3.Clinical significance of anti-neutrophil cytoplasmic antibodies and anti-endothelial cell antibodies in children with Kawasaki disease.
Chinese Journal of Contemporary Pediatrics 2014;16(7):740-744
OBJECTIVETo study the clinical significance of anti-endothelial cell antibodies (AECA) and anti-neutrophil cytoplasmic antibodies (ANCA) in Kawasaki disease (KD) and its complication of coronary arterial lesions (CAL).
METHODSForty-two children with KD, as well as 20 children with fever caused by respiratory infection (fever control group) and 15 children for selective operation (normal control group), were included in the study. Serum levels of AECA and ANCA were measured using enzyme-linked immunosorbent assay. Echocardiography was performed to evaluate CAL in KD patients.
RESULTSDuring the acute phase, the KD patients had significantly higher serum AECA and ANCA levels than the two control groups (P<0.01). The KD patients had reduced serum ANCA levels (P<0.01) in the remission phase, but they were still higher than those of the two control groups (P<0.05). Among KD patients, those with CAL had significantly higher ANCA levels than those without CAL (P<0.01) in the acute phase. There was a positive correlation between serum ANCA levels and the ratio of left coronary artery to aortic annular diameter in KD patients with CAL (r=0.88, P<0.01).
CONCLUSIONSAECA and ANCA may be involved in vasculitis and CAL among children with KD. Serum levels of AECA and ANCA may be used as indicators for the diagnosis of suspected KD cases in the acute phase. Elevated ANCA level has a certain predictive value for CAL.
Antibodies, Antineutrophil Cytoplasmic ; blood ; Autoantibodies ; blood ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; immunology ; Severity of Illness Index
4.Clinical significance of antineutrophil cytoplasmic antibodies in patients with lupus nephritis.
Yong-wu YU ; Zheng-rong LIU ; Di XIE ; Sheng-xiao CHEN ; Hong-yan LI
Journal of Southern Medical University 2006;26(6):833-836
OBJECTIVETo analyze the clinical features of patients with lupus nephritis positive for antineutrophil cytoplasmic antibodies (ANCA) and explore the clinical implications of ANCA detection.
METHODSTotally 261 patients with lupus nephritis were enrolled in this study, including 53 ANCA-positive and 208 ANCA-negative ones. The clinical data of the patients pertaining to the disease history, physical examination, laboratory examinations and pathological inspection were retrospectively analyzed.
RESULTSCompared with patients negative for ANCA, the ANCA-positive patients had significantly higher incidence of serositis (75.5%), acute renal failure (64.2%), myocarditis (30.2%), neuropsychiatric involvement (26.4%) and lung hemorrhage (7.5%)(P<0.05). Significant differences were also found between the two groups in SLE disease active index (SLE-DAI), number of the diagnostic criteria, erythrocyte sedimentation rate (ESR), anemia, anti-Sm antibodies, and serum complement C(3). Most patients positive for ANCA (67.9%) had type IV lupus nephritis with more crescent formation, renal tubular atrophy, hyaline thrombi, and higher mortality rate as well than the negative patients.
CONCLUSIONANCA detection may benefit the estimation of the disease severity and prognostic evaluation of lupus nephritis.
Adolescent ; Adult ; Antibodies, Antineutrophil Cytoplasmic ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunologic Factors ; blood ; Lupus Nephritis ; immunology ; pathology ; Male ; Prognosis ; Retrospective Studies
5.Comparison of Behcet's Disease and Recurrent Aphthous Ulcer According to Characteristics of Gastrointestinal Symptoms.
Seung Ho RHEE ; Young Bae KIM ; Eun So LEE
Journal of Korean Medical Science 2005;20(6):971-976
Behcet's disease (BD) is a multisystemic chronic inflammatory disease. It is characterized by recurrent oral and genital ulcers, uveitis, skin lesions and other manifestations, including neurologic, vascular, joint, and gastrointestinal ulcers of variable severity. Recurrent aphthous ulcer (RAU) represents a very common, but poorly understood, mucosal disorder. If a patient of RAU without any other typical symptoms of BD has gastrointestinal symptoms, it is difficult to distinguish this RAU from true BD with gastrointestinal involvement. Because pathognomonic clinical features and tools are absent, the differential diagnosis of these two diseases relies on the characteristic clinical features and the judgement of an experienced physician. Sixty-five out of a total 960 RAU patients and forty-four of 556 BD patients with gastrointestinal symptoms between January 1996 and December 2003 participated in this study. All were evaluated with esophagogastroduodenoscopy and colonoscopy. Clinical, endoscopic and histopathologic findings were analyzed and ELISA tests were conducted to detect serum levels of ASCA and pANCA. No significant difference was found between the two groups. Differential diagnosis between RAU with gastrointestinal symptoms and BD with gastrointestinal involvement requires further prospective, large-scale study.
