CRYOGLOBULINEMIA NOT ASSOCIATED WITH HEPATITIS C IN SYSTEMIC LUPUS ERYTHEMATOSUS
https://doi.org/10.24884/1561-6274-2010-14-4-36-41
Abstract
THE AIM. Assess the relationship cryoglobulinemia (CGE), associated with systemic lupus erythematosus (SLE) with features of the clinical course of SLE. PATIENTS AND METHODS. A total of 100 patients with systemic lupus erythematosus, 65 of whom had KGE were examined. All patients evaluated the presence of complement components C3, C4, CEC, RF, IgG and IgM, antibodies to native and denatured DNA, lymphocyte, CD3, CD4 and CD8, CD4/CD8, and the presence of Cor-NS-unstructured antigens, determination of HCV RNA C and HBV DNA by PCR, IgM and IgG antibodies to the herpes virus by ELISA. Cryoglobulins (CG) were determined in serum by the method of Meltzer and assessed in terms of cryocrit, as well as spectrophotometrically at a wavelength λ= 492 nm. To assess the relationship CGE with features of the clinical course of SLE were examined 50 patients in the dynamics of next year. The control group consisted of 30 persons. RESULTS. Patients with CGE had significantly more severe course of illness, often with renal, central nervous system, blood and heart diseases, which was accompanied by lower levels of CD3+, CD4+, and C3-complement component with an increase in CD8+ compared with patients without CGE. Titer of antiphospholipid antibodies was higher in the group with CGE. Observation of the dynamics showed that in patients with CGE often revealed disease progression with the development of cerebrovasculitis, recurrence of active lupus nephritis with severe nephrotic syndrome. In 3 cases there was death, which was not in patients without CGE. CONCLUSION. The presence of CGE in SLE patients is associated with clinical and immunological features of the disease and contributes to an unfavorable course of the process.
About the Authors
N. N. TrikomenasRussian Federation
O. V. Bugrova
Russian Federation
L. V. Kirin
Russian Federation
A. A. Nikonorov
Russian Federation
A. T. Bagautdinov
Russian Federation
K. A. Nagornova
Russian Federation
References
1. Насонова ВА, Бунчук НВ, ред. Ревматические болезни: руководство для врачей. Медицина, М., 1997
2. Насонова ВА. Ревматические болезни. Медицина, М., 1989; 160-172
3. Altenberg L. Measuring the Cryocrit in Cryoglobulinemia. Comments by Lee Altenberg. Cryoglobulin Assay (revised 24.03.1997)/www.dynamics.org/cryo/Cryocrit.html
4. Сатыбалдыев АМ, Сычев ГЛ, Иванова СМ, Меркулова ИБ. О значении криоглобулинемии в клинике ревматических болезней на примере жителей Москвы (оседлое население) и Тынды (пришлое население Сибири). Тер архив 1998; (11): 60-64
5. Баранаускайте АА, Соловьев СК, Насонов ЕЛ и др. Клинико-иммунологические особенности больных системной красной волчанкой с криоглобулинемией. Ревматология 1991; (2): 3-5
6. Вермель АЕ. Криоглобулины и криоглобулинемия. Клин мед 2000; (12):14-19
7. Вест СД. Секреты ревматологии. «Бином», М., «Невский диалект» СПб, 1999; 285-290
8. Erhardt CC, Mumford P, Maini RN. Differences in immunochemical characteristics of cryoglobulins in rheumatoid arthritis and systemic lupus erythematosus and their complement binding properties. Ann Rheumatic Dis 1984; (43): 451-456
