梅毒与系统性红斑狼疮患者抗心磷脂抗体的比较研究

目的 对梅毒和系统性红斑狼疮(SLE)患者血清中抗心磷脂(ACL)抗体的反应强度以及类型进行比较研究。方法 应用ELISA法对99例梅毒和75例SLE患者的血清中ACL抗体的反应强度以及ACL抗体的IgG与IgM类型进行检测。结果 SLE和梅毒患者血清中IgG型ACL抗体阳性率分别为48.00%和40.40%;梅毒的阳性血清反应强度高于SLE患者(P<0.001);IgM型ACL抗体的阳性率在SLE和梅毒患者中分别为18.67%和61.62%,梅毒的ACL抗体阳性率显著高于SLE患者(P<0.001),且梅毒患者IgM型ACL抗体阳性血清反应强度高于SLE患者(P<0.005)。结论 这种ACL抗体IgG、IgM阳性率与反应强度的差异,反映了SLE患者和梅毒患者产生ACL抗体的机理与功能有所不同。     

SLE患者血清抗磷脂抗体的分布及临床意义

目的:探讨抗磷脂抗体(APA)在SLE患者血清中的分布及临床意义。方法:应用酶联免疫吸附实验(ELISA)法检测64例正常人和56例SLE患者血清中6种APA。结果:SLE患者IgG型抗心磷脂抗体(aCL)、抗磷脂酰肌醇抗体(aPI)、抗磷脂酸抗体(aPA)、抗磷脂酰丝氨酸抗体(aPS)、抗磷脂酰胆碱抗体(aPC)的A值和阳性率均显著高于正常人;IgM型aCL、aPA、aPE、aPS、aPC的A值和阳性率均显著高于正常人。SLE时IgG型和IgM型APA的总阳性率分别为67.86%和69.65%。结论:正常人血清中存在低滴度的APA,SLE患者血清中APA的阳性率高于正常人。APA的检测对早期诊断SLE可能有一定意义。     

慢性荨麻疹和酒渣鼻患者血清中幽门螺杆菌抗体的检测与评价

目的检测慢性荨麻疹患者和酒渣鼻患者血清中的抗HP IgG抗体.方法采用AssureTM H.pylori IgG抗体层析板测定慢性荨麻疹和酒渣鼻患者血清中的抗HP IgG抗体,并设立正常对照组.结果186例慢性荨麻疹患者血清中有121例抗HP IgG抗体阳性,阳性率为65.05%,其中有88例提示为现症感染;38例酒渣鼻患者血清中有32例抗HP IgG抗体阳性,阳性率为84.21%,其中有21例提示为现症感染;正常对照组血清40例有11例抗HPIgG抗体阳性,阳性率为27.50%.结论慢性荨麻疹组患者血清中抗HPIgG抗体阳性率为65.05%,明显高于正常对照组27.50%(P＜0.01);酒渣鼻组患者血清中抗HP IgG抗体阳性率为84.21%,也明显高于正常对照组27.50%(P＜0.01).     

变态反应性皮肤病与食物特异性IgG抗体的相关性分析

目的:探讨变态反应性皮肤病与血清中14种食物特异性IgG抗体的相关性。方法:采用酶联免疫吸附法对5 310例变态反应性皮肤病患者和100例健康人群血清中14种食物特异性IgG抗体水平进行检测。结果:3种变态反应性皮肤病患者食物不耐受IgG抗体总阳性率为84.99%,其中以鸡蛋、螃蟹和牛奶的阳性率最高,对照组的总阳性率为14.00%,二者总阳性率比较差异有统计学意义(χ2=362.17,P<0.05)。结论:变态反应性皮肤病与血清食物特异性IgG抗体有明显相关性,检测血清食物特异性IgG抗体对变态反应性皮肤病的诊疗具有指导意义。     

