{"title":"类风湿因子血清反应阳性的系统性红斑狼疮患者的临床和实验室模式。","authors":"Oleg Iaremenko, Galyna Protsenko, Vitalii Dubas, Daria Koliadenko","doi":"10.5114/reum/192613","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to investigate the associations between the presence and level of rheumatoid factor (RF) in the blood serum and the clinical and laboratory characteristics of patients with systemic lupus erythematosus (SLE).</p><p><strong>Material and methods: </strong>This retrospective tricentric cross-sectional study analyzed a Ukrainian contingent of SLE patients. Medical records of 495 patients were evaluated. Rheumatoid factor serum concentration was tested in 206 of them (41.6%) using turbidimetry technique. Clinical manifestations, routine laboratory parameters, specific immunological tests, disease activity (SLEDAI-2K), and damage indices (SLICC/ACR DI) were evaluated.</p><p><strong>Results: </strong>Our study revealed that RF was elevated in 27.7% of patients. The RF-positive patients experienced a longer delay in SLE diagnosis (2.0 vs. 0.5 years, <i>p</i> = 0.046), less frequent kidney involvement (42.1% vs. 59.4%, <i>p</i> = 0.045) and fever (42.1% vs. 59.2%, <i>p</i> = 0.046), and more frequent lymphadenopathy (59.6% vs. 42.3%, <i>p</i> = 0.039) compared to RF-negative patients. Patients with RF positivity had higher levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and antinuclear antibody (ANA) titer, and were more frequently positive for antibodies to Ro/SSA and La/SSB. Rheumatoid factor concentration directly correlated with CRP (<i>r</i> = 0.318; <i>p</i> < 0.01) and ESR (<i>r</i> = 0.228; <i>p</i> = 0.04) levels. However, no associations were found between RF levels and SLEDAI-2K, joint involvement frequency, SLICC/ACR DI or drug therapy content. Univariate logistic regression analysis showed that RF positivity was independently associated with lymphadenopathy, presence of anti-Ro/SSA and anti-La/SSB antibodies, and negatively associated with kidney involvement.</p><p><strong>Conclusions: </strong>In RF-seropositive SLE patients (approximately 28%), the diagnosis is established later compared to RF-seronegative ones; kidney involvement and fever are less common, while lymphadenopathy develops more frequently. Rheumatoid factor seropositivity is associated with higher levels of ESR, CRP, ANA, and the presence of antibodies to Ro/SSA and La/SSB. According to the results of univariate logistic regression analysis, an independent association with RF positivity was confirmed only for kidney involvement, lymphadenopathy, and antibodies to Ro/SSA and La/SSB.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457312/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical and laboratory pattern of patients with systemic lupus erythematosus seropositive for rheumatoid factor.\",\"authors\":\"Oleg Iaremenko, Galyna Protsenko, Vitalii Dubas, Daria Koliadenko\",\"doi\":\"10.5114/reum/192613\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The aim of the study was to investigate the associations between the presence and level of rheumatoid factor (RF) in the blood serum and the clinical and laboratory characteristics of patients with systemic lupus erythematosus (SLE).</p><p><strong>Material and methods: </strong>This retrospective tricentric cross-sectional study analyzed a Ukrainian contingent of SLE patients. Medical records of 495 patients were evaluated. Rheumatoid factor serum concentration was tested in 206 of them (41.6%) using turbidimetry technique. Clinical manifestations, routine laboratory parameters, specific immunological tests, disease activity (SLEDAI-2K), and damage indices (SLICC/ACR DI) were evaluated.</p><p><strong>Results: </strong>Our study revealed that RF was elevated in 27.7% of patients. The RF-positive patients experienced a longer delay in SLE diagnosis (2.0 vs. 0.5 years, <i>p</i> = 0.046), less frequent kidney involvement (42.1% vs. 59.4%, <i>p</i> = 0.045) and fever (42.1% vs. 59.2%, <i>p</i> = 0.046), and more frequent lymphadenopathy (59.6% vs. 42.3%, <i>p</i> = 0.039) compared to RF-negative patients. Patients with RF positivity had higher levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and antinuclear antibody (ANA) titer, and were more frequently positive for antibodies to Ro/SSA and La/SSB. Rheumatoid factor concentration directly correlated with CRP (<i>r</i> = 0.318; <i>p</i> < 0.01) and ESR (<i>r</i> = 0.228; <i>p</i> = 0.04) levels. However, no associations were found between RF levels and SLEDAI-2K, joint involvement frequency, SLICC/ACR DI or drug therapy content. Univariate logistic regression analysis showed that RF positivity was independently associated with lymphadenopathy, presence of anti-Ro/SSA and anti-La/SSB antibodies, and negatively associated with kidney involvement.