scholarly journals Adalimumab-Induced Rhupus Syndrome in a Female Patient Affected with Anti-Citrullinated Protein Antibody (ACPA)-Positive Rheumatoid Arthritis (RA): A Case Report and Review of Literature

2021 ◽  
Vol 11 (3) ◽  
pp. 404-409
Author(s):  
Ciro Manzo ◽  
Alberto Castagna
Keyword(s):  
Rheumatoid Arthritis ◽  
Female Patient ◽  
Lupus Erythematosus ◽  
Drug Induced ◽  
Dsdna Antibody ◽  
Antibody Positivity ◽  
Homogeneous Pattern ◽  
Dsdna Antibodies ◽  
Citrullinated Protein

We report a 38-year-old female patient affected with anti-citrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA) who developed mild hemolytic anemia (Hb = 10.5 vs. >12 gr/dL), indolent oral ulceration, ANA (1:1280, homogeneous pattern), and anti-dsDNA antibody positivity following 8 months of therapy with an adalimumab biosimilar (GP2017). Rhupus syndrome was diagnosed. Replacing GP2017 with infliximab, anemia, oral ulcer, and anti-dsDNA antibodies quickly disappeared, while low-titers (1:80) ANA are still present after more than a year. The possibility that the patient suffered from rhupus rather than drug-induced lupus erythematosus associated to anti-ACPA positivity RA was discussed. To date, after a 14-month follow-up, no manifestations of LE have reappeared. To the best of our knowledge, this is the first report of adalimumab-induced rhupus.

Do all anti-citrullinated protein/peptide antibody tests measure the same? Evaluation of discrepancy between anti-citrullinated protein/peptide antibody tests in patients with and without rheumatoid arthritis

2007 ◽  
Vol 67 (4) ◽  
pp. 542-546 ◽  
Author(s):  
B Vander Cruyssen ◽  
L Nogueira ◽  
J Van Praet ◽  
D Deforce ◽  
D Elewaut ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Psoriatic Arthritis ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Human Fibrinogen ◽  
Peptide Antibody ◽  
Test Variability ◽  
Antibody Tests ◽  
Citrullinated Protein

Background:Different methods exist to demonstrate anti-citrullinated protein/peptide antibodies (ACPA).Aims:To evaluate discrepancy between four ACPA tests.Patients and methods:Population 1 consisted of patients with a new diagnostic problem, including 86 patients with rheumatoid arthritis (RA) and 450 patients without RA. Population 2 consisted of 155 patients with RA who had long-standing disease. Population 3 consisted of 188 patients with psoriatic arthritis and in population 4 there were 192 patients with systemic lupus erythematosus. Populations 1 and 2 were tested with the anti-human fibrinogen antibody (AhfibA) test, anti-CCP2 from Eurodiagnostica (CCP2-euro), anti-CCP2 from Pharmacia (CCP2-phar) and anti-CCP3 test by Inova (CCP3). Samples were annotated as discrepant if positive in one and negative in at least one other test. Each discrepant sample was re-analysed in a different run. Populations 3 and 4 were analysed in the CCP2-euro and AhFibA test.Results:In population 1, ACPA positivity was found in 17 of 450 (3.8%) patients without RA; 14 (82%) of these 17 samples were discrepant. In contrast, 61 of 86 (70.9%) patients with RA were ACPA positive of whom 18 of 61 (29.5%) were discrepant (70.9% vs. 29.5%, p<0.001). The discrepancies between tests could be partly attributed to borderline results, inter-assay discrepancy and inter-test variability. They were more prevalent in patients with systemic lupus erythematosus who were ACPA positive than in those with psoriatic arthritis who were ACPA positive.Conclusions:Discrepancy between different ACPA tests was observed attributable to the occurrence of borderline results, inter-assay variability and mainly to inter-test variability. The lowest inter-test discrepancy is observed between tests that use the same substrate.

scholarly journals Interleukin 23 is elevated in the serum of patients with SLE

Lupus ◽  
2020 ◽  
Vol 29 (14) ◽  
pp. 1943-1947 ◽  
Author(s):  
Milena Vukelic ◽  
Anita Laloo ◽  
Vasileios C Kyttaris
Keyword(s):  
Disease Activity ◽  
Lupus Erythematosus ◽  
Standard Of Care ◽  
Systemic Lupus ◽  
Current Standard ◽  
Cutaneous Manifestations ◽  
Autoantibody Profile ◽  
Dsdna Antibody ◽  
Antibody Positivity ◽  
Interleukin 23

