Carbohydrate-deficient transferrin depends on disease activity in rheumatoid arthritis and systemic sclerosis.

OBJECTIVES: Changes in the glycosylation of plasma proteins have been linked to the aetiology of the rheumatic diseases. The aim of this study was to determine and compare the levels of carbohydrate-deficient transferrin (CDT) in patients with rheumatoid arthritis (RA), systemic sclerosis (SSc), and systemic lupus erythematosus (SLE). METHOD: Studies were carried out in 29 female patients with RA, 27 with SSc, and 17 with SLE. CDT was assayed by the N Latex CDT immunonephelometric assay. RESULTS: The levels of %CDT in the sera of RA, SLE, and SSc patients were significantly higher than in controls while the absolute concentrations of CDT were unchanged. %CDT, CDT, and transferrin do not differ significantly between patients with rheumatic diseases. In RA and SSc patients, a positive correlation was observed between %CDT and C-reactive protein (CRP), as well as a positive correlation in RA patients between %CDT and 28-joint Disease Activity Score (DAS28). CONCLUSIONS: The changes in the serum %CDT concentration in patients with RA and SSc correlated with disease activity markers.

Relationship between CDT and disease activity in rheumatoid arthritis.

The aim of this study was to estimate the serum concentration of carbohydrate-deficient transferrin (CDT) in patients with rheumatoid arthritis (RA) and the relationship between the CDT level and disease activity in RA patients. Studies were carried out in 47 female patients with RA and 32 healthy women. Disease activity of RA was evaluated using the 28-joint count Disease Activity Score (DAS 28). Serum CDT was determined by particle-enhanced immunononephelometry using the N Latex CDT test. Patients with RA had significantly lower serum concentrations of CDT compared with controls. The correlation study showed the significant negative relationship between CDT and DAS 28 (r = - 0.483, p = 0.011). There were no correlations between serum CDT level and patient's age, disease duration, number of tender and swollen joints, and degree of disability evaluated by the Health Assessment Questionnaire. The level of CDT in patients with RA was significantly decreased and confirms the changes in transferrin glycosylation which are dependent on the disease activity. Therefore, measurement of CDT in the sera of patients with RA can be useful for the evaluation of disease activity in these patients.

Evaluation of skin thickness lesions in patients with Lyme disease measured by modified Rodnan total skin score.

Recently, a possible etiological connection between infection with Borrelia burgdorferi and various skin lesions, including morphea and systemic sclerosis (SSc), has been discussed. The aim of our study was the evaluation of frequency of skin thickening typical of SSc or morphea in the group of patients with Lyme disease (LD) with frequent exposition to tick bites. The group consisted of 110 patients with LD frequently exposed to tick bites form the northeastern Poland, which is an endemic area for this disease. To measure the skin lesions, the modified Rodnan total skin score (RTSS) was used. In the analyzed group, no skin changes typical of morphea or skin thickening were found. According to RTSS, all patients scored 0 points. Raynaud's phenomenon in all patients was not found. The relationship between scleroderma or morphea and LD is still a matter of controversy. Described by some authors, cases with LD and scleroderma may be associated with co-existence of B. burgdorferi infection with autoimmune process.

Relationship between serum acute-phase proteins and high disease activity in patients with rheumatoid arthritis.

PURPOSE: The aim of this study was to assess the relationship between serum acute-phase proteins and high disease activity evaluated by activity score (DAS28) in patients with rheumatoid arthritis. MATERIAL/METHODS: Studies were carried out on 27 females with RA and 32 control women. Acute-phase proteins were divided into 4 fractions as follows: alpha1-globulins represented by alpha1-acid glycoprotein (AGP) and alpha1-antitrypsin (AAT); alpha2-globulins - haptoglobin (Hp); beta-globulins - complement C3 (C3) and total transferrin (Tf); gamma-globulins - C reactive protein (CRP), rheumatoid factor (RF) and immunoglobulin G (IgG), and determined by immunoturbidimetric methods. RESULTS: The serum levels of acute-phase proteins changed in RA patients. On account of the alterations of concentration, acute-phase proteins are placed in the downgrade scale as follows: CRP, Hp, AGP, C3, AAT and Tf. None of the acute-phase proteins correlated with the RF and the majority of them were closely related to ESR. Almost all of the acute-phase proteins (without C3) were closely related to RA activity (based on DAS28) and their places in the downgrade scale were as follows: CRP, Tf, AGP, Hp and AAT. The degree of disability evaluated by Health Assessment Questionnaire has affected on the concentrations of AGP, Tf and CRP. Serum AGP, AAT and RF levels significantly correlated with the patient's age. No correlations were observed between IgG, TP levels, and clinical data. CONCLUSIONS: Among the entire panel, the CRP and AGP appeared to be the most useful biochemical markers for evaluation of the disease activity of patients with RA.

The importance of early diagnosis of systemic sclerosis.

Systemic sclerosis (SSc) is a connective tissue disease which etiology and pathogenesis is still unknown. The vascular and immunological changes are the major elements of the SSc. The preliminary ACR criteria of SSc are the oldest criteria for rheumatic diseases and are not sensitive enough in respect to early SSc. Many authors suggest that these criteria should be extended by capillaroscopic and immunological changes. In 2001 LeRoy and Medsger proposed new criteria for SSc that could help to identify SSc patients with early stage of the disease. This will give the opportunity for the early and proper treatment.

The occurrence of pulmonary hypertension in patients with systemic sclerosis hospitalized in the Department of Rheumatology and Internal Diseases Medical University of Bialystok in years 2003-2004.

Pulmonary hypertension (PH) is one the most fatal complications of systemic sclerosis (SSc). The aim of the present study was to investigate the occurrence of PH in SSc patients hospitalized in Department of Rheumatology and Internal Diseases University Hospital of Bialystok in years 2003-2004. PH was defined as pulmonary artery systolic pressure (PASP) higher than 35 mmHg as evaluated by ECHO-Doppler. We found PH in 23 out of 53 (43%) SSc patients included in the study. In the majority of patients 20/23 (87%) PH coexisted with the presence of scleroderma lung disease as evaluated by high resolution computed tomography of the lungs. In the remaining 3/23 (13%) patients isolated (arterial) PH was detected. Patients with isolated PH tend to have higher values of PASP (82 +/- 39.0 mmHg) than those with PH and interstitial lung disease (42.5 +/- 6.4 mmHg). The results of our study indicate that PH is a frequent complication of SSc.

[Rapid clinical course of glomerulonephritis accompanying postinfectious reactive arthritis]. / Pozakazne reaktywne zapalenie stawów z zewnatrzwlosniczkowym klebuszkowym zapaleniem nerek o gwaltownym przebiegu klinicznym.

A case of 17 years old patient, hospitalized for evaluation of bilateral ankle arthritis and polyarticular arthralgia, that developed soon after upper respiratory tract infection, was described. In few weeks of hospitalization, rapid progress of glomerulonephritis in course of reactive arthritis, was observed. In spite of treatment with antibiotics, steroids and immunosuppressive agents, patient's state showed no improvement. After 3 months extracorporeal dialysis became necessary. Now patient is waiting for renal transplantation.