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Severe infection constitutes a predictor of poor prognosis in SLE patients, is more common in Latin-Americans and is associated with age, previous infection, and smoking. Antimalarials exerted a protective effect.

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Objective. Previous studies have shown either a lack of effect of IRF5 polymorphisms or an association of the IRF5 gene in only a minor subset of rheumatoid arthritis (RA) patients in whom anti-citrullinated protein antibodies (ACPAs) are absent. The present study was undertaken to investigate the role of genetic variation in IRF5 in susceptibility to RA.Methods. Nine IRF5 single-nucleotide polymorphisms (SNPs) were studied in 1,338 patients with RA and 1,342 control subjects in analyses of exploratory and replication sample collections, with stratification according to sex and by the presence or absence of ACPAs, rheumatoid factor, the shared epitope, the 620W PTPN22 allele, and erosions. A meta-analysis that included results from previous studies was also carried out.Results. Our findings together with those from previous studies, in a total of 4,620 RA patients and 3,741 controls, showed a significant association of the rs2004640 IRF5 SNP in RA patients as a whole (odds ratio [OR] 0.88, 95% confidence interval [95% CI] 0.83-0.94; P ‫؍‬ 6.5 ؋ 10 ؊5 versus controls). This association was stronger in ACPA؊ patients, but was also present in ACPA؉ patients (from 3 sample collections). Further analysis of our exploratory sample collection showed that only patients in the ACPA؉ and SE؊ group lacked an association with IRF5 SNPs. All of the remaining RA patients (ACPA؊ or SE؉) showed a strong association with IRF5 SNPs, which followed a complex pattern of opposing effects mediated by independent haplotypes. The susceptibility haplotype showed an OR of 1.8 (95% CI 1.4-2.3; P ‫؍‬ 1.2 ؋ 10 ؊6 versus controls), whereas the protective haplotype showed an OR of 0.76 (95% CI 0.6-0.98; P ‫؍‬ 0.046 versus controls).Conclusion. IRF5 polymorphisms seem to influence RA susceptibility in a large subgroup of patients, following a pattern of association very similar to that described in patients with systemic lupus erythematosus.

Patient-assessed and physician-assessed overall RA activity showed acceptable agreement. Patient self-assessment overestimated disease activity determined by the DAS28. At the patient level, physician-assessed joint swelling showed an acceptable concordance with Doppler US synovitis.

Objective. To compare the prevalence of the main comorbidities in 2 large cohorts of patients with primary Sj€ ogren's syndrome (SS) and systemic lupus erythematosus (SLE), with a focus on cardiovascular (CV) diseases. Methods. This was a cross-sectional multicenter study where the prevalence of more relevant comorbidities in 2 cohorts was compared. Patients under followup from SJOGRENSER (Spanish Rheumatology Society Registry of Primary SS) and RELESSER (Spanish Rheumatology Society Registry of SLE), and who fulfilled the 2002 American-European Consensus Group and 1997 American College of Rheumatology classification criteria, respectively, were included. A binomial logistic regression analysis was carried out to explore potential differences, making general adjustments for age, sex, and disease duration and specific adjustments for each variable, including CV risk factors and treatments, when appropriate. Results. A total of 437 primary SS patients (95% female) and 2,926 SLE patients (89% female) were included. The mean age was 58.6 years (interquartile range [IQR] 50.0-69.9 years) for primary SS patients and 45.1 years (IQR 36.4-56.3 years) for SLE patients (P < 0.001), and disease duration was 10.4 years (IQR 6.0-16.7 years) and 13.0 years years), respectively (P < 0.001). Smoking, dyslipidemia, and arterial hypertension were associated less frequently with primary SS (odds ratio Conclusion. Primary SS patients have a consistently less serious CV comorbidity burden and a lower prevalence of severe infection than those with SLE. In contrast, their risk of lymphoma is greater.[

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We have studied sera from 44 children with Human Immunodeficiency Virus infection and Acquired Immunodeficiency Syndrome using immunoblotting, radioimmunoassay, enzymoimmunoassay and indirect immunofluorescence. We have detected a low incidence of antinuclear (2.9%), anti‐reticulin (2.9%) and anti‐smooth muscle (14.7%) antibodies by indirect immunofluorescence. By enzymoimmunoassay we have detected anti‐dsDNA (20.5%) and anti‐ENA [anti‐nRNP (61.3%), anti‐Sm (29.5%), anti‐Ro (47.7%) and anti‐La (18.1%)] antibodies. Tests for anti‐dsDNA by radioimmunoassay were negative, suggesting the presence of low‐avidity anti‐DNA antibodies. By immunoblotting we have detected anti‐C (nRNP) (33.3%), anti‐BB′ (Sm) (33.3%), anti‐Ro (60 KD) (4.5%) and anti‐La (11.3%) antibodies. The presence of anti‐Ro antibodies was associated with progressive neurological disease. Long‐term follow‐up studies with larger numbers of patients are necessary to evaluate the clinical significance of the presence of anti‐dsDNA and anti‐ENA antibodies in children infected with Human Immunodeficiency Virus.