Aim: Interleukin-23 (IL-23) is a cytokine that promotes the differentiation of T cells into pro-inflammatory Th17. We have previously shown that IL-23 is upregulated in systemic lupus erythematosus (SLE) patients and lupus prone mice. As SLE is highly heterogeneous, we asked whether IL-23 production correlates with different manifestations of the disease. Methods: We recruited 56 subjects who fulfilled the ACR criteria for SLE. Interleukin-23 was measured in the serum by ELISA. Results: IL-23 levels were positively correlated with the overall SLE disease activity as measured with the SLEDAI. Moreover, IL-23 correlated with the skin, renal domains of SLEDAI and arthritis but not with cytopenias or serositis. IL-23 did also correlate with anti-dsDNA antibody positivity and inversely correlated with C3 levels. We found no relationship between patients’ demographics, prior disease manifestations, medications, or autoantibody profile and IL-23 levels. No immunomodulatory medication seemed to be affecting IL-23 levels suggesting that current medications used in SLE are not as effective in shutting down the IL-23/IL-17 axis. Conclusions: IL-23 levels track SLE disease activity mostly in the renal, skin and musculoskeletal domains. Our data suggest that IL-23 inhibitors may be helpful in combination with current standard of care in alleviating arthritis, renal and cutaneous manifestations of the disease.

scholarly journals Pattern and Frequency of Anti-nuclear Antibody Positivity in Paediatric Rheumatic Diseases

2019 ◽  
Vol 43 (1) ◽  
pp. 21-26
Author(s):  
Mohammad Imnul Islam ◽  
Kamrul Laila ◽  
Shahana A Rahman
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Staining Pattern ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Speckled Pattern ◽  
Nuclear Antigens ◽  
Antibody Positivity ◽  
Homogeneous Pattern ◽  
Paediatric Rheumatic Diseases

Background: Anti-nuclear antibodies (ANAs) are specific antibodies directed against a variety of nuclear antigens detected in the serum of patients with many rheumatic and non-rheumatic diseases.These antibodies are not only involved in the pathogenesis, but also constitute the basis for diagnosis and treatment of paediatric rheumatic diseases. The objective of the study was to identify the patterns and frequency of ANA positivity in Paediatric Rheumatic Diseases. Methodology: It was a retrospective study. Fourteen hundred and sixty eight records of paediaric rheumatology patients were analyzed. Statistical analysis were done to observe the frequency and association of different patterns of ANA in Juvenile idiopathic arthritis and systemic lupus erythematosus patients. Results: Among the 1468 patients of PRDs, frequency of JIA cases was the highest (65 %) followed by SLE, Scleroderma, juvenile dermatomyositis, and others. Among the 261 PRD patients ANA positivity was 65%. ANA positivity was 100%, 92%, 40% and 31.5% in Mixed connective tissue disease, SLE, JDM and Scleroderma patients respectively. Homogenous staining pattern was found in 59% and speckled pattern in 22.9%. There was significant association between ANA positivity and uveitis in oligoarticular JIA patients. Significant association was also found between homogeneous patterns of ANA and renal involvement in SLE patients. Conclusion: ANA positivity was highest in MCTD cases followed by SLE cases. Majority of SLE cases had homogeneous pattern of ANA.Staining patterns of ANA had significant association with the clinical manifestations in SLE and JIA cases. Bangladesh J Child Health 2019; VOL 43 (1) :21-26

scholarly journals Onset of systemic lupus erythematosus after conversion of infliximab to adalimumab treatment in rheumatoid arthritis with a pre-existing anti-dsDNA antibody level

Rheumatology ◽  
2006 ◽  
Vol 45 (10) ◽  
pp. 1317-1319 ◽  
Author(s):  
A. W. A. M. van Rijthoven ◽  
J. W. J. Bijlsma ◽  
M. Canninga-van Dijk ◽  
R. H. W. M. Derksen ◽  
J. A. G. van Roon
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Antibody Level ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Dsdna Antibody ◽  
Adalimumab Treatment

Prevalence and Risk Factors for Liver Biochemical Abnormalities in Canadian Patients with Systemic Lupus Erythematosus

