bluuebunny/crossref_metadata_2025 huggingface dataset:
C‐Reactive Protein in Systemic Lupus Erythematosus
Authors: Honig Stephen , Gorevic Peter , Weissmann Gerald
Published: February 2007

The presence of C‐reactive protein (CRP) was determined in the sera of 70 patients with systemic lupus erythematosus (SLE), 24 patients with rheumatoid arthritis (RA), and 17 patients hospitalized with acute infections. CRP (precipitin reaction > 3 mm) was present in only 2 of 50 patients with active, uncomplicated SLE (4%). However CRP was found in the sera of 11 patients with active SLE in the presence of superimposed infection. Treatment of the intercurrent infection resulted in the loss of CRP from the sera of these SLE patients. CRP was found in 85% of patients with active RA and in 100% of non‐SLE infected patients. Appropriate treatment of the latter group resulted in loss of CRP from the convalescent sera. Corticosteroid therapy did not appear to influence the presence of CRP in the RA or SLE groups. Fourteen of 50 noninfected patients (28%) with active SLE were not receiving steroids at the time of CRP negativity. Appropriate experiments with mixed sera failed to demonstrate serum factors that could influence CRP precipitation in the CRP‐negative SLE group. These studies suggest that patients with active SLE usually do not have CRP in their sera, and the results distinguish this group of patients from those with active RA, a disease generally marked by CRP positivity. Moreover, the finding of significant CRP precipitin in the sera of SLE patients may suggest the presence of superimposed infection.
Plant Thorn Synovitis
Authors: Sugarman Michael , Stobie Dennis G. , Quismorio Francisco P. , Terry Roger , Hanson Virgil
Published: February 2007

Five children with an inflammatory monarthritis due to penetration of the joint by plant thorns are presented. The clinical presentation was that of a transient acute synovitis followed by a relatively asymptomatic period, and later by chronic arthritis often after the thorn injury was forgotten. Histopathology demonstrated a granulomatous synovitis. Polarized light microscopy facilitated identification of the plant tissue within the synovium. Conservative medical therapy was ineffective, but surgical excision of the affected synovium resulted in normal joint function. The differential diagnosis of monarthritis in children is extensive, and awareness of this condition is necessary to elicit a comprehensive history and to avoid delay in treatment.
Idiopathic or Traumatic Olecranon Bursitis
Authors: Canoso Juan J.
Published: February 2007

Thirty cases of idiopathic olecranon bursitis were studied. Most had previous local trauma. The process was unilateral and often associated with nontender pitting edema in cases of short duration. Ten patients exhibited a bony spur at the olecranon process, and amorphous calcific deposits were seen in 6. The bursal fluid was hemorrhagic with a xanthochromic supernatant, and the mucin clot test was poor or fair. Leukocyte count averaged 878/mm3, predominantly mononuclears. Many cells contained inclusion bodies. Glucose, total protein, and complement (C3) concentration averaged 80, 60, and 60% of the respective serum values.
Collagenase at Sites of Cartilage Erosion in the Rheumatoid Joint
Authors: Woolley David E. , Crossley Malcolm J. , Evanson John M.
Published: February 2007

Immunolocalization studies of rheumatoid tissues employing specific synovial collagenase antibody have demonstrated immunoreactive enzyme at the cartilage/pannus junction. Collagenase was not detected in chondrocytes or the cartilage matrix remote from the resorbing front, and relatively little enzyme was observed in the hypertrophied synovial membrane itself. These observations directly support the idea that synovial collagenase participates in cartilage erosion in rheumatoid arthritis.
Experimental Radiation Synovectomy by 165Dy Ferric Hydroxide Macroaggregate
Authors: Sledge Clement B. , Noble Jonathan , Hnatowich Donald J. , Kramer Richard , Shortkroff Sonya
Published: February 2007

The short half—life beta emitter 165Dy coprecipitated as a macroaggregate with ferric hydroxide (FHMA) has been shown to destroy knee synovium in the antigen—induced arthritic rabbit. Using 153Gd as a gamma tracer for leakage studies revealed that the leakage of this system from rabbit knee joints never exceeded 1.2% over 24 hours. This is much less than the leakage rates reported from any human studies or our rabbit studies using 198Au.
Patellar Whiskers and Acute Calcific Quadriceps Tendinitis in a General Hospital Population
Authors: Trujeque L. , Spohn P. , Bankhurst Arthur D. , Messner R. , Searles R.
Published: February 2007

Described is a case of acute calcific quadriceps tendinitis which presented as monoarticular arthritis. A survey of general hospital patients revealed a 7% incidence of calcification of the superior patellar tendon. The most common concurrent abnormality was degenerative joint disease (94%); concomitant chondrocalcinosis was not seen. The “patellar whisker” is a relatively common x‐ray finding that may be the clue to an uncommon cause of acute arthritis.
Prostaglandin e1 treatment of NZB/NZW F1 hybrid MICE
Authors: Zurier Robert B. , Damjanov Ivan , Sayadoff Donna M. , Rothfield Naomi F.
Published: February 2007

