ABSTRACT
Hepatitis C virus (HCV) infects B-lymphocytes, provokes cellular dysfunction and causes lymphoproliferative diseases such as cryoglobulinemia and non-Hodgkin's B-cell lymphoma. In the present study, we investigated the serum levels of kappa and lambda free light chains (FLC) of immunoglobulins and the kappa/lambda FLC ratio in Brazilian patients with chronic HCV infection and cryoglobulinemia. We also analyzed the immunochemical composition of the cryoglobulins in these patients. Twenty-eight cryoglobulinemic HCV patients composed the target group, while 37 HCV patients without cryoglobulinemia were included as controls. The median levels of kappa and lambda FLC were higher in patients with cryoglobulinemia compared to controls (p = 0.001 and p = 0.003, respectively), but the kappa/lambda FLC ratio was similar in patients with and without cryoglobulinemia (p > 0.05). The median FLC ratio was higher in HCV patients presenting with advanced fibrosis of the liver compared to HCV patients without fibrosis (p = 0.004). Kappa and lambda FLC levels were strongly correlated with the IgA, IgG and IgM levels in the patients with cryoglobulinemia. In patients without cryoglobulinemia, the kappa FLC level was only correlated with the IgG level, whereas the lambda FLC were weakly correlated with the IgA, IgG and IgM levels. An immunochemical pattern of mixed cryoglobulins (MC), predominantly IgM, IgG, IgA and kappa light chain, was verified in these immune complexes. We concluded that HCV-infected patients presenting cryoglobulinemia have vigorous polyclonal B-lymphocyte activation due to chronic HCV infection and persistent immune stimulation.
Subject(s)
Female , Humans , Male , Middle Aged , Cryoglobulinemia/etiology , Cryoglobulins/analysis , Hepatitis C, Chronic/complications , Immunoglobulin kappa-Chains/blood , Immunoglobulin lambda-Chains/blood , Case-Control Studies , Hepatitis C, Chronic/blood , Immunohistochemistry , Immunoglobulin G/blood , Immunoglobulin M/bloodABSTRACT
Objective: To evaluate musculoskeletal involvement and autoantibodies in pediatric leprosy patients. Methods: 50 leprosy patients and 47 healthy children and adolescents were assessed according to musculoskeletal manifestations (arthralgia, arthritis, and myalgia), musculoskeletal pain syndromes (juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, and tendinitis), and a panel of autoantibodies and cryoglobulins. Health assessment scores and treatment were performed in leprosy patients. Results: At least one musculoskeletal manifestation was observed in 14% of leprosy patients and in none of the controls. Five leprosy patients had asymmetric polyarthritis of small hands joints. Nerve function impairment was observed in 22% of leprosy patients, type 1 leprosy reaction in 18%, and silent neuropathy in 16%. None of the patients and controls presented musculoskeletal pain syndromes, and the frequencies of all antibodies and cyoglobulins were similar in both groups (p > 0.05). Further analysis of leprosy patients demonstrated that the frequencies of nerve function impairment, type 1 leprosy reaction, and silent neuropathy were significantly observed in patients with versus without musculoskeletal manifestations (p = 0.0036, p = 0.0001, and p = 0.309, respectively), as well as multibacillary subtypes in leprosy (86% vs. 42%, p = 0.045). The median of physicians' visual analog scale (VAS), patients' VAS, pain VAS, and Childhood Health Assessment Questionnaire (CHAQ) were significantly higher in leprosy patients with musculoskeletal manifestations (p = 0.0001, p = 0.002, p = 0002, and p = 0.001, respectively). Conclusions: This was the first study to identify musculoskeletal manifestations associated with nerve dysfunction in pediatric leprosy patients. Hansen's disease should be included in the differential diagnosis of asymmetric arthritis, especially in endemic regions. .
