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Serologic studies were performed on 25 patients with systemic lupus erythematosus (SLE) during 29 acute episodes of central nervous system (CNS) disease. Increased anti-DNA antibody and decreased total serum hemolytic complement activity were observed only in those patients with associated extra-CNS disease manifestations. Patients with isolated CNS disease were otherwise in apparent clinical and serological remission regarding these two indices. No special association of cold-reactive IgM antilymphocyte antibodies was demonstrable in patients with ongoing CNS injury. Of special interest was an increased incidence of anti-Sm antibodies in the patients with CNS dysfunction relative to that in a large group of patients without neuropsychiatric disease. The incidence of anti-RNP was not increased. The data do not support direct involvement in SLE brain injury of either DNA/anti-DNA complexes or of lymphocytotoxic antibodies cross-reactive with brain cells, but do suggest an association of anti-Sm with CNS disease in this disorder.  相似文献   

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The records of 37 patients with systemic lupus erythematosus (SLE) followed at The Children's Hospital of Philadelphia between 1968 and 1978 were reviewed for evidence of central nervous system (CNS) involvement. Criteria for CNS involvement included evidence of organic brain syndrome, electroencephalographic abnormalities with symptoms referable to CNS, or objective neurologic signs. Sixteen of 37 children had CNS involvement (43%). Thirteen patients had CNS involvement at the onset of SLE. Three patients had late onset CNS manifestations 1 to 2 years after the diagnosis of SLE. The most frequently observed symptoms were headache, behavior disorder, lethargy, diplopia, blurred vision, memory alteration, dizziness, and alteration of consciousness. The most frequently observed neurologic signs were seizures, cranial nerve palsy, ataxia, papilledema, nystagmus, meningitis, tremor, rigidity, cortical blindness, and coma. Neuropsychiatric manifestations included organic brain syndrome, functional psychosis, and personality disorder. Laboratory tests showed elevated cerebrospinal fluid opening pressure and protein, negative cultures, and abnormal electroencephalograms and computerized axial tomography scans. Fourteen of 16 children with CNS manifestations are alive. Thirteen had a mean IQ of 89 by the Wechsler Intelligence Tests. Twelve are in educational programs. One required long-term psychiatric care. A residual neurologic abnormality, a seizure disorder, was present in 3. CNS involvement with SLE in children carries a favorable prognosis.  相似文献   

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Cyclic-GMP (C-GMP), a normal constituent of the central nervous system, was found to be present in increased amounts in the cerebrospinal fluid (CSF) of systemic lupus erythematosus (SLE) patients with active neurologic disease. Twenty-four CSF samples from 17 patients with SLE were evaluated for C-GMP concentration by radioimmunoassay. This study extends our initial observations and examines three groups of SLE patients based on their clinical status at the time of each lumbar puncture: those with active neurologic and psychologic abnormalities (group I), active neurologic abnormalities (group II), and psychologic abnormalities without active neurologic involvement (group III). Groups I and II had mean CSF C-GMP values of 3.1 nM ± 0.64 (SE) and 4.1 nM ± 0.10 respectively, which were both significantly higher than the mean for group III (1.2 nM ± 0.43) (P < 0.05). Other CSF findings did not display this close correlation with activity of neurologic disease. In 4 SLE patients, significantly higher levels of CSF C-GMP were found on serial sampling during times when neurologic abnormalities were active. Thus elevated CSF C-GMP concentration may be a marker of active neurologic disease in SLE.  相似文献   

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Antibodies to double-stranded deoxyribonucleic acid were studied using the kinetoplast of Crithidia luciliue. Titers were determined separately by conventional immunofluorescence and the complement fluorescent technique, and results by the two methods were compared. Complement fixing activity varied independently of antibody content in whole serum and in IgG fractions. The well established correlation of complement fixing activity of this antibody with activity of lupus nephritis appears related, therefore, to qualitative rather than solely quantitative differences. This finding has important implications for the clinical assessment of patients with lupus, and investigations on the relationship of anti-DNA antibodies to lupus nephritis.  相似文献   

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Sera from 31 patients with lupus erythematosus, 31 controls matched by age and sex and 33 patients with connective tissue disorders other than SLE were examined for specific antibodies to 15 viral antigens by hemagglutination-inhibition tests. Complement-fixation tests were also employed to measure antibodies to measles virus and rubella virus. Sera from patients with LE had significantly higher geometric mean antibody titers than matched controls to measles, rubella, parainfluenza types 2 and 3 and reovirus type 2 antigens. When antibody levels from patients with LE were compared with those from patients with other connective tissue disorders, significant differences were noted for measles, rubella, parainfluenza types 1 and 2 and mumps antigens. Removal of nonspecific antinuclear antibodies from selected SLE sera by adsorption with mouse liver nuclear antigens failed to appreciably alter specific viral antibody. The elevated antibody levels in sera from patients with SLE are consistent with the existence of a hyperreactive immunologic state in this disorder and do not necessarily carry etiologic implications.  相似文献   

