ABSTRACT
OBJECTIVES: To evaluate the presence of anti-C1q, anti-chromatin/nucleosome and anti-double stranded DNA (dsDNA) antibodies in juvenile systemic lupus erythematosus (JSLE) and controls. METHODS: Sixty-seven JSLE and 34 healthy controls were analyzed for the presence of anti-C1q, anti-chromatin/nucleosome, and anti-dsDNA antibodies by ELISA. C1q levels were evaluated by radial immunodiffusion. RESULTS: The mean current age was similar in JSLE patients and controls (14.6 ± 3.86 vs. 13.6 ± 2.93 years, P = 0.14). Higher frequencies of anti-C1q, anti-chromatin/nucleosome, and anti-dsDNA antibodies were observed in JSLE compared to controls (20% vs. 0%, P = 0.0037; 48% vs. 0%, P < 0.0001 and 69% vs. 3%, P < 0.0001, respectively). The median of anti-C1q, anti-chromatin/nucleosome, and antidsDNA antibodies were also significantly higher in JSLE patients than in controls [9.6 (5.5-127) vs. 7.5 (5-20) units, P = 0.0006; 18 (1.9-212) vs. 3.2 (1.7-17) units, P < 0.0001; and 111 IU/mL (6-741) vs. 14 (6-33) IU/mL; P < 0.0001, respectively]. The sensitivity for anti-C1q, anti-chromatin/nucleosome, and anti-dsDNA antibodies was 21% (CI: 11-33), 49% (CI: 36-62), and 70% (CI: 57-81). The specificity was 100% (CI: 88-100), 100% (88-100), and 97% (CI: 83-99), respectively. A positive correlation was found between anti-dsDNA levels and both anti-C1q (r = 0.51; CI: 0.29-0.68; P < 0.0001) and anti-chromatin/nucleosome antibodies (r = 0.87; CI: 0.79-0.92; P < 0.0001) levels. A negative correlation was observed between anti-C1q and C1q levels (r = -0.33; CI: -0.56-0.05; P = 0.018). The frequency of anti-dsDNA was higher in patients with SLEDAI-2K >1 (P = 0.0047) and no differences were observed in the frequencies of these three autoantibodies and nephritis (P > 0.05). CONCLUSION: Our study demonstrated an elevated specificity for lupus diagnosis involving the three autoantibodies, especially anti-C1q and anti-chromatin/nucleosome.
Subject(s)
Autoantibodies/blood , Chromatin/immunology , Complement C1q/immunology , DNA/immunology , Lupus Erythematosus, Systemic/blood , Lupus Erythematosus, Systemic/diagnosis , Nucleosomes/immunology , Child , Female , Humans , Lupus Erythematosus, Systemic/immunology , Lupus Nephritis/blood , Lupus Nephritis/immunology , Male , Predictive Value of Tests , Sensitivity and SpecificitySubject(s)
Antibodies, Antinuclear/blood , Arthritis, Infectious/immunology , Arthritis, Infectious/microbiology , Leprosy/immunology , Vitamin D/analogs & derivatives , Arthritis, Infectious/epidemiology , Brazil , Endemic Diseases/statistics & numerical data , Humans , Leprosy/blood , Leprosy/epidemiology , Vitamin D/bloodABSTRACT
Autologous stem cell transplant is one of the therapies employed in the treatment of primary amyloidosis or AL. The authors report on a 46-year-old patient with bilateral periorbital hematomas, macroglossia who presented, during the investigation, IgG-Kappa paraprotein in serum. The diagnosis of primary amyloidosis or AL was confirmed and the treatment proposed consisted of high-dose melphalan as conditioning regimen before autologous stem cell transplant, which determined complete remission of the disease, along with the disappearance of clinical signs and absence of the monoclonal component.
Subject(s)
Amyloidosis , Stem Cell Transplantation , Amyloidosis/surgery , Humans , Immunoglobulin Light-chain Amyloidosis , Male , Middle Aged , Remission InductionABSTRACT
Transplante autólogo de células tronco é uma das formas de tratamento da amiloidose primária ou AL. Os autores relatam um paciente de 46 anos com hematomas periorbitais bilaterais, macroglossia, em quem, na investigação, se constatou a presença de paraproteínas IgG Kappa no soro. O diagnóstico de amiloidose primária ou AL foi confirmado, e o tratamento proposto com condicionamento com doses altas de Melfalan, seguido de transplante autólogo de células tronco, determinou a remissão completa da doença com desaparecimento de sinais clínicos e ausência do componente monoclonal.
Autologous stem cell transplant is one of the therapies employed in the treatment of primary amyloidosis or AL. The authors report on a 46-year-old patient with bilateral periorbital hematomas, macroglossia who presented, during the investigation, IgG-Kappa paraprotein in serum. The diagnosis of primary amyloidosis or AL was confirmed and the treatment proposed consisted of high-dose melphalan as conditioning regimen before autologous stem cell transplant, which determined complete remission of the disease, along with the disappearance of clinical signs and absence of the monoclonal component.
Subject(s)
Humans , Male , Middle Aged , Stem Cell Transplantation , Amyloidosis/surgery , Remission InductionSubject(s)
Antibodies, Monoclonal/therapeutic use , Immunization, Secondary , Yellow Fever Vaccine/therapeutic use , Yellow Fever/prevention & control , Adult , Arthritis, Rheumatoid/blood , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Cohort Studies , Female , Humans , Immunization, Secondary/methods , Infliximab , Male , Middle Aged , Yellow Fever/blood , Yellow Fever/complications , Yellow Fever Vaccine/bloodABSTRACT
Avaliamos a prevalencia de algumas doencas parasitarias no municipio de Cajati-SP (Vale do Ribeira), atraves da Bandeira Cientifica-1998, do Departamento Cientifico do Centro Academico Oswaldo Cruz, da Faculdade de Medicina da Universidade de Sao Paulo. Durante uma semana de intervencao, foram colhidas amostras em pacientes que buscaram ativamente um dos 3 postos de saude locais, englobando...
