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2.
Ann Biol Clin (Paris) ; 78(2): 201-205, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32319950

RESUMO

Anti-citrullinated cyclic peptide antibodies (ACPA) were initially considered very specific for the diagnosis of rheumatoid arthritis (RA), and can predict the prognosis of the disease. However, these antibodies can be detected in other autoimmune diseases, including systemic lupus erythematosus (SLE), the most common manifestation of which is inflammatory arthritis, which is often found in early-stage rheumatoid arthritis. The aim of our study is to evaluate the prevalence of ACPA antibodies and to analyze the profiles of their associations with autoantibodies specific to lupus, in order to look for a possible rhupus overlap syndrome in our patients. This is a retrospective study, carried out at the immunology unit, at Blida University Hospital, Algeria, involving 96 lupus patients, diagnosed according to the criteria of the American college of rheumatology (ACR). ACPA have been identified by the ELISA technique. ACPA was positive in 14,56% of our patients, whereas anti-DNA, anti-Sm and rheumatoid factor (RF) autoantibodies were positive, respectively in 47.09%, 35.41%, and in 26.04% of our patients. In addition, the presence of ACPA with anti DNA was found in 12.5% of patients. Of the 14 with ACPA+, 57.14% had arthritis. Our results confirm that ACPA auto-antibodies do not represent a pathognomonic criterion of RA. This sometimes makes the differential diagnosis with lupus difficult especially at the beginning of the disease.


Assuntos
Artrite Reumatoide/sangue , Biomarcadores/sangue , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/epidemiologia , Fator Reumatoide/sangue , Adolescente , Adulto , Idoso , Argélia/epidemiologia , Anticorpos Antinucleares/análise , Anticorpos Antinucleares/sangue , Artrite Reumatoide/epidemiologia , Autoanticorpos/análise , Autoanticorpos/sangue , Biomarcadores/análise , Criança , Citrulinação , Comorbidade , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeos Cíclicos/imunologia , Peptídeos Cíclicos/metabolismo , Estudos Retrospectivos , Fator Reumatoide/análise , Adulto Jovem
4.
Autoimmun Rev ; 19(5): 102508, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32173518

RESUMO

The past decade has witnessed a significant paradigm shift in the clinical approach to autoimmune diseases, lead primarily by initiatives in precision medicine, precision health and precision public health initiatives. An understanding and pragmatic implementation of these approaches require an understanding of the drivers, gaps and limitations of precision medicine. Gaining the trust of the public and patients is paramount but understanding that technologies such as artificial intelligences and machine learning still require context that can only be provided by human input or what is called augmented machine learning. The role of genomics, the microbiome and proteomics, such as autoantibody testing, requires continuing refinement through research and pragmatic approaches to their use in applied precision medicine.


Assuntos
Doenças Autoimunes , Medicina de Precisão , Autoanticorpos/análise , Autoanticorpos/imunologia , Doenças Autoimunes/genética , Doenças Autoimunes/imunologia , Doenças Autoimunes/metabolismo , Genômica , Humanos , Aprendizado de Máquina , Proteômica
5.
Ann Biol Clin (Paris) ; 78(2): 126-133, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32175889

RESUMO

AIM: To describe the autoantibody profile in a cohort of Algerian patients with systemic sclerosis (SSc) and to determine clinical associations between SSc-related autoantibodies, disease subtypes and specific clinical features. METHODS: Consecutive Algerian patients with SSc were included in the present study. In addition to clinical characterization, all subjects underwent autoantibody testing using indirect immunofluorescence, immunoenzymatic, and line immunoblot assays. RESULTS: A total of 150 patients were included in this study, 103 (68.7%) had limited cutaneous SSc (lcSSc), 42 (28%) had diffuse cutaneous SSc (dcSSc) and 5 (3.3%) had sine cutaneous scleroderma. One hundred thirty-five (90.0%) patients were positive for SSc-related autoantibodies, including 63 (42%) with more than one autoantibody. The two most frequent autoantibodies were anti-topoisomerase I (ATA) (76; 50.7%) and anti-SSA/Ro (49; 32.7%). Only 23 (15.3%) patients were positive for anticentromere; 9 (6%) were positive for anti RNA polymerase III; 5 (3.3%) for anti-U3 RNP; 3 (2%) for anti Th/To; 25 (16.7%) for anti-U1 RNP; 11 (7.3%) for anti-PM/Scl and 4 (2.7%) for anti-Ku. Anti-topoisomerase I was associated with dcSSc (p <0.0001), interstitial lung disease (ILD) (p <0.0001) and digital ulcers (p <0.0001). Anti-U3 RNP was associated with pulmonary arterial hypertension (PAH) (p=0.031). CONCLUSION: Notable similarities and differences in the prevalence of SSc-related autoantibodies were found in our population when compared to other ethnic groups. ATA and anti-U3 RNP may be a reliable biomarker for ILD and PAH. Further studies should be conducted to better understand the ethnic influence on disease expression and autoantibody production.


