Determination Of Rheumatoid Factor Research Articles

TREATMENT OF JUVENILE IDIOPATHIC ARTHRITIS WITH SYSTEMIC MANIFESTATIONS WITH INTERLEUKIN INHIBITORS-1 (CLINICAL CASE)

The purpose of this study is to evaluate the effectiveness of the treatment of juvenile idiopathic arthritis with systemic manifestations with interleukin-1 (IL-1) inhibitors. Material and methods. A prospective analysis of the course of systemic juvenile idiopathic arthritis was performed in a 15-year-old patient; she was examined using laboratory and instrumental methods before and after therapy with the interleukin-1 (IL-1) inhibitor canakinumab. Laboratory examination included general and biochemical blood tests, determination of rheumatoid factor, C-reactive protein, lactate dehydrogenase, procalcitonin, antinuclear antibodies, anti-citrullinated peptide (ACCP) antibody titer, antistreptolysin-O titer. The patient underwent ECG, echocardiography (EchoCG), ultrasound examination of the pleural cavities, abdominal organs, kidneys, knee joints, radiography of the chest cavity organs and radiography of the hand, computed tomography of the chest and abdominal cavities. Results. Examination of the patient revealed: synovitis of the knee joints, bilateral pleurisy and pericarditis, positive markers of the inflammatory process, characteristic of juvenile idiopathic arthritis with systemic manifestations. The patient was diagnosed with leukocytosis up to 20.3×109/l with a stab shift of leukocytes up to 18%, an increase in the erythrocyte sedimentation rate of 55 mm/h, an increase in C-reactive protein up to 288 mg/l, lactate dehydrogenase up to 500 units/l, in the analyzes urine revealed moderate hematuria and proteinuria. X-ray examination revealed structural changes in the knee and interphalangeal joints. We observed the effectiveness of canakinumab therapy. During therapy with canakinumab, after the second injection, positive dynamics was noted: leukocytes 5.1 × 109/l, ESR 6 mm/h, CRP 12 mg/l, relief of symptoms of the disease. Conclusions. During therapy with canakinumab, the patient showed positive clinical and laboratory dynamics of the disease. The study demonstrated the effectiveness of interleukin-1 (IL-1) inhibitors, canakinumab, in achieving remission of the disease.

Rheumatic aspects of arthralgias associated with aromatase inhibitor therapy (analysis of a clinical case series)

Objective: to describe the rheumatic aspects of arthralgia associated with aromatase inhibitor therapy in a clinical case series.Material and methods. The article presents a series of clinical cases – 16 patients (mean age 61±14 years) with histologically verified breast cancer (BC) and the onset of musculoskeletal pathology during hormone therapy with aromatase inhibitors (letrozole, anastrozole, exemestane). The laboratory and instrumental examination data, including ultrasound, joint X-rays, general and immunological blood tests with the determination of rheumatoid factor (RF), antibodies to cyclic citrullinated peptide (ACCP), CRP and antinuclear factor (ANF) are presented. The detected musculoskeletal pathology was compared with valid classification and/or diagnostic criteria for rheumatic diseases.Results and discussion. In 10 (63%) cases, musculoskeletal pathology debuted in the first 3 months of therapy with aromatase inhibitors and in all patients it was represented by inflammatory manifestations, including clinically significant synovitis (n=13), tenosynovitis (n=12), enthesitis (n=5), morning stiffness in the joints >30 min (n=6) and inflammatory rhythm lower back pain (n=1). In 15 (94%) patients, ultrasound showed signs of synovitis (with increased vascularization in 5 cases), tenosynovitis in 15 (94%), and erosions in 1 (6%). X-rays showed osteoarthritis in 12 patients, and chronic erosive arthritis in 2. Increased ESR >30 mm/h and CRP level >5 mg/l were present in 6 (38%) and 7 (44%) patients, respectively; ANF (Hеp2) titer 1/160 was found in 8 (53%) out 15 examined patients. RF and ACCP were not detected in any case. During rheumatological examination, the following were diagnosed: polymyalgia rheumatica (n=1), undifferentiated arthritis (n=6), psoriatic arthritis (n=1), rheumatoid arthritis (n=1), recurrent proliferative synovitis of the knee joints with a pronounced exudative component (n=3), inflammatory lesions of periarticular tissues (n=4).Conclusion. Based on the obtained data, it can be assumed that arthralgias induced by breast cancer hormone therapy may be a manifestation of inflammatory diseases of the musculoskeletal system. Given the heterogeneity of manifestations of musculoskeletal pathology in such patients, a complete rheumatological examination is necessary to establish the diagnosis and conduct adequate therapy.