The F1 hybrid of New Zealand black and New Zealand white mice—the NZB/NZW mouse—spontaneously develops a disease similar to human systemic lupus erythematous, characterized by impaired cell‐mediated and enhanced humoral immune responses, development of antibodies to nuclear antigens, and immune complex glomerulonephritis. Because there is experimental evidence that prostaglandin E1 (PGE1) can enhance T‐cell function and cell‐mediated responses and suppress B‐cell activity, NZB/NZW mice were treated with 200 μg PGE1 subcutaneously once or twice daily from 6 weeks of age. PGE1 treatment of female and male mice prevents glomerular deposition of immunoglobulins and complement (monitored by immunofluorescence), and development of the proliferative glomerulonephritis (determined by light and electron microscopy) characteristic of untreated NZB/NZW mice. After 1 year of treatment, 18 of 19 female mice survived, whereas only 2 of 19 untreated control mice were alive. Male mice treated with 200 μg PGE1 daily were also protected: 9 of 11 versus 2 of 9 untreated mice were alive at 65 weeks. PGE1 treatment did not prevent development of antibodies to nuclear material in any of the treated groups.
Antibodies to cytoplasmic antigens in lupus erythematosus
Authors: Provost Thomas T. , Razzaque Ahmed A. , Maddison Peter J. , Reichlin Morris
Published: February 2007

Seven patients with classic cutaneous lupus ery‐thematosus are described. Three of these patients had features satisfying four of the American Rheumatism Association (ARA) preliminary criteria for the diagnosis of systemic lupus erythematosus (SLE). Their sera, however, lacked antinuclear antibodies but demonstrated precipitating antibodies reactive against cytoplasmic RNP (La) and non‐nucleic acid (Ro) antigens. Four additional ANA‐negative patients lacking significant skin disease but having a lupus‐like multisystem disease were found to have antibodies to soluble cytoplasmic antigens. Thirty‐three of 130 ANA‐positive SLE patients, but none of 16 discoid lupus patients, possessed these anticytoplasmic antibodies. These findings suggest that antibodies to Ro and La may be a marker for systemic disease in ANA‐negative patients with 1) cutaneous lupus and 2) a distinct sub‐population of patients with a lupus‐like syndrome without skin disease.
Clinical evaluation of D‐penicillamine by multicentric double‐blind comparative study in chronic rheumatoid arthritis
Authors: Shiokawa Yuichi , Horiuchi Yoshihiko , Honma Mitsuo , Kageyama Takamasa , Okada Takao , Azuma Takeshi
Published: February 2007

In order to evaluate clinical efficacy of D‐penicillamine (DP) a double‐blind study was conducted by the Metalcaptase Research Group consisting of forty‐one rheumatological centers in Japan. A total of 179 patients with rheumatoid arthritis (RA) was divided into two groups; one treated with 5 mg (control group) and the other with 100 mg (drug group) of DP in capsule form. The trial lasted 24 weeks. Global judgment by physicians revealed that improvement was found in 27% in the controls and 65% in the drug group. Adverse reactions occurred in 34% of the controls and 49% of the drug group. Skin rashes, taste disturbances, gastrointestinal upset and proteinuria were frequent in the drug group, but severe or fatal reactions could not be seen in this trial.
A double‐blind trial of high versus conventional dosages of gold salts for rheumatoid arthritis
Authors: Furst D. E. , Levine S. , Srinivasan R. , Metzger A. L. , Bangert R. , Paulus H. E.
Published: February 2007

In a double‐blind study, patients were randomly selected for treatment using conventional doses (CD; 50 mg) or high doses (HD; 150 mg) of sodium aurothiomalate given weekly by injection. Twenty‐three patients were assigned to the CD group and 24 to the HD group. Neither efficacy nor toxicity correlated with serum gold concentrations. Conventional doses were as efficacious as high doses with respect to both rapidity and degree of response. However, side effects were much more frequent and severe in the HD group. Thus there is no reason to recommend a 150 mg weekly dosage regimen.
Severe systemic lupus erythematosus with nephritis in a boy with deficiency of the fourth component of complement
Authors: Schaller Jane G. , Gilliland Bruce G. , Ochs Hans D. , Leddy John P. , Agodoa Lawrence C. Y. , Rosenfeld Stephen I.
Published: February 2007

A young boy with severe systemic lupus erythematosus was found to be totally deficient in the fourth component of complement. Family studies were consistent with an autosomal recessive mode of transmission and with linkage of the gene(s) determining C4 deficiency to the major histocompatibility complex; no disease states were associated with heterozygosity. This patient has had severe multisystem disease and immune complex glomer‐ulonephritis; presumably the alternative pathway of complement was utilized in the pathogenesis of his nephritis.
Radiographic abnormalities of rheumatoid arthritis in patients with diffuse idiopathic skeletal hyperostosis
Authors: Resnick Donald , Curd John , Shapiro Robert F. , Wiesner Kenneth B.
Published: February 2007

Radiographic abnormalities of rheumatoid arthritis (RA) in 8 patients with diffuse idiopathic skeletal hyperostosis (DISH) included atypical features: lack of osteoporosis, bone sclerosis and proliferation about erosions, osteophytosis, and bony ankylosis. Atypical clinical features included a high incidence of flexion contractures of elbows, wrists, ankles, or knees. It is not surprising that bone production occurs about involved articulations in patients with RA·DISH, as the latter disorder is characterized by bony proliferation at sites of ligament and tendon attachment to bone in the axial and extraaxial skeleton, perhaps related to stress.
Comparative studies of antilymphocyte, antipolynucleotide, and antiviral antibodies among families of patients with systemic lupus erythematosus
Authors: Folomeeva O. , Nassonova V. A. , Alekberova A. S. , Talal N. , Williams R. C.
Published: February 2007

