We present a retrospective review of DNA immunoadsorption (DNA-IA) therapy on clinical symptoms as well as indicators in pediatric cases with systemic lupus erythematosus (SLE), and follow up the short-term curative e...We present a retrospective review of DNA immunoadsorption (DNA-IA) therapy on clinical symptoms as well as indicators in pediatric cases with systemic lupus erythematosus (SLE), and follow up the short-term curative effects. 16 SLE cases were treated by DNA-IA for 3 times every other day. We observed the changes on clinical manifestations and immunological indicators, in order to compare the alteration of these indicators including clinical manifestations, Systemic Lupus Erythematosus Disease Active Index (SLEDAI) scores, 24 hurinary protein excretion, autoantibodies, serum IgG and complement C3. 13 cases were followed up regularly, within 3 months after DNA-IA therapy, 12 cases of clinical manifestations improved (92.3%). SLEDAI scores in 10 cases decreased from (16.20 ± 12.54) to less than 5 (76.9%), 8 cases of ANA, anti-DNA antibodies were negative (61.5%), 13 cases with IgG level in serum recovered to normal (10.39 ± 4.38) g/L, C3 level rose to normal (1.06 ± 0.23) g/L. 3 to 6 months after IA, clinical manifestations and laboratory examinations in all cases got maximum improved. 9 months after IA, SLEDAI score in 2 cases (15.4%) rose to more than 5, anti-DNA antibody in 2 cases (15.4%) became positive, and 1case (7.7%) with serum C3 decreased again. 2 cases died from multiple organs dysfunction within 3 to 6 months after IA. No serious complications were found during DNA-IA. We recommend that DNA immunoadsorption is a safe and effective therapy for active childhood-onset SLE, which could improve clinical symptoms, eliminate ANA and anti-DNA antibodies. Combining with corticosteroids and immunosuppressive drugs, DNA-IA could significantly reduce the activity of disease and protect vital organs function in the short term.展开更多
目的探讨甲基CpG结合蛋白2(methyl-CpG-binding protein 2,MeCP2)基因单核苷酸多态性与中国长江以南汉族人群系统性红斑狼疮(systemic lupus erythematosus,SLE)的易感性。方法采用病例对照研究设计,收集病例141例,对照144例。应用聚合...目的探讨甲基CpG结合蛋白2(methyl-CpG-binding protein 2,MeCP2)基因单核苷酸多态性与中国长江以南汉族人群系统性红斑狼疮(systemic lupus erythematosus,SLE)的易感性。方法采用病例对照研究设计,收集病例141例,对照144例。应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术对rs2239464、rs2075596两位点进行基因分型,在不同的遗传模式下分析两个位点基因多态性与SLE的相关性。根据赤池信息准则(Akaike’s information criteria,AIC)值最小原则,筛选最优模型。结果在显性、隐性、相加及相乘遗传模式下,两位点基因型或等位基因频率分布在病例组与对照组间的差异均有统计学意义(P<0.05)。显性遗传模式下,rs2239464、rs2075596位点GG/AG基因型为SLE的保护性基因型(ORrs2239464=0.528,95%CIrs2239464:0.315～0.885;ORrs2075596=0.435,95%CIrs2075596:0.264～0.717)。隐性遗传模式下,rs2239464、rs2075596位点GG基因型在统计学上具有显著的保护性作用(ORrs2239464=0.108,95%CIrs2239464:0.013～0.863;ORrs2075596=0.097,95%CIrs2075596:0.012～0.771)。相加遗传模式下,以AA基因型为参照,rs2239464位点GG基因型为SLE的保护性基因型(OR=0.094,95%CI:0.012～0.758),rs2075596位点AG及GG基因型也具有保护性作用(ORAG=0.498,95%CIAG:0.298～0.832;ORGG=0.077,95%CIGG:0.010～0.612)。相乘遗传模式下,rs2239464、rs2075596两位点的G等位基因为SLE的保护性等位基因(ORrs2239464=0.503,95%CIrs2239464:0.319～0.793;ORrs2075596=0.445,95%CIrs2075596:0.289～0.686)。rs2239464,rs2075596位点的最优遗传模式均为相加遗传模式。结论在中国长江以南汉族人群中MECP2基因rs2239464,rs2075596位点基因多态性与SLE相关,突变等位基因G可能是SLE保护性等位基因。展开更多
Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that m...Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that mimics septic arthritis caused by the deposition of lipid droplets in the joint. We present the case of a patient hospitalized for mono-arthritis, which revealed systemic lupus. Observation: The patient is a 19-year-old woman, single, without children, and with no previous medical history, who was hospitalized for fever and inflammatory polyarthralgia. The clinical examination revealed an inflammatory swelling of the right knee with patellar ballottement, yellow citrine synovial fluid, an inflammatory tumor on the left arm, which was round, mobile, and fluctuating with purulent content, edema of the lower limbs, and facial puffiness, along with a systemic inflammatory response syndrome. Paraclinical examination showed hyperleukocytosis with neutrophil predominance, microcytic anemia, thrombocytopenia, antistreptolysin O (ASLO) 3, suggesting inflammatory arthritis. Bacteriological tests did not isolate any pathogens. An arthrotomy with synovial biopsy was performed, and the histopathological examination supported non-specific synovitis. A joint ultrasound showed signs of arthritis with a septic appearance. During the third hospitalization for persistent fever, she presented with facial puffiness, anemia syndrome, systemic inflammatory response syndrome, and a malar rash across the bridge of the nose. Antinuclear antibodies returned positive with a titer of 1280 and a speckled fluorescence pattern, and anti-native DNA antibodies were positive at 60.1 (normal Conclusion: Pseudo-septic arthritis is a feature of lupus that can mimic septic arthritis. Monoarticular involvement is rare but possible. The absence of pathogens and the inflammatory nature of the synovial fluid should prompt consideration of a lupus-related etiology.展开更多
