[Gout, chondrocalcinosis and hypothyroidism].
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Biomedical subjects
Publications and source records attributed to E Lience.
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Eighty-two patients with systemic lupus erythematosus (SLE) were investigated for the presence and significance of serum antibodies to Extractable Nuclear Antigen (ENA) and its major components, RNP, Sm and SS-B (or Ha). The counterimmunoelectrophoresis assay allowed independent detection and measurement of antibodies to the different components. Forty patients had anti-ENA antibodies, 25 (30%) were of anti-RNP type alone or anti-RNP associated with anti-Sm, and 12 (15%) were of anti-RNP type alone. Anti-ENA antibodies distinguished a subset of patients with less common incidence of renal disease, positive Coombs test, anticoagulant serum factors and high titres of anti-DNAds antibodies, with higher incidence of Raynaud's phenomenon, swollen hands, hypergammaglobulinemia and high titres of antinuclear antibodies with speckled pattern on immunofluorescence. SLE patients with anti-RNP antibodies had in addition a high frequency of normal complement values. All but one SLE patient with only anti-RNP antibodies fulfilled at least four or more criteria for the diagnosis of SLE. We conclude that anti-ENA antibodies in SLE patients are associated with a low prevalence of nephritis and a clinical and laboratory profile similar to that of the MCTD syndrome. These findings demonstrate the difficulty of inferring rigid differences between MCTD and SLE. The MCTD syndrome probably represents only one segment of the whole clinical spectrum of SLE.
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Circulating immune complexes (IC) in 52 rheumatoid arthritis (RA) seropositive, 25 RA seronegative and 32 ankylosing spondylitis (AS) patients were assayed by two methods: 1) precipitation with a final 2% polyethylene glycol (PEG) concentration with immunoglobulins (Igs) quantitation in the precipitate and 2) the ability of IC to consume complement, evaluating conversion products from human C3 by bidimensional rocket immunoelectrophoresis. CH50, C3, C4, C3PA and circulating C3 conversion products were quantitated. IC precipitates with 2% PEG contained three classes of Igs: IgG, IgM and IgA, the latter being the most rare. In the control group Igs level precipitated with 2% PEG were: 2% PEG-IgG 2.5 mg/100 ml +/- 2; 2% PEG-IgM 0.72 mg/100 ml +/- 1.09; 2% PEG-IgA 0.04 mg/100 ml +/- 0.18. With 2% PEG IC-like material was detected in 58.5% of RA seropositive patients but none generated C3 conversion products. With neither methods was IC-like material detected in the RA seronegative group and none with 2% PEG in AS, either. However, in the latter, 21.8% generated C3 conversion products and 18.7% circulating C3 conversión products. In the RA seropositive patients no correlation was observed between the levels of 2% PEG-IgG and 2% PEG-IgM and the titre of antinuclear antibodies (ANA) nor between 2% PEG-IgG and that of IgG in serum. However, there was a low correlation between 2% PEG-IgM and that of IgM in serum and between 2% PEG-IgG and 2% PEG-IgM with rheumatoid factor (RF). It should be stressed that the value of the PEG method in the detection of IC-like material must be reconsidered, since using a 2% final concentration and a specific evaluation of Igs and complement components in the precipitate, it may be a method easy to perform and useful for clinical purposes.
Chronic interstitial pneumonia, necrobiotic nodules and pleural lesions are felt to be extraarticular manifestations of rheumatoid arthritis (RA). In a prospective study, posteroanterior and lateral chest X-ray films were taken in 89 patients with classical or definite RA (15 male and 74 female), of whom 64 (71.9%) were seropositive. The findings were compared with those of 103 age and sex matched controls. The chest X-rays were blindly evaluated by two of the authors (a pneumologist and a radiologist), and the presence of an interstitial pattern, nodules or pleural lesions was recorded. The following results were obtained: Interstitial pattern, in patients with RA, 5/89 (5.6%), and in controls, 5/103 (4.6%). Pulmonary nodules, in RA, 2/89 (2.2%), and in controls, 2/103 (1.9%). Pleural adhesions, in RA, 32/89 (35.9%), and in controls, 24/103 (23.5%). The results of the present series demonstrate that radiological pulmonary lesions are not more frequent in RA than in controls, similar conclusions having been reached by other authors.
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