Comparative study between clinical disease activity index and simplified disease activity index by assessing the activity of rheumatoid arthritis / 中华风湿病学杂志

ObjectiveTo compare the clinical disease activity index (CDAI) and simplified disease activity index(SDAI) as well as disease activity score 28(DAS28) by assessing the activity of rheumatoid arthritis (RA) and to explore which one is better.MethodsTwo hundred RA patients were enrolled.Swelling joint counts (SJC),tenderness joint counts(TJC ),patient's and doctor's global assessment of disease activity based on visual analogue scale(PGA,PhGA),health assessment questionnaire(HAQ) were recorded and the erythrocyte sedimentation rate(ESR),C reaction protein (CRP) of each patient were tested.DAS28,CDAI,SDAI of all patients were calculated for all patients.Statistical analysiswas carried out by Pearson correlation for the association between DAS28 and the above parameters,as well as CDAI,and SDAI.We created 4 patient groups based on DAS28,CDAI and SDAI ranks and used kappa statistics to assess the level of overall agreement of different disease activity categories between any of the two indices above for individual patients.We assessed the discriminating validity using receiver operating characteristic(ROC) curve analysis to compare the ability of the CDAI and SDAI to discriminate betwecn patients with remission, low and moderate,high disease activity.ResultsOf all the patients,CDAI(17.2±11.1) and SDA[(19.1±11.6) were correlated with DAS28 (4.3±1.5),the correlation coefficients were 0.876,0.861 (P＜0.05) respectively.CDAI and SDAI were correlated with HAQ (0.6±0.7),as well as DAS28.The correlation coefficients were 0.522,0.523,and 0.482(P＜0.05).The Kappa of CDAI and SDAI was 0.777.The Kappa of CDAI and DAS28,SDAI and DAS28 were 0.482,0.394.The areas under ROC of CDAI and SDAI were 0.906,0.888 if DAS28 was used as the gold standard.ConclusionCDAI and SDAI as well as DAS28 can be used to assess the activity of RA and both are better correlated with HAQ than DAS28.Though there is no CRP in CDAI when compared with SDAI,CDAI has very goodoverall agreement with SDAI and the overall agreement of CDAI and DAS28 is better than SDAI and DAS28.In addition, CDAI is better in discriminating between patients with remission/low and moderate/high disease activity.So,CDAI is a simple,convenient,accurate,quick assessment tool and is suitable for daily application.

Anti-endothelial cell antibodies and central nervous system involvement in Behçet's disease

INTRODUCTION: Previous studies have detected the presence of anti-endothelial cell antibodies (AECA) in patients with Behçet's disease (BD). However, no real evidence exists whether these antibodies exert any influence on clinical presentation and/or activity of this disease. OBJECTIVES: To determine the frequency of AECA in patients with BD and analyze possible clinical associations. METHODS: 50 patients with BD who fulfilled diagnostic criteria were selected. Thirty-seven patients were females, and 13 were males; the mean age was 44 ± 9 years with a mean follow-up time of 10 ± 7.5 years. AECA were assayed by ELISA using ECV-304 cells as the antigenic substrate. The prevalence of AECA was determined, and their possible relationships with present and past clinical features were investigated. RESULTS: AECA were detected in the sera of 38 percent of the patients (IgG in 13, IgM in four, and IgG plus IgM in two). An association was observed between AECA and a previous history of central nervous system involvement (OR= 5.4, p= 0.03). This association was more evident for IgG-AECA (OR= 6.0, p= 0.02). A trend of an increased risk of aneurysms was also observed in patients with IgG-AECA (OR= 2.58, p= 0.77). None of the other clinical characteristics showed a relevant association with these antibodies. CONCLUSION: Our data suggest that IgG-AECA may be a marker of more severe lesions in patients with BD based on the higher frequency of previous central nervous system manifestations in patients who presently display circulating AECA.

INTRODUÇÃO: Estudos anteriores detectaram a presence de anticorpos anti-célula endotelial (AACE) em pacientes com doença de Behçet, porém não há nenhuma evidência se a presença destes anticorpos exerce alguma influência na apresentação clínica ou atividade da doença. OBJETIVOS: Determinar a freqüência de AACE em pacientes com doença de Behçet e analisar possíveis associações clínicas. MÉTODOS: Foram selecionados 50 pacientes que preencheram corretamente os critérios diagnósticos para a doença de Behçet. Trinta e sete pacientes eram do sexo feminino e 13 do sexo masculino, média de idade de 44 ± 9 anos e tempo médio de seguimento de 10 ± 7,5 anos. O AACE foram analisados por ELISA utilizando células ECV-304 como substrato antigênico. A prevalência de AACE foi determinada e foram investigadas possíveis relações com características clínicas atuais e pregressas. RESULTADOS: Os AACE foram detectados no soro de 38 por cento dos pacientes (13 na forma IgG, 4 IgM e 2 nas formas IgG e IgM). Observamos uma associação entre o AACE e história pregressa de envolvimento de sistema nervoso central (OR=5,4; p=0,03). Esta associação era mais evidente para o AACE na forma IgG (OR=6,0; p=0,02). Observamos também uma tendência de risco aumentado de aneurismas em pacientes com AACE na forma IgG (OR=2,58; p=0,77). Nenhuma outra característica clínica mostrou-se relevante com o anticorpo estudado. CONCLUSÃO: Nossos dados sugerem que o AACE na forma IgG pode ser uma marcador de lesão mais grave em pacientes com doença de Behçet baseado no fato de encontrarmos uma maior freqüência de história pregressa de manifestação de sistema nervoso central em pacientes com AACE circulante.

Correlation of serum interleukin 8 with clinical disease activity in systemic lupus erythematosus (SLE) / 대한내과학회지

OBJECTIVES: To evaluate serum Interleukin 8 (IL-8) as a predictor of disease activity in SLE and to provide insight into the potential role of IL-8 in the pathogenesis of SLE. METHODS: Sixty-four paired sera from the 32 SLE patients and 10 healthy control sera were obtained. Serum IL-8 levels were determined by ELISA technique. Tests for other laboratory parameters, such as circulating immune complex (CIC), C3, C4, ANA, anti-dsDNA, Hb, Hct, leukocyte, lymphocyte, platelet and ESR, were performed for every sample coincidently with assessment of clinical disease activity by the Lahita scales. RESULTS: We found that serum IL-8 levels in SLE patients were significantly higher than those of healthy controls. Serum IL-8 levels significantly correlated with clinical disease activity. Serum IL-8 levels correlated with CIC, but it had no correlation with other laboratory parameters. CONCLUSON: These findings suggest that serum IL-8 can be used as a marker of disease activity in patients with SLE. These results may have implication in the pathogenesis of SLE.