9. Козловская ЛВ, Гордовская НБ, Малышко ЕЮ и др. Криоглобулинемическое поражение почек: особенности течения и лечение. Нефрология и диализ 2002; (1): 4-8
10. Константинова НА. Криоглобулины и патология. «Медицина», М., 1999; 24-141
11. Милованов ЮС, Комягин ЮВ, Козловская ЛВ, Гордовская НБ. Криоаферез при лечении больных криоглобулинемическим мезангиокапиллярным гломерулонефритом с острой почечной недостаточностью. Тер архив 2001; (2): 48-50
12. Мухин НА, Козловская ЛВ, Малышко ЕЮ и др. Криоглобулинемический нефрит, ассоциированный с хронической инфекцией вируса гепатита С. Тер архив 2000; (6): 5-9
13. Назаренко ГИ, Кишкун АА. Клиническая оценка результатов лабораторных исследований.«Медицина», М., 2002; 293-300
14. Agnello V. The etiology of mixed cryoglobulinemia secondary to hepatitis C virus infection. Springer Semin Immunophatol 1997; (19):111
15. Lamprecht P, Gause A, Gross WL. Cryoglobulinemic vasculitis. Arth Rheumatism 1999; 12: 2507-2516
16. Rieu V, Cohen P, Andre M.-H et al. Characteristic and outcome of 49 patients with symptomatic cryoglobulinaemia. Rheumatology 2002; 41: 290-300
17. Балобанова РМ, Шекшина ЕВ, Козлов ЛВ. Иммунологические особенности ревматоидного артрита у больных, инфицированных вирусами гепатита В, С, и с криоглобулинемией. Тер архив 2004; (11): 74-77
18. Козловская ЛВ, Милованова СЮ. Криоглобулинемический гломерулонефрит, ассоциированный с инфекцией, обусловленной вирусом гепатита С. Возможности и ограничения противовирусной терапии. Болезни почек 2006; (4): 14-17
19. Grey HM, Kohler PF. Cryoimmunoglobulins. Semin Hematol 1973; (10): 87-112
20. Ferri C, Greco F, Longombardo G et al. Assotiation between hepatitis C virus and mixed cryoglobulinemia. Clin Exp Rheumatol 1991; (6): 621-624
21. Meltzer M, Franklin EC. Cryoglobulinemia – a study of twenty-nine patients. I. IgG and IgM cryoglobulins and factors affecting cryoprecipitability. Am J Med 1966; 40(6): 828-836
22. Tissot J-D, Pietrogrande M, Testoni L, Invernizzi F. Clinical implications of the types of cryoglobulins determined by two-dimensional polyacrylamide gel electrophoresis. Haematologica 1998; (83): 693-700
23. Tomas L. Labor and Diagnose. Indikation und Bewertung von Laborbefunden fur fie medezinische Diagnostik. TH-Books Verlagsgesellschaft mbH, Frankfurt/Main, 1998; 698-700
24. Насонов ЕЛ. Клинические рекомендации. Ревматология. «ГЭОТАР-Медиа», М., 2007: 141-167
25. Сигидин ЯА, Гусева НГ, Иванова МИ. Диффузные болезни соединительной ткани. Медицина, М., 2004; 32-48
26. Cacoub P, Costedoat-Chalumeau N, Lidove O, Alric L. Cryoglobulinemia vasculitis. Current Opinion Rheumatol 2002; 14: 29-35
27. Morra E. Cryoglobulinemia. Hematology 2005; 368-372
28. Christian CL, Hatfield WB, Chase PH. Systemic lupus erythematosus. Cryoprecipitation in sera. J Clin Invest 1963; 6: 823-829
29. Johnson RJ, Gretch DR, Yamabe H. Membrano-proliferative glomerulonephritis associated with hepatitis C virus infection. New Engl J Med 1993; 328: 465-470
Review
For citations:
Trikomenas N.N., Bugrova O.V., Kirin L.V., Nikonorov A.A., Bagautdinov A.T., Nagornova K.A. CRYOGLOBULINEMIA NOT ASSOCIATED WITH HEPATITIS C IN SYSTEMIC LUPUS ERYTHEMATOSUS. Nephrology (Saint-Petersburg). 2010;14(4):36-41. (In Russ.) https://doi.org/10.24884/1561-6274-2010-14-4-36-41