Antilymphocyte, antipolynucleotide, and antiviral antibodies in 15 Soviet systemic lupus erythematosus (SLE) probands and their 41 relatives were compared with those in 57 members of 15 control Russian families. Seventy‐eight and three‐tenths percent of SLE relatives were positive for antilymphocyte antibody versus 26.3% positive reactions in controls. Antipolynucleotide antibody closely paralleled antilymphocyte antibody in both groups. Antiviral antibody was significantly increased in SLE relatives as compared to control family members. No correlation was noted between quantitative IgG, IgA, or IgM levels and various antibodies studied.
Impaired immunoglobulin synthesis by peripheral blood lymphocytes in systemic lupus erythematosus
Authors: Nies Kenneth M. , Louie James S.
Published: February 2007

Pokeweed mitogen (PWM)‐induced immunoglobulin (Ig) synthesis by peripheral blood mononuclear cells (PBL) from 33 patients with systemic lupus erythematosus (SLE) was compared to that synthesized by PBL from 22 normal individuals. Short‐term unstimulated culture of SLE‐PBL immediately after separation from PB revealed Ig synthesis 4 times that of normal PBL. However, SLE‐PBL had a depressed PWM‐induced Ig synthetic response that was partially, but not totally, related to active disease and was not correctable by coculture with normal lymphocyte populations. In both the short‐term‐unstimulated and the PWM‐stimulated cultures, IgM was the major Ig class synthesized by normal PBL, while IgM synthesis by SLE‐PBL was depressed more than the other Ig classes. These results can best be explained by a preactivated PBL population in SLE.
Kinetic studies of phagocytosis.
Authors: Hällgren R. , HåKansson L. , Venge P.
Published: February 2007

The initial phagocytic rate of IgG coated polyvinyl toluene latex particles was assayed for isolated PMN cells. The kinetic studies of phagocytosis were performed in serum‐free medium using an electronic particle counter. The mean phagocytic rate for the reference group of apparently healthy individuals was 0.60 min−1. PMN cells from 5 of 26 patients with rheumatoid arthritis (RA) had subnormal values of particle ingestion rate, although the mean of the group was not significantly reduced compared to the controls. Correlation coefficient between the log of rheumatoid factor titer and phagocytic rate was 0.58 (P < 0.001). During penicillamine treatment an increased rate of phagocytosis was observed in patients with RA. Granulocytes isolated from 17 patients with systemic lupus erythematosus (SLE) had a significantly increased (P < 0.001) mean initial rate of phagocytosis (0.91 min−1). Two patients in this group had an acute exacerbation of disease activity and were treated with large doses of prednisone. An appreciable decline in phagocytic rate was observed during the intensive corticosteroid therapy.
Familial lupus. family studies of hla and serologic findings
Authors: Cleland Leslie G. , Bell David A. , Willans Martin , Saurino Bruce C.
Published: February 2007

HLA profiles in 103 members of 4 separate kindred with multiple occurrence of SLE were compatible with the presence of a disease susceptibility factor linked to HLA or a direct effect of antigens B8, A11, and B35 on disease expression. Serum ANA was found in 52.9% of consanguineous, 56.5% of nonconsanguineous relatives of SLE probands, and 5% of controls, a finding that suggests the presence of a transmissible agent in the families. By contrast, lymphocytotoxic antibodies were not increased in relatives compared to controls.
Multiple myeloma complicating the course of seronegative systemic lupus erythematosus
Authors: Jordan Edward , Burnstein Stephen L. , Calabro John J. , Henderson Edward S.
Published: February 2007

A patient with a 20‐year history of clinical systemic lupus erythematosus (SLE) who later developed multiple myeloma is described. SLE was diagnosed on the basis of a butterfly rash, photosensitivity, nondeforming arthritis, pleuropericarditis, and alopecia. However, the patient has never had LE cells, antinuclear antibody, or depressed complement. The patient was treated with intermittent courses of corticosteroids over a 20‐year period with good results. Multiple myeloma, diagnosed by bone marrow biopsy, has responded favorably to therapy with L‐phenylalanine mustard and prednisone.
Serologic Studies In Patients With Systemic Lupus Erythematosus And Central Nervous System Dysfunction
Authors: Winfield John B. , Brunner Carolyn M. , Koffler David
Published: February 2007

Serologic studies were performed on 25 patients with systemic lupus erythematosus (SLE) during 29 acute episodes of central nervous system (CNS) disease. Increased anti‐DNA antibody and decreased total serum hemolytic complement activity were observed only in those patients with associated extra‐CNS disease manifestations. Patients with isolated CNS disease were otherwise in apparent clinical and serological remission regarding these two indices. No special association of cold‐reactive IgM antilymphocyte antibodies was demonstrable in patients with ongoing CNS injury. Of special interest was an increased incidence of anti‐Sm antibodies in the patients with CNS dysfunction relative to that in a large group of patients without neuropsychiatric disease. The incidence of anti‐RNP was not increased.

