Evaluation of potential biomarkers for the diagnosis and monitoring of Systemic Lupus Erythematosus using the Cytometric Beads Array (CBA).

BACKGROUND: Systemic Lupus Erythematosus (SLE) is an autoimmune, multisystemic disease. Currently diagnosis depends on complex criteria developed by the American College of Rheumatology. Moreover, the lack of specific biomarkers also challenges the diagnosis. METHODS: Inflammatory biomarkers such as IL-8, IP-10, MIG, MIP-1α and RANTES were measured in serum samples from SLE patients and subjects in control groups (patients with other autoimmune diseases and healthy individuals). Forty-six SLE patients (22 patients with low activity, SLEDAI-2 K ≤ 4, 24 patients with moderate/high activity, SLEDAI-2 K > 4), 42 patients with other autoimmune diseases (OAD group), and 8 healthy volunteers participated in this study. RESULTS: MIG (p < .001) and RANTES (p < .001) concentrations in SLE patients and healthy controls, and IP-10 concentrations in SLE patients with different disease activities (low activity, p < .01, moderate/high activity, p < .05) differed significantly. IL-8 (p < .001) and MIP-1α (p < .001) concentrations in SLE patients differed from those in patients from the OAD group. IL-8 (p < .05), IP-10 (p < .01), MIG (p < .05), MIP-1α (p < .001), and RANTES (p < .05) were correlated with SLE activity; their concentrations in SLE patients with low and moderate/high activity differed significantly. CONCLUSIONS: Given the findings of this study, one can envision the possibility of future use of some of these cytokines to assist in the screening of SLE patients, or even in monitoring disease activity.

Sensorineural dysacusis in patients with systemic lupus erythematosus.

The objective of this study was to establish the frequency of involvement of the auditory apparatus in 45 female patients with systemic lupus erythematosus (SLE) submitted to general clinical and laboratory assessments, and tone and vocal audiometry accompanied by a questionnaire evaluating auditory symptoms. The control group consisted of 45 healthy women, matched by age. Auditory symptoms were present in 25 (55.5%) patients, with a diagnosis of sensorineural hearing loss in seven (15.6%) patients. A significant correlation with hypoacusis (P < 0.001), ear fullness (P = 0.012) and tinnitus (P = 0.017) was observed in patients with hearing loss. None of the clinical or laboratory parameters showed an association with sensorineural hearing loss. In the control group, three women (6.7%) presented audiometric alterations, including two with altered tympanometry results and one with mild sensorineural hearing loss. In conclusion, an adequate investigation of auditory symptoms is important during the follow-up of patients with SLE, since manifestations of the auditory apparatus and sensorineural hearing loss can affect a significant proportion of patients.

Efficacy of auranofin as demonstrated by improvement in clinical parameters and decrease in anti-inflammatory usage: a long-term, multicenter study.

An open, noncomparative study at 8 rheumatology centers in Brazil assessed the efficacy and safety of auranofin (AF) when given for up to 24 months. The study enrolled 80 patients with classic or definite rheumatoid arthritis (RA); disease was severe in 20 (25%), moderate in 55 (69%), and mild in 5 (6%). Patients received auranofin, 3 mg twice daily, and varying doses of anti-inflammatory drugs (aspirin, nonsteroidal anti-inflammatory drugs, and corticosteroids). Sixty patients (75%) completed the full 24 months of therapy. No patients were withdrawn from therapy because of insufficient therapeutic effect. There was statistically significant improvement (p less than 0.001) in 9 clinical parameters of disease activity, evident as early as 3 months after beginning AF therapy, increasing steadily over 12 months, and remaining at improved levels for another 12 months. Improvements in some parameters were particularly striking. By 24 months, assessment of well-being had increased by 150%, intensity of pain had decreased by 66%, and duration of morning stiffness had decreased by 78%. The average daily dose of anti-inflammatory drugs also decreased over time. The safety profile of AF was similar to that found in comparable trials. Ten patients (12.5%) were withdrawn because of adverse events: 6 for diarrhea (7.5%), 2 for proteinuria (2.5%), and 1 each for pruritus and anemia (1.25%). Adverse events occurred in 24 of 80 patients; some reported more than one adverse event. The most common adverse events were loose stools (20 patients) or diarrhea (11 patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Artrite reumatoide juvenil. 1a. parte Analise clinica de 111 casos. / Juvenile rheumatoid arthritis. Part I - Clinical analysis of III cases

Cento e onze pacientes de artrite reumatoide juvenil (ARJ) foram classificados, segundo o acometimento articular inicial, nos 3 tipos principais: oligoarticular, poliarticular e sistemico. O sexo feminino teve predominancia de 59% em ARJ. O grupo etario com maior incidencia de casos foi de 6 a 10 anos. A quase totalidade dos pacientes do tipo SI se iniciou antes dos 10. As articulacoes mais frequentemente acometidas foram o joelho e o tornozelo. Treze casos com diagnostico inicial de AJR, na grande maioria do tipo oligoarticular, evoluiram para espondilite anquilosante. A iridociclite cronica foi observada em tres casos do tipo aligoarticular. Manifestacoes hepaticas foram as alteracoes iniciais em dois pacientes do tipo sitemico. A biopsia de um nodulo ao nivel de coluna dorsal baixa definiu o diagnostico, em um tipo sistemico, apos 4 anos de febre intermitente

Artrite reumatoide juvenil: 2§ parte; achados laboratoriais e radiologicos em 111 casos / Juvenil rheumatoid arthritis: part 2; laboratorial and radiological findings in 111 cases

Os achados laboratoriais e radiologicos foram descritos em 111 pacientes de ARJ. A positividade da pesquisa do FAN foi de 15% e a do latex de 13%. O HLA B27 foi positivo em 63% dos pacientes de espondilite anquilosante. A menor incidencia de alteracao dos exames de plaquetas, de hemossedimentacao, de leucocitos e de hemoglobina na espondilite anquilosante constitui um fato importante para o diagnostico diferencial dessa patologia. O aumento de partes moles foi o achado radiologico mais precoce e frequente, enquanto a osteoporose e periostite nao foram tao iniciais. Dois casos de subluxacao atlas-axis no tipo poliarticular foram observados