Objetivo: Avaliar o envolvimento musculoesquelético e os autoanticorpos em pacientes pediátricos com hanseníase. Métodos: Foram avaliados 50 pacientes com hanseníase e 47 crianças e adolescentes saudáveis de acordo com manifestações musculoesqueléticas (artralgia, artrite e mialgia), síndromes dolorosas musculoesqueléticas (fibromialgia juvenil, síndrome de hipermobilidade articular benigna, síndrome miofascial e tendinite) e painel de autoanticorpos e crioglobulinas. Escores de avaliação de saúde e tratamento foram realizados nos pacientes com hanseníase. Resultados: Pelo menos uma manifestação musculoesquelética foi observada em 14% dos pacientes com hanseníase e em nenhum controle. Dentre os pacientes com hanseníase, cinco tinham poliartrite assimétrica das pequenas articulações das mãos. Comprometimento da função do nervo foi observado em 22% dos pacientes com hanseníase, reação tipo I hansênica em 18% e neuropatia silenciosa em 16%. Nenhum dos pacientes e controles apresentou síndromes de dor musculoesquelética e as frequências dos anticorpos e crioglobulinas foram semelhantes nos dois grupos (p > 0,05). Comprometimentos da função nervosa, reação hansênica tipo I e neuropatia silenciosa foram observados em pacientes com vs sem manifestações musculoesqueléticas (p = 0,0036, p = 0,0001 e p = 0,309, respectivamente), bem como subtipos de hanseníase multibacilar (86% vs 42%, p = 0,045). A escala visual analógica (EVA) do médico, dos pacientes, e da dor e o Questionário de Avaliação de Saúde Infantil foram maiores em pacientes com manifestações musculoesqueléticas (p = 0,0001, p = 0,002, p = 0002 e p = 0,001, respectivamente). Conclusão: Este foi o primeiro ...
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Autoantibodies/analysis , Leprosy/complications , Musculoskeletal Diseases/etiology , Arthritis/complications , Arthritis/diagnosis , Brazil , Cross-Sectional Studies , Cryoglobulins/analysis , Fluorescent Antibody Technique, Indirect , Musculoskeletal Diseases/diagnosis , Students , Visual Analog ScaleABSTRACT
OBJECTIVE: To analyze the immune response in peripheral blood of patients with infective endocarditis. METHODS: We studied 10 patients with infective endocarditis, age range from 20 to 50 years-old, males and females, and 20 healthy subjects in the same age range. The diagnosis of the disease was based on the clinical picture, echocardiogram, and hemoculture based upon samples drawn and tested before the treatment started. The were no history of atopy or malnutrition, no autoimmune disease, and they were not using any immunosuppressant or antibiotic medication. RESULTS: The patients with endocarditis had significantly higher T and B lymphocyte, CD4+ and CD8+ cell counts, IgM and IgG serum levels, and C4 component of the complement than the control group; no significant difference concerning serum IgA and neutrophil oxidative metabolism; a significant decrease in C3, chemotaxis, and monocyte phagocytosis;cryoglobulins were detected in 66.6 percent of patients and they were formed by IgG, IgM, IgA, C3, and C4. CONCLUSION: The patients with infective endocarditis were immunocompetent in most sectors of immune response and, at a certain moment, an autoimmune component may be present
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Antibodies, Monoclonal/blood , Endocarditis/immunology , Antibodies, Monoclonal/immunology , /blood , /blood , Autoimmunity/immunology , Case-Control Studies , Cryoglobulins/analysis , Cryoglobulins/immunology , Immunodiffusion , Immunoglobulin A/blood , Immunoglobulin G/blood , Immunoglobulin M/blood , Lymphocyte CountABSTRACT
From 1987 to 1996, we retrospectively analyzed 84 children and 38 adults admitted to Chang Gung Memorial Hospital with the diagnosis of Henoch-Schönlein purpura (HSP). All of the adult patients had skin biopsy finding showing leukocytoclastic vasculitis. Male predominance was noted in children, but not in adults. Preceding infection was noted in 40.5% of children and 31.6% of the adults (P = 0.46). 8.3% of children and 13.2% of adults had medication intake at disease onset (P = 0.62). Children had more frequent abdominal pain than the adults (70.2% vs 28.9%, P < 0.01). Renal involvement was more common and severe in adults, manifested as more frequent hypertension (P < 0.05) and heavy proteinuria (P < 0.01). During acute attack, leukocytosis, thrombocytosis, elevation of serum C-reactive protein levels were more frequently observed in children, while elevated serum IgA and cryoglobulin levels were more common in adults. The overall prognosis was good in both age groups, although two adults developed end stage renal disease. Our study demonstrated the different expression of HSP in Chinese children and adults.
