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Aggarwal A, Chandra T, Ladha P, Mittal S, Haldule S, Nirmal S, Edpuganti N, Jain N, Cavagna L, Zanframundo G, Faghihi-Kashani S, Aggarwal R. Heterogeneity in nomenclature and abbreviation usage for anti-synthetase syndrome: a scoping review. Rheumatol Int 2024:10.1007/s00296-024-05670-w. [PMID: 39212691 DOI: 10.1007/s00296-024-05670-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024]
Abstract
Anti-synthetase syndrome constitutes a dynamically evolving subset of Idiopathic Inflammatory Myopathy, however, the nomenclature and abbreviations for this syndrome are plagued by heterogeneity, leading to lack of consistency in literature. The objective of this study is to evaluate existing diversity in disease names and abbreviations, with a future goal to develop consensus on the nomenclature. A scoping review format was used for analysis. A comprehensive PUBMED search was conducted from January 1, 1984 (the initial description of anti-synthetase autoantibodies) to November 30, 2023, encompassing all pertinent articles published within this timeframe. Search terms included, ((antisynthetase syndrome) OR (anti synthetase syndrome)) OR (anti-synthetase syndrome)). The articles were screened for presence of terminology and abbreviations used. The search yielded 936 items with the specified terms. After excluding 303 irrelevant articles and 58 non-English publications, the remaining n = 575 articles underwent detailed review of the abstract and full article. Out of n = 575, 54.7% (n = 314) used 'antisynthetase syndrome' and 43.4% (n = 249) preferred 'anti-synthetase syndrome' with few novel names also. Among these, 394 articles used abbreviations while 181 did not. Most utilized term was ASS; in 64.7% (n = 255), followed AS in 11.9% (n = 47), ASSD in 9.9% (n = 39) and ASyS in 7.6% (n = 30). A discordance in nomenclature is evident, with about half using antisynthetase syndrome and other half using anti-synthetase syndrome. Moreover, significant heterogeneity exists in abbreviation use aswell. There is a pressing need to bridge this disparity and establish a uniform identifier for the disease with an objective to develop greater coherence in future research, educational initiatives, and interdisciplinary collaboration.
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Affiliation(s)
- Anushka Aggarwal
- Department of Rheumatology, Indraprastha Apollo Hospital, New Delhi, India
| | - Tanya Chandra
- Department of Medicine, Arthritis and Autoimmunity Center and UPMC Myositis Center, Division of Rheumatology and Clinical Immunology, School of Medicine, University of Pittsburgh, BST S 727, 3500 Terrace Street, Pittsburgh, PA, 15261, USA
| | - Parth Ladha
- Byramjee Jeejeebhoy Medical College, Pune, India
| | | | | | | | | | - Nakul Jain
- Netaji Subhash Institute of Technology, New Delhi, India
| | - Lorenzo Cavagna
- Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - Giovanni Zanframundo
- Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - Sara Faghihi-Kashani
- Department of Medicine, Arthritis and Autoimmunity Center and UPMC Myositis Center, Division of Rheumatology and Clinical Immunology, School of Medicine, University of Pittsburgh, BST S 727, 3500 Terrace Street, Pittsburgh, PA, 15261, USA
| | - Rohit Aggarwal
- Department of Medicine, Arthritis and Autoimmunity Center and UPMC Myositis Center, Division of Rheumatology and Clinical Immunology, School of Medicine, University of Pittsburgh, BST S 727, 3500 Terrace Street, Pittsburgh, PA, 15261, USA.
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Grzybowski A, Pawlikowska-Łagód K. Stefania Jabłońska (1920-2017): A giant in 20 th century dermatology. Clin Dermatol 2023; 41:772-780. [PMID: 37722550 DOI: 10.1016/j.clindermatol.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Stefania Jabłońska (1920-2017) is remembered as a physician extraordinaire, outstanding medical scientist, and superb professor of dermatology. She served as Professor and Chairman of Dermatology at the Warsaw Medical School. Not only is she one of the most cited of Polish physicians, she also was world renowned, being elected to honorary membership in innumerable dermatology societies. Jabłońska in 1972 was the first to describe the relationship between the human papillomavirus and skin cancer in epidermodysplasia verruciformis. She collaborated with Professor Gérard Charles Jacques Orth (1936-), with whom she characterized the molecular structure of the oncogenic virus to be the first to be discovered in dermatologic diseases. They also showed that a viral infection could not spread to people with different genetic patterns. For this discovery, Jabłońska and Orth in 1985 were awarded the Robert Koch Medal, which was presented to them by the President of the Federal Republic of Germany, Richard Karl Freiherr von Weizsäcker (1920-2015). Jabłońska is the only Polish scientist to be so honored.
