Establishment of the upper reference limit for thyroid peroxidase autoantibodies according to the guidelines proposed by the National Academy of Clinical Biochemistry: comparison of five different automated methods
Abstract Aim of the study The estimation of the upper reference limit (URL) for autoantibodies against thyroid peroxidase (TPOAbs) is a controversial issue, because of an uncertainty associated with the criteria used to correctly define the reference population. In addition, the URL of TPOAbs is method-dependent and often arbitrarily established in current laboratory practice. The aim of this study was to determine the reference limits of TPOAbs in a male sample according to the National Academy of Clinical Biochemistry (NACB) guidelines, and to compare them with those obtained in a female ...
Source: Autoimmunity Highlights - November 18, 2015 Category: Allergy & Immunology Source Type: research

Typical evanescent and atypical persistent polymorphic cutaneous rash in an adult Brazilian with Still’s disease: a case report and review of the literature
Abstract Adult onset Still’s disease (AOSD) is a systemic auto-inflammatory condition of unknown etiology, characterized by high fever, an evanescent, salmon-pink maculopapular skin rash, arthralgia or arthritis and leukocytosis. AOSD can also present with atypical cutaneous manifestations, such as persistent pruritic coalescent papules or plaques and linear lesions that have highly distinctive pathological features and are usually associated with severe disease. Herein, we present a 31-year-old Brazilian man with both typical Still’s rash and atypical persistent polymorphic cutaneous manifestations a...
Source: Autoimmunity Highlights - November 18, 2015 Category: Allergy & Immunology Source Type: research

Automation, consolidation, and integration in autoimmune diagnostics
Abstract Over the past two decades, we have witnessed an extraordinary change in autoimmune diagnostics, characterized by the progressive evolution of analytical technologies, the availability of new tests, and the explosive growth of molecular biology and proteomics. Aside from these huge improvements, organizational changes have also occurred which brought about a more modern vision of the autoimmune laboratory. The introduction of automation (for harmonization of testing, reduction of human error, reduction of handling steps, increase of productivity, decrease of turnaround time, improvement of safety), consol...
Source: Autoimmunity Highlights - August 1, 2015 Category: Allergy & Immunology Source Type: research

IgG4-related disease: case report and literature review
Abstract IgG4-related disease (IgG4-RD) is relatively a new growing entity of immune-mediated origin, characterized by a mass-forming lesion, the infiltration of IgG4-positive plasma cells and occasionally elevated serum IgG4. It is considered to be both a systemic inflammation and sclerosing disease. The most common manifestations are parotid and lacrimal swelling, lymphadenopathy and autoimmune pancreatitis. Sclerosing cholangitis and retroperitoneal fibrosis are among the other mentioned frequent manifestations. The diagnosis should be approved histo-pathologically but other conditions such as lymphoma should ...
Source: Autoimmunity Highlights - August 1, 2015 Category: Allergy & Immunology Source Type: research

Decreased serum cell-free DNA levels in rheumatoid arthritis
Conclusions Our results demonstrate that cfDNA levels are strongly reduced in the sera of established RA patients, which is not caused by changes in DNase activity. Measurement of cfDNA can distinguish established RA patients from early RA patients. Thus, cfDNA may serve as a biomarker in RA. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - August 1, 2015 Category: Allergy & Immunology Source Type: research

Anti-zinc transporter protein 8 autoantibodies significantly improve the diagnostic approach to type 1 diabetes: an Italian multicentre study on paediatric patients
Conclusion This study confirms ZnT8A as an important additional and independent diagnostic marker of T1D and supports its introduction in the routine diagnostic process to replace less sensitive methods and improve the overall autoantibody sensitivity. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - August 1, 2015 Category: Allergy & Immunology Source Type: research

Assessment of patients with idiopathic inflammatory myopathies and isolated creatin-kinase elevation
Abstract Idiopathic inflammatory myopathies (IIM) are a group of diseases characterized by inflammation of the skeletal muscle. Weakness, mainly affecting the proximal muscles, is the cardinal muscular symptom in IIM. In patients with dermatomyositis, peculiar skin lesions are observed. The assessment of patients with IIM includes clinical and laboratory evaluation, and clinimetric measurements. Different tools have been proposed to measure muscular and extramuscular disease activity and damage in patients with IIM. A core set of measurements to use in clinical practice was recently proposed. Among laboratory fea...
Source: Autoimmunity Highlights - December 1, 2014 Category: Allergy & Immunology Source Type: research

