RESUMO
An elevated expression of the alloantigen D8/17 on B lymphocytes has been previously proposed as a susceptibility marker in rheumatic fever. The aim of the study was to investigate the presence of the D8/17 marker on B lymphocytes in poststreptococcal reactive arthritis (PSRA). The study sample included 19 patients (15 boys, 4 girls; mean age 11.7 +/- 5.4 years) who were diagnosed with PSRA (mean age at diagnosis, 9.4 +/- 5.6 years) and 18 healthy controls (10 boys and 8 girls) matched for ethnic background. B-cell D8/17 expression was tested by flow cytometry assay using monoclonal antibodies. Laboratory results showed a higher expression of D8/17 in the patient group (23.1 +/- 10.4%, range 11.6-51.9%) than in the control group (17.1 +/- 8.2%, range 7.1-35.7) in controls; this difference was statistically significant after log transformation of the data (P = 0.035). The high rate of expression of the D8/17 marker in patients with PSRA suggests that RF and PSRA share the same genetic susceptibility.
Assuntos
Antígenos de Diferenciação de Linfócitos B/genética , Artrite Reativa/genética , Predisposição Genética para Doença/genética , Infecções Estreptocócicas/genética , Adolescente , Adulto , Artrite Reativa/etiologia , Artrite Reativa/microbiologia , Linfócitos B/metabolismo , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Isoantígenos/análise , Israel , Masculino , Febre Reumática/genética , Infecções Estreptocócicas/complicaçõesRESUMO
PURPOSE: To evaluate the ocular changes and medical and surgical therapy after high-dose systemic steroid treatment in babies with infantile spasm and hypsarrhythmia. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: In 5 of the 9 (55%) babies with infantile spasm exposed to systemic corticosteroid treatment, an increase in intraocular pressure (IOP) and optic disc cupping was observed. INTERVENTION: Ophthalmic examination under mild sedation was conducted 3 to 4 weeks after initiation of systemic therapy. Antiglaucoma treatment was given to the patients found to have high IOPs and cup-to-disc ratio changes. Routine follow-up was continued until systemic therapy was completed. MAIN OUTCOME MEASURES: Controlled IOP with a decrease in cupping damage after antiglaucoma therapy. RESULTS: Five patients required antiglaucoma treatment; one also underwent augmented trabeculectomy. Mean IOP decreased in this subgroup from 30.1 +/- 9.5 mmHg to 15.4 +/- 4.2 mmHg in the right eye (P = 0.043) and from 32.6 +/- 7.4 mmHg to 15.2 +/- 1.8 mmHg in the left eye (P = 0.043). Mean cup-to-disc ratio improved from 0.53 +/- 0.2 to 0.37 +/- 0.04 in the right eye (P = 0.06) and from 0.57 +/- 0.12 to 0.35 +/- 0.05 in the left eye (P = 0.042). CONCLUSIONS: The rapid onset of IOP and cup-to-disc ratio changes in patients with infantile spasm and hypsarrhythmia treated by high-dose corticosteroids necessitates early and intensive monitoring to prevent anatomic ocular damage and visual impairment in the future.
Assuntos
Glucocorticoides/efeitos adversos , Pressão Intraocular/efeitos dos fármacos , Hipertensão Ocular/induzido quimicamente , Espasmos Infantis/tratamento farmacológico , Administração Oral , Anti-Hipertensivos/uso terapêutico , Cosintropina/efeitos adversos , Cosintropina/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Lactente , Injeções Intramusculares , Masculino , Hipertensão Ocular/tratamento farmacológico , Disco Óptico/efeitos dos fármacos , Doenças do Nervo Óptico/induzido quimicamente , Prednisona/efeitos adversos , Prednisona/uso terapêutico , Estudos Retrospectivos , Tonometria OcularRESUMO
We describe 3 patients who presented with a distinctive clinical picture of the purpuric rash called "gloves-and-socks syndrome" which was characterized by an acral distribution of the rash that involved not only the distal part of the extremities but also the chin and perioral area. Serologic analysis for parvovirus B19 yielded positive results. Parvovirus B19 should be included in the evaluation of febrile purpura.