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Affiliation(s)
- Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
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Satoh M, Ceribelli A, Hasegawa T, Tanaka S. Clinical Significance of Antinucleolar Antibodies: Biomarkers for Autoimmune Diseases, Malignancies, and others. Clin Rev Allergy Immunol 2022; 63:210-239. [PMID: 35258843 DOI: 10.1007/s12016-022-08931-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2022] [Indexed: 01/13/2023]
Abstract
Nucleolar staining is one of the standard patterns in immunofluorescence antinuclear antibodies (ANA), seen in 5-9% of ANA in various conditions. Antinucleolar antibodies (ANoA) are classified into 3 patterns in the International Consensus on ANA Patterns (ICAP) classification; AC-8 homogeneous pattern, AC-9 clumpy pattern, and AC-10 punctate pattern. Specificities known to show AC-8 include anti-Th/To, -PM-Scl, -nucleophosmin/B23, -nucleolin/C23, -No55, and others. AC-9 is seen by anti-fibrillarin/U3RNP and AC-10 by anti-RNA polymerase I and hUBF/NOR-90. ANoA has been classically known to be associated with scleroderma (SSc) and the characterization of nucleolar antigens identified several autoantigens recognized by SSc autoantibodies. The clinical association of anti-Th/To, PM-Scl, fibrillarin/U3RNP, and RNA polymerase I with SSc or SSc-overlap syndrome is well established, and commercial assays are developed. Anti-hUBF/NOR90, nucleophosmin/B23, and nucleolin/C23 are known for decades and reported in systemic autoimmune rheumatic diseases (SARDs), malignancies, graft versus host disease (GVHD), and others; however, their clinical significance remains to be established.
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Affiliation(s)
- Minoru Satoh
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, 1-1 Isei-gaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
| | - Angela Ceribelli
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano (Milan), 20089, Italy
- Department of Biomedical Sciences, Humanitas University, Via A. Manzoni 56, Pieve Emnuele (Milan), 20089, Italy
| | - Tomoko Hasegawa
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, 1-1 Isei-gaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Shin Tanaka
- Department of Human, Information and Sciences, School of Health Sciences, University of Occupational and Environmental Health, 1-1 Isei-gaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
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Fairley JL, Hansen D, Proudman S, Sahhar J, Ngian GS, Walker J, Strickland G, Wilson M, Morrisroe K, Ferdowsi N, Major G, Roddy J, Stevens W, Nikpour M. Clinical Features of Systemic Sclerosis-Mixed Connective Tissue Disease and Systemic Sclerosis Overlap Syndromes. Arthritis Care Res (Hoboken) 2020; 73:732-741. [PMID: 32058672 DOI: 10.1002/acr.24167] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 02/04/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To describe the clinical characteristics and outcomes of systemic sclerosis-mixed connective tissue disease (SSc-MCTD) and SSc overlap syndrome. METHODS We included patients from the Australian Scleroderma Cohort Study who met American College of Rheumatology/European Alliance of Associations for Rheumatology criteria for SSc. Three mutually exclusive groups were created: SSc-MCTD, SSc overlap, and SSc only. Univariate comparison of clinical features was performed by analysis of variance or chi-square test. Survival analysis was performed using Kaplan-Meier (KM) curves and Cox proportional hazards regression models. RESULTS Of 1,728 patients, 97 (5.6%) had SSc-MCTD, and 126 (7.3%) had SSc overlap. Those with MCTD-SSc were more commonly Asian (18.3% versus 10.1% in SSc overlap, and 3.6% in SSc only; P < 0.0001) and younger at disease onset (38.4 years versus 46.5 or 46.8 years, P < 0.0001). Those with SSc-MCTD or SSc overlap were more likely to have limited cutaneous SSc. All 3 groups had similar frequency of interstitial lung disease (ILD), although pulmonary arterial hypertension (PAH) was less common in SSc overlap. Synovitis and myositis were more common in SSc overlap and SSc-MCTD than in SSc only. KM curves showed better survival in SSc-MCTD than SSc overlap or SSc only (P = 0.011), but this was not significant after adjustment for sex and age at disease onset. SSc-specific antibodies were survival prognostic markers, with antinuclear antibody centromere or anti-RNP conferring better survival than anti-Scl-70 or anti-RNA polymerase III (P = 0.005). Patients with SSc-MCTD and SSc overlap had lower mortality following diagnosis of ILD and PAH than patients with SSc only. CONCLUSION This study provides insights into the clinical characteristics of patients with SSc-MCTD, SSc overlap, and SSc only and shows that anti-RNP antibodies are associated with better survival than anti-Scl-70 and anti-RNA polymerase III antibodies.
