Document Detail


A long-term immunological study of childhood onset systemic lupus erythematosus.
MedLine Citation:
PMID:  1540037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Immunological dysregulation is an important cause of the development of systemic lupus erythematosus (SLE). Serological evaluation has been useful in the clinical management of patients and as a prognostic indicator. Sixteen patients who developed SLE as children were followed up for more than three years and immunological data collected. The results showed that (a) complement C3 concentration was lower in the active stage of SLE, especially during a major clinical exacerbation, but rarely preceded a major flare up. The concentration was often normal during the mildly to moderately active stage. In contrast, a low complement C4 concentration often preceded a major clinical exacerbation and could be of longer duration, sometimes persisting regardless of disease activity. (b) A T cell subset distribution study showed persistently low CD4 positive T cells in the peripheral blood of patients with SLE during the long term follow up, strongly suggesting that the intrinsic defect is mainly localised in T helper/inducer cells. These abnormal cellular defects did not tend to return to normal even in long term remission. (c) The persistently higher serum interleukin 2 and interleukin 2 receptor concentrations in SLE strongly suggested that the T cells were preactivated in vivo and that these phenomena might persist even in remission. (d) The best single parameter for predicting active SLE was anti-dsDNA. It was highly correlated with disease activity in most patients, and the asymptomatic increase of anti-dsDNA (greater than or equal to 60 U/ml, radioimmunoassay) was often followed by a major clinical exacerbation, especially in patients with a simultaneously low complement C4 concentration, suggesting that it might be an important warning sign of a major flare up. High dose steroids are indicated in this group of patients.
Authors:
C K Ting; K H Hsieh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  51     ISSN:  0003-4967     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-04-02     Completed Date:  1992-04-02     Revised Date:  2010-09-07    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  45-51     Citation Subset:  IM; X    
Affiliation:
Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antibodies, Antinuclear / analysis
CD4-CD8 Ratio
Child
Complement C3c / analysis
Complement C4 / analysis
Complement C4b*
DNA / immunology
Female
Humans
Interleukin-2 / analysis
Lupus Erythematosus, Systemic / blood,  immunology*
Male
Peptide Fragments
Prognosis
Receptors, Interleukin-2 / analysis
Time Factors
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/Complement C4; 0/Interleukin-2; 0/Peptide Fragments; 0/Receptors, Interleukin-2; 0/complement C4c; 80295-44-9/Complement C3c; 80295-50-7/Complement C4b; 9007-49-2/DNA
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