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송정수 ( Jung Soo Song ),박금보래 ( Geum Borae Park ),박애자 ( Ae Ja Park ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.3
Objective: Serologic support is important for the diagnosis of rheumatoid arthritis (RA). Anti-cyclic citrullinated peptide (anti-CCP) has relatively low sensitivity despite of high specificity for the diagnosis of RA. Anti-mutated citrullinated vimentin (anti-MCV) is an indirect solid phase enzyme immunoassay for the quantitative measeurement of IgG class autoantibodies against MCV, a novel serologic marker for an aid in the diagnosis of RA. We investigated a diagnostic value of anti-MCV in comparison with those of anti-CCP, and rheumatoid factors (IgM, IgG, and IgA RFs) in RA patients. Methods: Cohorts of 48 patients with RA and 50 patients with osteoarthritis (OA) were enrolled. All patients underwent standard examinations, including anti-MCV, anti-CCP, IgM RF, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). We measured IgG RF and IgA RF titers in 21 RA and 50 OA patients. The sensitivities and specificities of anti-MCV, anti-CCP, RFs were determined. Correlations with these markers, ESR and CRP were analyzed. Results: The sensitivity of anti-MCV, anti-CCP, and IgM RF were 89.6%, 89.6%, and 77.1%, respectively. The specificities of them were 96.0%, 96.0%, and 88%, respectively. Combination of two tests such as anti-MCV or anti-CCP positivity increased the sensitivity up to 93.8%. None of these markers showed significant correlation with ESR and CRP. Anti-MCV correlated with anti-CCP (r=0.596, p<0.01) and IgM RF (r=0.301, p=0.038). Conclusion: Anti-MCV and anti-CCP showed high sensitivity and specificity for the diagnosis of RA. Combination of these markers increased the sensitivity without significant decrease in the specificity, suggesting they may be promising serologic markers for RA.
루푸스 방광염과 azathioprine에 의한 진성 적혈구 감소증이 병발된 전신성 홍반성 루푸스 1예
구태연 ( Tai Yeon Koo ),김현정 ( Hyun Jung Kim ),김경민 ( Kyung Min Kim ),오동규 ( Dong Kyu Oh ),박금보래 ( Geum Borae Park ),이상구 ( Sang Koo Lee ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.1
We report a case of lupus cystitis as the manifestation of lupus flare, and pure red cell aplasia resulting from the use of azathioprine in a patient with systemic lupus erythematosus (SLE). A 30-year-old female with a nine-year history of SLE was admitted to our hospital with complaint of anemia and azotemia. Eighteen and three months before, she had two episodes of lupus enteritis treated with high dose steroid. She had serologic evidence of an SLE flare at admission. Abdominal computed tomography revealed bilateral hydronephrosis and hydroureter with marked diffuse thickening of the urinary bladder wall, suggesting lupus cystitis. Treatment with corticosteroid led to prompt normalization of her renal function. Use of azathioprine may lead to severe anemia. The bone marrow examination revealed a decrease of erythropoiesis, suggesting pure red cell aplasia. Serologic tests for hepatitis B and parvovirus B19 were negative. There was immediate hemoglobin recovery after complete azathioprine discontinuation.