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Affiliation(s)
- Jessica L Fairley
- The Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Dylan Hansen
- St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Susanna Proudman
- Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne Sahhar
- Monash Health and Monash University, Melbourne, Victoria, Australia
| | - Gene-Siew Ngian
- Monash Health and Monash University, Melbourne, Victoria, Australia
| | - Jenny Walker
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Gemma Strickland
- St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Michelle Wilson
- St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | | | - Nava Ferdowsi
- St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Gabor Major
- Royal Newcastle Centre John Hunter Hospital and University of Newcastle, Newcastle, New South Wales, Australia
| | - Janet Roddy
- Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Wendy Stevens
- St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Mandana Nikpour
- St. Vincent's Hospital Melbourne, Melbourne, and The University of Melbourne at St Vincent's Hospital (Melbourne), Fitzroy, Victoria, Australia
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Ussavarungsi K, Nugent K, Gerke AK, Krasowski MD, Tuetken RS, Lenert PS. Interstitial lung disease associated with anti-PM-Scl antibody: A single center experience. Autoimmun Rev 2019; 18:102355. [DOI: 10.1016/j.autrev.2019.102355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/13/2019] [Indexed: 02/06/2023]
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Fotis L, Baszis KW, White AJ, French AR. Four Cases of Anti-PM/Scl Antibody-positive Juvenile Overlap Syndrome with Features of Myositis and Systemic Sclerosis. J Rheumatol 2018; 43:1768-9. [PMID: 27587018 DOI: 10.3899/jrheum.151445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Lampros Fotis
- Department of Pediatrics, Washington University in St. Louis School of Medicine;
| | - Kevin W Baszis
- Department of Pediatrics, Washington University in St. Louis School of Medicine
| | - Andrew J White
- Department of Pediatrics, Washington University in St. Louis School of Medicine
| | - Anthony R French
- Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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7
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Perosa F, Prete M, Di Lernia G, Ostuni C, Favoino E, Valentini G. Anti-centromere protein A antibodies in systemic sclerosis: Significance and origin. Autoimmun Rev 2015; 15:102-9. [PMID: 26455561 DOI: 10.1016/j.autrev.2015.10.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 10/04/2015] [Indexed: 02/03/2023]
Abstract
Systemic sclerosis (SSc) is systemic, autoimmune, connective tissue disorder characterized by vascular abnormalities, collagen deposition (fibrosis), and the production of autoantibodies to nuclear proteins. About 20%-40% of patients have antibodies to centromere protein (CENP)-A or -B. Despite the known association of anti-CENP antibodies with certain clinical features of SSc, the role of these antibodies in SSc physiopathology is still poorly understood. To better understand the clinical significance and origin of these antibodies, we and others have been studying the epitopic motifs (amino acid contact sites) on CENP-A with the aim of determining whether other proteins can prime or be targeted by them. Here, we review published and ongoing studies aimed at defining the fine specificity and origin of anti-CENP-A antibodies. We describe progress made in identifying the CENP-A epitopic motif amino acids, and the discovery of one of these motifs in forkhead box protein E3 (FOXE-3), a transcription factor previously studied only for its role in the development of lens fiber cells. Moreover, we discuss preliminary evidence for a possible role of FOXE-3 in SSc pathogenesis and for the association of different subsets of anti-CENP-A antibodies, heterogeneously expressed among SSc patients, with some clinical correlates.
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Affiliation(s)
- Federico Perosa
- Department of Biomedical Sciences and Human Oncology (DIMO), Section of Systemic Rheumatic and Autoimmune Diseases, University of Bari Medical School, Bari, Italy.
| | - Marcella Prete
- Department of Biomedical Sciences and Human Oncology (DIMO), Section of Internal Medicine, University of Bari Medical School, Bari, Italy
| | - Giuseppe Di Lernia
- Department of Biomedical Sciences and Human Oncology (DIMO), Section of Systemic Rheumatic and Autoimmune Diseases, University of Bari Medical School, Bari, Italy
| | - Carmela Ostuni
- Department of Biomedical Sciences and Human Oncology (DIMO), Section of Clinical Oncology, University of Bari Medical School, Bari, Italy
| | - Elvira Favoino
- Department of Biomedical Sciences and Human Oncology (DIMO), Section of Systemic Rheumatic and Autoimmune Diseases, University of Bari Medical School, Bari, Italy
| | - Gabriele Valentini
- Department of Clinical and Experimental Internal Medicine "F. Magrassi, A. Lanzara", Rheumatology Section, Second University of Naples, Naples, Italy
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Nakamura T, Hirakawa K, Takaoka H, Iyama KI. Dystrophic calcinosis with both a huge calcified mass in the cervical spine and calcification in the chest wall in a patient with rheumatoid overlap syndrome. Clin Rheumatol 2014; 35:1403-9. [PMID: 24894107 DOI: 10.1007/s10067-014-2696-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 05/23/2014] [Indexed: 11/28/2022]
Abstract
Dystrophic calcinosis in soft tissue occurs in damaged or devitalized tissues in the presence of normal calcium and phosphorous metabolism. It is often noted in subcutaneous tissues in patients with collagen vascular diseases and may involve a relatively localized area or be widespread. A 74-year-old Japanese woman with an overlap of rheumatoid arthritis, Sjögren's syndrome, and systemic sclerosis developed a huge tumor-like mass at the atlanto-axial vertebral joint region that caused severe cervical pain and difficulty in activities of daily living. She also had subcutaneous dystrophic calcification in the soft tissue of the chest wall. Calcinosis associated with systemic sclerosis is a well-recognized phenomenon, but a destructive paraspinal tumor in the cervical spine associated with overlap syndrome is extremely unique. Because calcinosis in spinal locations can be complicated by neurological involvement, patients with progressive symptoms may require surgical intervention. Surgical resection and biological therapy improved this patient's life and activities of daily living. Calcinosis is common in the conditions reviewed here, and different agents have been used for treatment. However, calcinosis management is poorly organized and lacks an accepted classification, systematic studies, and clinical therapeutic trials. The association of calcinosis and collagen vascular diseases is clinically and etiologically important. Although a combination of calcinosis and rheumatoid overlap syndrome is rare, various collagen vascular diseases may occur simultaneously. A perceptive diagnostic approach toward these diseases is critical, and early diagnosis and treatment are needed to prevent dystrophic calcinosis.
