Autoantibody profiles in systemic sclerosis: Predictive value for clinical evaluation and prognosis

Objective.To evaluate routinely collected non-invasive tests from 2 systemic sclerosis (SSc) cohorts to determine their predictive value alone and in combination versus right heart catheterization (RHC)-confirmed pulmonary arterial hypertension (PAH).Methods.We evaluated 2 cohorts of patients who were at risk or with incident PAH: (1) The Pulmonary Hypertension Assessment and Recognition Outcomes in Scleroderma (PHAROS) cohort and (2) an inception SSc cohort at Cochin Hospital, Paris, France. Estimated right ventricular systolic pressure (eRVSP) as determined by transthoracic echocardiogram (TTE) and pulmonary function test (PFT) measures was evaluated, and the predictive values determined. We then evaluated patients with PAH missed on TTE cutoffs that were subsequently identified by a PFT measure.Results.In the PHAROS cohort (n = 206), 59 (29%) had RHC-defined PAH. An eRVSP threshold of 35–50 mm Hg failed to diagnose PAH in 7% to 31% of patients, 50% to 70% of which (n = 2–13) were captured by PFT measures. In the Cochin cohort (n = 141), 10 (7%) patients had RHC confirmed PAH. An eRVSP threshold of 35–50 mm Hg missed 0% to 70% (n = 0–7) of patients, of which 0% to 68% (n = 0–6) were met by PFT measures. The combination of TTE and PFT improved the negative predictive value for diagnosing PAH.Conclusion.In 2 large SSc cohorts, screening with TTE and PFT captured a majority of patients with PAH. TTE and PFT complement each other for the diagnosis of PAH.

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Predictive value of clinical evaluation in the follow-up of children with a brain tumor

Medical and Pediatric Oncology ◽

10.1002/mpo.10054 ◽

2002 ◽

Vol 38 (4) ◽

pp. 254-257 ◽

Cited By ~ 5

Author(s):

Nanko de Graaf ◽

Joffre M. Hew ◽

Johanna M. Fock ◽

Willem A. Kamps ◽

Siebold S.N. de Graaf

Keyword(s):

Brain Tumor ◽

Clinical Evaluation ◽

Predictive Value

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Predictive Value of Serial High-Resolution Computed Tomography Analyses and Concurrent Lung Function Tests in Systemic Sclerosis

Arthritis & Rheumatology ◽

10.1002/art.39166 ◽

2015 ◽

Vol 67 (8) ◽

pp. 2205-2212 ◽

Cited By ~ 69

Author(s):

Anna-Maria Hoffmann-Vold ◽

Trond M. Aaløkken ◽

May Brit Lund ◽

Torhild Garen ◽

Øyvind Midtvedt ◽

...

Keyword(s):

Computed Tomography ◽

Systemic Sclerosis ◽

High Resolution ◽

Lung Function ◽

Predictive Value ◽

Lung Function Tests ◽

High Resolution Computed Tomography ◽

Function Tests

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A cross-sectional study of autoantibody profiles in the Waikato systemic sclerosis cohort, New Zealand

Clinical Rheumatology ◽

10.1007/s10067-015-2981-3 ◽

2015 ◽

Vol 34 (11) ◽

pp. 1921-1927 ◽

Cited By ~ 6

Author(s):

Winston S. J. Chang ◽

Joanna Schollum ◽

Douglas H. N. White ◽

Kamal K. Solanki

Keyword(s):

New Zealand ◽

Systemic Sclerosis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Autoantibody Profiles

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Correlation of optical coherence elastography with clinical evaluation of systemic sclerosis

Optical Elastography and Tissue Biomechanics VI ◽

10.1117/12.2510255 ◽

2019 ◽

Cited By ~ 1

Author(s):

Chih-Hao Liu ◽

Alexander Schill ◽

Manmohan Singh ◽

Chandra Mohan ◽

Sam Theodore ◽

...

Keyword(s):

Systemic Sclerosis ◽

Clinical Evaluation ◽

Optical Coherence

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Clinical Evaluation of Automatic Coronary Artery Disease Reporting and Data System (CAD-RADS TM) in Coronary CT Angiography Using Convolutional Neural Networks

10.21203/rs.3.rs-622726/v1 ◽

2021 ◽

Author(s):

Zengfa Huang ◽

Jianwei Xiao ◽

Yun Hu ◽

Zuoqin Li ◽

Ning Guo ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Clinical Evaluation ◽

Predictive Value ◽

Data System ◽

Post Processing ◽

Disease Reporting ◽

Standardized Report ◽

Significant Difference ◽

Artery Disease

Abstract Background: The coronary artery disease reporting and data system (CAD-RADSTM) was recently introduced for standard reporting. We aimed to evaluate the utility of an automatic post-processing and reporting system based on CAD-RADS in suspected CAD patients.Methods: The clinical evaluation was encompassed 346 patients who underwent coronary computed tomography angiography (CCTA). We compared deep learning (DL)-based CCTA with Readers for classification of CAD-RADS with commercially-available automated segmentation and manual post-processing in a prospective validation cohort. Results: Compared with invasive coronary angiography (ICA), the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of DL model for diagnosis of CAD were 79.02%, 86.52%, 89.50%, 73.94% and 82.08%, respectively. There was no significant difference between the DL-based and Readers-based CAD-RADS grading in CCTA. The consistency test showed that the Kappa value between the model and Readers was 0.775 (95% CI: 0.728-0.823, P < 0.001), 0.802 (95% CI: 0.756-0.847, P<0.001), and 0.796 (95% CI: 0.750-0.843, P < 0.001), respectively. This system reduces the time consumed from 14.97 ± 1.80 min to 5.02 ± 0.8 min (P < 0.001).Conclusion: The standardized report of DL-based CAD-RADS in CCTA can accurately evaluate suspected CAD patients with time-saving, and has good consistency with the radiologists.