结缔组织疾病

970972结缔组织病患者抗ENA抗体的检测及其临床意义/柳永和…∥湖南医科大学学报.-1996,21(5).-439用免疫印迹法(IBT)对228例(TD)患者(SLE139例,SS16例,MCTD18例,DM21例.PM13例,PSS21例)和64例健康献血员行7种血清抗ENA抗体检测.228例CTD患者血清抗ENA抗体,阳性率为71.9%,明显高于对照组的3.2%(P<0.01).在各种CTD中,SLE阳性率为67.6%,SS为88.9%,MCTD81.3%.PSS57.1%,PM76.9%,DM80.9%.结果表明;抗ENA抗体的检测对CTD的诊断、鉴别诊断及分型有重要价值.表2参10(宋志学)970973免疫印迹法检测SLE患者血清ENA抗体与临床关系的研究/汪新义…∥临床皮肤科杂志.-1996,25(5).-261～263     

获得性大疱性表皮松解症先发于SLE

作者报道3例及其他作者报告的2例确诊为获得性大疱性表皮松解症(EBA)之后发生SLE的病例,并检查了另外15例无SLE临床表现的EBA患者的血清狼疮相关抗体.结果提示SLE和EBA之间有明显的关系.在观察和检查的20例确诊为EBA的病例中,9例有狼疮相关抗体,其中5例在EBA确诊后出现SLE的临床表现和自身免疫血清学特征(抗dsDNA抗体、循环抗U1RNP抗体和ANA的阳性率均为100%,抗Ro/SSA抗体为20%;抗Sm抗体为20%),1例在诊断为EBA时即有U1RNP抗体,5例在SLE发病时均出现这种抗体.5例伴有SLE的EBA病人最终均出现了抗     

系统性红斑狼疮(SLE)患者及其无症状的亲属中抗总组蛋白及其亚组分抗体的测定

作者从75例SLE患者及其141名无症状的健康亲属(136名为SLE患者的一级亲属,4名为丈夫,1名为妻子)和115名健康人对照者取血,用酶联免疫吸附试验测定血清中的抗总组蛋白及其亚组分的IgG和IgM类抗体.结果:115名正常对照者中,抗总组蛋白IgG类抗体为0～0.44(均值要±标准差为0.044±0.082),正常上限为0.21OD单位.抗总组蛋白的IgM类抗体是0～0.54(均值±标准差为0.11±0.13);正常上限为0.37OD单位.75例SLE患者血清中,32例(43%)抗总组蛋白IgG类     

系统性红斑狼疮病人中的抗心脂质抗体

为研究未加选择的系统性红斑狼疮(SLE)病人血清中抗心脂质抗体的发生率,作者用酶联免疫吸附试验,对59例未经挑选的SLE病人血清中的抗心脂质抗体进行了测定.并对156份献血员和健康实验室工作人员的血清作了对照测定.结果发现32例(54.2%)SLE病人血清中抗心脂质抗体浓度增高,其中28例含有IgG类抗心脂质抗体,4例含IgM类抗心脂质抗体.28例含IgG类抗心脂质抗体的病人,此抗体水平>3Au,其中18例病人抗体水平≥5Au,5例病人≥10Au.并发现血清抗心脂质抗体量的增高和临床症状(诸如血小板减少、血栓形成)之间无明显关系.多数病人的血     

系统性红斑狼疮患者血清抗中性粒细胞胞浆抗体及抗血管内皮细胞抗体检测

探讨血清抗中性粒细胞胞浆抗体(ANCA)及抗血管内皮细胞抗体(AECA)在系统性红斑狼疮(SLE)发病中的作用和意义.收集SLE患者和正常人群血清,用间接免疫荧光技术检测血清中ANCA和AECA,并分型.50例SLE组ANCA阳性率为52%(26/50),其中核周型ANCA(P-ANCA)21例,阳性率42%,胞浆型ANCA(C-ANCA)5例,阳性率10%.与正常对照组比较差异有显著性(P≤0.05).AECA阳性率为62%(31/50),其中IgG-ANCA阳性19例,阳性率为38%,IgM-AECA阳性21例,阳性率42%,与正常对照组比较有显著性差异(P<0.01).患者中伴有浆膜炎和肾脏受累的,ANCA阳性组高于阴性组(P<0.05);伴有雷诺现象、网状青斑及肾脏损害的AECA阳性组高于阴性组(P<0.05);而在皮肤损害、低补体、抗核抗体阳性等方面ANCA及AECA阳性组与阴性组的差异均无显著性(P>0.05).ANCA及AECA都参与了SLE的发病,对SLE患者血清ANCA及AECA检测,有助于了解SLE血管及肾脏病变的发病机制.     