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Affiliation(s)
- Tadashi Nakamura
- Section of Clinical Rheumatology, Kumamoto Shinto General Hospital, 1-17-27 Shinyashiki, Chuo-ku, Kumamoto, 862-8655, Japan.
| | - Kei Hirakawa
- Section of Orthodeadic Surgery, Kumamoto Orthopaedic Hospital, Kumamoto, Japan
| | - Hirokazu Takaoka
- Section of Clinical Rheumatology, Kumamoto Shinto General Hospital, 1-17-27 Shinyashiki, Chuo-ku, Kumamoto, 862-8655, Japan
| | - Ken-Ichi Iyama
- Department of Surgical Pathology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
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Moinzadeh P, Aberer E, Ahmadi-Simab K, Blank N, Distler JHW, Fierlbeck G, Genth E, Guenther C, Hein R, Henes J, Herich L, Herrgott I, Koetter I, Kreuter A, Krieg T, Kuhr K, Lorenz HM, Meier F, Melchers I, Mensing H, Mueller-Ladner U, Pfeiffer C, Riemekasten G, Sárdy M, Schmalzing M, Sunderkoetter C, Susok L, Tarner IH, Vaith P, Worm M, Wozel G, Zeidler G, Hunzelmann N. Disease progression in systemic sclerosis-overlap syndrome is significantly different from limited and diffuse cutaneous systemic sclerosis. Ann Rheum Dis 2014; 74:730-7. [PMID: 24389298 PMCID: PMC4392314 DOI: 10.1136/annrheumdis-2013-204487] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Systemic sclerosis (SSc)-overlap syndromes are a very heterogeneous and remarkable subgroup of SSc-patients, who present at least two connective tissue diseases (CTD) at the same time, usually with a specific autoantibody status. OBJECTIVES To determine whether patients, classified as overlap syndromes, show a disease course different from patients with limited SSc (lcSSc) or diffuse cutaneous SSc (dcSSc). METHODS The data of 3240 prospectively included patients, registered in the database of the German Network for Systemic Scleroderma and followed between 2003 and 2013, were analysed. RESULTS Among 3240 registered patients, 10% were diagnosed as SSc-overlap syndrome. Of these, 82.5% were female. SSc-overlap patients had a mean age of 48±1.2 years and carried significantly more often 'other antibodies' (68.0%; p<0.0001), including anti-U1RNP, -PmScl, -Ro, -La, as well as anti-Jo-1 and -Ku antibodies. These patients developed musculoskeletal involvement earlier and more frequently (62.5%) than patients diagnosed as lcSSc (32.2%) or dcSSc (43.3%) (p<0.0001). The onset of lung fibrosis and heart involvement in SSc-overlap patients was significantly earlier than in patients with lcSSc and occurred later than in patients with dcSSc. Oesophagus, kidney and PH progression was similar to lcSSc patients, whereas dcSSc patients had a significantly earlier onset. CONCLUSIONS These data support the concept that SSc-overlap syndromes should be regarded as a separate SSc subset, distinct from lcSSc and dcSSc, due to a different progression of the disease, different proportional distribution of specific autoantibodies, and of different organ involvement.
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Affiliation(s)
- Pia Moinzadeh
- Department of Dermatology, Cologne University Hospital, Cologne, Germany
| | - Elisabeth Aberer
- Department of Dermatology, Medical University of Graz, Graz, Germany
| | | | - Norbert Blank
- Department of Internal Medicine, Division of Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Joerg H W Distler
- Department of Rheumatology, University of Erlangen, Erlangen, Germany
| | | | - Ekkehard Genth
- Department of Rheumatology, Clinic of Rheumatology of Aachen, Aachen, Germany
| | - Claudia Guenther
- Department of Dermatology, University-Hospital Carl Gustav Carus, Dresden, Germany
| | - Ruediger Hein
- Department of Dermatology, Munich University of Technology, Munich, Germany
| | - Joerg Henes
- Department of Rheumatology, University of Tuebingen, Tuebingen, Germany
| | - Lena Herich
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - Ilka Herrgott
- Department of Dermatology and Venereology, University of Muenster, Muenster, Germany
| | - Ina Koetter
- Department of Internal Medicine and Nephrology (Centre for interdisciplinary Rheumatology), Robert-Bosch-Hospital, Stuttgart, Germany
| | - Alexander Kreuter
- Department of Dermatology, Helios Clinic Oberhausen, Oberhausen, Germany
| | - Thomas Krieg
- Department of Dermatology, Cologne University Hospital, Cologne, Germany
| | - Kathrin Kuhr
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - Hanns-Martin Lorenz
- Department of Haemato-Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Florian Meier
- Department of Rheumatology and Clinical Immunology, Kerckhoff Clinic, Bad Nauheim, Germany
| | - Inga Melchers
- Clinical Research Unit for Rheumatology, University Medical Center Freiburg, Freiburg, Germany
| | | | - Ulf Mueller-Ladner
- Department of Rheumatology and Clinical Immunology, Kerckhoff Clinic, Bad Nauheim, Germany
| | | | - Gabriela Riemekasten
- Department of Rheumatology and Clinical Immunology, University of Berlin, Charité, Germany
| | - Miklós Sárdy
- Department of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany
| | - Marc Schmalzing
- Department of Rheumatology, University of Tuebingen, Tuebingen, Germany
| | - Cord Sunderkoetter
- Department of Dermatology and Venereology, University of Muenster, Muenster, Germany
| | - Laura Susok
- Department of Dermatology and Venereology, Ruhr University Bochum, Bochum, Germany
| | - Ingo H Tarner
- Department of Rheumatology and Clinical Immunology, Kerckhoff Clinic, Bad Nauheim, Germany
| | - Peter Vaith
- Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg, Freiburg, Germany
| | - Margitta Worm
- Department of Dermatology and Venerology, University of Berlin, Charité, Berlin, Germany
| | - Gottfried Wozel
- Department of Dermatology, University-Hospital Carl Gustav Carus, Dresden, Germany
| | - Gabriele Zeidler
- Department of Rheumatology, Johanniter-Hospital, Treuenbrietzen, Germany
| | - Nicolas Hunzelmann
- Department of Dermatology, Cologne University Hospital, Cologne, Germany
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Ferreira DC, Nogueira G, Cancio VA, Cavalcante FS, Godefroy P, Sousa DSC, Hespanhol W, dos Santos KRN, Cavalcante MAB. Loss of lingual sensitivity and slightly increased size signaling schwannoma in a patient with mixed conjunctive tissue disease. SPECIAL CARE IN DENTISTRY 2013; 33:301-3. [PMID: 24164229 DOI: 10.1111/j.1754-4505.2012.00308.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to describe an unusual case of a lingual schwannoma associated with a mixed connective tissue disease (MCTD). A case report. A lingual schwannoma with loss of lingual sensitivity and slightly increased size in an 18-year-old patient with MCTD was correctly diagnosed through a biopsy and no reoccurrence was observed one year after the surgical removal of the tumor and sensitivity returned 3 months after surgery. This case was considered uncommon, making the clinical diagnosis challenging in view of the diversity of possibilities for its differential diagnosis, thus showing the importance of a biopsy to confirm the diagnosis and long term follow up in such cases.
