A 46-year-old woman developed a right pleural effusion 8 weeks after standard chemotherapy for tuberculous pleurisy on the left side had been started. Pleural biospy demonstrated caseous granulomatous changes. The patient improved following continuation of the same treatment.

Drug Therapy, Combination↗

PubMed1984

Incidence and clinical significance of anti-ENA antibodies in systemic lupus erythematosus. Estimation by counterimmunoelectrophoresis.

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.

Antibodies, Antinuclear↗

PubMed1984

Diagnostic value of antikeratin antibodies in rheumatoid arthritis.

The value of testing for antikeratin antibodies (AKA) in the diagnosis of rheumatic diseases was investigated. AKA were found in the serum of 71 (54%) of 131 patients with rheumatoid arthritis (RA) (including 10 rheumatoid factor (RF) negative individuals) but only in 7 (2%) of 266 patients with non-RA rheumatic diseases, in 2 (3%) of 69 patients with miscellaneous immunological diseases and in one of 100 healthy controls. AKA positivity in RA patients correlated with their age and the presence of RF, antinuclear antibodies, subcutaneous nodules, as well as the extent and severity of systemic disease manifestations. Our study suggests that determination of AKA would be of value in the assessment of patients suspected of having RA.

Antibodies, Antinuclear↗