Adolescent
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Adult
;
Aged
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Antibodies, Antineutrophil Cytoplasmic/blood
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Antibodies, Fungal/blood
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Behcet Syndrome/*diagnosis/immunology/pathology
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Comparative Study
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Diagnosis, Differential
;
Endoscopy
;
Female
;
Gastrointestinal Diseases/*diagnosis/immunology/pathology
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Humans
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Male
;
Middle Aged
;
Saccharomyces cerevisiae/immunology
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Serologic Tests
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Stomatitis, Aphthous/*diagnosis/immunology/pathology
6.Detection of auto-antibodies for diagnosing auto-immunous hepatitis.
Li-ming TAN ; Ye DONG ; Hua LI ; Ning LIU ; Li-li CAI ; Yuan-yuan WANG ; Jian-yuan AO
Chinese Journal of Hepatology 2006;14(6):463-464
Actins
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immunology
;
Adolescent
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Adult
;
Aged
;
Antibodies, Antineutrophil Cytoplasmic
;
blood
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Antibodies, Antinuclear
;
blood
;
Autoantibodies
;
blood
;
Child
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Child, Preschool
;
Female
;
Hepatitis, Autoimmune
;
diagnosis
;
immunology
;
Humans
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Male
;
Middle Aged
;
Muscle, Smooth
;
immunology
7.Antibiotic-induced Severe Neutropenia with Multidrug-Dependent Antineutrophil Antibodies Developed in A Child with Streptococcus pneumoniae Infection.
Young Ho LEE ; Ha Baik LEE ; Jung Yun KIM ; Yeon Jung LIM ; Su A SHIN ; Tae Hee HAN
Journal of Korean Medical Science 2009;24(5):975-978
Drug-induced neutropenia (DIN), particularly that in which antibiotic-dependent antineutrophil antibodies have been detected, is a rare disorder. We report the case of a child with pneumococcal pneumonia, who experienced severe neutropenia during various antibiotic treatments. We detected 4 kinds (cefotaxim, augmentin, vancomycin, and tobramycin) of antibiotic-dependent antineutrophil antibodies by using the mixed passive hemagglutination assay (MPHA) technique with this child.
Anti-Bacterial Agents/*therapeutic use
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Antibodies, Antineutrophil Cytoplasmic/*blood/immunology
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Autoantibodies/blood/immunology
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Drug Therapy, Combination
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Humans
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Infant
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Male
;
Neutropenia/chemically induced/*diagnosis
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Pneumonia, Pneumococcal/complications/*drug therapy
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Tomography, X-Ray Computed
8.Co-existing proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis with immunoglobulin A nephropathy.
Adem KUCUK ; Yalcin SOLAK ; Abduzhappar GAIPOV ; Sinan BAGCACI ; Hasan ESEN ; Suleyman TURK ; Recep TUNC
The Korean Journal of Internal Medicine 2016;31(1):194-196
No abstract available.
Adult
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Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications/diagnosis/drug therapy/immunology
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Antibodies, Antineutrophil Cytoplasmic/*blood
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Biomarkers/blood
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Biopsy
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Drug Therapy, Combination
;
Fluorescent Antibody Technique
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Glomerulonephritis, IGA/*complications/diagnosis/drug therapy/immunology
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Humans
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Immunosuppressive Agents/therapeutic use
;
Male
;
Myeloblastin/*immunology
;
Treatment Outcome
9.Clinical features and prognostic factors of Churg-Strauss syndrome.