Drugs in induction and treatment of idiopathic inflammatory myopathies
Abstract Idiopathic inflammatory myopathies (IIM) are a rare disease; so far standardized therapy has not been adequately defined by national or international guidelines or recommendations. Corticosteroids are the mainstay of treatment, but these drugs are burdened by several side effects. Thus, additional treatment based on immunosuppressive agents, especially azathioprine, methotrexate, mycophenolate mofetil and cyclosporine, is often needed. This combinate approach both improves the disease response and allows reduction of the dosage of corticosteroids, decreasing the risk of steroid-related long-term complica...
Source: Autoimmunity Highlights - December 1, 2014 Category: Allergy & Immunology Source Type: research

Myositis autoantibodies and clinical phenotypes
Abstract Autoantibodies are powerful diagnostic tools in idiopathic inflammatory myopathies, especially for confirming the diagnosis and contributing to the definition of disease subsets. They are present in over 80 % of patients with immuno-mediated myositis and directed towards ubiquitously expressed intracellular complexes. Most of these autoantibodies are reported also in other autoimmune diseases, while some are considered myositis-specific. Myositis autoantibodies are traditionally categorized in two groups, based on their diagnostic accuracy: myositis-specific antibodies (MSA) and myositis-associated ...
Source: Autoimmunity Highlights - December 1, 2014 Category: Allergy & Immunology Source Type: research

Muscle biopsy features of idiopathic inflammatory myopathies and differential diagnosis
Abstract The gold standard to characterize idiopathic inflammatory myopathies is the morphological, immunohistochemical and immunopathological analysis of muscle biopsy. Mononuclear cell infiltrates and muscle fiber necrosis are commonly shared histopathological features. Inflammatory cells that surround, invade and destroy healthy muscle fibers expressing MHC class I antigen are the typical pathological finding of polymyositis. Perifascicular atrophy and microangiopathy strongly support a diagnosis of dermatomyositis. Randomly distributed necrotic muscle fibers without mononuclear cell infiltrates represent the ...
Source: Autoimmunity Highlights - December 1, 2014 Category: Allergy & Immunology Source Type: research

Pathogenesis and potential therapeutic targets in systemic lupus erythematosus: from bench to bedside
Abstract Systemic lupus erythematosus (SLE) is considered an autoimmune disease with multiorgan involvement. Many advances have been made during the last decade regarding inflammatory pathways, genetic and epigenetic alterations, adaptive and innate immune system mechanisms specifically involved in SLE pathogenesis. Apoptosis has been proposed as an important player in SLE pathogenesis more than a decade ago. However, only recently new key apoptotic pathways have been investigated and the link between apoptotic debris containing autoantigens, innate immunity and ongoing inflammation has been further elucidated. B...
Source: Autoimmunity Highlights - September 1, 2014 Category: Allergy & Immunology Source Type: research

Efficiency of a solid-phase chemiluminescence immunoassay for detection of antinuclear and cytoplasmic autoantibodies compared with gold standard immunoprecipitation
Abstract Purpose The aim of this study was to compare the degree of agreement of a novel Zenit RA chemiluminescent immunoassay (CLIA) from A. Menarini Diagnostics (Florence, Italy) and the gold standard immunoprecipitation assay to screen for the presence of specific anti-U1snRNP, anti-Sm, anti-Ro/SS-A, anti-La/SS-B, anti-Jo-1(histRNA-Synthetase) and anti-Scl-70(Topo I) antibodies. Materials and methods We studied 114 sera, 98 from patients with well-defined autoimmune connective tissue diseases and 16 from blood donor volunteers. All samples were...
Source: Autoimmunity Highlights - September 1, 2014 Category: Allergy & Immunology Source Type: research

Celiac and non-celiac gluten sensitivity: a review on the association with schizophrenia and mood disorders
Abstract An association between many psychiatric and gluten-related disorders has been known for some time. In the case of schizophrenia and mood disorders, the major psychiatric disorders, there is much evidence, not without contradictions, of a possible association between schizophrenia and celiac disease. The association between mood disorders and gluten-related disorders, especially celiac disease, has only been studied for depression, often coupled with anxiety, and very recently for bipolar disorder. Since non-celiac gluten sensitivity is now known to be different from celiac disease, many studies have ...
Source: Autoimmunity Highlights - September 1, 2014 Category: Allergy & Immunology Source Type: research