Assuntos
Autoanticorpos/sangue , Escleroderma Sistêmico/sangue , Escleroderma Sistêmico/epidemiologia , Adulto , Argélia/epidemiologia , Autoanticorpos/análise , Biomarcadores/análise , Biomarcadores/sangue , Estudos de Coortes , Feminino , Imunofluorescência , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Escleroderma Sistêmico/diagnóstico
6.
Isr Med Assoc J ; 22(2): 100-103, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32043327

RESUMO

BACKGROUND: Autoimmune hepatitis (AIH) may be associated with other autoimmune diseases. Autoantibodies are common in AIH suggesting their potential role in the pathogenesis of the disease. Among these autoantibodies, thyroid autoantibodies have been reported in patients with chronic hepatitis, with greater prevalence in patients with chronic hepatitis C infection. OBJECTIVES: To assess the prevalence of thyroid dysfunction among patients with AIH. METHODS: In this case-control, retrospective study, we examined patients diagnosed with AIH according to both the original and revised international AIH group scoring systems. Patients with other hepatic pathologies were excluded AIH was evaluated as an independent risk factor for thyroid disease by a logistic regression model. Univariate and multivariate regression analyses were conducted using hypothyroidism and hyperthyroidism as the dependent variables. RESULTS: Our cohort comprised 163 patients diagnosed with AIH and 1104 healthy age- and gender-matched controls. Hypothyroidism was more prevalent among those with AIH compared to controls (17.7% vs. 5%, respectively, 95% confidence interval [95%CI] 1.68-2.48, P < 0.001). Hyperthyroidism was more prevalent in AIH patients compared to controls (odds ratio 3.2% and 1.2%, respectively, 95%CI 1.68-2.47, P < 0.001). Using a multivariate logistic analysis, we found an independent association between AIH and hypothyroidism but not with hyperthyroidism. CONCLUSIONS: Thyroid dysfunction is more prevalent in patients with AIH. Whether thyroid dysfunction is the cause or a risk factor for AIH, or vice versa, is still unclear. Screening for thyroid dysfunction is warranted after AIH is diagnosed.


Assuntos
Hepatite Autoimune , Hipotireoidismo , Glândula Tireoide/imunologia , Adulto , Autoanticorpos/análise , Autoimunidade/imunologia , Estudos de Casos e Controles , Feminino , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/imunologia , Hepatite Autoimune/diagnóstico , Hepatite Autoimune/epidemiologia , Hepatite Autoimune/imunologia , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/epidemiologia , Hipotireoidismo/imunologia , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Medição de Risco , Testes de Função Tireóidea/métodos , Testes de Função Tireóidea/estatística & dados numéricos
7.
Mil Med ; 185(Suppl 1): 383-389, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-32074315

RESUMO

INTRODUCTION: Military and civil aviation have documented physiological episodes among aircrews. Therefore, continued efforts are being made to improve the internal environment. Studies have shown that exposures to many organic compounds present in emissions are known to cause a variety of physiological symptoms. We hypothesize that these compounds may reversibly inhibit acetylcholinesterase, which may disrupt synaptic signaling. As a result, neural proteins leak through the damaged blood-brain barrier into the blood and in some, elicit an autoimmune response. MATERIALS AND METHODS: Neural-specific autoantibodies of immunoglobulin-G (IgG) class were estimated by the Western blotting technique in the sera of 26 aircrew members and compared with the sera of 19 normal healthy nonaircrew members, used as controls. RESULTS: We found significantly elevated levels of circulating IgG-class autoantibodies to neurofilament triplet proteins, tubulin, microtubule-associated tau proteins (Tau), microtubule-associated protein-2, myelin basic protein, and glial fibrillary acidic protein, but not S100 calcium-binding protein B compared to healthy controls. CONCLUSION: Repetitive physiological episodes may initiate cellular injury, leading to neuronal degeneration in selected individuals. Diagnosis and intervention should occur at early postinjury periods. Use of blood-based biomarkers to assess subclinical brain injury would help in both diagnosis and treatment.


