Serum concentrations of 25-OH vitamin D in patients with systemic lupus erythematosus (SLE) are inversely related to disease activity: is it time to routinely supplement patients with SLE with vitamin D?

BACKGROUND: Low serum vitamin D concentrations have been reported in several autoimmune disorders. OBJECTIVE: To assess whether low serum vitamin D concentrations are related to disease activity of patients with systemic lupus erythematosus (SLE). METHODS: 378 patients from several European and Israeli cohorts were pooled and their disease activity was measured by two different methods: 278 patients had SLE disease activity-2000 (SLEDAI-2K) scores and 100 patients had European Consensus Lupus Activity Measurement (ECLAM) scores. In order to combine the two systems the scores were converted into standardised values (z-scores), enabling univariate summary statistics for the two variables (SLEDAI-2K and ECLAM). The commercial kit, LIAISON 25-OH vitamin D assay (310900-Diasorin) was used to measure serum concentration of 25-OH vitamin D in 378 patients with SLE. RESULTS: A significant negative correlation was demonstrated between the serum concentration of vitamin D and the standardised values (z-scores) of disease activity scores as measured by the SLEDAI-2K and ECLAM scales (Pearson's correlation coefficient r=-0.12, p=0.018). CONCLUSIONS: In a cohort of patients with SLE originating from Israel and Europe vitamin D serum concentrations were found to be inversely related to disease activity.

[Prevalence of rheumatic manifestations and non-organ specific autoimmunity in patients with autoimmune thyreopathy]. / Výskyt reumatických manifestácií a orgánovo nespecifickej autoimunity a chorých s autoimunitnou tyreopatiou.

INTRODUCTION: A variety of rheumatic manifestations (RM) has been described in association with autoimmune thyroiditis (AIT). In the past, most of these manifestations were attributed to the underlying thyroid dysfunction, in particular hypothyroidism. AIT is often associated with non-organ specific autoimmunity. Increased prevalence of non-organ specific autoantibodies in patients with AIT without any evidence of rhemautic manifestations is clinically unclear. Aim of this study was to find out the frequency of apperance of non-organ specific antibodies in serum in patients with AIT and prevalence of RM (arthralgia/arthitis). PATIENTS AND METHODS: The group consisted of 80 patients with diagnosis AIT. The diagnosis of AIT was made according to established criteria. This diagnosis was primarily based on laboratory markers including thyroid hormone levels (TSH, fT4, fT3), the detection of antithyroid antibodies (anti-TPO, anti-TG, anti-RTSH antibodies) and on ultrasound examination (imaging signs of thyroid autoimmunity) of thyroidal gland. None of the above patients had a history of systemic autoimmune disorders. In the group of patients with AIT we evaluated the prevalence of non-organ specific antibodies (ANA/Hep 2, ENA scr., SSA, SSB, nRNP, dsDNA, DNP, RF, ACLA scr., ANCA/MPO, ANCA/PR3) and presence of RM (arthritis/arthralgia). The control group consisted of 34 patients with no overt history of AIT or systemic autoimmune disorders. RESULTS: In the group of patients with AIT ANA positivity was found in 36/80 (45%) patients compared with 5/34 (14.7%) in healthy controls (p < 0.05). The prevalence of ANA autoantibodies was significantly higher in patients with AIT than in healthy controls. Other levels of non-organ specific antibodies (ENA scr., SSA, SSB, nRNP, dsDNA, DNP, RF, ACLA scr., ANCA/MPO, ANCA/PR3) were not significantly different among patients with AIT and healthy controls. 40/80 (50%) of patients with AIT had artralgia compared with 7/34 (20.6%) in healthy controls (p < 0.05) and 19/80 (23.75%) of patients with AIT had arthritis compared with 1/34 (2.9%) in healthy controls (p < 0.05). The prevalence of RM (arthralgia and arthritis) in group of patients with AIT was significantly higher than in healthy controls. CONCLUSION: The prevalence ofANA autoantibodies and RM (arthralgia/arthritis - both) was significantly higher in patients with AIT than in healthy controls.

Primary B-cell pituitary lymphoma of the Burkitt type: case report of the rare clinic entity with typical clinical presentation.

Primary CNS lymphomas (PCNSLs) constitute 3% of all intracranial neoplasms. From these, primary pituitary lymphomas (PPLs) represent extremely rare clinical entity. Nearly all of PCNSLs are non-Hodgkin diffuse large B-cell lymphomas. We present a 60-year-old female with right-sided third cranial nerve palsy, mild bitemporal visual field deficit, severe cephalea, and polyuria-polydipsia. Hypopituitarism with hyperprolactinemia was confirmed; brain imaging revealed a 16 mm-diameter sellar mass with suprasellar extension. A presumptive diagnosis of pituitary adenoma was established. The patient underwent a neurosurgical intervention. Histopathological examination and immunophenotyping (cytokeratin, CD45+, CD79+, bcl-2-) verified high-grade B-cell non-Hodgkin lymphoma of the Burkitt type. Systemic work-up showed no other foci of lymphoma, the patient's HIV status was negative, Epstein-Barr virus status was not disclosed. Although PPL can be undistinguishable from pituitary adenoma at imaging, one should consider lymphoma when evaluating an invasive sellar mass that is iso- to hypointense on T2-weighted magnetic resonance images, particularly when the patient is immunocompromised or old and presents with diabetes insipidus, cranial nerve palsy and fever of unknown origin in addition to the expected finding of hypopituitarism.

