A 48 year-old Chinese woman suffering from polyarthritis,irregular fever and trichomadesis was admitted to the hospital.A diagnosis of systemic lupus erythematosus(SLE)was made based on polyarthritis,pancytopenia,redu...A 48 year-old Chinese woman suffering from polyarthritis,irregular fever and trichomadesis was admitted to the hospital.A diagnosis of systemic lupus erythematosus(SLE)was made based on polyarthritis,pancytopenia,reduced complement 3,multiple positive autoantibodies,a positive Coomb’s test and protein in her urine.In addition,splenomegaly was detected during physical examination and confirmed by abdominal ultrasonography and magnetic resonance imaging,indicating that the patient had SLE and portal hypertension.Further negative investigations ruled out the possibility of cirrhosis.The patient was diagnosed with active SLE complicated by noncirrhotic portal hypertension(NCPH)without liver histopathology,due to the patient’s refusal for liver biopsy.Portal vein diameter and splenomegaly decreased following treatment with methylprednisolone,hydroxychloroquine and metoprolol tartrate.To date,SLE complicated by NCPH has rarely been reported,as it is under-recognized clinically as well as pathologically.Here we describe a case of SLE complicated by NCPH and review the literature for its characteristics,which may contribute to improving the recognition of NCPH and reducing missed and delayed diagnosis of this disorder.展开更多
Objective To examine the expression of FLICE-inhibitory protein (FLIP) in juvenile idiopathic arthritis (JIA) and analyze its correlation with synovial inflammation. Methods The expression of FLIP was assessed in 11 J...Objective To examine the expression of FLICE-inhibitory protein (FLIP) in juvenile idiopathic arthritis (JIA) and analyze its correlation with synovial inflammation. Methods The expression of FLIP was assessed in 11 JIA and 3 normal synovial tissue samples by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. The cell types expressing FLIP were further characterized,and the correlation of FLIP expression with the degree of synovial inflammation,as well as the activity of caspase 8 was then analyzed. Results RT-PCR revealed the expression of FLIP mRNA in all 11 JIA samples,but not in 3 normal synovial tissues. In JIA,FLIP expression could be found in both the lining and sublining layers,mainly in the macrophage-like cells. Moreover,the expression of FLIP in JIA synovial tissues was positively correlated with the degree of synovial inflammation (r=0.563,P<0.05). Conclusion The expression of antiapoptotic FLIP in JIA synovial tissue and its correlation to accumulation of inflammatory cells in synovial tissue suggests that FLIP potentially extends the lifespan of synovial cells and thus contributes to the progression of joint destruction.展开更多
基金Supported by the National Natural Science Foundation of China,No.81670801Medical Association of Sichuan Province,No.S16027+1 种基金Health and Family Planning Commission of Sichuan Province,No.17PJ059Science and Technology Department of Sichuan Province,No.2018JY0498
文摘A 48 year-old Chinese woman suffering from polyarthritis,irregular fever and trichomadesis was admitted to the hospital.A diagnosis of systemic lupus erythematosus(SLE)was made based on polyarthritis,pancytopenia,reduced complement 3,multiple positive autoantibodies,a positive Coomb’s test and protein in her urine.In addition,splenomegaly was detected during physical examination and confirmed by abdominal ultrasonography and magnetic resonance imaging,indicating that the patient had SLE and portal hypertension.Further negative investigations ruled out the possibility of cirrhosis.The patient was diagnosed with active SLE complicated by noncirrhotic portal hypertension(NCPH)without liver histopathology,due to the patient’s refusal for liver biopsy.Portal vein diameter and splenomegaly decreased following treatment with methylprednisolone,hydroxychloroquine and metoprolol tartrate.To date,SLE complicated by NCPH has rarely been reported,as it is under-recognized clinically as well as pathologically.Here we describe a case of SLE complicated by NCPH and review the literature for its characteristics,which may contribute to improving the recognition of NCPH and reducing missed and delayed diagnosis of this disorder.
基金Supported by grants from the Chinese Ministry of Health (2008BAI59B01)the Department of Health of Sichuan province (020035)
文摘Objective To examine the expression of FLICE-inhibitory protein (FLIP) in juvenile idiopathic arthritis (JIA) and analyze its correlation with synovial inflammation. Methods The expression of FLIP was assessed in 11 JIA and 3 normal synovial tissue samples by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. The cell types expressing FLIP were further characterized,and the correlation of FLIP expression with the degree of synovial inflammation,as well as the activity of caspase 8 was then analyzed. Results RT-PCR revealed the expression of FLIP mRNA in all 11 JIA samples,but not in 3 normal synovial tissues. In JIA,FLIP expression could be found in both the lining and sublining layers,mainly in the macrophage-like cells. Moreover,the expression of FLIP in JIA synovial tissues was positively correlated with the degree of synovial inflammation (r=0.563,P<0.05). Conclusion The expression of antiapoptotic FLIP in JIA synovial tissue and its correlation to accumulation of inflammatory cells in synovial tissue suggests that FLIP potentially extends the lifespan of synovial cells and thus contributes to the progression of joint destruction.