梅毒、红斑狼疮和皮肌炎患者抗磷脂抗体检测

目的：探讨抗磷脂抗体与梅毒、系统性红斑狼疮(SLE)和皮肌炎(DM)的关系。方法：应用酶联免疫吸附试验检测16例梅毒患者、32例SLE患者和11例皮肌炎患者血清中的抗磷脂抗体。结果：①梅毒患者抗磷脂抗体的吸光度（A值)[lgG型抗磷脂酰胆碱抗体(aPC)除外]和IgM型阳性率[抗磷脂酸抗体(aPA)除外]与正常人相比显著升高，IgG型抗磷脂抗体阳性率只有抗心磷脂抗体(aCL)和抗磷脂酸抗体(aPA)，与正常人相比显著升高；②SLE患者抗磷脂抗体的A值和阳性率[IgG型抗磷脂酰乙醇胺抗体(aPE)和IgM型抗磷脂酰肌醇抗体(aPI)除外1与正常人相比显著升高；③DM患者抗磷脂抗体的A值[IgG型抗磷脂酰乙醇胺抗体(aPE)除外1与正常人相比显著升高。④梅毒和SLE患者总阳性率与正常人相比显著升高。结论：自身免疫性疾病患者的抗磷脂抗体与感染时有所不同；抗磷脂抗体虽然存在于多种自身免疫性疾病中，但以SLE的阳性率最高。     

Clinical significance and correlation of antinuclear antibodies and anti-DNA antibodies.

The clinical significance and correlation of antinuclear antibodies (ANA) and anti-DNA antibodies was studied using 142 ANA positive sera from different patients having various diseases. High titers of ANA were found briefly in systemic lupus erythematosus and sometimes in scleroderma or mixed connective tissue disease. The peripheral pattern of ANA was seen exclusively in systemic lupus erythematosus and occasionally in mixed connective tissue disease. Anti-DNA antibodies could be found in systemic lupus erythematosus, discoid lupus erythematosus, scleroderma, chronic active hepatitis, but a high titer of anti-DNA (over 60 unit/ml) was present only in patients with systemic lupus erythematosus, especially those having lupus nephritis. There was little correlation between ANA and anti-DNA antibodies.     

Epidermolysis bullosa acquisita preceding the development of systemic lupus erythematosus

In most cases of epidermolysis bullosa acquisita that occur in patients with systemic lupus erythematosus, the diagnosis of systemic lupus erythematosus is made before the development of blistering. We observed three patients with well-documented epidermolysis bullosa acquisita that developed several years before the onset of systemic lupus erythematosus. One patient was producing anti-U1RNP autoantibodies at the time epidermolysis bullosa acquisita was diagnosed, and all five produced this antibody during the systemic lupus erythematosus phase of their illness. In addition, in all five cases of epidermolysis bullosa acquisita with systemic lupus erythematosus antibodies to double-stranded DNA ultimately developed, and severe systemic lupus erythematosus and lupus nephritis developed in four patients. Sera from 15 other patients with epidermolysis bullosa acquisita without overt systemic lupus erythematosus were analyzed for systemic lupus erythematosus-related autoantibodies. Four patients were found to have at least one such autoantibody. These findings further document an association between epidermolysis bullosa acquisita and systemic lupus erythematosus and suggest that patients with systemic lupus erythematosus who present with epidermolysis bullosa acquisita may represent a subset of lupus erythematosus that puts the patient at increased risk for the development of more severe systemic illness. Patients presenting with epidermolysis bullosa acquisita, especially those who are black or Hispanic, should be monitored for the development of potentially life-threatening systemic lupus erythematosus.     