The data do not support direct involvement in SLE brain injury of either DNA/anti‐DNA complexes or of lymphocytotoxic antibodies cross‐reactive with brain cells, but do suggest an association of anti‐Sm with CNS disease in this disorder.
Studies on immune complexes in rheumatoid arthritis
Authors: Nishimaki Tomoe , Kano Kyoichi , Milgrom Felix
Published: February 2007

Sera and synovial fluids of patients with rheumatoid arthritis were studied for immune complexes by means of the anti‐antibody inhibition test; approximately 40% of these specimens were shown to contain immune complexes. To study the nature of antigens participating in the formation of complexes under investigation, the anti‐antibody inhibition test was repeated after addition of various soluble antigens to the complex‐positive rheumatoid arthritis sera. This resulted in conversion of some sera from inhibitory to noninhibitory. It was found that of 15 positive rheumatoid arthritis sera, 7 had complexes formed by heterophile, Hanganutziu‐Deicher antigen and of 12 positive sera tested, 2 had complexes formed by human IgG.
A study of hla antigens in adults with acute rheumatic fever
Authors: Murray Garvin C. , Montiel Milka M. , Persellin Robert H.
Published: February 2007

By use of a microlymphocytotoxic assay to detect 32 HLA antigens of the A and B series, we examined 49 Mexican‐American adults with acute rheumatic fever and contrasted the findings with 100 ethnically identical controls. Eighty‐nine percent of the total possible antigens were identified. Strong associations between HLA antigens from either locus and acute rheumatic fever were not detected. These findings serve to emphasize the importance of nongenetic factors in the pathogenesis of acute rheumatic fever and help clarify the role of HLA antigens in rheumatic diseases.
Androgenic status of males with systemic lupus erythematosus
Authors: Stahl Neil I. , Decker John L.
Published: February 2007

The female predominance among patients with systemic lupus erythematosus and the protective effects of androgens in the murine lupus model prompted us to assess the androgenic status of 12 men with the disease. Save for minor abnormalities explained by treatment or renal insufficiency, normal serum testosterone, luteinizing hormone, and follicle stimulating hormone levels were found. Hypogonadism or androgen deficiency was not evident.
Antigen‐induced arthritis. decreased proteoglycan content and inhibition of proteoglycan synthesis in articular cartilage
Authors: Lowther Dennis A. , Sandy John D. , Santer Vivien B. , L. G. Brown Heather
Published: February 2007

An arthritis was induced in rabbits immunized with human serum albumin by injection of antigen into the hind knee joint. Histological changes in the synovial membrane and an increase in polymorphonuclear granulocytes in the synovial fluid indicated an inflammatory response similar to that described with fibrin as antigen (1). The arthritis was accompanied by no significant change in the collagen content, but a marked decrease in the proteoglycan content of the cartilage was noted. Cartilage from inflamed joints generally exhibited a decreased ability to synthesize proteoglycan in vitro.
The amyloidosis of juvenile rheumatoid arthritis—comparative studies in polish and american children. i. levels of serum saa protein
Authors: Filipowicz‐Sosnowska Anna Maria , Roztropowicz‐Denisiewicz Katarzyna , Julian Rosenthal C. , Baum John
Published: February 2007

Serum SAA concentration was determined by radioimmunoassay in 21 Polish children with amyloidosis secondary to juvenile rheumatoid arthritis (JRA). The results were compared to controls and children with JRA in Polish populations (where amyloidosis is a frequent complication of JRA) as well as to American children with JRA (where amyloidosis in JRA has been observed only sporadically) and American control children. No significant differences of SAA protein levels were found in the amyloidotic Polish children when compared to JRA Polish and American children. However, significantly higher levels of SAA protein were present in amyloidotic Polish children when compared to the control Polish and American group.

High serum SAA protein concentration in JRA children did not necessarily correlate with the presence of secondary amyloidosis. Other mechanisms are probably involved in the development of amyloidosis.
Atypical axial osteomalacia. report of four cases with two having features of ankylosing spondylitis
Authors: Nelson A. M. , Riggs B. L. , Jowsey J. O.
Published: February 2007

Four patients with a clinical syndrome of musculo‐skeletal aching associated with coarse trabeculation primarily in the axial skeleton and normal or near‐normal biochemical parameters are reported. Two of these patients had a clinical syndrome consistent with the diagnosis of ankylosing spondylitis. A genetic link between the two conditions is postulated.
Gastrointestinal systemic sclerosis in serologic mixed connective tissue disease
Authors: Norman Daniel A. , Fleischmann Roy M.
Published: February 2007

Mixed connective tissue disease is a clinical entity defined by overlapping features of progressive systemic sclerosis, systemic lupus erythematosus, polymyositis, rheumatoid arthritis, and distinct serologic findings. Esophageal dilatation and dysmotility have been the only gastrointestinal manifestations reported. Three patients with serologic findings of mixed connective tissue disease and extensive gastrointestinal involvement compatible with the changes found in progressive systemic sclerosis are presented. Gastrointestinal manifestations of progressive systemic sclerosis are reviewed and were found to be indistinguishable from the findings in these patients.
Autoimmunity and the immunologic network
Authors: Talal Norman
Published: February 2007

Recent developments in autoimmunity suggest that there are three stages in the response to self, which can be called autorecognition, autoimmunity, and autoimmune disease. The first is physiologic and fundamental to a network theory of immunologic control that is based upon recognition of idiotypes and antigens related to the major histocompatibility complex. Many foreign antigens may be recognized immunologically only if they can be imposed upon an existing network of immunologic communication. The existence of anti‐receptor autoimmune diseases (such as myasthenia gravis and Graves' disease) leads to the postulate that the immune network may normally function to help regulate hormone and other nonimmune cell surface receptors. Chronic autoimmune diseases may be caused either by genetically determined abnormalities in the immune network or by an antigenic perturbation of the network that results in unresponsiveness and tolerance of an offending agent.
Familial deficiency of two subunits of the first component of complement. c1r and c1s associated with a lupus erythematosus‐like disease
Authors: Lee Stanley L. , Wallace Stanley L. , Barone Richard , Blum Livia , Harvey Chase P.
Published: February 2007