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Affiliation(s)
- D C Ferreira
- Laboratório de Infecção hospitalar - IMPPG - UFRJ
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11
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Mehra S, Walker J, Patterson K, Fritzler MJ. Autoantibodies in systemic sclerosis. Autoimmun Rev 2013; 12:340-54. [DOI: 10.1016/j.autrev.2012.05.011] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 05/15/2012] [Indexed: 01/06/2023]
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12
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Scarlata S, Costanzo L, Giua R, Pedone C, Incalzi RA. Diagnosis and prognostic value of restrictive ventilatory disorders in the elderly: A systematic review of the literature. Exp Gerontol 2012; 47:281-9. [DOI: 10.1016/j.exger.2012.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 02/09/2012] [Accepted: 02/10/2012] [Indexed: 10/28/2022]
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13
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Sung JJ, Chen TS, Gilliam AC, McCalmont TH, Gilliam AE. Clinicohistopathological correlations in juvenile localized scleroderma: Studies on a subset of children with hypopigmented juvenile localized scleroderma due to loss of epidermal melanocytes. J Am Acad Dermatol 2011; 65:364-373. [DOI: 10.1016/j.jaad.2010.02.065] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Revised: 02/08/2010] [Accepted: 02/16/2010] [Indexed: 10/18/2022]
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14
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Nakashima R, Mimori T. Clinical and pathophysiological significance of myositis-specific and myositis-associated autoantibodies. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/ijr.10.48] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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DNase1 exon2 analysis in Tunisian patients with rheumatoid arthritis, systemic lupus erythematosus and Sjögren syndrome and healthy subjects. Rheumatol Int 2009; 30:69-74. [DOI: 10.1007/s00296-009-0917-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 03/25/2009] [Indexed: 11/26/2022]
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Christen-Zaech S, Hakim MD, Afsar FS, Paller AS. Pediatric morphea (localized scleroderma): review of 136 patients. J Am Acad Dermatol 2008; 59:385-96. [PMID: 18571769 DOI: 10.1016/j.jaad.2008.05.005] [Citation(s) in RCA: 172] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2007] [Revised: 04/20/2008] [Accepted: 05/07/2008] [Indexed: 12/19/2022]
Abstract
BACKGROUND Morphea is an autoimmune inflammatory sclerosing disorder that may cause permanent functional disability and disfigurement. OBJECTIVES We sought to determine the clinical features of morphea in a large pediatric cohort. METHODS We conducted a retrospective chart review of 136 pediatric patients with morphea from one center, 1989 to 2006. RESULTS Most children showed linear morphea, with a disproportionately high number of Caucasian and female patients. Two patients with rapidly progressing generalized or extensive linear morphea and arthralgias developed restrictive pulmonary disease. Initial oral corticosteroid treatment and long-term methotrexate administration stabilized and/or led to disease improvement in most patients with aggressive disease. LIMITATIONS Retrospective analysis, relatively small sample size, and risk of a selected referral population to the single site are limitations. CONCLUSIONS These data suggest an increased prevalence of morphea in Caucasian girls, and support methotrexate as treatment for problematic forms. Visceral manifestations rarely occur; the presence of progressive problematic cutaneous disease and arthralgias should trigger closer patient monitoring.