Assuntos
Militares/estatística & dados numéricos , Fenômenos Fisiológicos/fisiologia , Medicina Aeroespacial/métodos , Medicina Aeroespacial/estatística & dados numéricos , Aeronaves , Autoanticorpos/análise , Autoanticorpos/sangue , Biomarcadores/análise , Biomarcadores/sangue , Western Blotting/métodos , Proteína Glial Fibrilar Ácida/análise , Proteína Glial Fibrilar Ácida/sangue , Humanos , Imunoglobulina G/análise , Imunoglobulina G/sangue , Proteínas Associadas aos Microtúbulos/análise , Proteínas Associadas aos Microtúbulos/sangue , Proteína Básica da Mielina/análise , Proteína Básica da Mielina/sangue , Proteínas de Neurofilamentos/análise , Proteínas de Neurofilamentos/sangue , Proteínas S100/análise , Proteínas S100/sangue , Tubulina (Proteína)/análise , Tubulina (Proteína)/sangue
9.
Autoimmun Rev ; 19(2): 102450, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31838165

RESUMO

Autoimmune diseases are mostly characterized by autoantibodies in the patients' serum or cerebrospinal fluid, representing diagnostic or prognostic biomarkers. For decades, research has focused on single autoantigens or panels of single autoantigens. In this article, we advocate to broaden the focus by addressing the entire autoantigen repertoire in a systemic "omics-like" way. This approach aims to capture the enormous biodiversity in the sets of targeted antigens and pave the way toward a more holistic understanding of the concerted character of antibody-related humoral immune responses. Ongoing technological progress permits high-throughput screenings of thousands of autoantigens in parallel, e.g., via protein microarrays, phage display, or immunoprecipitation with mass spectrometry. We argue that the time is right for combining omics and autoantibody screening approaches into "autoantigenomics" as a novel omics subcategory. In this article, we introduce the concept of autoantigenomics, describe its roots and application options, and demarcate the method from related holistic approaches such as systems serology or immune-related transcriptomics and proteomics. We suggest the following extendable method set to be applied to autoantigen repertoires: (1) principal component analysis, (2) hierarchical cluster analysis, (3) partial least-square discriminant analysis or orthogonal projections to latent structures discriminant analysis, (4) analysis of the repertoire sizes in disease groups and clinical subgroups, (5) overrepresentation analyses using databases like those of Gene Ontology, Reactome Pathway, or DisGeNET, (6) analysis of pathways that are significantly targeted by specific repertoires, and (7) machine learning approaches. In an unsupervised way, these methods can identify clusters of autoantigens sharing certain functional or spatial properties, or clusters of patients comprising clinical subgroups potentially useful for patient stratification. In a supervised way, these methods can lead to prediction models that may eventually assist diagnosis and prognosis. The untargeted autoantigenomics approach allows for the systematic survey of antibody-related humoral immune responses. This may enhance our understanding of autoimmune diseases in a more comprehensive way compared to current single or panel autoantibodies approaches.


Assuntos
Autoanticorpos/análise , Autoanticorpos/genética , Autoantígenos/análise , Autoantígenos/genética , Doenças Autoimunes/genética , Doenças Autoimunes/imunologia , Proteômica , Autoanticorpos/imunologia , Autoantígenos/imunologia , Humanos
10.
Hautarzt ; 71(2): 130-133, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31501972

RESUMO

Anti-p200 pemphigoid is a rare autoimmune blistering dermatosis. The clinical course is heterogeneous. Typically, immunoglobulin G (IgG) antibodies are found on the floor of salt-split skin, which differentiates p200 pemphigoid from bullous pemphigoid. It is necessary to perform immunoblotting and enzyme-linked immunosorbent assays (ELISA) to confirm the diagnosis. Small amounts of dapsone are often sufficient for disease control. The clinical and diagnostic characteristics of anti-p200 pemphigoid and the principles of treatment are presented exemplified by two case reports.