Subject(s)
Adult , Biopsy , Blood Platelets/immunology , C-Reactive Protein/analysis , Child , Child, Preschool , Cryoglobulins/analysis , Female , Humans , Immunoglobulin A/blood , Leukocyte Count , Longitudinal Studies , Male , Middle Aged , IgA Vasculitis/diagnosis , Retrospective Studies , Skin/pathology , Taiwan/epidemiologyABSTRACT
Introduçao: Desde a década de 60, tem-se observado alteraçoes da imunidade humoral na hanseníade. Os auto-anticorpos apresentam-se em freqüências diversas, nestes pacientes, mais habitualmente na hanseníase virchoviana, em doença de longa evoluçao e em surtos reacionais. Variaçao nas freqüências pode ser atribuída a diferença metodologias empregadas na detecçao dos anticorpos e ao grupo de doentes selecionado. Material e Métodos: Esta revisao enfoca os resultados obtidos em diversos estudos de auto-anticorpos, complexos imunes, crioglubulinas, complemento sérico na hanseníase. Destaca-se também, os anticorpos contra glicolipídeos do Mycobacterium leprae, como os antiglicolipídeos fenólitos.I, cuja magnetide é variável e depende do patrimônio genético apresentado pelo enfermo.
Subject(s)
Humans , Animals , Mice , Rabbits , Mycobacterium leprae/immunology , Leprosy/immunology , Autoantibodies/analysis , Complement System Proteins/analysis , Cryoglobulins/analysis , Antigen-Antibody Complex/analysisABSTRACT
Os autores pesquisaram a presença de crioglobulinemia em 26 pacientes com Esclerose Sistêmica, encontrando-a positiva em 12 (46,23%). A incidência de acometimento pulmonar é mais freqüente nos indivíduos com crioglobulinemia
Subject(s)
Humans , Adult , Middle Aged , Male , Female , Cryoglobulins/analysis , Scleroderma, Systemic/immunology , Scleroderma, Systemic/etiology , Scleroderma, Systemic/blood , Longitudinal StudiesABSTRACT
Twenty-two patients with systemic lupus erythematosus (SLE) were investigated to study the incidence and immunochemical nature of circulating immune complexes. In 68.18% of patients, the immune complexes were detected as cryoglobulins. A significantly high value of serum IgG and IgA (1980.64 +/- 1031.53 and 283.81 +/- 131.02 mg% respectively) were observed in these patients compared to those in normal (1097.04 +/- 298.10 and 200.93 +/- 89.96 mg% respectively). The patients also had significantly low levels of serum complement fraction C3 (61.35 +/- 22.64 mg%). Correlation of these parameters could help in understanding of the role of immunochemical factors in the pathogenesis of the disease.
Subject(s)
Adolescent , Adult , Aged , Cryoglobulins/analysis , Humans , Immunoglobulin A/immunology , Immunoglobulin G/immunology , Immunoglobulin M/immunology , Lupus Erythematosus, Systemic/etiology , Middle AgedABSTRACT
Em virtude de nuances existentes entre crioglobulinas (CRIO) e complexos imunes circulantes (ICC), avaliam-se as inter-relaçöes entre ambos em 160 pacientes; três com crioglobulinemia essencial, 84 com lúpus eritematoso sistêmico (LFS), 32 com vasculite, 11 com síndrome de Sjögren, 13 com doença reumatóide e 17 com nefropatias. Verificou-se que 10% dos portadores de crioglobulinemia essencial obviamente, apresentam crioglobulinas no soro e 90% têm ICC; 22% dos pacientes com LES mostran CRIO enquanto 50% têm ICC; 12,5% dos pacientes com vasculite revelam CRIO e 28% têm ICC; na síndrome de Sjögren, 27% têm crioglobulinas e 70% ICC; na doença reumatóide a CRIO aparece em 27% dos pacientes enquanto os ICC em 70% e nos indivíduos com acometimento renal primário, 25% mostram CRIO e 60% revelam ICC. Embora a freqüência de crioglobulinas seja menor que a de ICC, na maioria das doenças avaliadas (exceto na crioglobulinemia essencial), näo ocorreu associaçäo significante entre CRIO e ICC, exceto no LES (X = 10,11; gl:1; alfa = 0,05. As inter-relaçöes entre CRIO e ICC podem ser devidas à existência de fraçäo crioprecipitável nos ICC, ou pelo comportamento físico-químico das crioglobulinas