</p><p><strong>Conclusions: </strong>In RF-seropositive SLE patients (approximately 28%), the diagnosis is established later compared to RF-seronegative ones; kidney involvement and fever are less common, while lymphadenopathy develops more frequently. Rheumatoid factor seropositivity is associated with higher levels of ESR, CRP, ANA, and the presence of antibodies to Ro/SSA and La/SSB. According to the results of univariate logistic regression analysis, an independent association with RF positivity was confirmed only for kidney involvement, lymphadenopathy, and antibodies to Ro/SSA and La/SSB.</p>\",\"PeriodicalId\":21312,\"journal\":{\"name\":\"Reumatologia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457312/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reumatologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5114/reum/192613\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reumatologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5114/reum/192613","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/16 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
导言本研究旨在探讨血清中类风湿因子(RF)的存在和水平与系统性红斑狼疮(SLE)患者的临床和实验室特征之间的关联:这项回顾性三中心横断面研究分析了乌克兰的系统性红斑狼疮患者。研究评估了 495 名患者的医疗记录。采用比浊法检测了其中206名患者(41.6%)的类风湿因子血清浓度。对临床表现、常规实验室参数、特异性免疫学检测、疾病活动性(SLEDAI-2K)和损害指数(SLICC/ACR DI)进行了评估:我们的研究显示,27.7%的患者RF升高。与RF阴性患者相比,RF阳性患者的系统性红斑狼疮诊断延迟时间更长(2.0年 vs. 0.5年,p = 0.046),肾脏受累(42.1% vs. 59.4%,p = 0.045)和发热(42.1% vs. 59.2%,p = 0.046)的发生率更低,淋巴结病(59.6% vs. 42.3%,p = 0.039)的发生率更高。类风湿因子阳性患者的 C 反应蛋白(CRP)、红细胞沉降率(ESR)和抗核抗体(ANA)滴度水平较高,Ro/SSA 和 La/SSB 抗体阳性率较高。类风湿因子浓度与 CRP(r = 0.318;p < 0.01)和 ESR(r = 0.228;p = 0.04)水平直接相关。然而,RF水平与SLEDAI-2K、关节受累频率、SLICC/ACR DI或药物治疗内容之间没有关联。单变量逻辑回归分析显示,RF阳性与淋巴结病、抗Ro/SSA和抗La/SSB抗体的存在独立相关,与肾脏受累呈负相关:在类风湿因子血清阳性的系统性红斑狼疮患者中(约占28%),与类风湿因子血清阴性的患者相比,确诊时间较晚;肾脏受累和发热较少见,而淋巴结病变则更常见。类风湿因子血清阳性与较高水平的血沉、CRP、ANA 以及 Ro/SSA 和 La/SSB 抗体有关。根据单变量逻辑回归分析的结果,只有肾脏受累、淋巴结病、Ro/SSA 和 La/SSB 抗体与类风湿因子阳性有独立关联。
Clinical and laboratory pattern of patients with systemic lupus erythematosus seropositive for rheumatoid factor.
Introduction: The aim of the study was to investigate the associations between the presence and level of rheumatoid factor (RF) in the blood serum and the clinical and laboratory characteristics of patients with systemic lupus erythematosus (SLE).
Material and methods: This retrospective tricentric cross-sectional study analyzed a Ukrainian contingent of SLE patients. Medical records of 495 patients were evaluated. Rheumatoid factor serum concentration was tested in 206 of them (41.6%) using turbidimetry technique. Clinical manifestations, routine laboratory parameters, specific immunological tests, disease activity (SLEDAI-2K), and damage indices (SLICC/ACR DI) were evaluated.
Results: Our study revealed that RF was elevated in 27.7% of patients. The RF-positive patients experienced a longer delay in SLE diagnosis (2.0 vs. 0.5 years, p = 0.046), less frequent kidney involvement (42.1% vs. 59.4%, p = 0.045) and fever (42.1% vs. 59.2%, p = 0.046), and more frequent lymphadenopathy (59.6% vs. 42.3%, p = 0.039) compared to RF-negative patients. Patients with RF positivity had higher levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and antinuclear antibody (ANA) titer, and were more frequently positive for antibodies to Ro/SSA and La/SSB. Rheumatoid factor concentration directly correlated with CRP (r = 0.318; p < 0.01) and ESR (r = 0.228; p = 0.04) levels. However, no associations were found between RF levels and SLEDAI-2K, joint involvement frequency, SLICC/ACR DI or drug therapy content. Univariate logistic regression analysis showed that RF positivity was independently associated with lymphadenopathy, presence of anti-Ro/SSA and anti-La/SSB antibodies, and negatively associated with kidney involvement.
Conclusions: In RF-seropositive SLE patients (approximately 28%), the diagnosis is established later compared to RF-seronegative ones; kidney involvement and fever are less common, while lymphadenopathy develops more frequently. Rheumatoid factor seropositivity is associated with higher levels of ESR, CRP, ANA, and the presence of antibodies to Ro/SSA and La/SSB. According to the results of univariate logistic regression analysis, an independent association with RF positivity was confirmed only for kidney involvement, lymphadenopathy, and antibodies to Ro/SSA and La/SSB.