Serum galectin-3 and galectin-3 binding protein levels in Behçet's disease and their association with disease activity.

OBJECTIVE: To determine the serum levels of galectin-3 (Gal-3) and galectin-3 binding protein (G3BP) and to evaluate the associations between clinical features and these levels in patients with Behçet's disease (BD). METHODS: Fifty patients with BD (mean age 40.6 +/- SEM 1.4 years; 21 males, 29 females; 26 active and 24 inactive patients), 20 patients with rheumatoid arthritis (RA), and 20 patients with systemic lupus erythematosus (SLE) were enrolled. Clinical features of BD patients including BD activity and severity over the previous 4 weeks were reviewed and serum levels of Gal-3 and G3BP were determined using enzyme-linked immunosorbent assays (ELISA). RESULTS: Serum Gal-3 levels were significantly higher in total BD patients than in healthy controls (mean +/- SEM, 10.68 +/- 0.93 versus 7.59 +/- 0.48 ng/mL; p = 0.0042 by Student's t-test), and active BD patients had significantly higher levels of serum Gal-3 than inactive patients and controls (13.08 +/- 1.53 in active BD, 8.08 +/- 0.71 ng/mL in inactive BD; p = 0.000039 by one way ANOVA). Although mean G3BP serum levels were not different in total BD patients and controls, active BD patients (6806.63 +/- 468.58 ng/mL) had higher G3BP levels than controls (5421.05 +/- 286.02 ng/mL; p = 0.031 by one way ANOVA). Additionally, serum Gal-3 significantly increased in patients with RA (p = 0.019 by t-test) and SLE (p = 0.00069) and G3BP increased in patients with SLE (p = 0.000012), compared to those in healthy controls. When we analyzed for associations with clinical features over the previous 4 weeks, Gal-3 was associated with orogenital ulcers (p = 0.036 by t-test) and time elapsed from symptom onset (p = 0.032, Pearson's coefficient = 0.314). Serum concentrations of Gal-3 (p = 0.013) and G3BP (p = 0.032) were positively correlated with the BD severity score for the previous 4 weeks. Gal-3 levels were significantly correlated with TNF-alpha (p = 0.048, Pearson's coefficient = 0.281) and G3BP levels were correlated with levels of C-reactive protein (p = 0.021, Pearson's coefficient = 0.329) in total BD patients. In multivariate analysis of all cytokines levels, only Gal-3 was significantly related to BD activity or severity for the previous 4 weeks. CONCLUSION: These results suggest that serum levels of Gal-3 and G3BP are increased in active BD patients and Gal-3 can be a new biomarker indicating disease activity in BD although their increments are not disease-specific.

Arthritis information on the Web and its influence on patients and physicians: a Korean study.

OBJECTIVES: This study was conducted to assess the contents of Web-sourced arthritis information and to determine its influence on arthritis patients and medical practice in Korea. METHODS: An electronic search was conducted using the word "arthritis". Web sites found in the Korean language were critically assessed according to authorship, the type of publication, contents, financial interests, and the type of financial interest. Questionnaire surveys of arthritis patients and rheumatologists were performed to appraise the impact of the arthritis information on the Web. RESULTS: Among 138 web sites retrieved, 18.8% were classified as advertisement and 44.9% as having financial interests, such as the promotion of products or services. Among 257 arthritis patients surveyed, 28% reported that they searched for arthritis information on the web, and the parameters significantly associated with Internet searching were a younger age, being employed, and having a higher income and a higher education. While the difference in ratings regarding the accuracy of Web-sourced arthritis information between physicians and patients was not significant, only 16.1% of physicians responded that their patients understand the Internet content accurately. Physicians also tended to reply more negatively about the contents and the influence of Web-sourced arthritis information than patients. CONCLUSION: Analysis of Korean arthritis web sites revealed many sites with financial interests. There was also a discrepancy found between patients and physicians regarding the impact of Web-sourced arthritis information on the doctor-patient relationship. Because the impact of the Internet on health care is expected to increase, physicians need to be prepared to help patients benefit from information obtained from the Internet.

Sweet's syndrome during the treatment of acute promyelocytic leukemia with all-trans retinoic acid.

All-trans retinoic acid (ATRA) is the standard induction treatment for acute promyelocytic leukemia (APL). Quite many ATRA-related side effects, including retinoic acid syndrome, were reported. So far, it has rarely been reported that Sweet's syndrome, characterized by fever, neutrophilia, painful erythematous cutaneous plaques, dense dermal infiltrates of mature neutrophils and rapid response to steroid therapy, is associated with ATRA. In the case that Sweet's syndrome associated with ATRA is found, physicians will have to face a great challenge over the possibility of infectious conditions. We present here a case of Sweet's syndrome associated with ATRA. A 35-year-old female with APL developed fever, painful erythematous cutaneous plaques on both cheeks, right wrist and both shins during induction chemotherapy with ATRA. A skin biopsy revealed a dense dermal infiltrate, consisting of mature neutrophils without vasculitis or cutaneous immunoglobulin deposits, which is compatible with Sweet's syndrome. Oral prednisone was administered and the lesions started to improve within 48 hours.