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Affiliation(s)
- Stéphanie Christen-Zaech
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611-2997, USA
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17
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Coexistence of five autoimmune diseases: diagnostic and therapeutic difficulties. Rheumatol Int 2008; 28:919-23. [PMID: 18320193 DOI: 10.1007/s00296-008-0544-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Accepted: 02/11/2008] [Indexed: 10/22/2022]
Abstract
We report the case of coexistence of five autoimmune diseases in a 36-year-old woman, who initially developed psoriasis. Several years later, the patient was diagnosed with a mixed connective tissue disease and primary biliary cirrhosis (PBC). On admission to the Department of Rheumatology and Connective Tissue Diseases, the patient fulfilled classification criteria of an overlap syndrome systemic lupus erythematosus (SLE) with secondary antiphospholipid syndrome/systemic sclerosis (SSc)/Sjogren's syndrome (SS) with coexisting PBC and psoriasis. The SLE symptoms included discoid lupus erythematosus, arthritis, pancytopenia, antinuclear antibodies and anticardiolipin antibodies. Moreover, the patient met the criteria of antiphospholipid syndrome diagnosed based on preterm delivery before week 34, and high values of anticardiolipin antibodies were found at repeated determinations. The SSc symptoms included sclerodactyly, pulmonary fibrosis with pulmonary hypertension and esophageal dysfunction. The SS syndrome involved xerostomia, xerophthalmia, the positive Schirmer's test and presence of anti-SS antibodies. The literature reports overlap syndromes in various combinations; however, the coexistence of five autoimmune diseases is extremely rare.
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Grassegger A, Pohla-Gubo G, Frauscher M, Hintner H. Autoantibodies in systemic sclerosis (scleroderma): clues for clinical evaluation, prognosis and pathogenesis. Wien Med Wochenschr 2008; 158:19-28. [DOI: 10.1007/s10354-007-0451-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Accepted: 06/21/2007] [Indexed: 12/28/2022]
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19
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Wedderburn LR, McHugh NJ, Chinoy H, Cooper RG, Salway F, Ollier WER, McCann LJ, Varsani H, Dunphy J, North J, Davidson JE. HLA class II haplotype and autoantibody associations in children with juvenile dermatomyositis and juvenile dermatomyositis–scleroderma overlap. Rheumatology (Oxford) 2007; 46:1786-91. [DOI: 10.1093/rheumatology/kem265] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Mégarbané H, Tomb R, Makhoul E. [Plaque-type scleroderma associated with linear and oesophageal features and facial and extra-facial hemiatrophy]. Ann Dermatol Venereol 2007; 134:68-71. [PMID: 17384549 DOI: 10.1016/s0151-9638(07)88995-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Association of scleroderma with hemiatrophy is rare. The case we describe is unusual because of the combination in the same patient of several sub-types of scleroderma with oesophageal involvement and facial and extra-facial hemiatrophy. CASE REPORT A 38-year-old women suffering from plaque-type morphea presented oesophageal dysfunction during the course of her disease with positive anti-Scl70-antibodies and progressive right-sided hemiatrophy of the face, sternocleidomastoid, thumb and thenar eminence. Linear hyperpigmentation of the right arm and a "coup de sabre" appearance on the face were also noted. DISCUSSION Facial and extra-facial hemiatrophies are usually associated with or originate secondary to linear scleroderma. Only two cases with systemic involvement have been reported but hemiatrophy was localised to the face. The present case is unusual because of its onset as morphea in plaque form, because of the oesophageal involvement and the additional association of morphea in a linear form and facial and extra facial hemiatrophy. The relationship between sclerodermic facial hemiatrophy and Romberg facial hemiatrophy is also discussed. CONCLUSION The combination of several sub-types of scleroderma and facial and extra-facial hemiatrophy in the same patient may indicate that these entities actually represent different spectra of the same disease.
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Affiliation(s)
- H Mégarbané
- Service de Dermatologie, Hôtel-Dieu de France, Beyrouth, Liban
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21
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Gaudin C, Fortenfant F, Adoue D, Beyne-Rauzy O. Autoanticorps anti-PM-Scl. Étude de prévalence et de signification. Rev Med Interne 2006; 27:665-70. [PMID: 16797795 DOI: 10.1016/j.revmed.2006.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Accepted: 05/19/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of our study is to appreciate the prevalence of antibodies anti PM-Scl within the framework of antinuclear antibodies detection and to clarify clinical biological and evolutive features associated to these antibodies. METHODS 9,747 consecutive antinuclear testing datas allowed us to evaluate anti PM-Scl antibodies frequency. A retrospective analysis of patients characteristics was performed to identify clinical, biological and evolutive signs associated with this antibody over a five years follow up period. RESULTS Over the 9,747 samples tested for antinuclear antibodies detection, 3,493 (35.8%) are positive. An anti ENA activity is observed in 727 (7.5%) cases and anti PM-Scl in 6 (0.06%). These antibodies are described in systemic sclerosis, myositis or overlap syndromes. All theses diseases showed a low evolutivity over the five years of follow up. CONCLUSIONS Low prevalence and possible association with an overlap autoimmune syndrome of quite good prognosis are reported with anti PM-Scl antibodies.