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Cold-reactive antibodies cytotoxic for peripheral monocytes from more than half of normal donors were found in the sera of 2 of 25 patients with systemic lupus erythematosus (SLE) and 1 of 26 with rheumatoid arthritis (RA), and they were absent in 25 normal sera. In contrast, lymphocytotoxic activity for T or B lymphocytes was found in over half of the lupus sera. The antibodies to monocytes were primarily IgM and exhibited varying specificities. Some of the antibodies were directed against antigenic determinants common to monocytes, T and B cells, or against determinants shared between monocytes and one lymphocyte type. One serum possessed a high titer of antibodies that were specific for monocytes. The clinical significance of antimonocyte antibodies remains to be established.  相似文献   

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Sera from six sets of twins (five monozygotic and one dyzygotic) in whom one or both has systemic lupus erythematosus (SLE) were evaluated for antibodies to DNA and RNA. Sera from three monozygotic twin sets were further studied to determine the distribution of 19S and 7S antibodies to DNA and RNA. The presence of significant binding of polyriboadenylic acid and of native DNA correlated with the presence of clinical SLE in this study. Sucrose density gradient fractionation studies of the sera revealed that the clinically normal twins had some binding of Poly A and DNA limited to the 19S region, whereas the twins with SLE generally had significant levels of 19S and 7S antibodies to DNA and/or Poly A. On the other hand, concordance for presence or absence of antibodies to double-stranded RNA was demonstrated within each twin set irrespective of concordance or discordance for clinical SLE. These results suggest that genetic factors may be important in determining which nucleic acids antigens become immunogenic, but genetic factors alone do not determine the immunoglobulin class distribution of antibodies to nucleic acids.  相似文献   

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Evaluation of antiphospholipid antibodies (aPL) and correlation with heart valve abnormalities among patients with systemic lupus erythematosus (SLE). Nested case-control study was conducted with 70 patients with SLE selected from a longitudinal database based on levels of aPL and presence or absence of valve disease by echocardiogram. Valvular abnormalities observed were regurgitation (52), other (14), artificial valves (4), stenosis (2), thickening (2) and no Libman-Sacks endocarditis (0). The mitral valve was the most commonly affected (30 abnormalities), followed by the tricuspid (20 abnormalities). Multivariate logistic regression for those with and without an aPL value ≥20 units/mL, adjusted for disease duration and age, showed significant differences for any valve abnormality (odds ratio [OR] = 3.1; 95% CI: 1.0-8.9; P = 0.041) and individually for the tricuspid valve (OR = 3.3; 95% CI: 1.0-11.1; P = 0.052) but not for the mitral valve (OR = 2.1; 95% CI: 0.68-6.45; P = 0.195). Levels of aPL ≥20 units/mL showed no association with aortic (P = 0.253), pulmonic (P = 1.000), tricuspid (P = 0.127), or mitral (P = 0.249) valve abnormalities. Levels of aPL correlate with certain valvular abnormalities among patients with SLE.  相似文献   

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Background: Antiphospholipid antibody syndrome (APS) can either occur as a primary syndrome or associated with other autoimmune diseases such as systemic lupus erythematosus (SLE). Anticardiolipin antibody (aCL) of IgG and/or IgM isotype in blood, measured by a standardized ELISA is the most acceptable laboratory criteria. APS IgG isotype, particularly IgG2 subclass is more strongly associated with thrombosis. Objectives: This study was done to determine the prevalence of IgG aCL and its subclasses in relation to APS symptoms, in a group of juvenile rheumatoid arthritis (JRA) and juvenile systemic lupus erythematosus (SLE) patients.   Methods: In this prospective study, 28 JRA and 16 SLE patients, aged 3-18 years, were enrolled. IgG aCL was assayed by standard aCL ELISA. IgG subclasses were also assayed by ELISA on sera with medium to high titers of aCL. ACL assay was performed on at least two occasions for each patient, over 3-6 months period of follow up.   Results: 29% (8/28) of JRA patients and 44% (7/16) of SLE patients had aCL. Six of SLE patients displayed APS related manifestations: hemolytic anemia, thrombocytopenia, arterial occlusion, valvular heart disease, livedo reticularis and pulmonary hypertension, but none of them had persistant medium or high titer of aCL. The lack of association of high titer of aCL with APS related symptoms was observed in two patients. The IgG subclasses were primarily IgG1 and IgG3.   Conclusion: The prevalence of IgG aCL in this group of pediatric SLE and JRA is not uncommon but it’s relation to clinical manifestations is not clear. IgG1 and IgG3 subclasses were not associated with thrombosis, which is in agreement with previous studies.  相似文献   

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A 45-yr-old female with mild chronic systemic lupus erythematosus for 20 yr, and with a stroke, digital infarction, and transient vocal cord paralysis during those 20 yr, had severe abdominal pain for 2 wk due to omental infarction associated with the presence of anticardiolipin antibodies. This report suggests that patients with otherwise mild systemic lupus erythematosus may develop severe recurrent thromboembolic events associated with anticardiolipin antibodies, that anticardiolipin antibodies may be associated with mesenteric ischemia, and that mesenteric ischemia associated with anticardiolipin antibodies should be considered in the differential of significant, unexplained abdominal pain in patients with systemic lupus erythematosus.  相似文献   

