Association of CXCL13 serum level and ultrasonographic findings of joints in patients with systemic lupus erythematosus and Jaccoud’s arthropathy

Ribeiro, Dlds; Lins, Carolina Freitas; Galvão, Verena; Santos, Willer Gonçalves Dourado; Rosa, Genevievi; Machicado, Viviane; Pedreira, Ana Luisa Souza; Fonseca, E P da; Souza, A P Mota Duque; Baleeiro, Carla; Ferreira, L G; Oliveira, Ilka Regina Souza de; Silva, J P Cotrim Gama da; Atta, Ajax Mercês; Santiago, MB

doi:10.1177/0961203317753557

“…Both patients were negative for ACPA and RF; however, the synovitis, ESR, and CRP status of the patients were not mentioned, and therefore, RA diagnosis cannot be excluded. Similar flaws appeared in the findings of Ribeiro et al, Lins et al, and Sá Ribeiro et al 16 , 21 , 22 …”

Section: Discussionsupporting

confidence: 87%

“…Both patients were negative for ACPA and RF; however, the synovitis, ESR, and CRP status of the patients were not mentioned, and therefore, RA diagnosis cannot be excluded. Similar flaws appeared in the findings of Ribeiro et al, Lins et al, and Sá Ribeiro et al 16,21,22 While there are currently no diagnostic criteria for RA, classification criteria can be used to assist the diagnosis. 23 When a JA patient has more than 10 joints involved, accompanied by synovitis and elevated CRP levels or ESR, RA can be diagnosed according to the 2010 American College of Rheumatology (ACR)/European Alliance of Association for Rheumatology RA classification criteria.…”

Section: Discussionsupporting

confidence: 63%

Case report: Joint deformity associated with systemic lupus erythematosus

Chen

¹

,

Zheng

²

,

Zhang

³

et al. 2022

Immunity Inflam & Disease

2

0

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Objective Typically, Jaccoud arthropathy (JA) is characterized by joint deformation without bone erosion. However, some recent studies have shown that bone erosion also occurs in JA; however, this remains controversial. To date, there have been no unified diagnostic standards for JA. Herein, we report a case of systemic lupus erythematosus complicated with JA without bone erosion. Methods A 27‐year‐old woman was admitted to our department with a 2‐year history of pain, swelling, and progressive deformities of her hands and feet. She was diagnosed with systemic lupus erythematosus and class V lupus nephritis 5 years prior. Upon examination, her erythrocyte sedimentation rate and C‐reactive protein levels were found to be increased. She was positive for antinuclear antibodies, antidouble stranded DNA antibodies, and antiextractable nuclear antigen antibodies, with a decreased complement C3 and C4. Radiography and magnetic resonance imaging revealed no bone erosion. The patient was diagnosed with JA. She was treated with oral prednisone (10 mg daily), tofacitinib (5 mg twice daily), methotrexate (10 mg weekly), and celecoxib (0.2 g twice daily). Results The patient's joint symptoms improved after treatment. No further progress was observed during the 4‐month follow‐up period. Conclusion We believe that bone erosion is the key to distinguish rhupus syndrome from JA. However, this needs to be confirmed with further long‐term follow‐up studies. We found that the use tofacitinib, MTX, and celecoxib in combination with prednisone may be an effective regimen for the treatment of JA.

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“…Lower extremity vascular diseases in patients with diabetes mellitus generally cannot be detected clinically in the early stages due to the common complications of neuropathy [ 2 , 3 ]. Patients with diabetes mellitus usually are unaware of the fact that the early progress of lower extremity vascular disease is due to the loss of pain and the decreasing frequency of intermittent claudication, until the symptoms get worsen and the disease turns into an ulcer or gangrene, which usually occurs at the last stage of the lower extremity vascular disease and eventually leads to amputation [ 4 , 5 ]. Therefore, the early diagnosis and treatment of diabetes patients requires the index of early lower extremity vascular disease, which helps in avoiding amputation and in improving the living quality of patients [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Lower Extremity Vascular Disease, Coronary Artery, and Carotid Artery Atherosclerosis in Patients with Type 2 Diabetes Mellitus

