Biomedical subjects
Publications and source records attributed to S Havelka.
HLA class II alleles were investigated in 27 Czech patients (11 females and 16 males) with juvenile dermatomyositis. The immunogenetic investigation comprised determination of DRB1, DRB3, DRB5, DQA1, DQB1, and DPB1 alleles. Their prevalence was compared with that found in healthy Czech controls. No allele was found significantly more frequently in patients than in controls.
The use of corticosteroid therapy in the treatment of juvenile chronic arthritis in Czechoslovakia is summarized. The indispensability of corticosteroids in pediatric rheumatology is confirmed and some practical aspects of their application are discussed.
Adult rheumatoid factor (RF) positive rheumatoid arthritis (RA) and RF positive arthritis of childhood are associated with DRB1*0401 in Caucasians, and DRB1*0405 in Orientals, and in Ashkenazi and nonAshkenazi Jews. Certain other DRB1 alleles (DRB1*0101,1001) which have a similar sequence in the 3rd hypervariable region of the 1st domain are also associated with RA, but they appear to function as weaker risk factors. The difference in the relative strength of the associations is likely to be due to structural differences in the 1st and 2nd variable regions of the first domain of these alleles. Similarities and differences in the HLA associations between North American Caucasoid patients with juvenile arthritis in Dallas, TX, USA, and in Prague, Czechoslovakia, are discussed.
Restriction fragment length polymorphism (RFLP) typing of MHC-class II loci DRB, DQA1, DQB1, DQA2 and DPB1 was performed in 94 patients with seronegative juvenile chronic arthritis (JCA) and 184 random controls. Analysis of allele frequencies and MHC-class II 4-loci haplotypes indicate: (1) Susceptibility to JCA is more strongly associated with the HLA-DQ subregion than with the HLA-DR subregion, especially in early onset pauciarticular JCA (EOPA-JCA). (2) Haplotype and sequence analysis show two independent MHC-class II associations for susceptibility to EOPA-JCA, one located in DQA1, the other in DPB1. (3) Two RFLP defined patterns of the DQA1 locus, DQA1.5 (DQA1*0501) and DQA1.8 (DQA1*0401, *0601) are strongly associated with the disease. (4) Analysis of amino-acid (AA) sequences coded in exon 2 of DQA1 reveals an AA sequence of six AAs common to all three associated DQA1 alleles. This suggests a model that includes a functional role for HLA-DQ molecules in the pathogenesis of JCA.
Thirty nine consecutive patients with pauciarticular and polyarticular juvenile chronic arthritis were randomised to treatment with either sulphasalazine or Delagil (chlorochinum diphosphoricum) in a parallel 6 month clinical trial. We compared clinical and laboratory signs of activity before and after the treatment. Of 21 patients with Sulphasalazine 10 were improved, 7 unchanged and in 4 patients had the therapy to be withdrawn. Of 18 patients with Delagil 5 were improved, 12 without effect and withdrawal was necessary in 1.
A boy with neurofibromatosis suffered mumps at the age of 5. A full-blown juvenile polymyositis developed shortly afterwards. First hematological consultation was done for monocytosis in peripheral blood at the age of 7. He suffered varicella at the age of 8. Diagnosis of acute nonlymphocytic leukemia with monosomy 7 was done before the age of 9. The boy died at the age of 10.
A case of multilocular pigmented villonodular synovitis in a child is described. It is an uncommon disorder, slowly progressive. Investigation, diagnosis and treatment are very difficult.
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The authors describe the incidence of diffuse idiopathic skeletal hyperostosis in three members of a family--father and two daughters. Some diagnostic problems of the disease are also discussed.
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In 38 children with juvenile chronic arthritis the authors tested Sulphasalazine in an open clinical trial. The drug was administered for 26 weeks, 20-30 mg/kg/day. The action of the drug was followed up with regard to clinical (number of criteria of juvenile chronic arthritis, functional state, period of morning stiffness, number of affected joints painfulness of joints) and laboratory (red cell sedimentation rate, circulating immunocomplexes) indicators. A favourable effect (improvement of at least five of the above indicators) was recorded in 42.1% of the children. Undesirable effects were found in 11 children (30%) incl. six where they were the cause of discontinuation of treatment. All undesirable effects were reversible. The majority of them (exanthema, headache, leukopenia, microscopic haematuria) developed during the first 3-4 weeks of treatment.
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Using the ELISA method, the authors assessed titres of antibodies to collagen type I, II and III in serum of patients with juvenile chronic arthritis (JCA). The results were compared with antibody titres in patients with rheumatoid arthritis (RA). Elevated antibody titres to all collagen types were found, as compared with age-matched controls. The mean titres in patients with RA were higher than in the group with JCA. Investigation of a correlation between the collagen antibody titres and values of the sedimentation rate after one hour revealed a statistical relationship only in collagen type II in patients with RA.
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Using ELISA antibodies, titres to collagen type I, II and III in sera of patients with juvenile chronic arthritis (JCA) were assayed. Results were compared with titres of patients with rheumatoid arthritis (RA). Increased antibodies titres to all three collagen types were found in comparison with healthy individuals of the same age. Average titres in patients with RA were higher than those of the JCA group. When antibodies titres were correlated with erythrocyte sedimentation rate in 1 hour (ESR/1h) statistical significance was found only in RA group for collagen type II.
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