Iba-Ba J, Biteghe B, Missounga L, Ibouili R Bignoumba, Mipinda J B, Coniquet S, Kombila J B Moussavou, Boguikouma J B
Service de médecine A, Centre hospitalier de Libreville, BP 2228 Libreville, Gabon.
Sante. 2009 Apr-Jun;19(2):67-71. doi: 10.1684/san.2009.0159.
CRP rarely increases during systemic lupus exacerbations.
This retrospective study of patients with systemic lupus diagnosed according to ACR criteria examined all patients with no intercurrent infectious disease and responding to corticosteroid treatment and compared the patients with normal and with significantly elevated (> or = 30 mg/l) CRP.
23 black patients (22 women, 1 man) were selected and classified in two groups: group I with CRP > 30 mg/l (n = 12) and the controls, group II, with normal CRP (n =11). In group I, mean CRP was 279 mg/l. Four patients had isolated pericarditis, and one pericarditis associated with pleurisy. Nine patients had no cardiovascular risk factors or abnormal liver function enzymes. Antinuclear antibodies were specific for anti-DNA (n= 8), anti-Sm (n = 2), anti-RNP (n = 1), and anti-SSA (n = 1). In group II, seven patients had pericarditis, and nine had no cardiovascular risk factors or liver function results. Antinuclear antibodies were specific for anti-DNA (n = 9), anti-Sm (n = 1) and unknown (n = 1).
The paucity of data about black Africans in the literature makes it difficult to interpret these results in terms of their specificity for this population or as a typical profile of elevated CRP without infectious disease.
In absence of a specific profile for patients with elevated CRP without intercurrent infectious disease, we consider the possibility of a subgroup of the black population that may be particularly vulnerable and express CRP more easily.
在系统性红斑狼疮病情加重期间,C反应蛋白(CRP)很少升高。
本回顾性研究对根据美国风湿病学会(ACR)标准诊断为系统性红斑狼疮的患者进行了检查,纳入所有无并发感染性疾病且对皮质类固醇治疗有反应的患者,并比较了CRP正常和显著升高(≥30mg/l)的患者。
选取了23名黑人患者(22名女性,1名男性),分为两组:第一组CRP>30mg/l(n = 12),第二组为对照组,CRP正常(n = 11)。在第一组中,平均CRP为279mg/l。4名患者患有孤立性心包炎,1名患者心包炎合并胸膜炎。9名患者无心血管危险因素或肝功能酶异常。抗核抗体中抗DNA特异性的有8例,抗Sm特异性的有2例,抗RNP特异性的有1例,抗SSA特异性的有1例。在第二组中,7名患者有心包炎,9名患者无心血管危险因素或肝功能异常。抗核抗体中抗DNA特异性的有9例,抗Sm特异性的有1例,不明特异性的有1例。
文献中关于非洲黑人的数据匮乏,使得难以根据这些结果判断其对该人群的特异性,或作为无传染病时CRP升高的典型特征。
由于没有无并发感染性疾病时CRP升高患者的特异性特征,我们考虑存在一个可能特别易患且更易表达CRP的黑人亚群。