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Affiliation(s)
- C Gaudin
- Service de Médecine Interne et Immunopathologie Clinique, Pavillon des Médecines, CHU de Toulouse-Purpan, TSA 40031, 31049 Toulouse Cedex 09, France
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22
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Manuel Pardal-Fernández J, Rodríguez-Vázquez M, Medrano-González F, Iñiguez-De Onzoño Martín L. [Not Available]. REUMATOLOGIA CLINICA 2006; 2:278-279. [PMID: 21794342 DOI: 10.1016/s1699-258x(06)73060-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- José Manuel Pardal-Fernández
- Unidad de Electromiografía Clínica. Servicio de Neurofisiología. Complejo Hospitalario Universitario de Albacete. Albacete. España
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23
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Turkcapar N, Olmez U, Ozer D, Duzgun N, Duman M. A case of overlap syndrome with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis and secondary Sjögren's syndrome. Rheumatol Int 2005; 26:841-5. [PMID: 16328417 DOI: 10.1007/s00296-005-0084-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2005] [Accepted: 10/21/2005] [Indexed: 10/25/2022]
Abstract
We report an unusual case of overlap syndrome that had the coexistence of five autoimmune diseases. A 45-year-old woman initially developed seropositive erosive rheumatoid arthritis (RA) 11 years ago. She then developed progressive systemic sclerosis (PSS) (including pulmonary hypertension, esophageal dysfunction, cardiac involvement and sclerodactilitis), systemic lupus erythematosus (SLE) (including photosensitivity, nephritis, leukopenia, lymphopenia, thrombocytopenia and Coombs positive hemolytic anemia and positive anti-dsDNA), and secondary Sjögren's syndrome (SSS) in the last 7 years before she was admitted to our clinic. The patient fulfilled classification criteria for RA, SLE, PSS and SSS, as determined by American College of Rheumatology. Hypothyroidism with positive autoantibodies due to Hashimoto's thyroiditis, the beginning of which could not be defined, was coexistent with this overlap syndrome. In the literature, although overlap syndromes in different combinations were reported, we very rarely observed a complex case like this patient. In our opinion, this is the first well-documented case of RA, PSS, SLE, SSS and Hashimoto's thyroiditis existing together in the same patient. Although immunosuppressive therapy was administered, the disease rapidly deteriorated and the patient died.
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Affiliation(s)
- Nuran Turkcapar
- Department of Clinical Immunology and Rheumatology, School of Medicine, Ankara University, Ankara, Turkey.
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24
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Kim S, Genth E, Krieg T, Hunzelmann N. PM-Scl-Antikörper positive systemische Sklerodermie assoziiert mit Einschlusskörper-Myositis. Z Rheumatol 2005; 64:499-502. [PMID: 16244833 DOI: 10.1007/s00393-005-0664-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2004] [Accepted: 09/07/2004] [Indexed: 12/26/2022]
Abstract
We describe a 72- year-old patient with a ten year history of anti-PM-Scl positive systemic sclerosis associated with inclusion-body myositis. While the association of dermatomyositis and polymyositis with anti-PM-Scl positive systemic sclerosis is frequently reported, inclusion-body myositis was, to the best of our knowledge, only previously described once in association with anti-PM-Scl-positive systemic sclerosis. The distinction between inclusion-body myositis and other forms of inflammatory myopathy, like the histopathologically well distinguishable polymyositis or dermatomyositis, is relevant because of the poor response of inclusion- body myositis to immunosuppressive treatment. Our case underlines that in patients with anti-PM-Scl-positive systemic sclerosis and treatment resistant progressive myopathy the diagnosis of inclusion body myositis should be considered.
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Affiliation(s)
- S Kim
- Klinik und Poliklinik für Dermatologie und Venerologie der Universität Köln, Joseph-Stelzmann-Strasse 9, 50937 Köln, Germany
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25
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Anderson PJ, Molony D, Haan E, David DJ. Familial Parry-Romberg disease. Int J Pediatr Otorhinolaryngol 2005; 69:705-8. [PMID: 15850693 DOI: 10.1016/j.ijporl.2004.12.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2004] [Revised: 10/11/2004] [Accepted: 12/10/2004] [Indexed: 12/01/2022]
Abstract
Parry-Romberg disease (or hemifacial atrophy) is a rare condition affecting the face. It commences in childhood but its aetiology remains unknown, and is sporadic. Two cases are presented who were biological first cousins. We believe that this is the first recorded example of this condition occurring in family members.
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Affiliation(s)
- Peter J Anderson
- Australian Craniofacial Unit, Women's and Children's Hospital, SA, Australia.
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26
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Cepeda EJ, Reveille JD. Autoantibodies in systemic sclerosis and fibrosing syndromes: clinical indications and relevance. Curr Opin Rheumatol 2004; 16:723-32. [PMID: 15577611 DOI: 10.1097/01.bor.0000144760.37777.fa] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Systemic sclerosis, or scleroderma, is associated with a variety of autoantibodies, each of them having their own clinical associations. The fibrosing disorders, other than systemic sclerosis, represent a diverse group of diseases with systemic or localized effect and with limited understanding of their pathogenesis. The purpose of this review is to analyze the literature on the clinical usefulness of examining serum autoantibodies in patients with known or suspected scleroderma and fibrosing disorders. RECENT FINDINGS Studies on autoantibodies within the past year highlight their clinical utility in systemic sclerosis. Anticentromere antibodies are most often seen with limited cutaneous involvement and lower frequency of pulmonary fibrosis and lower mortality (despite an increased risk for pulmonary hypertension) compared with anti-Scl-70 and antinucleolar antibodies. Anti-Scl-70 antibodies are associated with diffuse cutaneous involvement, increased frequency of pulmonary fibrosis, and higher mortality. The anti-polymyositis-scleroderma autoantibody is associated with the polymyositis-scleroderma overlap syndrome. Anti-Th/To antibodies are associated with milder skin and systemic involvement but with more severe pulmonary fibrosis and overall worse prognosis. Anti-RNA-polymerase family antibodies and antifibrillarin antibodies are predictive of diffuse cutaneous and systemic involvement and greater mortality. Less specific autoantibodies for systemic sclerosis and limited data on some other autoantibodies limit their clinical utility in patients with systemic sclerosis. For the most part, the association between autoantibodies and fibrosing disorders other than systemic sclerosis remains inconclusive. SUMMARY Autoantibodies in systemic sclerosis provide important and prognostic information and are useful in defining clinical subsets of the disease. When used appropriately, they can be a useful instrument in the management of scleroderma.