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Sudden sensorineural hearing loss is a rarely reported manifestation of systemic lupus erythematosus (SLE). This condition has been most frequently seen in individuals with concomitant anticardiolipin antibody (ACL) syndrome, although a direct causal relationship remains unconfirmed. We report an unusual case of a young male with sudden unilateral hearing loss as the first manifestation of SLE. This individual was also found to be ACL positive and subsequently presented with other thrombotic manifestations compatible with this syndrome. The literature regarding this condition is reviewed and the significance of this case in fortifying the association of anticardiolipin antibodies and sensorineural hearing loss is discussed. Received: 27 September 2000 / Accepted: 4 December 2000  相似文献   

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侯巍  惠艳 《地方病通报》2005,20(2):98-99
目的探讨抗中性粒细胞胞浆抗体(ANCA)与系统性红斑狼疮(SLE)的关系及临床意义.方法回顾性分析65例SLE患者的ANCA检测结果; ANCA与SLE主要临床表现、实验室检查结果的关系; SLE患者病情活动组与非活动组ANCA阳性率的比较.结果 IIF法检测ANCA在SLE中的阳性率是61.5 %,ANCA阳性组中有血管炎皮损(67.5 %)及浆膜炎(55.0 %)者明显高于阴性组(P<0.05);同时ANCA阳性组与阴性组比较,在24 h尿蛋白大于0.5 g/L,血红蛋白低于90 g/L,抗ds-DNA抗体阳性,低补体血症方面差别有统计学意义(P<0.05).结论提示ANCA可能是判断SLE病情复发与缓解的一个有用指标,推测ANCA与活动性狼疮肾炎有关.  相似文献   

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目的 通过检测系统性红斑狼疮(SLE)患者血清中抗核小体抗体(AnuA)、抗双链DNA (dsDNA)抗体和抗超敏双链DNA (dsDNA-NcX)抗体的水平,分析其在SLE患者中的敏感性、特异性及与其他实验室指标的相关性.方法 采用酶联免疫吸附试验(ELISA)法分别检测91例SLE患者、45例非SLE疾病对照和46例健康对照组血清中AnuA、抗dsDNA抗体和抗dsDNA-NcX抗体的水平,比较3种抗体对SLE诊断的敏感性和特异性,评价其与其他实验室指标的关系.结果 SLE患者AnuA、抗dsDNA抗体和抗dsDNA-NcX抗体的阳性率分别为49.45%、56.04%和61.54%;特异性分别为94.51%、94.51%和100.00%.AnuA、抗dsDNA抗体和抗dsDNA-NcX抗体均与SLEDAI评分呈正相关(r=0.50,P=0.00;r =0.49,P=0.00;r =0.42,P=0.00).ANA的滴度与AnuA的浓度呈正相关(r=0.30,P=0.00),与抗dsDNA抗体的滴度无相关性(r=0.19,P=0.08),与抗dsDNA-NcX抗体的浓度呈正相关(r=0.50,P=0.00).红细胞沉降率在抗dsDNA-NcX抗体、抗dsDNA抗体阴性和阳性组间比较差异无统计学意义(x2=0.76,P=0.38;x2=0.13,P=0.18),而在AnuA阴性与阳性组间比较差异有统计学意义(x2 =20.31,P=0.00).CRP及24小时尿蛋白定量在三者阴性与阳性组间比较差异无统计学意义.补体C3、C4在AnuA、抗dsDNA抗体和抗dsDNA-NcX抗体的阴性与阳性组间比较差异有统计学意义(x2=9.84,P=0.00;x2=16.53,P=0.00;x2 =10.33,P=0.00;x2 =11.61,P=0.00;x2 =12.69,P=0.00;x2=8.77,P=0.00).胱抑素在抗dsDNA抗体和AnuA的阴性与阳性组间比较差异无统计学意义,而在抗dsDNA-NcX抗体阴性与阳性组间比较差异有统计学意义(x2 =4.04,P=0.04).结论 抗dsDNA-NcX抗体可作为SLE的特异性抗体之一,其敏感性和特异性均高于抗dsDNA抗体和AnuA,三者均与SLE的疾病活动相关,联合检测有助于评估病情.  相似文献   

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Canine Systemic Lupus Erythematosus   总被引:9,自引:0,他引:9  
A naturally occurring immunologic disease, characterized by autoimmunehemolytic anemia, idiopathic thrombocytopenic purpura and nephritis, isdescribed in seven dogs. The disease primarily affected formed elements inthe blood, glomeruli and blood vessels. Abnormal serum proteins, includingthe LE factor, rheumatoid factor and antithyroid antibody were found inaffected dogs. Corticosteroids and splenectomy were effective in controllingthe hematologic components of the disease, but apparently had no effect onthe renal lesions. Recurrence was frequent and the prognosis was grave. Additional abnormalities, including malar eruption, intermittent lameness andalopecia were occasionally found as an integral part in the sequential involvement of several tissues during the course of the disease.

Submitted on February 24, 1964 Accepted on May 5, 1964  相似文献   

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