Zheng

¹

,

Han

²

,

Zhang

³

et al. 2021

Computational and Mathematical Methods in Medicine

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The motive of this article is to present the case study of patients to investigate the association between the ultrasonographic findings of lower extremity vascular disease (LEAD) and plaque formation. Secondly, to examine the association between the formation of coronary artery and carotid artery atherosclerosis in patients with type 2 diabetes mellitus. 124 patients with type 2 diabetes (64 males and 60 females with the age group 25-78 years) are considered for the research studies who have registered themselves in the Department of Endocrinology and Metabolism from April 2017 to February 2019. All participants have reported their clinical information regarding diabetes, alcohol consumption, smoking status, and medication. The blood samples from subjects are collected for measurement of HbA1c, total cholesterol, triglycerides, HDL-c, and LDL-c levels. Two-dimensional ultrasound has been used to measure the inner diameter, peak flow velocity, blood flow, and spectral width of the femoral artery, pop artery, anterior iliac artery, posterior tibial artery, and dorsal artery and to calculate the artery stenosis degree. Independent factors of atherosclerosis are determined by multivariate logistic regression analysis. The results are evaluated within the control group and it is found that there is no significant impact of gender, age, and body mass index ( P > 0.05 ) on the lower extremity vascular diseases. Those with smoking, alcohol consumption, hypertension, and dyslipidemia have higher positive rate ( P < 0.05 ). The type 2 diabetes mellitus group has higher diastolic blood pressure and lower triglyceride ( P < 0.05 ). Diastolic blood pressure, HbA1C, total cholesterol, HDL-c, and LDL-C are not remarkably dissimilar between the type 2 diabetes mellitus group and the control group ( P > 0.05 ). Compared with the control group, the type 2 diabetes mellitus group has higher frequency of lower extremity vascular diseases in the dorsal artery than in the pop artery ( P < 0.05 ). The blood flow of type 2 diabetes mellitus group is found to be lower than that of the control group, especially in the dorsal artery ( P < 0.05 ). The blood flow velocity of the dorsal artery is accelerated ( P < 0.01 ). Among 117 patients of type 2 diabetes mellitus (94.35%) with a certain degree of injury, there are 72 cases of type I carotid stenosis (58.06%), 30 cases of type II carotid stenosis (24.19%), and 15 cases of type III carotid stenosis (12.10%). Out of 108 subjects in the control group, there are 84 cases of type 0 carotid stenosis (77.78%), 19 cases of type I carotid stenosis (17.59%), 5 cases of type II carotid stenosis (4.63%), and 0 case of type III carotid stenosis (0.00%). Compared with the control group, carotid stenosis is more common in patients with type 2 diabetes mellitus ( P < 0.05 ). Age, smoking, duration of diseases, systolic blood pressure, and degree of carotid stenosis are found to be associated with atherosclerosis. The findings suggest that the color Doppler ultrasonography can give early warning when applied in patients with carotid and lower extremity vascular diseases to delay the incidence of diabetic macroangiopathy and to control the development of cerebral infarction, thus providing an important basis for clinical diagnosis and treatment.

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“…Interestingly, CXCL10/13 levels were not uniformly increased across the SLE cohort but appeared to be restricted to a subset of patients who were more likely to have serologically active disease (high anti-dsDNA and low complement) and inflammatory arthritis. Recently a small study by Ribeiro et al (2018) identified that patients with SLE with Jaccoud’s arthropathy were significantly more likely to be ds-DNA positive and tended to have higher CXCL13 levels, although in this study there was no association between CXCL13 and synovitis or the arthritis component of the SLEDAI score [ 16 ]. CXCL13 has also been identified in the serum of patients with rheumatoid arthritis where it is associated with active disease [ 17 ].…”

Section: Discussionmentioning

confidence: 74%

Cytokine profiling in active and quiescent SLE reveals distinct patient subpopulations

Reynolds

¹

,

McCarthy

²

,

Haque

³

et al. 2018

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BackgroundPatients with SLE display marked clinical and immunlogical heterogeneity. The purpose of the study was to investigate patterns of serum cytokines in patients with active and stable systemic lupus erythematosus (SLE) and to determine how they relate to clinical phenotype.MethodsSerum levels of 10 cytokines were measured retrospectively in a cohort of patients with SLE and in healthy controls using a high-sensitivity multiplex bead array. Disease activity was determined using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and British Isles Lupus Assessment Group (BILAG-2004) indices. Logistic regression models were used to determine the association between cytokine levels and active SLE. Principal component analysis (PCA) and cluster analysis was then used to identify subgroups of patients on the basis of cytokine levels.ResultsSerum chemokine (C-X-C motif) ligand 10 (CXCL10) and CXCL13 were significantly higher in patients with SLE compared to healthy controls. Two cytokines (pentraxin-related protein (PTX3) and CXCL10) were significantly higher in patients with active disease after adjustment for potential confounding factors. Measurement of four cytokines (CXCL10, IL-10, IL-21 and PTX3) significantly improved the performance of a model to identify patients with clinically active disease. Cluster analysis revealed that the patients formed 3 distinct groups, characterised by higher levels of interferon alpha (IFNα) and B lymphocyte stimulator (BLyS) (group 1), increased CXCL10 and CXCL13 (group 2) or low levels of cytokines (group 3). Group 2 had significantly lower serum complement and higher anti-double-stranded DNA antibodies and increased prevalence of inflammatory arthritis.ConclusionsMultiplex analysis has identified a serum cytokine signature for active SLE. Within the SLE population distinct cytokine subgroups were identified, with differing clinical and immunological phenotypes that appeared stable over time. Assessment of cytokine profiles may reveal unique insights into disease heterogeneity.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1666-0) contains supplementary material, which is available to authorized users.

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Association of CXCL13 serum level and ultrasonographic findings of joints in patients with systemic lupus erythematosus and Jaccoud’s arthropathy

Cited by 8 publications

References 31 publications

Case report: Joint deformity associated with systemic lupus erythematosus

Case report: Joint deformity associated with systemic lupus erythematosus

Association of Lower Extremity Vascular Disease, Coronary Artery, and Carotid Artery Atherosclerosis in Patients with Type 2 Diabetes Mellitus

Cytokine profiling in active and quiescent SLE reveals distinct patient subpopulations

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