Assuntos
Autoanticorpos/análise , Laminina/imunologia , Penfigoide Bolhoso/diagnóstico , Penfigoide Bolhoso/imunologia , Autoanticorpos/imunologia , Autoantígenos/imunologia , Vesícula , Ensaio de Imunoadsorção Enzimática , Humanos , Immunoblotting , Imunoglobulina G/imunologia
11.
J Neuroimmunol ; 338: 577092, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31706113

RESUMO

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory condition associated with antibodies against aquaporin-4 (AQP4). To date, 4 cases of B-cell lymphomas have been reported in patients with NMOSD. Here we describe two individuals with AQP4+ NMOSD and T-cell lymphomas (TCL). CONCLUSION: Possible mechanisms that may explain co-existence of NMOSD with TCL include a paraneoplastic syndrome leading to AQP4 antibody production, or a generalized dysfunction of the adaptive immune system. Both patients were diagnosed with NMOSD and initiated on anti-CD20 agents prior to lymphoma diagnosis, though the short duration of exposure argues against a direct role. Further research is needed to examine the rate of lymphoproliferative disorders in NMOSD.


Assuntos
Aquaporina 4/imunologia , Autoanticorpos/análise , Linfoma de Células T/etiologia , Neuromielite Óptica/imunologia , Adolescente , Adulto , Feminino , Humanos , Neuromielite Óptica/complicações
12.
Clin Dermatol ; 37(6): 692-712, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31864451

RESUMO

Autoimmune bullous dermatoses are defined by autoantibodies directed against adhesion proteins in the epidermis or basement membrane zone, resulting in blister formation on the skin and mucosa. Diagnosis depends on lesional biopsy for histopathology and perilesional biopsy for direct immunofluorescence. Additional diagnostic methods include indirect immunofluorescence, enzyme-linked immunosorbent assay, and immunoblot (Western blot), which may be selected in specific clinical scenarios due to improved sensitivity and/or specificity. This contribution reviews the available evidence supporting the use of each method to provide a practical reference for clinicians when diagnosing autoimmune bullous disorders. Techniques and cost are reviewed, and newer diagnostic techniques with potential for clinical application are.


Assuntos
Doenças Autoimunes/diagnóstico , Dermatopatias Vesiculobolhosas/diagnóstico , Autoanticorpos/análise , Doenças Autoimunes/patologia , Biomarcadores/análise , Western Blotting , Ensaio de Imunoadsorção Enzimática , Epiderme/metabolismo , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Dermatopatias Vesiculobolhosas/patologia
14.
Anal Bioanal Chem ; 411(29): 7725-7735, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31760445

RESUMO

The rapid and simultaneous detection of DNA and protein biomarkers is necessary to detect the outbreak of a disease or to monitor a disease. For example, cardiovascular diseases are a major cause of adult mortality worldwide. We have developed a rapidly adaptable platform to assess biomarkers using a microfluidic technology. Our model mimics autoantibodies against three proteins, C-reactive protein (CRP), brain natriuretic peptide (BNP), and low-density lipoprotein (LDL). Cell-free mitochondrial DNA (cfmDNA) and DNA controls are detected via fluorescence probes. The biomarkers are covalently bound on the surface of size- (11-15 µm) and dual-color encoded microbeads and immobilized as planar layer in a microfluidic chip flow cell. Binding events of target molecules were analyzed by fluorescence measurements with a fully automatized fluorescence microscope (end-point and real-time) developed in house. The model system was optimized for buffers and immobilization strategies of the microbeads to enable the simultaneous detection of protein and DNA biomarkers. All prime target molecules (anti-CRP, anti-BNP, anti-LDL, cfmDNA) and the controls were successfully detected both in independent reactions and simultaneously. In addition, the biomarkers could also be detected in spiked human serum in a similar way as in the optimized buffer system. The detection limit specified by the manufacturer is reduced by at least a factor of five for each biomarker as a result of the antibody detection and kinetic experiments indicate that nearly 50 % of the fluorescence intensity is achieved within 7 min. For rapid data inspection, we have developed the open source software digilogger, which can be applied for data evaluation and visualization. Graphical abstract.


