Subarachnoid hemorrhage as a complication of systemic lupus erythematosus.

BACKGROUND: Subarachnoid hemorrhage (SAH) is a rare complication of systemic lupus erythematosus (SLE). METHODS: We made a retrospective search for patients with SLE and nontraumatic SAH from 1990 to 2006. RESULTS: We found 10 patients with SLE and primary SAH of a total of 1,077 patients with SLE (0.93%); mean age of onset was 37.4 +/- 15.25 years and the mean duration of SLE at the onset of SAH was 98.3 +/- 50.32 months. SLEDAI and chronic damage scores were 3.67 +/- 5.20 (n = 9) and 2.90 +/- 1.45 (n = 10), respectively; 60% of patients had high Hunt-Hess scores and in only 50% of cases a saccular aneurysm was identified. CONCLUSIONS: SAH presents in about 1% of SLE patients. Long duration of SLE and chronic damage scores might be associated risk factors.

[Isolation and characterization of immune complexes associated with malignant tumors and leprosy]. / Aislamiento y caracterización de complejos inmunes asociados a tumores malignos y a lepra.

We are dedicated to the study of circulating immune complexes (CIC) associated with different diseases: malignant tumors, leprosy and rheumatoid arthritis. Immune complexes were evaluated by various methods: 125I-Clq binding assay, 125I-IgG binding test, 125I-bovine conglutinin binding assay and polyethylene glycol precipitation test (3.5% and 2.5%). Techniques for the isolation and splitting of CIC in their components were performed in sera from patients with tumors and with leprosy. These methods consisted in the combination of CIC with protein A followed by elution with different buffers. CIC splitting techniques were first applied on immune complexes formed in vitro (BSA-aBSA, OVA-aOVA). The analysis of CIC fractions was done by SDS-PAGE, immunoelectrophoresis and immunoblotting techniques. Results were as follows: CIC levels correlated with active stages of disease, decreasing during remission so that CIC detection can be useful to evaluate response to treatment. The isolation and splitting of immune complexes into their components resulted in the obtention of immunologically active fractions, especially in sera from patients with gastrointestinal and breast cancer and with leprosy.

Aislamiento y caracterización de complejos inmunes asociados a tumores malignos y a lepra. / [Isolation and characterization of immune complexes associated with malignant tumors and leprosy]

We are dedicated to the study of circulating immune complexes (CIC) associated with different diseases: malignant tumors, leprosy and rheumatoid arthritis. Immune complexes were evaluated by various methods: 125I-Clq binding assay, 125I-IgG binding test, 125I-bovine conglutinin binding assay and polyethylene glycol precipitation test (3.5

and 2.5

). Techniques for the isolation and splitting of CIC in their components were performed in sera from patients with tumors and with leprosy. These methods consisted in the combination of CIC with protein A followed by elution with different buffers. CIC splitting techniques were first applied on immune complexes formed in vitro (BSA-aBSA, OVA-aOVA). The analysis of CIC fractions was done by SDS-PAGE, immunoelectrophoresis and immunoblotting techniques. Results were as follows: CIC levels correlated with active stages of disease, decreasing during remission so that CIC detection can be useful to evaluate response to treatment. The isolation and splitting of immune complexes into their components resulted in the obtention of immunologically active fractions, especially in sera from patients with gastrointestinal and breast cancer and with leprosy.

Evaluation of circulating immune complexes in leprosy.

Circulating immune complexes (CIC) were evaluated in leprosy by 4 methods: the 125I-C1q binding assay (C1q), the platelet aggregation test (PAT), the 3.5% polyethylene glycol (PEG) precipitation test and the 2.5% PEG precipitation assay. Serum samples belonged to lepromatous leprosy bacilloscopy positive (LL+), lepromatous leprosy bacilloscopy negative (LL-), tuberculoid (TT) and first grade contact group (Co). Studies performed by the 3 first methods showed higher CIC levels in LL+ group (p less than 0.01) and lower values in the 3 others, all of them when compared to normals. On the contrary, the 2.5% PEG precipitation test gave less discriminative results giving only p less than 0.01 in LL+. CIC values obtained in the contact group showed significant results compared to normals but similar to LL- and TT groups. The C1q binding assay and the PAT were the most discriminative methods giving r = 0.90; C1q versus 3.5% PEG, r = 0.36; C1q vs 2.5% PEG, r = 0.14. The PAT compared to 3.5% PEG, r = 0.48 and PAT vs. 2.5% PEG, r = 0.24. Therefore it may be concluded as follows: a) The radioiodinated C1q binding assay and the PAT are recommended for the study of CIC in leprosy; b) The 2.5% PEG precipitation assay offers less sensitivity since it gave similar value in LL-, TT, Co and controls; c) CIC levels observed in LL+ patients may be induced by the antigenic overload demonstrated by the positive bacilloscopy; d) The contacts have CIC levels significantly different from the normal population possibly caused by a subclinical infection.

Evaluation of circulating immune complexes in leprosy.

Circulating immune complexes (CIC) were evaluated in leprosy by 4 methods: the 125I-C1q binding assay (C1q), the platelet aggregation test (PAT), the 3.5

polyethylene glycol (PEG) precipitation test and the 2.5

PEG precipitation assay. Serum samples belonged to lepromatous leprosy bacilloscopy positive (LL+), lepromatous leprosy bacilloscopy negative (LL-), tuberculoid (TT) and first grade contact group (Co). Studies performed by the 3 first methods showed higher CIC levels in LL+ group (p less than 0.01) and lower values in the 3 others, all of them when compared to normals. On the contrary, the 2.5

PEG precipitation test gave less discriminative results giving only p less than 0.01 in LL+. CIC values obtained in the contact group showed significant results compared to normals but similar to LL- and TT groups. The C1q binding assay and the PAT were the most discriminative methods giving r = 0.90; C1q versus 3.5

PEG, r = 0.36; C1q vs 2.5

PEG, r = 0.14. The PAT compared to 3.5

PEG, r = 0.48 and PAT vs. 2.5

PEG, r = 0.24. Therefore it may be concluded as follows: a) The radioiodinated C1q binding assay and the PAT are recommended for the study of CIC in leprosy; b) The 2.5

PEG precipitation assay offers less sensitivity since it gave similar value in LL-, TT, Co and controls; c) CIC levels observed in LL+ patients may be induced by the antigenic overload demonstrated by the positive bacilloscopy; d) The contacts have CIC levels significantly different from the normal population possibly caused by a subclinical infection.