The introduction of anti-phosphatidylserine/prothrombin autoantibodies in the laboratory diagnostic process of anti-phospholipid antibody syndrome: 6 months of observation
Conclusions The introduction of aPS/PT antibodies in the diagnostic process of APS is highly recommended, since they disclose a notable diagnostic performance and a high correlation with LA activity, such that they can be a viable alternative. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - September 1, 2014 Category: Allergy & Immunology Source Type: research

The Th17 axis in psoriatic disease: pathogenetic and therapeutic implications
Abstract Psoriasis and psoriatic arthritis represent two paradigmatic conditions characterized by chronic inflammation and possibly autoimmunity, despite the absence of known serum autoantibodies. The two diseases, albeit strongly correlated from clinical, genetic, and epidemiogical standpoints, manifest significant differences in terms of etiology and pathogenetic mechanisms. Nonetheless, Th17 cells appear crucial to both diseases, and IL23 is the cytokine involved in determining the fate of naive CD4+ cells to differentiate into a pathogenic phenotype. This basic experimental observation led to a clear understa...
Source: Autoimmunity Highlights - June 1, 2014 Category: Allergy & Immunology Source Type: research

Treatment of the antiphospholipid syndrome
Abstract The antiphospholipid syndrome is characterized by a combination of laboratory findings (i.e., the presence of at least one antiphospholipid antibody) and clinical manifestations (arterial and/or venous thrombosis, obstetrical complications). Long-term oral anticoagulant is recommended to prevent recurrence of both arterial and venous thrombosis, whereas (low molecular weight) heparin plus aspirin is the treatment of choice to prevent further obstetrical complications. In the rare case of catastrophic antiphospholipid syndrome, heparin plus high-dose corticosteroids plus plasma exchange is associated with...
Source: Autoimmunity Highlights - June 1, 2014 Category: Allergy & Immunology Source Type: research

A rare combination of type 3 autoimmune polyendocrine syndrome (APS-3) or multiple autoimmune syndrome (MAS-3)
Conclusions In this article we report a complex case of APS-3, characterized by the association of seven different autoimmune diseases, which required a complex therapeutic strategy. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - June 1, 2014 Category: Allergy & Immunology Source Type: research

Skin CD30 + T cells and circulating levels of soluble CD30 are increased in patients with graft versus host disease
Abstract Objective To determine serum soluble CD30 (sCD30) levels in patients with graft versus host disease (GVHD). Methods Serum soluble CD30 levels and IgE levels were assayed by a sensitive ELISA in 57 patients with bone marrow transplantation, and in 44 healthy controls. We analyzed the type of effector T cells in patients with GVHD. Results Serum levels of sCD30 and serum IgE levels were significantly higher (p values
Source: Autoimmunity Highlights - June 1, 2014 Category: Allergy & Immunology Source Type: research

Intravenous immunoglobulin therapy in vasculitic ulcers: a case of polyarteritis nodosa
Discussion IVIG therapy has proven benefit in Kawasaki disease, also showing efficacy in refractory ANCA-associated vasculitis. In PAN, only very few case reports show benefit. In this case, IVIG therapy induced total remission of LL ulcers and PNP, suggesting that it may be useful in selected cases of refractory PAN. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - December 1, 2013 Category: Allergy & Immunology Source Type: research

New insights into HLA class I association to Behçet’s syndrome in Iranian Azari patients
Abstract Behçet’s syndrome (BS) is a chronic recurrent inflammatory disorder characterized by oral and genital ulcers and ocular inflammation. BS has a complex genetic etiology. To evaluate the influence of human leukocyte antigen (HLA) class I in BS susceptibility in Iranian Azari population, we studied 290 BS patients and 300 healthy controls. As expected, a high frequency of HLA-B5 was found. Remarkably, HLA-B35 frequency was higher in the patient than control group, and the frequency of HLA-B51, HLA-B52, and HLA-BW4 was significantly elevated. Thus, HLA-B5 and HLA-B35 seem to confer susceptibilit...
Source: Autoimmunity Highlights - December 1, 2013 Category: Allergy & Immunology Source Type: research