文摘We present a retrospective review of DNA immunoadsorption (DNA-IA) therapy on clinical symptoms as well as indicators in pediatric cases with systemic lupus erythematosus (SLE), and follow up the short-term curative effects. 16 SLE cases were treated by DNA-IA for 3 times every other day. We observed the changes on clinical manifestations and immunological indicators, in order to compare the alteration of these indicators including clinical manifestations, Systemic Lupus Erythematosus Disease Active Index (SLEDAI) scores, 24 hurinary protein excretion, autoantibodies, serum IgG and complement C3. 13 cases were followed up regularly, within 3 months after DNA-IA therapy, 12 cases of clinical manifestations improved (92.3%). SLEDAI scores in 10 cases decreased from (16.20 ± 12.54) to less than 5 (76.9%), 8 cases of ANA, anti-DNA antibodies were negative (61.5%), 13 cases with IgG level in serum recovered to normal (10.39 ± 4.38) g/L, C3 level rose to normal (1.06 ± 0.23) g/L. 3 to 6 months after IA, clinical manifestations and laboratory examinations in all cases got maximum improved. 9 months after IA, SLEDAI score in 2 cases (15.4%) rose to more than 5, anti-DNA antibody in 2 cases (15.4%) became positive, and 1case (7.7%) with serum C3 decreased again. 2 cases died from multiple organs dysfunction within 3 to 6 months after IA. No serious complications were found during DNA-IA. We recommend that DNA immunoadsorption is a safe and effective therapy for active childhood-onset SLE, which could improve clinical symptoms, eliminate ANA and anti-DNA antibodies. Combining with corticosteroids and immunosuppressive drugs, DNA-IA could significantly reduce the activity of disease and protect vital organs function in the short term.
文摘目的探讨甲基CpG结合蛋白2(methyl-CpG-binding protein 2,MeCP2)基因单核苷酸多态性与中国长江以南汉族人群系统性红斑狼疮(systemic lupus erythematosus,SLE)的易感性。方法采用病例对照研究设计,收集病例141例,对照144例。应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术对rs2239464、rs2075596两位点进行基因分型,在不同的遗传模式下分析两个位点基因多态性与SLE的相关性。根据赤池信息准则(Akaike’s information criteria,AIC)值最小原则,筛选最优模型。结果在显性、隐性、相加及相乘遗传模式下,两位点基因型或等位基因频率分布在病例组与对照组间的差异均有统计学意义(P<0.05)。显性遗传模式下,rs2239464、rs2075596位点GG/AG基因型为SLE的保护性基因型(ORrs2239464=0.528,95%CIrs2239464:0.315～0.885;ORrs2075596=0.435,95%CIrs2075596:0.264～0.717)。隐性遗传模式下,rs2239464、rs2075596位点GG基因型在统计学上具有显著的保护性作用(ORrs2239464=0.108,95%CIrs2239464:0.013～0.863;ORrs2075596=0.097,95%CIrs2075596:0.012～0.771)。相加遗传模式下,以AA基因型为参照,rs2239464位点GG基因型为SLE的保护性基因型(OR=0.094,95%CI:0.012～0.758),rs2075596位点AG及GG基因型也具有保护性作用(ORAG=0.498,95%CIAG:0.298～0.832;ORGG=0.077,95%CIGG:0.010～0.612)。相乘遗传模式下,rs2239464、rs2075596两位点的G等位基因为SLE的保护性等位基因(ORrs2239464=0.503,95%CIrs2239464:0.319～0.793;ORrs2075596=0.445,95%CIrs2075596:0.289～0.686)。rs2239464,rs2075596位点的最优遗传模式均为相加遗传模式。结论在中国长江以南汉族人群中MECP2基因rs2239464,rs2075596位点基因多态性与SLE相关,突变等位基因G可能是SLE保护性等位基因。
文摘Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that mimics septic arthritis caused by the deposition of lipid droplets in the joint. We present the case of a patient hospitalized for mono-arthritis, which revealed systemic lupus. Observation: The patient is a 19-year-old woman, single, without children, and with no previous medical history, who was hospitalized for fever and inflammatory polyarthralgia. The clinical examination revealed an inflammatory swelling of the right knee with patellar ballottement, yellow citrine synovial fluid, an inflammatory tumor on the left arm, which was round, mobile, and fluctuating with purulent content, edema of the lower limbs, and facial puffiness, along with a systemic inflammatory response syndrome. Paraclinical examination showed hyperleukocytosis with neutrophil predominance, microcytic anemia, thrombocytopenia, antistreptolysin O (ASLO) 3, suggesting inflammatory arthritis. Bacteriological tests did not isolate any pathogens. An arthrotomy with synovial biopsy was performed, and the histopathological examination supported non-specific synovitis. A joint ultrasound showed signs of arthritis with a septic appearance. During the third hospitalization for persistent fever, she presented with facial puffiness, anemia syndrome, systemic inflammatory response syndrome, and a malar rash across the bridge of the nose. Antinuclear antibodies returned positive with a titer of 1280 and a speckled fluorescence pattern, and anti-native DNA antibodies were positive at 60.1 (normal Conclusion: Pseudo-septic arthritis is a feature of lupus that can mimic septic arthritis. Monoarticular involvement is rare but possible. The absence of pathogens and the inflammatory nature of the synovial fluid should prompt consideration of a lupus-related etiology.
