[Practical results of monitoring pregnancy in women with systemic lupus erythematosus]. / Praktické výsledky sledování tehotenství u zen se systémovým lupus erythematodes.

BACKGROUND: The authors dealt with the urgent problem under what conditions it is possible to achieve in a woman with systemic lupus erythematosus (SLE) or another collagenosis, or secondary antiphospholipid syndrome (APS) a favourable outcome of pregnancy and the delivery of a healthy infant. METHODS AND RESULTS: The investigation comprised 23 women incl. 20 with SLE, two with the mixed form of a diffuse connective tissue disease (MCTD) and one with Sjögren's syndrome of the primary type. From the total number of 20 pregnancies six were consulted in advance with a doctor (group I-s-called planned pregnancies) and all terminated by a successful delivery. Of 11 pregnancies which were not consulted with a doctor in advance (group II-so-called unplanned pregnancies) 9 were terminated in term, however, only 5 with a successful delivery (55.5%), two women are still pregnant. Exacerbation of the basic disease during pregnancy was recorded only once and did not lead to discontinuation of the pregnancy. CONCLUSIONS: The authors provide evidence that desired pregnancy of informed women suffering from SLE or another collagenosis when assisted by a specialized medical team can lead to a successful delivery of an infant.

Herpes viruses in multicase families with rheumatoid arthritis.

OBJECTIVE: To investigate the rate and extent of infection by Epstein-Barr virus (EBV), cytomegalovirus, and herpesvirus 6 in families (affected and nonaffected members) with multiple cases of rheumatoid arthritis (RA). METHODS: Viral DNA was detected by polymerase chain amplification in cells from saliva and peripheral blood. Human leukocyte antigen pedigrees were characterized. RESULTS: Viral DNA, particularly EBV, was detected in increased frequency (p = 0.029) in the patients with RA compare to their nonaffected relatives. CONCLUSION: We suggest that in RA multicase families, increased frequency of viral infection is likely a consequence of the disease state and/or due to gene(s) as yet unidentified.

[Determination of antiphospholipid antibodies in serum using ELISA]. / Stanovení antifosfolipidových protilátek v séru metodami ELISA.

The authors compare two ELISA methods for the assessment of antiphospholipid antibodies, classes IgG and IgM, in serum: ELISA Pin Plate System ALPHA DIALAB Co. and the ELISA method developed in the Research Institute of Rheumatic Diseases. Both methods use cardiolipin as antigen. In the Pin Plate test the immunochemical reaction antigen/antibody does not take place at the surface of the pits of the microtitration plates but on the tip of the next plate. The results of examinations of antiphospholipid antibodies obtained by the tested methods are comparable, the Pin Plate test is quicker and more sensitive, but its price limits routine use.

[Antineutrophil cytoplasmic antibodies--ANCA]. / Protilátky proti cytoplazme neutrofilních leukocytu--ANCA.

Antibodies against cytoplasm of neutrophil leucocytes (ANCA) with a high sensitivity are found in idiopathic necrotizing vasculitis and idiopathic glomerulonephritis with formation of sickles (IGS). C-ANCA are directed against the myeloid lysosomal enzyme--proteinase 3 and are found above all in Wegener's granulomatosis and microscopic polyarteritis. P-ANCA are directed mainly against myeloperoxidase, less against leucocytic elastase or lactoferrin and are found above all in microscopic polyarteritis, IGS, polyarteritis nodosa or Churg-Strauss syndrome. The elevated ANCA level correlates with the activity of the disease or precedes a relapse. These autoantibodies activate probably neutrophil leucocytes for respiratory exacerbation and degranulation which may lead to extensive tissue damage.

[Why are there anti-cardiolipin antibodies in patients with infectious mononucleosis and in patients with systemic lupus erythematosus?]. / Proc antikardiolipinové protilátky u nemocných infekcní mononukleózou a u nemocných systémovým lupus erytematodes?

The phenomenon of anticardiolipin antibodies (aCL) is in recent years the subject of interest as it is connected with manifestations of thromboses at different sites, with repeated miscarriages in pregnant women and with thrombocytopenia. As compared with the original finding in patients with systemic lupus erythematosus (SLE), the authors find they are present also in infection with the Epstein-Barr virus--in patients with acute infectious mononucleosis, in as many as 61% of a total number of 77 examined patients; in a group of 60 patients with SLE in 41% and in a group of healthy controls in 3.9%. aCL differ, however, as regards the distribution of isotypes--aCL of class IgM are found mainly in infectious mononucleosis, class IgG in patients with SLE. The authors discuss problems associated with the development and practical importance of these antibodies.

Transbilayer redistribution of phosphatidylserine in erythrocytes of a patient with autoerythrocyte sensitization syndrome (psychogenic purpura).

We have investigated a female patient with autoerythrocyte sensitization syndrome (AES syndrome), having a positive skin response to her own red blood cells (RBC) and to phosphatidylserine (PS). Using 2,4,6-trinitrobenzenesulfonic acid (TNBS), bee venom phospholipase A2 and merocyanine 540 binding, we have demonstrated that in RBC of patient more than 50% of PS is redistributed into the outer leaflet of the plasma membrane. Using homologous RBC from a healthy donor we were able to induce transbilayer PS redistribution by incubation with the patient plasma. The presence of immunoglobulin E against cardiolipin and PS was proved in patient's plasma. We elaborated a method for cytoskeleton visualization using indirect immunofluorescence technique. We found disorders in cytoskeleton organization in RBC of the patient. We recommend in vitro testing for AES syndrome diagnosis. The positive effect of chlorpromazine treatment is described.