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2.
R I Med J (2013) ; 105(10): 52-55, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36413453

RESUMO

Cutaneous small vessel vasculitis (CSVV) or leukocytoclastic vasculitis (LCV) is a group of immune complex mediated vasculitides that affect dermal capillaries or post-capillary venules and classically presents as lower extremity palpable purpura. CSVV can be subdivided by antibody type and clinical features. In patients presenting with signs of LCV and ANCA positivity, clinicopathologic correlation is important in characterizing the type of vasculitis. We report an uncommon case of IgA vasculitis with concurrent ANCA-positivity attributed to bacterial endocarditis.


Assuntos
Endocardite Bacteriana , Vasculite por IgA , Poliarterite Nodosa , Vasculite , Humanos , Anticorpos Anticitoplasma de Neutrófilos , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico
5.
Telemed J E Health ; 15(5): 426-30, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19548822

RESUMO

Digital imaging of dermatology patients is a novel approach to remote data collection. A number of assessment tools have been developed to grade acne severity and to track clinical progress over time. Although these tools have been validated when used in a face-to-face setting, their efficacy and reliability when used to assess digital images have not been examined. The main purpose of this study was to determine whether specific assessment tools designed to grade acne during face-to-face visits can be applied to the evaluation of digital images. The secondary purpose was to ascertain whether images obtained by subjects are of adequate quality to allow such assessments to be made. Three hundred (300) digital images of patients with mild to moderate facial inflammatory acne from an ongoing randomized-controlled study were included in this analysis. These images were obtained from 20 patients and consisted of sets of 3 images taken over time. Of these images, 120 images were captured by subjects themselves and 180 were taken by study staff. Subjects were asked to retake their photographs if the initial images were deemed of poor quality by study staff. Images were evaluated by two dermatologists-in-training using validated acne assessment measures: Total Inflammatory Lesion Count, Leeds technique, and the Investigator's Global Assessment. Reliability of raters was evaluated using correlation coefficients and kappa statistics. Of the different acne assessment measures tested, the inter-rater reliability was highest for the total inflammatory lesion count (r = 0.871), but low for the Leeds technique (kappa = 0.381) and global assessment (kappa = 0.3119). Raters were able to evaluate over 89% of all images using each type of acne assessment measure despite the fact that images obtained by study staff were of higher quality than those obtained by patients (p < 0.001). Several existing clinical assessment measures can be used to evaluate digital images obtained from subjects with inflammatory acne lesions. The level of inter-rater agreement is highly variable across assessment measures, and we found the Total Inflammatory Lesion Count to be the most reliable. This measure could be used to allow a dermatologist to remotely track a patient's progress over time.


Assuntos
Acne Vulgar/diagnóstico , Interpretação de Imagem Assistida por Computador , Telemedicina , Acne Vulgar/classificação , Adolescente , Adulto , Feminino , Humanos , Masculino , Fotografação , Adulto Jovem
6.
Immunol Res ; 27(2-3): 219-34, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12857970

RESUMO

Anti-double-stranded DNA (dsDNA) B cells persist even in nonautoimmune- prone animals. In this review, we summarize data regarding the activation potential of these cells. Provision of cognate CD4 T cell help to anti-dsDNA B cells in nonautoimmune mice not only drives their maturation and entry into the B cell follicle, but also leads to secretion of anti-dsDNA autoantibodies. Intriguingly, if T regulatory cells are provided along with T helper cells, the antibody response of anti-dsDNA B cells is diminished. We have also found that T-independent stimulation with CpG oligodeoxynucleotides leads to the proliferation and enhanced recovery of antidsDNA B cells in vitro. These data suggest that control of anti-dsDNA antibody production may rely on elements from both the innate and adaptive arms of the immune system.


Assuntos
Anticorpos Antinucleares/imunologia , Autoimunidade , Linfócitos B/imunologia , Ativação Linfocitária/imunologia , Animais , DNA/imunologia , Cooperação Linfocítica/imunologia , Camundongos , Linfócitos T/imunologia
8.
Immunity ; 16(4): 535-46, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11970877

RESUMO

Autoreactive B cells that appear to be inactivated can be found in healthy individuals. In this study, we examined the potential of these anergic cells to become activated. We show that anergy of anti-double-stranded DNA (dsDNA) B cells in BALB/c mice is readily reversed, requiring only the provision of T cell help. We further show that spontaneous loss of anergy among anti-dsDNA B cells in autoimmune lpr/lpr mice occurs in two phases: an abortive initial response to T help followed by full loss of tolerance. Strikingly, the abortive response can be reproduced in nonautoimmune mice when CD4+CD25+ T regulatory cells are administered in conjunction with CD4+ T helper cells, suggesting that loss of B cell tolerance may require both the production of T cell help and the overcoming of T suppression.


Assuntos
Linfócitos B/imunologia , Linfócitos T CD4-Positivos/imunologia , DNA/imunologia , Imunoconjugados , Receptores de Interleucina-2/imunologia , Linfócitos T Auxiliares-Indutores/imunologia , Abatacepte , Animais , Antígenos CD , Antígenos de Diferenciação/imunologia , Linfócitos B/citologia , Antígeno B7-1/imunologia , Antígenos CD28/imunologia , Antígenos CD40/imunologia , Ligante de CD40/imunologia , Antígeno CTLA-4 , Diferenciação Celular , Anergia Clonal/imunologia , Feminino , Ativação Linfocitária/imunologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos MRL lpr , Camundongos Transgênicos , Modelos Imunológicos , Receptores CXCR5 , Receptores de Quimiocinas , Receptores de Citocinas/biossíntese , Receptores de Citocinas/imunologia , Baço/citologia , Baço/imunologia
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