, In Je Kim, Young Sun Hong, Soo Mee Lim, Min Sun Cho, Jisoo Lee Localized granulomatosis with polyangiitis (loc-GPA) is a milder disease state of GPA restricted to the respiratory tract. Transition from localized form to systemic/generalized disease is predicted to occur in approximately 10% of the patients. We report an unusual case of loc-GPA involving multiple cranial nerves, which in 3 years progressed into systemic disease involving pituitary gland. Initially antineutrophil cytoplasmic antibody (ANCA) was negative, but as symptoms of diabetes insipidus started, ANCA became positive. Clinical course of ANCA negative loc-GPA should be carefully monitored for development of systemic disease. ANCA may be a useful marker for detecting transition from localized to systemic disease.
, Jisoo Lee, You-Hyun Lee To define the abnormalities in homeostasis of B-1 B lymphocytes compartments in human SLE.
Perpheral blood was obtained from 7 patients with untreated active SLE patients and same patients at the time of incative disease after immunosuppressive therapy. The frequencies of CD5+CD45RAint B-1a B lymphocyte, and CD5+CD45RAlow B-1b B lymphocyte, CD5-CD45RAhigh conventional B-2 lymphocyte subsets were analyzed. For the control group, peripheral blood from 7 healthy adults and 7 patients with infectious fever were utilized.
B-1a B lymphocyte subset was found at high frequency in active SLE patients compared to the fever control(33.5±15.0% vs 20.1±5.3%,
These results indicate that there are abnormalities in B cell conpartments with expansion of B-1a B lymphocyte subset and contraction of B-2 B lymphocyte subset associated with the disease activity in patients wite SLE.
, JiSoo Lee, Eun-Suk Kang To evaluate the clinical significances of antibodies to cyclic citrullinated peptides (anti-CCP) and IgM Rheumatoid Factor(RF) in patients with established rheumatoid arthritis.
The subjects included 86 established RA patients according to the revised ACR criteria and 46 non-RA patients presenting joint manifestations and 61 healthy individuals as control. Anti-CCP and IgM RF were measured by ELISA and nephelometric method, respectively.
The sensitivity and specificity of anti-CCP were 64% and 98% and of IgM RF were 69% and 76%, respectively. Eleven (4 I %) out of 27 sero-negative RA patients had elevated anti-CCP. Combination of anti-CCP with IgM RF increased diagnostic sensitivity and specificity of RA to 81% and 99%, respectively.
Simultaneous measurement of IgM RF and anti-CCP for the initial evaluation of arthritis would increase the diagnostic efficacy of RA.
, Jisoo Lee To examine the management status of patients with rheumatoid arthritis (RA) taking glucocorticoids treated at a tertiary hospital rheumatology Practice.
A retrospective chart review was performed on 114 RA patients who were noted to be taking glucocorticoids during the period of 2000.7 to 2003.7, and who had been followed up for at least one year period. Use of bone densitometry and use of prescription medication for osteoporosis management were assessed.
Thirty one % of patients underwent bone densitometry, and 34% of patients received prescription medication for osteoporosis management. Sixty-six percent of patents who underwent bone densitometry showed osteoporosis with T score of less than 2.5, Osteoporosis medication was prescribed most often in the prednisolone exposure group of at least 7.5mg/d for at least 6 months. Factors associated with not receiving management for osteoporosis included male sex, young age, and premenopausal woman.
The use of bone densitometry and prescription medication for osteoporosis were suboptimal. Interventions to improve detection and prevention of glucocorticoid induced osteoporosis are necessary.
, Youn Ju Rye, Ji Eun Chang, Sung Ae Jung, Jisoo Lee, Young-Joo Cho, Kyung Eun Lee, Jihee Lee Bechet's disease(BD) is a chronic inflammatoroy condition involving several organs including gastrointestinal tract. Gastrointestinal tracts involvement in BD has been identified throughout the entire alimentary tract and commonly accompanies ulcerative lesions in the small and large bowel. It is debatable whether BD could be included among seronegative spondyloarthropathy (SPA).SPA usually occurs without overt sign of intestinal inflammation, but significant number of patients have asymptomatic intestinal inflammation, usually affecting ileum. Since most patients with SPA including BD are treated with NSAIDS. However, NSAID may play a role in aggravation or provocation of intestinal inflammation. Special attention to asymptomatic intestinal inflammation is needed, especially when NSAIDs are used for management of arthritic symptom in SpA. We experienced a case of BD which was complicated by a massive small bowel bleeding precipitated by NSAID use.
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