Complete absence of C1r and almost complete absence of C1s were found in 4 of 8 living siblings. Two of the 4 suffer from a syndrome that combines discoid lupus erythematosus and nondeforming rheumatoid‐like arthritis; one of the siblings has mild nephritis. The other 2 C1 deficient family members are clinically well. Evidence from this and other families suggests that deficiency of C1 components or C4 is associated with higher risk of developing a lupus‐like disease than is deficiency of C2.
Constrictive pericarditis in systemic lupus erythematosus. demonstration of immunoglobulins in the pericardium
Authors: Jacobson Edwin J. , Reza Michael J.
Published: February 2007

A 17‐year‐old male with systemic lupus erythematosus presented with clinical signs of severe constrictive pericarditis that was confirmed by cardiac catheterization. At surgery, a fibrous pericardium was removed, followed by complete relief of symptoms. Immunopathology of the pericardial tissue revealed deposition of IgG, IgM, and C3. A review of the literature produced only three similar cases. Although rare, constrictive pericarditis, a potentially life threatening complication, may occur in systemic lupus erythematosus presumably with an immunological basis.
Legionnaires' disease in a patient with systemic lupus erythematosus
Authors: Jacox Ralph F. , Donald Stuard I.
Published: February 2007

A young woman with systemic lupus erythematosus developed a rapidly fatal pneumonia from which no visible or culturable organisms were found. Subsequent stains disclosed typical findings of Legionnaires' disease. A cutaneous portal of entry was suspected and a fulminant lung abscess developed, neither of which has been previously reported in Legionnaires' disease.
Effects of estrogen on cartilage and experimentally induced osteoarthritis
Authors: Rosner Itzhak A. , Goldberg Victor M. , Getzy Lee , Moskowitz Roland W.
Published: February 2007

Estradiol valerate did not ameliorate experimentally induced osteoarthritis in the rabbit. Both normal and osteoarthritic cartilage were susceptible to estradiol suppression of proteoglycan synthesis. Proteoglycan concentration was not diminished with estradiol, suggesting estradiol suppression of proteoglycan catabolism. The severity of osteoarthritis was unchanged despite markedly decreased proteoglycan synthesis in the estrogen treated animals. Osteophyte proteoglycan metabolism differed from other osteoarthritic lesions. Differences in the metabolism of femoral and tibial articular cartilage were observed.
Tarsal tunnel syndrome with ankylosing spondylitis
Authors: Enright Tobias , Liang George C. , Fox Theodore A. , Mueller Roland F.
Published: February 2007

A young athletic male presented with rare coexistence of tarsal tunnel syndrome and ankylosing spondylitis.
Skin thickness and collagen content in progressive systemic sclerosis and localized scleroderma
Authors: Rodnan Gerald P. , Lipinski Esther , Luksick Joan
Published: February 2007

Skin biopsies of uniform location and surface area (7 mm diameter) were obtained from the extensor aspect of the forearm of 147 patients with progressive systemic sclerosis (PSS) (107 with diffuse scleroderma, 40 with the CREST syndrome variant) and 58 individuals with normal skin. After careful removal of all subcutaneous fatty tissue, the skin cores were weighed and their water and hydroxyproline content determined. Despite recent claims to the contrary, it was found that there is a marked and highly significant increase in the thickness of the skin during the indurative phase of PSS, and that this is associated with a proportionate increase in total dermal collagen content. A similar degree of thickening was found in the skin of patients with eosinophilic fasciitis and acromegaly. A close correlation was observed between clinical estimation of the degree of skin thickening and the weight of the skin biopsy cores. Change in the weight of skin cores was observed during the course of illness of the patients with PSS and may serve as a useful measurement of alteration in the degree of skin thickening.
Detection of low avidity anti‐dna antibodies in systemic lupus erythematosus
Authors: Riley Richard L. , Mcgrath Hugh , Taylor Ronald P.
Published: February 2007

The binding of sonicated, radiolabeled DNA by systemic lupus erythematosus (SLE) sera was measured by a high sensitivity polyethylene glycol (PEG) precipitation assay. This method is considerably more sensitive than currently used techniques. The results suggest that a significant concentration of low avidity antibodies is present in SLE sera; however, these antibodies are not detected by conventional techniques.
Alteration of lymphocyte function in nzb/nzw mice
Authors: Hahn Bevra H. , Knotts Linda L.
Published: February 2007

NZB/NZW F1 female mice received levamisole in an attempt to increase suppressor T cell function. Responses varied with dosage of drug and age of mice. When treatment with 25 μg/gm doses (intermittent or daily) was begun at 12 weeks of age, nephritis was accelerated in spite of transient reduction of anti‐DNA antibodies. When treatment was begun at 4 weeks, or when doses of 250 μg/gm were given, no clinical effects were observed. In the mice with accelerated disease, delayed hypersensitivity and antibody responses to sheep erythrocytes increased; antibody responses to pneumococcal poiysaccharide were unaffected. It is possible that some increased immune responses associated with levamisole are undesirable in murine lupus.
Circulating Immune Complexes in Mixed Connective Tissue Disease
Authors: Halla James T. , Volanakis John E. , Schrohenloher Ralph E.
Published: February 2007

