ABSTRACT
OBJECTIVE: The objective was to assess the proportion of Th1, Th2 and Th17 phenotypes in senescent CD4+CD28null cells from patients with systemic lupus erythematosus (SLE) and its association with the pattern of joint involvement. METHODS: This cross-sectional study was performed in SLE patients with erosive arthritis (rhupus) or nondeforming, nonerosive arthritis. Total CD4+CD28null cells as well as the proportion of these cells expressing T-bet, GATA3 or RORγt were analyzed by color-flow cytometry. Serum osteopontin levels were measured by ELISA. RESULTS: Eighteen SLE patients (nine with rhupus and nine with nonerosive arthritis) were studied. The percentage of CD4+CD28null/CD4+ cells (17.7%, 10.3-25.0% versus 9.4%, 8.1-22.4%; P = 0.386) as well as the osteopontin levels (5800, 5,134-5995 pg/ml versus 5578, 5171-5717 pg/ml; P > 0.05) were similar in both groups. A higher percentage of CD4+CD28nullT-bet+ cells (42.8%, 33.5-53.4% versus 30.0%, 23.3-34.2%) but a lower percentage of CD4+CD28nullGATA3+ cells (3.1%, 1.7-5.6% versus 6.2%, 2.6-18.4%) was observed in patients with rhupus than in their counterparts ( P = 0.016). The frequency of CD4+CD28nullRORγt+ cells was similar between groups. CONCLUSIONS: In patients with rhupus, senescent CD4+CD28null cells are preferentially polarized to a Th1 phenotype, whereas this is partial towards Th2 in lupus patients with a nonerosive arthritis pattern.
Subject(s)
Arthritis/complications , Lupus Erythematosus, Systemic/complications , T-Lymphocytes, Helper-Inducer/cytology , Adult , Cross-Sectional Studies , Female , Flow Cytometry , Humans , Male , Mexico , Middle Aged , PhenotypeABSTRACT
OBJECTIVE: The objective of this paper is to assess whether pulmonary hypertension (PH) may be detected at one point in time or longitudinally predicted by serum uric acid (sUA) levels in systemic lupus erythematosus (SLE). METHODS: We conducted a post-hoc analysis of a long-term followed cohort of Mexican SLE patients. Echocardiography-based definitions of PH by the ESC/ERS/ISHLT and its associations with clinical and laboratory data on enrollment were studied. Especially, the impact that sUA levels at baseline may have on the future development of PH in patients with normal pulmonary artery systolic pressure (PASP) was explored. RESULTS: Out of the 156 SLE patients originally enrolled in the cohort, 44 met the inclusion criteria for the present study and were grouped as having (n =10) or not having (n = 34) PH. At baseline, sUA levels of 5.83 ± 1.79 and 5.82 ± 1.97 mg/dl (p = ns) were found in patients with and without PH, respectively. No association between PASP and other markers was found. In patients with normal PASP, the presence of sUA ≥ 7 mg/dl at baseline predicted future development of PH (relative risk 8.5, 1.0009 to 72; p = 0.04). CONCLUSION: In SLE, sUA levels at one point in time are useless to detect PH. However, steady hyperuricemia may predict the future development of PH in patients with normal PASP at baseline.
Subject(s)
Hypertension, Pulmonary/etiology , Hyperuricemia/complications , Lupus Erythematosus, Systemic/complications , Uric Acid/blood , Adult , Arterial Pressure , Biomarkers/blood , Female , Follow-Up Studies , Humans , Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/physiopathology , Hyperuricemia/blood , Hyperuricemia/diagnosis , Longitudinal Studies , Lupus Erythematosus, Systemic/diagnosis , Male , Mexico , Middle Aged , Predictive Value of Tests , Prognosis , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/physiopathology , Risk Factors , Time Factors , UltrasonographySubject(s)
Bronchial Fistula/etiology , Esophageal Stenosis/etiology , Esophagectomy/adverse effects , Gastric Fistula/etiology , Anastomosis, Surgical/adverse effects , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/surgery , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/surgery , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/surgery , Esophageal Stenosis/diagnostic imaging , Esophageal Stenosis/surgery , Esophagectomy/methods , Esophagoscopy , Follow-Up Studies , Gastric Fistula/diagnostic imaging , Gastric Fistula/surgery , Humans , Male , Middle Aged , Reoperation , Risk Assessment , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Intestines/pathology , Mesenteric Cyst/complications , Aged , Female , Humans , Mesenteric Cyst/diagnosis , NecrosisABSTRACT
The authors report a case of primary hydatid disease in the lumbar muscles of a 40-year-old male patient. The rarity of this disease in our regions and the low incidence of this location make primary diagnosis difficult. The tumor had been treated elsewhere five years previously by means of simple excision. Recurrence of the lesion was diagnosed five years after the first surgery. Wide excision of the cyst and pericyst with a 3.5-cm security margin was performed. Six years after the last surgery, no recurrence has been detected.
