This case report highlights the rare occurrence of SLE in an elderly male patient. Despite the unusual presentation, the team was able to make a diagnosis of SLE using a combination of an atypical clinical picture, wi...This case report highlights the rare occurrence of SLE in an elderly male patient. Despite the unusual presentation, the team was able to make a diagnosis of SLE using a combination of an atypical clinical picture, with initial signs and symptoms of weight loss, anemia, leucopenia and arthlagia, in combination with investigation results, including a positive test for anti-dsDNA antibodies. A more indolent disease course, combined with non-specific initial manifestations and low prevalence within the elderly population, often leads to delayed diagnosis. This case underscores the importance of considering SLE in the differential diagnosis of elderly patients, even in those who do not fit the typical epidemiological profile.展开更多
To investigate the role of IL-17 in the overproduction of autoantibodies and IL-6 overexpression by peripheral blood mononuclear cells (PBMC) of lupus nephritis (LN) patients Methods Fifteen consecutively hospitaliz...To investigate the role of IL-17 in the overproduction of autoantibodies and IL-6 overexpression by peripheral blood mononuclear cells (PBMC) of lupus nephritis (LN) patients Methods Fifteen consecutively hospitalized LN patients were selected as subjects and 15 healthy adults as normal controls PBMC were obtained by Ficoll density gradient centrifugation IgG, anti-dsDNA antibody and IL-6 protein levels were assessed using enzyme-linked immunosorbent assays (ELISA) on the supernatant of cul tured PBMC of LN patients or normal controls IL-6 mRNA levels in PBMC were measured using reverse transcription-polymerase chain reaction (RT-PCR) Results In medium culture, IgG, anti-dsDNA and IL-6 protein levels of the supernatant of PBMC from LN patients were significantly higher than those from normal controls (1492 1±73 2 ng/ml vs 636 7±51 9 ng/ml for IgG, 306 6±53 7 IU/ml vs 95 8±11 6 IU/ml for anti-dsDNA and 50 92±15 92 ng/ml vs 1 77±0 73 ng/ml for IL-6, all P<0 001) In LN patients, IgG, anti-dsDNA and IL-6 protein levels were higher in the supernatants of PBMC in the IL-17-stimulated culture than the medium culture, but in normal controls, only the IL-6 protein levels were significantly higher The increase in IgG, anti-dsDNA and IL-6 protein levels induced by IL-17 was dose-dependent and could be completely blocked by IL-17 monoclonal antibody mIgG 28 and partially blocked by dexamethasone Similarly, IL-6 mRNA overexpression of PBMC in LN patients or normal controls induced by IL-17 was both dose- and time-dependent During medium culture, IL-6 mRNA levels in LN patients were significantly higher than those in normal controls (1 80±0 11 vs 0 36±0 07) During stimulation with IL-17, IL-6 mRNA levels in LN patients were higher than those in normal controls (3 21±0 24 vs 1 30±0 14, P<0 05) and also significantly higher when comparing the stimulated culture with the medium culture either in LN patients or normal control Conclusions IL-17 may play an important role in the pathogenesis of LN through the induction of IgG, anti-dsDNA overproduction and IL-6 overexpression of PBMC in LN patients展开更多
文摘This case report highlights the rare occurrence of SLE in an elderly male patient. Despite the unusual presentation, the team was able to make a diagnosis of SLE using a combination of an atypical clinical picture, with initial signs and symptoms of weight loss, anemia, leucopenia and arthlagia, in combination with investigation results, including a positive test for anti-dsDNA antibodies. A more indolent disease course, combined with non-specific initial manifestations and low prevalence within the elderly population, often leads to delayed diagnosis. This case underscores the importance of considering SLE in the differential diagnosis of elderly patients, even in those who do not fit the typical epidemiological profile.
基金Thisstudywassuportedfromgrantsfor211keyprojectsofSunYatSenUniversityofMedicalSciences (No .981 51 7)
文摘To investigate the role of IL-17 in the overproduction of autoantibodies and IL-6 overexpression by peripheral blood mononuclear cells (PBMC) of lupus nephritis (LN) patients Methods Fifteen consecutively hospitalized LN patients were selected as subjects and 15 healthy adults as normal controls PBMC were obtained by Ficoll density gradient centrifugation IgG, anti-dsDNA antibody and IL-6 protein levels were assessed using enzyme-linked immunosorbent assays (ELISA) on the supernatant of cul tured PBMC of LN patients or normal controls IL-6 mRNA levels in PBMC were measured using reverse transcription-polymerase chain reaction (RT-PCR) Results In medium culture, IgG, anti-dsDNA and IL-6 protein levels of the supernatant of PBMC from LN patients were significantly higher than those from normal controls (1492 1±73 2 ng/ml vs 636 7±51 9 ng/ml for IgG, 306 6±53 7 IU/ml vs 95 8±11 6 IU/ml for anti-dsDNA and 50 92±15 92 ng/ml vs 1 77±0 73 ng/ml for IL-6, all P<0 001) In LN patients, IgG, anti-dsDNA and IL-6 protein levels were higher in the supernatants of PBMC in the IL-17-stimulated culture than the medium culture, but in normal controls, only the IL-6 protein levels were significantly higher The increase in IgG, anti-dsDNA and IL-6 protein levels induced by IL-17 was dose-dependent and could be completely blocked by IL-17 monoclonal antibody mIgG 28 and partially blocked by dexamethasone Similarly, IL-6 mRNA overexpression of PBMC in LN patients or normal controls induced by IL-17 was both dose- and time-dependent During medium culture, IL-6 mRNA levels in LN patients were significantly higher than those in normal controls (1 80±0 11 vs 0 36±0 07) During stimulation with IL-17, IL-6 mRNA levels in LN patients were higher than those in normal controls (3 21±0 24 vs 1 30±0 14, P<0 05) and also significantly higher when comparing the stimulated culture with the medium culture either in LN patients or normal control Conclusions IL-17 may play an important role in the pathogenesis of LN through the induction of IgG, anti-dsDNA overproduction and IL-6 overexpression of PBMC in LN patients
