Systemic Lupus Erythematosus In Remission Research Articles

Studies of anti-F(ab')2 antibodies and possible immunologic control mechanisms in systemic lupus erythematosus.

Studies of anti-DNA and anti-F(ab')2 antibodies were performed by enzyme-linked immunosorbent assay in 51 patients with systemic lupus erythematosus (SLE). Patients with severe, uncontrolled disease showed high levels of anti-DNA and low levels of anti-F(ab')2 antibodies. Patients with quiescent SLE usually showed high levels of anti-F(ab')2 and low levels of anti-DNA antibodies. Isolated anti-F(ab')2 antibodies from autologous SLE remission serum or from the sera of unaffected siblings of SLE patients showed maximum inhibition in test systems using affinity-purified SLE anti-DNA antibodies reacting with single-stranded DNA.

Acute Respiratory Distress in a Child After Steroid-Induced Pancreatitis

Acute pancreatitis is a well-known but rare complication of corticosteroid therapy in both children1-3 and adu1ts.4,5 In adults, respiratory insufficiency may follow the onset of acute pancreatitis.6-8 This report describes a child with systemic lupus erythematosus (SLE) in whom acute respiratory distress developed after steroid-induced pancreatitis. CASE REPORT A 12-year-old girl with SLE in remission (maintenance therapy, 60 mg of prednisone on alternate days) was admitted to the University of California Los Angeles Hospital with a one-week history of fever, dysuria, facial rash, and joint pain. A urinary tract infection was detected and the patient was placed on a regimen of antibiotics.

Clinical studies of hemolytic complement and the 11S component

The availability of an antiserum specific for the 11S factor (C′ 1q), one of the three parts of the first component of complement (C′), permitted estimation of 11S by a simple immunodiffusion method. The 11S concentration of normal human serum was in the range of 18 to 28 γ of 11S nitrogen per cc. Since this component is fixed and removed during complement fixation, 11S levels were compared with total hemolytic complement activity in systemic lupus erythematosus, glomerulonephritis and other conditions possibly involving immune mechanisms. In most patients with active systemic lupus erythematosus, both 11S and C′ levels were low. In subjects with systemic lupus erythematosus in remission, both 11S and C′ tended to be near normal, but slightly lowered C′ levels were not always reflected by 11S measurements. (The 11S concentration, like total C′, is an acute phase reactant, increased in inflammatory states.) In other illnesses, correlation was poor although C′ activity was always diminished when 11S was low. Possible reasons for these discrepancies are discussed and current thoughts on the role of C′ in the pathogenesis of these conditions are reviewed.

SMOOTH MUSCLE OF THE PERIORBITA AND THE MECHANISM OF EXOPHTHALMOS

Fetal wastage is still high in the pregnancies of patients with systemic lupus erythematosus (SLE). We examined retrospectively the cases of 38 patients with inactive SLE in whom pregnancy was either desired or had already been obtained. The prevalence of antiphospholipid antibodies in the group with fetal loss was high. The antibodies were, however, also detected in five of 14 patients who had had a live birth. It was noted that low levels of serum complement activity (CH50 less than 25 U/ml) occurred in five of six patients with fetal loss, but in only two of 22 with a live birth. Serial studies also confirmed a close association between decreased serum complement activity and poor fetal prognosis in lupus pregnancy. Treatment with increased doses of prednisolone may help to achieve successful live births. Thus hypocomplementaemia may be associated with a worse prognosis for the fetus in the pregnancies of some patients with SLE in remission.