Circulating immune complexes were measured by three assays (monoclonal rheumatoid factor radioimmunoassay, Clq‐binding assay, Raji cell radioassay) in sera from patients with mixed connective tissue disease. Evidence for circulating immune complexes was found by at least one method in 94% of sera. The highest frequency of positive results was noted by the Raji cell radioassay (88%). However, a significant number of patients also had immune complexes measured by the Clq‐binding assay (50%) and monoclonal rheumatoid factor radioimmunoassay (45%). Further, the levels of immune complexes as measured by the Raji cell radioassay, and to a lesser extent the Clq‐binding assay, correlated with disease activity and represent a potentially useful clinical tool. The pattern of reactivity in mixed connective tissue disease sera differed from rheumatoid arthritis, scleroderma, and polymyositis. This suggests that a spectrum of immune complexes is found in these rheumatic diseases and supports the concept that mixed connective tissue disease is distinct from these diseases.
Scleroderma After Cosmetic Surgery
Authors: Kumagai Yasuo , Abe Chiyuki , Shiokawa Yuichi
Published: February 2007

In 9 cases of human adjuvant disease, 4 cases of scleroderma (3 progressive systemic sclerosis and 1 localized morphea) were observed. Seven to 19 years after injection of foreign substances into the breasts or nose for cosmetic purposes, some patients developed human adjuvant disease. In one case the foreign substances were removed by bilateral mastectomy with no discernible effects on the patient's clinical course. Histopathologic findings of the removed breasts demonstrated foreign body granulomas with calcification. The injected substance was identified as a mixture of liquid and solid paraffin. Human adjuvant disease might be caused by prolonged hypersensitization activated by the injected foreign materials which act as an adjuvant.
Synovial Fat Necrosis Associated with Ischemic Pancreatic Disease
Authors: Smukler Nathan M. , Schumacher H. Ralph , Pascual Eliseo , Brown Sylvan , Ryan William E. , Sadeghian M. Reza
Published: February 2007

A 59‐year‐old man with ischemic pancreatic disease, polyarthritis, and cutaneous nodules has shown histopathologic findings indicative of disseminated fat necrosis in a percutaneous biopsy specimen from the right knee. The histopathologic findings in the synovium included necrotic fat cells, distorted fat cells and adjacent lymphocytes, lipid laden histiocytes, and giant cells. In prior histopathologic studies of the joint involvement associated with this disorder, fat cell necrosis has been found only in the periarticular tissues, and the synovium has appeared normal or showed nonspecific inflammation. However, the present study shows that the synovial membrane may also be the site of fat necrosis and an associated inflammatory reaction; thus patients with this disorder may manifest arthritis in addition to periarthritis.
Mortality in lupus nephritis
Authors: Karsh Jacob , Klippel John H. , Balow James E. , Decker John L.
Published: February 2007

The principal causes of death of 68 patients with lupus glomerulonephritis were reviewed. Renal failure (40%), vascular events (25%), and infections (16%) were the predominant causes. Diffuse proliferative glomerulonephritis was associated with an increased frequency of renal failure. A bimodal pattern of early deaths due to active lupus and sepsis and late deaths from vascular events was found superimposed on a constant rate of death from renal failure.
A syndrome resembling progressive systemic sclerosis after bone marrow transplantation
Authors: Furst Daniel E. , Clements Philip J. , Graze Peter , Gale Robert , Roberts Nigel
Published: February 2007

Six long term survivors of bone marrow transplants developed a syndrome similar to progressive systemic sclerosis (PSS). Cutaneous involvement (6/6), pulmonary disease (6/6), musculoskeletal involvement (4/6), keratoconjunctivitis/positive Schirmer's test (4/6), Raynaud's phenomenon (2/6), and renal and cardiac disease (1/6) were similar to findings in PSS patients. T and B lymphocyte counts and functions were also similar. This PSS‐like syndrome, including visceral involvement, after bone marrow transplantation lends support to an immunologic hypothesis of the pathogenesis of progressive systemic sclerosis.
Reassessment of the clinical significance of native dna antibodies in systemic lupus erythematosus
Authors: Miniter Michael F. , Stollar B. David , Agnello Vincent
Published: February 2007

To further clarify the clinical significance of nDNA antibodies in systemic lupus erythematosus, 70 patients were studied longitudinally over an average period of 3 years each. Serum hemolytic complement (CH50) and nDNA antibodies measured by antigen binding and complement fixation were assessed during episodes of clinically inactive and active disease. Only slightly more than half of episodes of active disease were associated with low CH50 and high nDNA binding, and there was a significant occurrence of high nDNA binding or low CH50 with inactive disease. In contrast, nDNA antibodies measured by complement fixation were never present in the absence of clinical disease. Complement fixing nDNA antibodies were associated mainly with episodes of renal disease, whereas all types of disease activity except those involving predominantly the central nervous system (CNS) showed some correlation with the combined parameters of low CH50 and high nDNA binding. Most episodes of CNS disease occurred without CH50 depression or high nDNA binding. Disease activity was less commonly associated with only low CH50 or high nDNA binding. However, when rash was the predominant manifestation, low CH50 alone was frequently present. The CH50 test correlated with disease activity better than the nDNA antibody binding or complement fixation tests. However, as illustrated by longitudinal studies, a combination of these assays provided the best monitoring of disease activity. Contrary to recent reports, IgG/IgM nDNA antibody ratios did not correlate with disease activity. Studies on isolated nDNA antibody populations provided evidence that differences in complement‐fixing activity were not due to class or subclass composition as previously proposed. Consideration of the above qualifications may result in more effective clinical application of the nDNA antibody test.
Lymphocyte depletion by continuous flow cell centrifugation in rheumatoid arthritis
Authors: Karsh Jacob , Wright Daniel G. , Klippel John H. , Decker John L. , Deisseroth Albert B. , Flye M. Wayne
Published: February 2007

