RESUMO
Objective To evaluate the distribution and significance of IgG subclasses of anti-cyclic cirullinated peptide antibody (anti-CCP) in sera from patients with rheumatoid arthritis (RA).Methods A total of 83 patients with RA at the Department of Endocrinology of Taizhou Hospital , 51 disease controls and 50 healthy controls during the period from August 2012 to June 2013 were enrolled.The total serum IgG and IgG subclasses of anti-CCP antibodies were detected by antigen specific enzyme linked immune-sorbent assay( ELISA ).The prevalence and relative amount of IgG subclasses were calculated and compared.Statistical analysis was performed by χ2 test and Kruskal-Wallis H test.Results The positive rates of IgG subclasses of anti-CCP were anti-IgG 71.1%(59/83), anti-IgG1 78.3%(65/83), anti-IgG2 26.5%(22/83), anti-IgG3 60.2%(50/83), anti-IgG4 74.7%(62/83) respectively.The diagnostic value of anti-CCP-IgG1, anti-CCP-IgG3 and anti-CCP-IgG4 alone or combined (AUC =0.818-0.901),compared with anti-CCP-IgG(AUC=0.857), had no significant difference(Z=0.028-0.045,P>0.05).The DAS28 score of anti-CCP-IgG1(DAS28 =6.5), and anti-CCP-IgG4(DAS28 =6.5)positive in patients with RA were significantly higher than those in negative groups (DAS28=4.5,4.6)(U=396.0,427.5,P<0.01).The T28(T28=4.0,4.0)and SW28(SW28=4.0,4.0) results of CCP-IgG1and CCP-IgG4 positive in patients with RA were significantly higher than those in negative groups (T28=3.0,3.0,SW28 =3.0,3.0)(U=377.5,406.0,255.5,286.5,P<0.05).Conclusions The distribution of IgG subclasses of anti-CCP in sera from patients with RA was predominantly anti-CCP-IgG1, anti-CCP-IgG3 and anti-CCP-IgG4 associated with RA disease activity.However , whether joint detection of IgG subclasses can replace conventional anti -CCP is questionable.
RESUMO
Objective To study the clinicopathologic features,effective therapeutic regimen and prognosis of human immunodeficiency virus (HIV) infection with acute promyelocytic leukemia (APL) and chronic myeloid leukemia (CML).Methods Two cases of HIV infection concurrent with leukemia,one with APL,one with CML,were studied and relevant literatures were reviewed.Results Case 1 was HIV infection concurrent with APL,ATO was used to induce remission,in the eight day of therapy,the patient died of brain disorder.Case 2 was HIV infection concurrent with CML,hydroxycarbamide and interferon were used to induce remission,three month later,state of an illness progressed to acute phase,after combination chemotherapy,concurrent with lung multiple infection (fungus and pneumocystis carinii),at last,the patient died of respiratory failure.Conclusion HIV infection concurrent with acute and chronic leukemia has poor therapeutic effect,and is easy to infect seriously.