2011 ◽  
Vol 39 (2) ◽  
pp. 254-261 ◽  
Author(s):  
DARRYL HUANG ◽  
ELAHEH AGHDASSI ◽  
JIANDONG SU ◽  
JEFFREY MOSKO ◽  
GIDEON M. HIRSCHFIELD ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Laboratory Data ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Related Factors ◽  
University Of Toronto ◽  
American College Of Rheumatology ◽  
Dsdna Antibody ◽  
Biochemical Abnormalities

Objective.To determine the prevalence of abnormal liver enzymes in patients with systemic lupus erythematosus (SLE) and whether further investigations were done, and the differences in SLE-related and/or metabolic factors in patients with and without liver biochemical abnormalities.Method.Patients from the University of Toronto Lupus Clinic who met at least 4 of the American College of Rheumatology classification criteria for SLE and had 1.5 times the upper limit for aspartate transaminase or alanine transaminase on 2 consecutive visits within a 2-year period were matched with controls for age, sex, and SLE duration. Demographic, clinical, and laboratory data were extracted at the time of the first appearance of liver enzyme abnormality for the cases and at the reference point for the controls.Results.From the 1533 patients reviewed, 134 (8.7%) met the inclusion criteria. Thirty of these patients were evaluated by a hepatologist, 75 had imaging studies (41 were done specifically for liver investigation), and 13 had liver biopsies. Results based on these investigations showed 31 fatty livers, 35 cases of drug-induced hepatotoxicity, 10 autoimmune etiologies, and 3 cases of viral hepatitis. Compared to controls, cases were higher in body mass index, anti-dsDNA antibody, prevalence of hypertension, antiphospholipid syndrome, and use of immunosuppressive medication, especially azathioprine and methotrexate; they were lower in IgM.Conclusion.Metabolic abnormalities such as obesity and hypertension and hepatotoxic effects of medication used to treat SLE may contribute more than SLE-related factors to liver biochemical abnormalities in patients with SLE.

TCONS_00483150 as a novel diagnostic biomarker of systemic lupus erythematosus

Epigenomics ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 973-988
Author(s):  
Gangqiang Guo ◽  
Aqiong Chen ◽  
Lele Ye ◽  
Huijing Wang ◽  
Zhiyuan Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Noncoding Rnas ◽  
Differentially Expressed ◽  
Healthy Controls ◽  
Diagnostic Biomarker ◽  
Systemic Lupus ◽  
Functional Roles ◽  
Antibody Positivity

Aim: We aimed to identify differentially expressed Long noncoding RNAs (lncRNAs) and explore their functional roles in systemic lupus erythematosus (SLE). Materials & methods: We identified dysregulated lncRNAs and investigated their prognostic values and potential functions using MiRTarget2, catRAPID omics and Bedtools/blast/Pearson analyses. Results: Among the 143 differentially expressed lncRNAs, TCONS_00483150 could be used to distinguish patients with SLE from healthy controls and those with rheumatoid arthritis and patients with active/stable SLE from healthy controls. TCONS_00483150 was significantly correlated with anti-Rib-P antibody positivity and low C3 levels; TCONS_00483150 dysregulation might contribute to the metabolism of RNA and proteins in SLE patients. Conclusion: Overall, our findings offer a transcriptome-wide overview of aberrantly expressed lncRNAs in patients with SLE and highlight TCONS_00483150 as a potential novel diagnostic biomarker.

Development of sulfasalazine-associated drug-induced lupus erythematosus in patient with rheumatoid arthritis (clinical case)

2021 ◽  
pp. 26-29
Author(s):  
A. N. Kovshik ◽  
E. P. Kiseleva ◽  
N. G. Klyukvina ◽  
G. V. Lukina
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Drug Induced ◽  
Reliable Diagnosis ◽  
Term Administration ◽  
Lupus Syndrome

Drug-induced lupus syndrome (DLS) is a rare adverse event with a variety of drugs. More than a hundred of drugs are known that can cause the development of DLS, and this list is growing as new drugs appear. Physicians of any specialty can face such complications of therapy and should be aware of this pathology. The article presents an analysis of a clinical case of DLS development against the background of long-term administration of sulfasalazine in a patient with a reliable diagnosis of rheumatoid arthritis, as well as a literature review, which includes data on the prevalence, drug groups, clinical manifestations, diagnosis and treatment of this pathology.

Sign in / Sign up

Export Citation Format

Share Document