Pediatric acute-onset neuropsychiatric syndrome: clinical/laboratory characteristics

Based on the current conceptions on the genesis of hyperkinetic syndromes in children and adolescents, to single out a group of patients with suggestive PANS, compare clinical and laboratory results and determine clinical/laboratory characteristics of this syndrome. Sixty-nine patients with tics were studied using neurological examination, questionnaires and international scales for assessment of tics, obsessive-compulsive disorders and attention deficit hyperactivity disorder (ADHD). Laboratory tests included general blood tests, antistreptolysin O test, determination of rheumatoid factor, C-reactive protein, circulating immune complexes, nasopharyngeal wash for β-hemolytic streptococcus, antineuronal antibodies and immunoglobulins A, M, G, E, CD4, CD8-lymphocytes. The same tests were performed in the control group. Clinical symptoms were different by the severity and phenomenology of tic hyperkineses in patients with PANS compared to the patients with tics without immune disorders. Most of the patients were diagnosed with Tourette syndrome. ADHD was the most common diagnosis in the PANS group. Its frequency was 2.5 higher in the male patients. A chronic focus of infection did no predict the development of PANS. Based on the laboratory results, one can assume that β-hemolytic streptococcus A infection, lower JgM levels and an elevated CD8+ lymphocytes predict the development of autoimmune mental and neurological disorders in the group of PANS patients.

Highly sensitive capillary electrophoretic immunoassay of rheumatoid factor in human serum with gold nanoparticles enhanced chemiluminescence detection

A new CE-based immunoassay method for the determination of rheumatoid factor was developed using chemiluminescent reaction of luminol and hydrogen peroxide catalyzed by gold nanoparticles (AuNPs). In this method, AuNPs were synthesized and conjugated with anti-RF (antibody, Ab) to form tagged Ab (AuNPs-Ab, Ab*), which subsequently linked to limited amount of RF (antigen, Ag) to produce Ab*-Ag complex by a noncompetitive immunoreaction. AuNPs were used to label antibody and amplify chemiluminescent signal. Under the optimized conditions, the mixture of free Ab* and Ab*-Ag complex was well separated and detected. This method yields a wide linear range of 0.01-20 μg/mL with a correlation coefficient of 0.997, and the detection limit of RF reaches 5.95 ng/mL (ca. 6.0 pmol/L, S/N = 3). The proposed method was successfully applied for the quantification of RF in human sera from patients with rheumatoid arthritis. This highly sensitive and selective method could be developed into a promising and useful technique for biological molecules determination in clinical analysis.

Viruses and Arthritis: New Challenges in Diagnosis, Therapy, and Immunization

BackgroundAlthough many viruses produce musculoskeletal symptoms during an acute infection, a long-term inflammatory arthritis remains an unusual consequence. When evaluating arthritis in a patient with a chronic or latent viral infection, serologic testing and therapeutic options are significantly altered. ResultsThe example of hepatitis C reveals how chronic infection can complicate the diagnosis of rheumatoid arthritis. Determination of rheumatoid factor is of limited utility, whereas the anticyclic citrullinated peptide has become a new test with improved specificity. Therapeutic options are severely constrained because of potential hepatotoxicity of oral agents such as methotrexate and leflunomide. Antitumor necrosis factor α biologics have demonstrated initial safety in the setting of hepatitis C virus but may be associated with reactivation of hepatitis B virus. Biologics such as abatacept and rituximab have been inadequately studied in this population to date. Prevention of viral infections by influenza and herpes zoster vaccines in rheumatoid arthritis patients needs improved administration rates and careful planning to maximize efficacy. ConclusionsChronic viral infections complicate the diagnosis and therapy of inflammatory arthritis. The antitumor necrosis factor α biologics have become important therapeutic options for patients with hepatitis C. Vaccination against influenza and herpes zoster are underused in health maintenance of arthritis patients.

Connective tissue markers of rheumatoid arthritis

Rheumatoid arthritis (RA) is a common systemic autoimmune disorder of unknown aetiology. The most common outcome of RA is a progressive development of joint destruction and deformity. Early introduction of disease-modifying antirheumatic drugs seems important for prevention of the long term injuries of articular cartilage and bone. Early diagnosis and selection of patients with rapidly progressive disease therefore is of clinical significance. Routine laboratory tests are valuable in monitoring for renal, hepatic and haematological side effects of medical treatment. Determination of rheumatoid factor contributes to the classification of arthritis as RA, and acute phase reactants are useful for quantifying and comparing the level of inflammatory activity in the course of a given patient. There is, however, a lack of sensitive and specific biochemical markers for RA, and frontline biochemical research is devoted to characterizing molecules which are of diagnostic and prognostic value, as well as molecules which are indicators of the degree of joint cartilage and bone destruction. The present survey summarizes current knowledge concerning possible tissue-specific marker molecules of RA.