Four patients with active, severe rheumatoid arthritis were subjected to the removal of circulating lymphocytes (lymphapheresis) for a 6‐week period by use of a continuous flow cell centrifuge. Repetitive venous access was gained through forearm arteriovenous fistulae. In all patients the Ritchie‐Camp articular index declined rapidly in the first week and more slowly thereafter for a total mean drop of 61% below the initial value. The index continued to decline after lymphapheresis but exacerbation of disease activity developed at an average of 19 weeks. No significant untoward effects of the procedure were observed; occasional transfusions were required to compensate for the small, unavoidable erythrocyte loss.
A y chromosome associated factor in strain bxsb producing accelerated autoimmunity and lymphoproliferation
Authors: Murphy Edwin D. , Roths John B.
Published: February 2007

Strain BXSB/Mp mice develop a spontaneous lupus‐like syndrome which is strikingly accelerated in males. The accelerated autoimmune disease occurs in male F1 hybrids with strains NZB/BINJ, SJL/J, and C57BL/6J when the male parent is BXSB but not in the reciprocal hybrid male nor in females. The pattern is similar in F2 hybrids with strains NZB and SJL. The accelerated disease in males occurs only when the Y chromosome is derived from recombinant inbred strain BXSB and ultimately from strain SB/Le.
The role of the endocrine thymus in female reproduction
Authors: Michael Sandra D.
Published: February 2007

Neonatal thymectomy in mice induces ovarian disturbances, indicating some relationship between the thymus and the ovaries. The mechanism of the relationship, however, is not fully understood. One approach to elucidating the complex relationship has been to measure circulating hormone levels in thymectomized animals and those with small thymus glands, and compare these levels with those found in control animals. The data indicate that a thymus‐pituitary‐ovarian axis exists and that thymus disturbances may hasten the aging processes of the ovaries.
Immunologic regulation in pregnancy
Authors: Stites Daniel P. , Pavia Charles S. , Clemens Louis E. , Kuhn Robert W. , Siiteri Pentti K.
Published: February 2007

Theories to explain the failure of rejection of the fetus by the mother during pregnancy include immunologic privilege of the uterus as a graft site, lack of transplantation antigen expression on the trophoblast, weakening of maternal cellular immunity during pregnancy, and separation of maternal and fetal circulations. Evidence for and against each of these theories is discussed. Local concentration of a variety of hormones, including human chorionic gonadotropin (HCG), sex steroids, alpha‐fetoprotein, and immunoglobulins, could provide a blocking mechanism to prevent maternal cellular immune attack. Possibly, progesterone, antibodies, and immune complexes are important in protecting the placenta and ultimately the fetus from rejection. Elucidation of regulatory mechanisms in pregnancy may be applicable to other problems in immunology.
A controlled study of pneumococcal polysaccharide vaccine in systemic lupus erythematosus
Authors: Klippel John H , Karsh Jacob , Stahl Neil I , Decker John L , Steinberg Alfred D , Schiffman Gerald
Published: February 2007

The immunogenicity and potential for disease modification of pneumococcal polysaccharide vaccine in systemic lupus erythematosus were evaluated in a controlled, double‐blind study. Forty patients were randomly chosen to receive an intramuscular injection of either vaccine or placebo. Changes in mean antibody concentrations (nanograms antibody nitrogen per milliliter serum) to 12 type‐specific pneumococcal capsular antigens from prevaccination to one month after vaccination were 177 to 1045 in the vaccine (P < 0.001) and 164 to 153 in the placebo‐treated patients. In the month after vaccination, neither vaccine nor placebo‐treated patients had a significant change in lupus disease activity as assessed by a composite clinical, laboratory, and serologic index. We conclude that patients with systemic lupus erythematosus can be successfully immunized with pneumococcal vaccine without detectable alterations of the underlying disease.
Evidence for the presence of receptors for c3 and IgG Fc on human synovial cells
Authors: Theofilopoulos Argyrios N. , Carson Dennis A. , Tavassoli Mehdi , Slovin Susan F. , Speers Wendell C. , Jensen Fred B. , Vaughan John H.
Published: February 2007

The presence of receptors for IgG Fc and fragments of C3 on primary cultures and cryostat sections of normal and rheumatoid synovial tissues was assessed. Significant proportions of large rounded cells with asteroid projections found in such cultures had receptors for both IgG Fc and fragments of C3. Moreover, Gram negative bacteria that had fixed complement, but not EAC, bound in a linear fashion on the superficial layers of synovial cryostat sections. On the basis of morphologic and histochemical criteria, the cultured cells bearing these receptors were tentatively determined to represent a subset of synovial lining cells. The possible role of such receptors on synovial lining cells in the pathogenesis of rheumatoid arthritis is discussed.
Synovial origins of rice bodies in joint fluid
Authors: Cheung Herman S. , Ryan Lawrence M. , Kozin Franklin , Mccarty Daniel J.
Published: February 2007

Rice bodies and synovia obtained from knee joints of rheumatoid arthritis patients were solubilized by limited pepsin treatment. The quantity of each type of collagen in both tissues was determined by differential salt precipitation, cyanogen bromide peptide analysis, and SDS polyacrylamide gel electrophoresis. Rice bodies and synovial membrane contained equal proportions of Type I and III collagens with trace amounts of Type “A‐B” collagen.
Measurement of patient outcome in arthritis
Authors: Fries James F. , Spitz Patricia , Kraines R. Guy , Holman Halsted R.
Published: February 2007

