Analysis of clinical characteristics and risk factors in patients with neuropsychiatric systemic lupus erythematosus (NPSLE) / 细胞与分子免疫学杂志

Objective To analyze clinical characteristics of patients with neuropsychiatric systemic lupus erythematosus (NPSLE) and to explore the risk factors affecting the occurrence of NPSLE. Methods A total of 63 NPSLE patients and 61 non-NPSLE patients were enrolled. The clinical manifestations and laboratory examination data of the two groups were collected, and the disease characteristics of NPSLE were summarized to analyze the risk factors affecting the occurrence of NPSLE by multivariate Logistic regression. Results The most common clinical manifestations of NPSLE patients were headache (39.7%), affective disorder (33.3%) and cognitive impairment (30.2%), with cranial magnetic resonance abnormalities (63.5%) and a high cerebrospinal fluid protein positive rate (52.4%). Compared with non-NPSLE patients, there were significantly increased levels of Raynaud's phenomenon, renal involvement, anti-RNP antibody, anti-ribosomal P protein, hypocomplementemia, lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) in NPSLE patients. Multivariate Logistic regression analysis showed that renal involvement, Raynaud's phenomenon, positive anti-ribosomal P protein antibody, and elevated LMR and NLR were independent risk factors for NPSLE. Conclusion Headache is the most common symptom in patients with NPSLE, and abnormal cranial MRI and cerebrospinal fluid examination are more common. SLE patients who present with renal involvement, Raynaud's phenomenon, positive anti-ribosomal P protein antibodies, and elevated levels of LMR and NLR are more susceptible to developing NPSLE.

Clinical Characteristics of Dermatomyositis with Double-positive Anti-melanoma Differentiation Associated Protein-5 Antibody and Anti-Ro-52 Antibody / 医学研究杂志

Objective To investigate the clinical features and prognosis of melanoma differentiation associated protein-5(MDA5)antibody and anti-Ro-52 antibody in double-positive dermatomyositis.Methods Forty-seven dermatomyositis patients with anti-MDA5 antibody positive admitted to the Second Affiliated Hospital of Air Force Military Medical University,Tangdu Hospital from August 2018 to July 2022 were collected.According to whether anti-Ro-52 antibody was positive,they were divided into MDA5 + Ro-52 pos-itive group(n =23)and MDA5 + Ro-52 negative group(n =24).The clinical data of the two groups were retrospectively analyzed,and the differences in the clinical characteristics,laboratory indicators,incidence of rapidly progressive interstitial lung disease and mortality between the two groups were compared.Results Compared between the two groups,the incidence of Gotton rash and hoarseness in the MDA5 + Ro-52 positive group was higher than that in the MDA5 + Ro-52 negative group,and the difference was statistically significant(P<0.05).There were no significant difference in the incidence of skin ulcers,periapillary erythema,positive rash,cape sign,fever,joint pain and sore throat(P>0.05).Lymphocyte count[0.65(0.50,0.81)×109/L vs 1.18(0.91,1.63)×109/L,z =-3.821,P =0.001]and serum albumin[33.40(29.40,35.67)g/L vs 37.25(32.65,40.27)g/L,z =-3.325,P =0.001],oxygen partial pressure[66.60(58.60,86.80)mmHg vs 88.60(75.67,95.72)mmHg,z =-2.373,P = 0.018],blood oxygen saturation[90.40%(89.00%,95.00%)vs 94.90%(90.50%,97.73%),z =-2.353,P = 0.019]in MDA5 + Ro-52 positive group were lower than those in MDA5 + Ro-52 negative group,and the difference were statistically significant(P<0.05).Erythrocyte sedimenta-tion rate[41.00(30.00,62.50)mm/h vs 28.50(21.50,48.75)mm/h,z =2.161,P =0.031]and serum lactate dehydrogenase lev-els[426.00(335.50,605.50)U/L vs 260.00(217.50,373.25)U/L,z =3.313,P =0.011],serum ferritin level[1210.00(465.50,2749.00)μg/L vs 366.00(150.25,629.25)μg/L,z =2.856,P =0.004],the incidence of rapidly progressive interstitial lung disease(73.91%vs 25.00%,χ2 =11.245,P =0.001)and mortality(43.47%vs8.33%,χ2 =7.630,P =0.006)in MDA5 + Ro-52posi-tive group were higher than those in anti-MDA5 + Ro-52 negative group,and the differences were statistically significant(P<0.05).Conclusion Dermatomyositis patients with double-positive anti-MDA5 antibody and anti-Ro-52 antibody are more likely to have increased serum serum lactate dehydrogenase and serum ferritin,decreased serum albumin and peripheral blood lymphocyte count,and more likely to be complicated with rapidly progressive interstitial lung disease and hypoxemia.The prognosis is poor and the mortality is high,which should be paid attention to by clinicians.