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Anti-Th/To Are Common Antinucleolar Autoantibodies in Italian Patients with Scleroderma

The Journal of Rheumatology ◽

10.3899/jrheum.100316 ◽

2010 ◽

Vol 37 (10) ◽

pp. 2071-2075 ◽

Cited By ~ 37

Author(s):

ANGELA CERIBELLI ◽

ILARIA CAVAZZANA ◽

FRANCO FRANCESCHINI ◽

PAOLO AIRÒ ◽

ANGELA TINCANI ◽

...

Keyword(s):

Systemic Sclerosis ◽

Interstitial Lung Disease ◽

Pulmonary Function ◽

Rna Polymerase ◽

Rna Polymerase Iii ◽

Clinical Manifestations ◽

Cell Extract ◽

Clinical Laboratories ◽

Autoantibody Profile ◽

Autoantibody Profiles

Objective.Patients with scleroderma (systemic sclerosis; SSc) can be classified into subsets based on autoantibody profile and clinical features. Specificities such as anti-Th/To and anti-fibrillarin (U3RNP) are detectable mainly by immunoprecipitation (IP), which is not widely used in clinical laboratories. We examined the autoantibody profiles and clinical manifestations in a cohort of Italian patients with SSc, focusing on anti-Th/To and anticentromere (ACA) antibodies, associated with limited cutaneous SSc (lcSSc).Methods.Sera from 216 consecutive patients with SSc were tested for ACA (by indirect immunofluorescence), antitopoisomerase I (topo I; by counterimmunoelectrophoresis), and anti-RNA polymerase III (RNAPIII; by ELISA). Forty-one sera negative for these specificities were tested by IP analysis of proteins (35S-methionine labeled K562 cell extract) and RNA (silver staining).Results.Among 216 SSc patients analyzed, anti-topo I, ACA, and anti-RNAPIII were detected in 38% (81/216), 31% (67/216) and 7% (15/216), respectively. Among 41 sera negative for ACA, anti-topo I, and anti-RNAPIII and which were tested by IP, 14 were nucleolar stain-positive. Eight out of 14 (57%) showed anti-Th/To reactivity, but no anti-U3RNP was found. In comparison with ACA-positive patients, anti-Th/To-positive patients were younger (p = 0.0046) and more commonly were male (p = 0.0006). All 8 anti-Th/To-positive and all but one ACA-positive patients had lcSSc. Interstitial lung disease (ILD) and pericarditis were more frequent in anti-Th/To-positive patients.Conclusion.Anti-Th/To are common in antinucleolar antibody-positive Italian patients with SSc. Anti-Th/To and ACA patients had lcSSc, with excellent prognosis. The anti-Th/To group had frequent pericarditis and ILD, although impairment of pulmonary function appeared mild.

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The Place of Nailfold Capillaroscopy Among Instrumental Methods for Assessment of Some Peripheral Ischaemic Syndromes in Rheumatology

Folia Medica ◽

10.1515/folmed-2016-0011 ◽

2016 ◽

Vol 58 (2) ◽

pp. 77-88 ◽

Cited By ~ 2

Author(s):

Sevdalina N. Lambova

Keyword(s):

Differential Diagnosis ◽

Systemic Sclerosis ◽

Doppler Ultrasound ◽

Predictive Value ◽

Laser Doppler ◽

Nailfold Capillaroscopy ◽

Doppler Imaging ◽

Peripheral Arteries ◽

Doppler Flowmetry ◽

Instrumental Methods

AbstractMicro- and macrovascular pathology is a frequent finding in a number of common rheumatic diseases. Secondary Raynaud’s phenomenon (RP) is among the most common symptoms in systemic sclerosis and several other systemic autoimmune diseases including a broad differential diagnosis. It should be also differential from other peripheral vascular syndromes such as embolism, thrombosis, etc., some of which lead to clinical manifestation of the blue toe syndrome.The current review discusses the instrumental methods for vascular assessments.Nailfold capillaroscopy is the only method among the imaging techniques that can be used for morphological assessment of the nutritive capillaries in the nailfold area. Laser-Doppler flowmetry and laser-Doppler imaging are methods for functional assessment of microcirculation, while thermography and plethysmography reflect both blood flow in peripheral arteries and microcirculation. Doppler ultrasound and angiography visualize peripheral arteries. The choice of the appropriate instrumental method is guided by the clinical presentation. The main role of capillaroscopy is to provide differential diagnosis between primary and secondary RP. In rheumatology, capillaroscopic changes in systemic sclerosis have been recently defined as diagnostic. The appearance of abnormal capillaroscopic pattern inherits high positive predictive value for the development of a connective tissue disease that is higher than the predictive value of antinuclear antibodies. In cases of abrupt onset of peripheral ischaemia, clinical signs of critical ischaemia, unilateral or lower limb involvement, Doppler ultrasound and angiography are indicated. The most common causes for such clinical picture that may be referred to rheumatologic consultation are the antiphospholipid syndrome, mimickers of vasculitides such as atherosclerosis with cholesterol emboli, and neoplasms.

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