Bullous Lupus: An Unusual Initial Presentation of Systemic Lupus Erythematosus in an Adolescent Girl

Abstract: Bullous systemic lupus erythematosus is a subepidermal blistering disease that occurs only rarely in a subset of patients with systemic lupus erythematosus and even less commonly in pediatric patients. Autoimmunity in bullous systemic lupus erythematosus is characterized by the presence of circulating anti‐type VII collagen antibodies. We report here a case of a child whose initial systemic lupus erythematosus presentation was a diffuse bullous eruption.     

Prevalence and characteristics of anti-single-stranded DNA antibodies in localized scleroderma. Comparison with systemic lupus erythematosus

Prevalence, levels, and immunoglobulin classes of anti-single-stranded DNA antibodies were determined by an enzyme-linked immunosorbent assay in 52 patients with localized scleroderma (33 with morphea, four with generalized morphea, and 15 with linear scleroderma), in 60 healthy controls, and, for comparison, in 31 patients with systemic lupus erythematosus. Localized scleroderma revealed a significant prevalence of anti-single-stranded DNA antibodies, mainly characterized by high levels and IgM and IgA isotypes. Comparison of antibody characteristics in different clinical forms of localized scleroderma showed some significant differences (levels and immunoglobulin isotypes). Comparison with systemic lupus erythematosus showed that frequency, high levels, and IgG isotype of anti-single-stranded DNA antibodies significantly prevailed in systemic lupus erythematosus, while the IgM isotype significantly prevailed in localized scleroderma. However, generalized morphea and linear scleroderma did not significantly differ from systemic lupus erythematosus as regards antibody frequency and prevalence of high antibody levels.     

Livedo reticularis associated with increased titers of anticardiolipin antibodies in systemic lupus erythematosus

Seventy-eight consecutive patients with systemic lupus erythematosus were assessed for the presence of livedo reticularis. The possible association of livedo reticularis with other clinical and laboratory features including anticardiolipin antibodies was explored. Thirty-eight patients had livedo reticularis. Four cases were severe, 11 moderate, and 23 mild. There was a statistically significant association between the combined moderate and severe livedo reticularis group and elevated levels of anticardiolipin antibodies. The recognized association of anticardiolipin antibodies with thrombotic events suggests a possible pathogenetic role. The presence or history of central nervous system disease, renal disease, vasculitis, or lupus inhibitor was significantly associated with the moderate and severe livedo reticularis group. Livedo reticularis may be a cutaneous marker for the later development of important systemic events in systemic lupus erythematosus.     

Lupus erythematosus associated with genetically determined deficiency of the second component of the complement

BACKGROUND: The gene deletion responsible for the type I human complement C2 deficiency was reported in 1992. The purpose of our study is to evaluate clinical and immunological characteristics of 11 patients with lupus erythematosus and type I C2 deficiency. OBSERVATIONS: We observed 5 patients with a homozygous C2 deficiency and 6 with a heterozygous C2 deficiency. Eight patients had systemic lupus erythematosus, 2 had subacute cutaneous lupus erythematosus, and 1 had chronic lupus erythematosus. Photosensitivity was present in 73% of the patients, and 64% tested positive for anti-Ro (SSA) antibodies. Renal involvement that required immunosuppressive therapy was present in 54% of the patients. Ninety percent of the patients tested positive for antinuclear antibodies, and 54% tested positive for anti-double-stranded DNA antibodies. Phenotyping of the fourth component of the complement was performed in 82% of the patients and showed a C4A4B2 phenotype, which is suggestive for the type I C2 deficiency. CONCLUSIONS: Most patients with lupus erythematosus associated with C2 type I deficiency are photosensitive, and this is probably related to the presence of anti-Ro (SSA) autoantibodies. The prognosis for those patients is not better than that for patients with lupus erythematosus in general.     

New aspects of drug induced lupus erythematosus (author's transl)

Approximately 8% of patients with systemic lupus erythematosus have drug induced disease. Many drugs are associated with lupus erythematosus-like syndrom (Chart 1). It is also a well known fact that the administration of other drugs may exacerbate corticoid treated systemic lupus erythematosus (Chart 2). This report illustrates that it is obvious that we must learn the relationship of diseases and the drugs which induce antinuclear antibodies.     