Assuntos
Doenças Cardiovasculares/metabolismo , Ácidos Nucleicos Livres/análise , Dispositivos Lab-On-A-Chip , Proteínas/análise , Autoanticorpos/análise , Biomarcadores/análise , Corantes Fluorescentes/química , Humanos , Limite de Detecção , Microesferas , Proteínas/imunologia
15.
Lupus ; 28(14): 1656-1662, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31679449

RESUMO

OBJECTIVE: Non-infectious myelitis in systemic lupus erythematosus (SLE) may be due to SLE myelitis, comorbid multiple sclerosis (MS), or neuromyelitis optica (NMO). We compared characteristics of these three conditions in SLE patients at a large academic institution. METHODS: We searched for neurologic diagnoses of SLE myelitis, NMO myelitis, and MS myelitis among 2297 patients with at least four 1997 American College of Rheumatology revised criteria for SLE between 2000 and 2015. Each subject was reviewed by a neurologist to confirm the underlying neurologic diagnosis. Demographic, clinical, laboratory, and radiographic data were extracted and compared using Fisher's exact test, analysis of variance, and Wilcoxon rank-sum test. RESULTS: Fifteen of the 2297 subjects with SLE (0.7%) met criteria for a spinal cord syndrome: seven had SLE myelitis, three had AQP4 seropositive NMO, and five had MS. The median SLE Disease Activity Index 2000 score at time of neurologic syndrome presentation was higher in SLE myelitis subjects (8, interquartile range (IQR) 7-16) compared with subjects with NMO (6, IQR 0-14) or MS (2, IQR 0-4), p = 0.02. Subjects with SLE myelitis were also more likely to have elevated anti-dsDNA antibodies at presentation (86%) compared with subjects with NMO (33%) or MS (0%), p = 0.03. CONCLUSION: Myelitis occurs rarely among patients with SLE. Compared with subjects with SLE + NMO and subjects with SLE + MS, subjects with SLE myelitis had higher SLE disease activity at presentation.


Assuntos
Lúpus Eritematoso Sistêmico/diagnóstico , Esclerose Múltipla/diagnóstico , Neuromielite Óptica/diagnóstico , Doenças da Medula Espinal/complicações , Medula Espinal/patologia , Adulto , Autoanticorpos/análise , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Índice de Gravidade de Doença
16.
BMC Infect Dis ; 19(1): 909, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664931

RESUMO

BACKGROUND: Disseminated nontuberculous mycobacteria (NTM) infections occur mostly in immunocompromised patients. Therefore, it is difficult to diagnose disseminated NTM infections in patients without history of immunocompromised diseases or using immunosuppressant. Patients with anti-interferon-γ (IFN-γ) autoantibodies are vulnerable to intracellular infections, such as disseminated NTM. Currently, there is no widely used and efficient technique for the detection of anti-IFN-γ autoantibodies. Herein, we report a case of an apparently healthy patient with disseminated Mycobacterium avium complex (MAC) infection who tested positive for anti-IFN-γ autoantibodies. CASE PRESENTATION: A 64-year-old non-immunocompromised and apparently healthy Asian male presented to the emergency department with complaints of progressive chest pain for about 6 months and weight loss. A bulging tumour was found in the anterior chest wall. Chest computed tomography showed a lung mass over the right lower lobe and an osteolytic lesion with a soft tissue component at the sternum. Sonography-guided biopsies for the osteolytic lesion and sputum culture confirmed the presence of disseminated MAC infection. In addition, positive test result of anti-IFN-γ autoantibodies was noted. The patient was prescribed antibiotics. The lesions over the right lower lobe and sternum attenuated following the antibiotic treatment. CONCLUSION: Detection of anti-IFN-γ autoantibodies is important among previously healthy people with disseminated NTM infection. Presence of anti-IFN-γ autoantibodies may suggest a high risk of severe intracellular infection, such as disseminated NTM infection.


Assuntos
Autoanticorpos/análise , Interferon gama/imunologia , Neoplasias Pulmonares/diagnóstico , Infecções por Mycobacterium não Tuberculosas/diagnóstico por imagem , Complexo Mycobacterium avium , Tuberculose Pulmonar/diagnóstico por imagem , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Biópsia/métodos , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/patologia , Infecção por Mycobacterium avium-intracellulare/tratamento farmacológico , Escarro/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia
18.
Rheum Dis Clin North Am ; 45(4): 569-581, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31564297

RESUMO

Major advances have been made in the field of idiopathic inflammatory myopathies (IIM), or myositis, that are likely to facilitate development of new therapeutic strategies that have not yet been applied in this group of diseases. These advances include new classification criteria to better identify the patients with IIM, detection of several new myositis-specific autoantibodies that facilitates subgrouping of patients into more specific clinical phenotypes, development of outcome measures for disease activity, and new response criteria. We have learned from clinical studies that exercise is an important part of treatment and that pharmacologic treatment should be combined with exercise.