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Affiliation(s)
- Eduardo J Cepeda
- Division of Rheumatology, The University of Texas-Houston Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA
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Jablonska S, Blaszyk M. Scleromyositis (scleroderma/polimyositis overlap) is an entity. J Eur Acad Dermatol Venereol 2004; 18:265-6. [PMID: 15096133 DOI: 10.1111/j.1468-3083.2004.00869.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Mehling A, Beissert S. Dendritic cells under investigation in autoimmune disease. Crit Rev Biochem Mol Biol 2003; 38:1-21. [PMID: 12641341 DOI: 10.1080/713609208] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Autoimmune disorders play an increasing role in public health, especially in light of the fact of the growing aged population, which primarily develop such diseases. A clear understanding of the mechanisms leading to the development of autoimmune responses and finally to autoimmune disease does not exist. Autoimmunity is characterized by the presence of autoantibodies and/or autoreactive T cells and the corresponding organ manifestation. Following the discovery of autoreactive T cells found in the periphery of mice and humans, the old immunological concept that autoreactive T cells are completely deleted in the thymus during evolution has been revised in recent years. Although antigen-presenting cells and particularly dendritic cells are known to play an important role in the regulation of immune responses and the activation of T cells, recent evidence suggests that the role of dendritic cells in the development of autoimmunity has been underestimated previously. This article aims to give a general overview on the basic immunological principles involved and gives a short review of the current literature on the functional relevance of dendritic cells in various human and murine autoimmune disorders.
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Affiliation(s)
- Annette Mehling
- Ludwig Boltzmann Institute for Cell Biology and Immunobiology of the Skin, Department of Dermatology, University of Münster, D-48149 Münster, Germany
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29
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Abstract
Scleroderma can be accompanied by arthralgias, inflammatory arthritis, flexion contractures, nerve entrapment, myositis, or myopathy. Antibodies in scleroderma can occur in other connective tissue diseases; overlap syndromes between scleroderma and Sjogren's syndrome, lupus, and rheumatoid arthritis are reported. Many of the musculoskeletal symptoms in scleroderma are treated symptomatically; most treatments are not proven in randomized controlled trials in these patients. Musculoskeletal manifestations are a major cause of morbidity and disability in scleroderma.
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Affiliation(s)
- Janet E Pope
- Division of Rheumatology, Department of Medicine, The University of Western Ontario, Canada.
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30
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Ho KT, Reveille JD. The clinical relevance of autoantibodies in scleroderma. Arthritis Res Ther 2003; 5:80-93. [PMID: 12718748 PMCID: PMC165038 DOI: 10.1186/ar628] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2002] [Revised: 01/14/2003] [Accepted: 01/17/2003] [Indexed: 12/31/2022] Open
Abstract
Scleroderma (systemic sclerosis) is associated with several autoantibodies, each of which is useful in the diagnosis of affected patients and in determining their prognosis. Anti-centromere antibodies (ACA) and anti-Scl-70 antibodies are very useful in distinguishing patients with systemic sclerosis (SSc) from healthy controls, from patients with other connective tissue disease, and from unaffected family members. Whereas ACA often predict a limited skin involvement and the absence of pulmonary involvement, the presence of anti-Scl-70 antibodies increases the risk for diffuse skin involvement and scleroderma lung disease. Anti-fibrillarin autoantibodies (which share significant serologic overlap with anti-U3-ribonucleoprotein antibodies) and anti-RNA-polymerase autoantibodies occur less frequently and are also predictive of diffuse skin involvement and systemic disease. Anti-Th/To and PM-Scl, in contrast, are associated with limited skin disease, but anti-Th/To might be a marker for the development of pulmonary hypertension. Other autoantibodies against extractable nuclear antigens have less specificity for SSc, including anti-Ro, which is a risk factor for sicca symptoms in patients with SSc, and anti-U1-ribonucleoprotein, which in high titer is seen in patients with SSc/systemic lupus erythematosus/polymyositis overlap syndromes. Limited reports of other autoantibodies (anti-Ku, antiphospholipid) have not established them as being clinically useful in following patients with SSc.
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Affiliation(s)
- Khanh T Ho
- Division of Rheumatology and Clinical Immunogenetics and General Medicine, The University of Texas-Houston Health Science Center (UTH-HSC), Houston, Texas, USA.
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Affiliation(s)
- Virendra N Sehgal
- Dermato-Venereology (Skin/VD) Centre, Sehgal Nursing Home, Panchwati, Azadpur, Delhi, India.
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Ramos-e-Silva M, Tanus FH, Cestari TF. Cutaneous manifestation of internal diseases in infants and children. Clin Dermatol 2002; 20:51-66. [PMID: 11849895 DOI: 10.1016/s0738-081x(01)00229-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Marcia Ramos-e-Silva
- Sector of Dermatology, HUCFF-UFRJ and School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Palazzi C, D'Amico E, De Santis D, Pace-Palitti V, Petricca A. Superficial calcinosis related to bleeding in a patient with undifferentiated connective tissue disease and primary biliary cirrhosis. Rheumatology (Oxford) 2001; 40:947-8. [PMID: 11511771 DOI: 10.1093/rheumatology/40.8.947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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