Subacute cutaneous lupus erythematosus: Clinical, serologic, and immunogenetic studies of forty-nine patients seen in a nonreferral setting

Subacute cutaneous lupus erythematosus has been clearly recognized as a distinct cutaneous manifestation of lupus erythematosus. Two forms have been described, an annular erythema and a papulosquamous variant. Previous data have suggested that these patients have a high incidence of mild to moderate systemic disease, anti-Ro (SS-A) antibodies, and human lymphocyte antigen (HLA)-DR3, particularly the annular form. We studied forty-nine patients with subacute cutaneous lupus erythematosus seen in local private practices in our area. Lesions of chronic cutaneous lupus erythematosus were seen in 34.8% of our patients. Twenty-five patients (51%) fulfilled the American Rheumatism Association criteria for the classification of systemic lupus erythematosus, and renal disease was present in nine of these patients (including 3 with decreased function). Antibodies to Ro (SS-A) and/or La (SS-B) were present in only sixteen patients, and HLA-DR3 was found in only seventeen patients. Twenty-two patients had inactive cutaneous disease at follow-up. We concluded that our patient population with subacute cutaneous lupus erythematosus skin lesions is less distinctive than previous literature suggests. The serologic and immunogenetic correlates were not demonstrated. The full range of lupus erythematosus-related disease was seen, although most patients follow a benign course.     

Neonatal lupus erythematosus: clinical character, investigation, and outcome

Neonatal lupus erythematosus is an uncommon maternal auto-antibody-associated disease characterized by cutaneous, cardiac, hepatic, hematological, neurological, and pulmonary involvement. A retrospective study was performed to review clinical manifestations, investigation results, outcomes of neonatal lupus erythematosus patients and their mothers at the Department of Pediatrics, Siriraj Hospital during 1993 to 2008. Seventeen neonatal lupus erythematosus patients (10 girls and seven boys) were identified. Cutaneous, cardiac, hepatobiliary, and hematological involvement was found in 70.6%, 64.7%, 52.9%, and 35.3% of infants, respectively. Skin lesions were erythematous patches (91.7%), subacute cutaneous lupus erythematosus (50%), petechiae (41.7%), persistent cutis marmorata (16.7%), and discoid lesions (8.3%). Congenital heart block was found in nine cases, and structural abnormalities were found in nine cases. All sera of patients were positive for antinuclear antibodies. Patients (87.5%) showed positive antiRo/SSA, and 50% had positive antiLa/SSB antibodies. Most neonatal lupus erythematosus mothers (64.7%) were asymptomatic. Five mothers were diagnosed with systemic lupus erythematosus, and one mother was diagnosed with mixed connective tissue disease. All maternal sera was positive for antinuclear antibodies and antiRo/SSA antibody. Seven patients required pacemaker implantation. The mortality rate was 11.8%, caused by congestive heart failure and pneumonia. Antinuclear antibody tests should be used as one of the screening tests in mothers or patients suspected of having neonatal lupus erythematosus.     

Clinical significance and correlation of anti-native DNA antibodies and immune complex level in systemic lupus erythematosus.

The clinical significance and correlation of anti-native DNA antibodies and immune complex level were evaluated in the present study. Anti-DNA antibodies were measured by radioimmunoassay using I¹²⁵-labeled DNA and immune complex was screened using the polyethylene glycol precipitation method. Anti-DNA antibodies of higher than 40 units/ml were found exclusively in patients with systemic lupus erythematosus, especially in patients with lupus nephritis. The level of anti-DNA antibodies was found to be directly correlated with the disease activity. Higher amounts of circulating immune complexes could be found in patients with systemic lupus erythematosus, vasculitis, and other diseases. The patients with more active lupus erythematosus also tended to have higher amounts of immune complexes, but the correlation was not so definite. There was also no reliable correlation between anti-DNA activity and immune complex level.