[Systemic lupus erythematodes]. / Systémový lupus erythematosus.

Systemic lupus erythematodes (SLE) is chronic autoimmune disease, characteristic by production of autoantibodies against different autoantigens. Etiopathogenesis in not precise determinated, but genetic, immunologic, hormonal factors or influence of environment are assumed. It manifests by various symptoms and it can affect whichever organ or system in the body. Clinical manifestation are due chronic inflammation in the tissues, which is caused first of all by deposit of immunocomplex and by cytotoxic damage. At the last decades the mortality of patients with SLE is markly lower and their live is prolong. In spite of this diagnostic, to follow up and therapy of this disease is complicated and it requires the colaboration of more branches of medicine.

Prolactin levels and autoantibodies in female patients with systemic lupus erythematosus.

We investigated the relationships between prolactin (PRL) levels and antibody occurrence in systemic lupus erythematosus (SLE). No significant association between PRL levels and the majority of the autoantibodies studied (anti-U1 RNP, anti-rRNP, anti-Sm, anti-dsDNA, anti-DNP, auto-LCA, anti-EACA) could be confirmed (P > 0.05), anti-Ro/SSA antibodies being an exception. Our results showed significantly increased frequencies of these antibodies in the group of female SLE patients with normal PRL levels (< 20 micrograms/L): anti Ro/SSA in 53% (P < 0.025, chi 2 = 5.80, RR = 4.0) and anti-Ro/SSA + anti-Ro/La in 60% (P < 0.05, chi 2 = 4.05) compared with female SLE patients with hyperprolactinemia.

Identification of Borrelia burgdorferi sensu lato tick isolates from Slovakia by PCR typing with 16S rRNA primers.

The first four strains of Borrelia burgdorferi isolated in Slovakia from ticks and mice were studied using monoclonal antibodies, the polymerase chain reaction (PCR) with 16S rRNA specific primers and plasmid profiles. Two tick isolates were typed as Borrelia garinii, one strain isolated from Apodemus flavicollis was found to be B. afzelii and the fourth tick isolate reacted as a mixed culture of B. garinii and B. afzelii. All four strains harboured several plasmids ranging from 6-50 kbp including a plasmid with a size of approximately 41 kbp.

[Preliminary identification of Borrelia burgdorferi isolated from Ixodes ricinus ticks in eastern Slovakia]. / Predbezná identifikácia izolátov Borrelia burgdorferi z kliest'ov Ixodes ricinus východného Slovenska.

The first finding of spirochetes Borrelia burgdorferi sensu lato in eastern Slovakia pertains to ticks Ixodes ricinus collected in the Kosice park forest in September 1995. The authors tested 7 strains using immunoblotting with 4 monoclonal antibodies (Mab): H9724--specific to the genus Borrelia, identifying 41 kDa flagellar protein, H5332--specific to OspA protein of B. burgdorferi, J 8.3 and I 17.3 specific to OspA and OspB proteins of B. afzelii. All the strains belong to the genus Borrelia (reacted with Mab H9724), 6 of 7 strains designated Ir103, Ir105, Ir107, Ir108, Ir112 and Ir113 were identified as B. burgdorferi sensu lato (reacted with Mab H5332). None of the strains reacted with Mab specific for B. afzelii.

[Detection of antibodies to submitochondrial particles, F1-ATPase complex and liver specific lipoprotein in liver diseases using ELISA]. / Detekce protilátek proti submitochondriálnym cásticím, F1-ATP-ázovému komplexu a jaternímu specifickému lipoproteínu u jaterních onemocnení pomocí ELISA.

ELISA was elaborated for the determination of antibodies against liver antigen complexes--submitochondrial particles, F1-ATPase and liver specific lipoprotein. The parameters achieved so far allow to use the assay as an undemanding complementary laboratory technique in diagnosing and monitoring hepatopathies of autoimmune origin. Cross reactivity between individual antigen complexes was recorded in the majority of sera from positively reacting patients. The preliminary results show that individual antigen complexes have similar antigen structures bound to high-molecular membrane complexes, some of which, however, can be solubilized on maintaining antigen activity in ELISA.

[Antibodies to Klebsiella pneumoniae in ankylosing spondylitis]. / Protilátky proti Klebsiella pneumoniae pri ankylozujúcej spondylitíde.

The authors investigated the incidence of antibodies against Klebsiella pneumoniae and E. coli in a group of patients with ankylosing spondylitis and in a group of healthy controls in all main immunoglobulin classes. The results revealed that in patients with ankylosing spondylitis there is a significantly higher incidence of specific antibodies of class IgA against Klebsiella pneumoniae and E. coli. This supports the thesis on the aetiopathogenetic interrelationship between enteric bacteria and the development of ankylosing spondylitis.