Assuntos
Antirreumáticos/farmacologia , Miosite , Administração dos Cuidados ao Paciente/métodos , Autoanticorpos/análise , Humanos , Miosite/diagnóstico , Miosite/imunologia , Miosite/terapia , Índice de Gravidade de Doença , Avaliação de Sintomas/métodos
19.
Clin Lab ; 65(9)2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31532090

RESUMO

BACKGROUND: Multiplex bead assays, also known as addressable laser bead immunoassays (ALBIA) or Luminex® technology, have provided an alternative to enzyme-linked immunoassay, which is still the most widely utilized routine immunoassay for detection of specific autoantibodies. Our laboratory adopted the ALBIA technology early into its routine service. METHODS: We report the performance and utility of measurement of three different autoantibody types tested using the FIDIS (BMD, Marne La Vallee, France) ALBIA system. The analytes discussed are thyroid antibodies (thyroglobulin [TG], thyroid peroxidase [TPO]), anti-neutrophil cytoplasmic antibodies (ANCA), and ribonucleo-protein (RNP) antibodies. RESULTS: In single antibody analysis, TPO antibody testing was superior to TG antibody in identifying patients with Graves' disease and Hashimoto's thyroiditis. However, testing only TPO antibody would result in missing 8.6% of Graves' and 11.9% of Hashimoto's thyroiditis patients, hence demonstrating an advantage for the multiplex TG plus TPO assay. With respect to ANCA, the FIDIS ALBIA produced an overall similar level of performance to our comparator method, the Phadia fluorescent enzyme linked immunoassay. Sensitivity of the ALBIA for RNP antibodies was low in comparison to countercurrent immunoelectrophoresis, but performance was improved by altering the cutoff value for the assay. CONCLUSIONS: ALBIA technology has many potential advantages in the routine laboratory, but as with any new assay, evaluation must be thorough and ongoing to ensure satisfactory clinical performance is obtained. Both false positive and false negative results have been reported in ALBIA studies. It may be necessary to re-evaluate assay performance and cutoff and consider further clinical correlation.


Assuntos
Anticorpos Anticitoplasma de Neutrófilos/análise , Autoanticorpos/análise , Imunoensaio/métodos , Iodeto Peroxidase/imunologia , Ribonucleoproteínas/imunologia , Adulto , Anticorpos Anticitoplasma de Neutrófilos/imunologia , Anticorpos Antinucleares/análise , Anticorpos Antinucleares/imunologia , Autoanticorpos/imunologia , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Técnicas Imunológicas/métodos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
20.
Acta Med Port ; 32(9): 614-617, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31493366

RESUMO

Intramural hematoma of the colon is very rare, particularly when associated with the development of autoantibodies against factor VIII.We report a case of a 66-year-old man with abdominal pain, hematochezia and clots in the left colon, without any radiologic signs of active bleeding or bowel occlusion or analytical changes in routine coagulation screening, but with positive autoantibodies against factor VIII. The clinical instability prompted surgical exploration. An intramural hematoma of the left colon was found, and a left colectomy was performed. The patient was treated with hemoderivatives and corticosteroids with clinical improvement. The diagnosis of spontaneous intramural hematoma might be a challenge, particularly in the absence of clinical suspicion. An early recognition is essential for a positive outcome. This case highlights a rare cause of bleeding and intestinal obstruction, but also the difficulty and relevance of establishing a clinical diagnosis when diagnostic tests are not completely informative.


Assuntos
Dor Abdominal/etiologia , Autoanticorpos/análise , Doenças do Colo/etiologia , Fator VIII/imunologia , Hematoma/etiologia , Hemofilia A/complicações , Idoso , Doenças do Colo/diagnóstico , Doenças do Colo/cirurgia , Colonoscopia , Fator VIII/análise , Hemorragia Gastrointestinal/etiologia , Hematoma/diagnóstico , Hematoma/cirurgia , Hemofilia A/diagnóstico , Humanos , Obstrução Intestinal/etiologia , Masculino
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