Mi Yeong KIM ; Kyoung Hee SOHN ; Woo Jung SONG ; Heung Woo PARK ; Sang Heon CHO ; Kyung Up MIN ; Hye Ryun KANG
The Korean Journal of Internal Medicine 2014;29(1):85-95
BACKGROUND/AIMS: Churg-Strauss syndrome (CSS) is a rare systemic necrotizing small-vessel vasculitis, with accompanying bronchial asthma, eosinophilia, and eosinophilic infiltration of various tissues. The purposes of our study were to characterize the clinical features of CSS and to identify factors associated with CSS prognosis in Koreans. METHODS: Medical records were reviewed retrospectively for all physician-diagnosed CSS patients in the Seoul National University Hospital between January 1990 and March 2011. RESULTS: Data from 52 CSS patients were analyzed. The respiratory tract was the most commonly involved organ (90.4%). Renal involvement was less frequent in antineutrophilic cytoplasmic antibody (ANCA)(-) patients than in ANCA(+) patients (p = 0.048). Clinical remission occurred in 95.3% of patients, but 16.3% of them relapsed. Patients who maintained remission for more than 6 months were relatively older (median, 51 years) at diagnosis (p = 0.004), had been diagnosed in earlier stages (p = 0.027), showed more frequent respiratory involvement (p = 0.024) and generalized symptoms (p = 0.039), and showed less frequent cutaneous involvement (p = 0.030) than those who did not achieve persistent (> 6 months) remission. Patients who achieved persistent remission also showed higher C-reactive protein (CRP) levels (p = 0.031) than those who did not. CONCLUSIONS: ANCA(-) CSS patients showed less frequent renal involvement. Characteristics of good responders were older age, diagnosis at earlier stages, less cutaneous involvement, more respiratory involvement, high CRP values, and more generalized symptoms.
Adolescent
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Adult
;
Aged
;
Antibodies, Antineutrophil Cytoplasmic/blood
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Churg-Strauss Syndrome/drug therapy/*epidemiology/immunology
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Female
;
Glucocorticoids/therapeutic use
;
Humans
;
Immunosuppressive Agents/therapeutic use
;
Male
;
Middle Aged
;
Prednisolone/therapeutic use
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Republic of Korea/epidemiology
;
Retrospective Studies
;
Young Adult
10.Clinical significance of antiphospholipid antibody in pediatric patients and review of literature.
Hui-Jie XIAO ; Ji-Yun YANG ; Tian-Ji GAO ; Jian-Ping HUANG ; Yong YAO ; Yan ZHANG
Chinese Journal of Pediatrics 2004;42(8):571-573
OBJECTIVEAntiphospholipid antibody (APL) is a particularly important laboratory diagnostic criterion for antiphospholipid syndrome (APS). The significances of positive APL in childhood are seldom reported nor fully understood. The purpose of this study was to analyze 13 cases with positive APL seen in our hospital and to study the relationship between the positive rates of APL and various clinical diseases especially systemic lupus erythematosus (SLE) in order to improve the clinical diagnoses and treatment level of APS in children.
METHODSThe clinical data collected from 2000 to 2002 of 13 hospitalized children with positive APL were retrospectively evaluated. Enzyme linked immunosorbent assay (ELISA) and indirect immunofluorescence technique were used respectively to detect APL and antineutrophil cytoplasmic autoantibodies (ANCA) of sera from those children. Other various indexes were also detected according to different characteristics of different diseases.
RESULTSEight cases had SLE; 2 had acute post-streptococcal infections. The other 3 cases did not show any evidences of primary diseases; they probably had primary APS. SLE was the most common primary diseases to cause development of APL and the cases with SLE showed more severe cutaneous vasculitis than SLE patients who were negative for APL. There was no significant relationship between the positive rates of APL and that of ANCA. Eight APL positive cases complicated with thrombocytopenia and bleeding were treated with high dosage of immunoglobulin [400 mg/(kg.d), for 3 - 5 d] intravenously; the clinical conditions of these cases were ameliorated soon. While the 5 cases who had thrombotic vasculitis and thromboembolism were treated with anticoagulant and antithrombotic therapy with low molecular weight heparin [50 - 100 U/(kg.d)], which led to good clinical effects.
CONCLUSIONSThe clinical manifestations of children positive for APL were somehow different from those of adults. Positive APL itself may be nonspecific, it can occur from different causes of diseases. APL detection may be useful to suggest anticoagulant and/or antithrombosis therapy. Treatments for APS should be variable according to different causes and severity of diseases, in the cases of thrombocytopenia and bleeding, high dose intravenous immunoglobulin should be given as soon as possible, while in the cases of thrombotic vasculitis and thromboembolism, anticoagulant and antithrombotic therapy should be given soon.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; blood ; Antibodies, Antiphospholipid ; blood ; immunology ; Anticoagulants ; therapeutic use ; Antiphospholipid Syndrome ; blood ; complications ; diagnosis ; therapy ; Child ; Fibrinolytic Agents ; therapeutic use ; Hemorrhage ; etiology ; therapy ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Lupus Erythematosus, Systemic ; immunology ; Streptococcal Infections ; immunology ; Thrombocytopenia ; etiology ; therapy ; Thromboembolism ; drug therapy ; etiology ; Thrombosis ; drug therapy ; etiology ; Vasculitis ; drug therapy ; etiology