A structure for representation of patient outcome is presented, together with a method for outcome measurement and validation of the technique in rheumatoid arthritis. The paradigm represents outcome by five separate dimensions: death, discomfort, disability, drug (therapeutic) toxicity, and dollar cost. Each dimension represents an outcome directly related to patient welfare. Quantitation of these outcome dimensions may be performed at interview or by patient questionnaire. With standardized, validated questions, similar scores are acheived by both methods. The questionnaire technique is preferred since it is inexpensive and does not require interobserver validation. These techniques appear extremely useful for evaluation of long term outcome of patients with rheumatic diseases.
A screening strategy for population studies in systemic lupus erythematosus
Authors: Liang Matthew H. , Meenan Robert F. , Cathcart Edgar S. , Schur Peter H.
Published: February 2007

A survey design which uses two tests in series greatly increases the efficiency of screening. We conducted a study to ascertain the sensitivity, specificity, and predictive value of a screening questionnaire for systemic lupus erythematosus (SLE) patients. A series design in which this questionnaire is used, followed by an antinuclear antibody test, increased the predictive value of a positive screening result by 5 to 10‐fold, depending on estimates of disease prevalence. An empirical study of the series design identified two new cases of SLE and indicated that the use of a questionnaire based on accepted criteria is theoretically sound and practical. This approach should prove useful for population surverys of SLE to avoid the sampling and detection biases of previous epidemiologic studies.
Diagnostic potential of in vivo capillary microscopy in scleroderma and related disorders
Authors: Maricq H.R. , LeRoy E. C. , D'Angelo W. A. , Medsger T. A. , Rodnan G. P. , Sharp G. C. , Wolfe J. F.
Published: February 2007

The prevalence of scleroderma‐type capillary abnormalities, as observed by in vivo microscopy, was determined in 173 patients from three rheumatic disease centers. The patients had a variety of connective tissue diseases: scleroderma (systemic sclerosis) 50; systemic lupus erythematosus 60; mixed connective tissue disease 26; Raynaud's disease 11; other rheumatic disorders 26. Enlarged and deformed capillary loops surrounded by relatively avascular areas, most prominently in the nailfolds, were found in 82% of patients with scleroderma and in 54% with mixed connective tissue disease. The rarity of these abnormalities in systemic lupus erythematosus (2%) despite the presence of Raynaud's phenomenon suggests that they are not an expression of the Raynaud's phenomenon frequently associated with scleroderma and mixed connective tissue disease. The single patient with Raynaud's disease and sclerodermatype capillary changes subsequently developed scleroderma.
Correlation and predictive accuracy of circulating immune complexes with disease activity in patients with systemic lupus erythematosus
Authors: Abrass Christine K. , Nies Kenneth M. , Louie James S. , Border Wayne A. , Glassock Richard J.
Published: February 2007

Serial serum samples from 48 patients with systemic lupus erythematosus (SLE) were assayed for C3, anti‐DNA antibody, and circulating immune complexes (CIC). CIC were measured by the fluid phase (FClq) and solid phase (SClq) Clq binding assays. Elevations of the SClq results were associated with the presence of manifestations of SLE (P < 0.001), including active renal disease (P < 0.005) and arthritis (P < 0.001), as well as changes in degree of disease activity which prompted physician action. A change in the SClq results correctly predicted a change in disease activity 82% of the time (P < 0.005). Abnormalities of FClq, anti‐DNA antibody, and C3 were neither associated with nor predictive of changes in disease activity of SLE. These data suggest that the SClq method of determining CIC is the most reliable laboratory indicator of clinical activity in SLE.
Treatment decisions in systemic lupus erythematosus
Authors: Wasner Cody K. , Fries James F.
Published: February 2007

Rheumatologists and nephrologists were surveyed, by the use of specifically designed case histories, regarding their management of selected aspects of systemic lupus erythematosus (SLE). Treatment was individualized on a case by case basis by the vast majority of respondents. There was agreement on the initial treatment of SLE involving mild arthritis, active nephritis, or central nervous system disease and on steroid tapering practices. There was disagreement about treatment of a “serologic flare” and the management of late‐stage nephropathy. Academic centers were more selective and less aggressive than practicing subspecialists. Areas of concordance document current standard treatment practices but sometimes show dissociation between the degree of consensus and the level of available medical knowledge.
Anti‐ss‐a antibody and other antinuclear antibodies in systemic lupus erythematosus
Authors: Scopelitis Eve , Biundo Joseph J. , Alspaugh Margaret A.
Published: February 2007

Randomly selected sera from 88 patients with systemic lupus erythematosus (SLE) were studied for the frequency of antibodies to SS‐A, SS‐B, RANA, RNP, Sm, Sc‐1, and dsDNA. Results were in agreement with previous reports except for an increased incidence of anti‐SS‐A antibody (33%). Nine of 14 patients with anti‐SS‐A antibody on whom serial studies were performed had fluctuating titers. Titer changes often correlated with disease activity and dsDNA antibody levels.
Vertebral osteophyte formation in experimental disc degeneration
Authors: Lipson Stephen J. , Muir Helen
Published: February 2007

Experimental intervertebral disc degeneration produced in rabbits by ventral nuclear herniation reliably produces vertebral osteophytes. Osteophytes arise from proliferating inner annular fibers which undergo metaplasia into cartilage, calcify, and proceed through an endochondral ossification sequence. Proteoglycans extracted from the osteophytes reveal that the degree of aggregation, molecular size of the monomer, and the chondroitin sulfate/keratin sulfate ratio are directly related to the cartilage state of the tissue.