), anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, antiphospholipid syndrome and primary biliary cirrhosis. SLE and SS accounted for 84.8% (28/33) in tpatients with cryoglobulinaemia. In patients withSLE, cryoglobulinaemia occurred at 2.0 (1.0-12.0) years after disease onset, and cryoglobulinpositive patients had more frequent renal involvement (71% vs 40%, P=0.004), positive anti-RNP (56% vs21%, P=0.007) and ACL (53% vs 8%, P=0.000). However, among patients with SS, cryoglo-bulinaemia occurred at 11.0 (4.0-18.0) years after disease onset, and cryoglobulin positive patients had higher rheumatoid factors (RF) [1 170 (230.00, 2 800.00) U/ml vs 57.80 (20.00, 230.50) U/ml, U=-0.002, P=0.001], IgM [3.54 (1.83, 4.34) g/L vs 1.17 (0.81, 2.26) g/L , U=0.016, P=0.014] and lower complement C3 [0.58 (0.33, 0.68) g/L vs 0.81 (0.67, 0.98 g/L), U=0.004, P=0.003] and C4 [0.06 (0.03, 0.12) g/L vs 0.16 (0.12, 0.22), U=0.017, P=0.016]. Conclusion Autoimmune disease complicated with cryoglo-bulinaemia is not uncommon in clinical practice, in which SLE and SS account for the leading two causes. Patients with positive anti-RNP and/or ACL are positively associated with cryoglobulinaemia. renal involvement of SLE is increased by the presence of cryoglobulin.
ABSTRACT
Objective To analyze the peripartum complications,frequency of neonatal abnormalities and the associated factors in patients with primary Sj?grenˊs syndrome (SS). Methods The chart of 39 patients with primary SS who were admitted to the hospital for delivery were retrospectively reviewed. The clinical data, obstetrical outcome and the frequency of neonatal abnormalities as well as the possible associated factors were analyzed. Results There were 76 pregnancies and 41 deliveries among these 39 patients. Two patients (5%) had pregnancy-related hypertension, 1 (3%) had gestational diabetes and 1 (3%) had eclampsia. Twenty-eight(72%) patients had at least one episode of complication. In which, 27(68%) were induced abortion, 2 (5%) were premature birth, 6 (21%) were amniotic fluid volume abnormalities, 2 (5%) were post-partum bleeding, 5 (13%) were premature rupture of membrane, 6 (21%) were intra-uterine distress and 3 (8%) had intra-uterine growth retardation. Fetal abnormality was detected in 7(18%) patients, in which 3 fetus (8%) died before delivery, 2 fetus (5%) were small than gestational age and 2 (5%) had fetal deformity. Compared to the reports in the literature, the rate of abortion and fetal death was higher, but the rate of growth retardation , induced abortion was lower. Conclusion The frequency of peri-partum complication and fetal abnormality is increased in patients with primary SS. Pregnancies in patients with primary SS should beclosely monitored by rheumatologists.