Ribeiro D Sá, Lins C F, Galvão V, Santos W G Dourado, Rosa G, Machicado V, Pedreira A L, da Fonseca E P, Souza A P Mota Duque, Baleeiro C, Ferreira L G, Oliveira I Silva de, Gama da Silva J P Cotrim, Atta A M, Santiago M B
1 156427 Escola Bahiana de Medicina e Saúde Pública , Salvador, Bahia, Brazil.
2 Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
Lupus. 2018 May;27(6):939-946. doi: 10.1177/0961203317753557. Epub 2018 Jan 16.
Objectives The objective of this paper is to perform an ultrasonography (US) analysis of hands and wrists in two groups of patients with systemic lupus erythematosus (SLE), with and without Jaccoud's arthropathy, matched by age and disease duration and to correlate them with levels of CXCL13 clinical features, laboratory tests and disease activity score. Methods Sixty-four patients with SLE were enrolled, 32 with and 32 without Jaccoud's arthropathy. Each patient underwent physical examination, laboratory tests (including CXCL13 by ELISA) and bilateral US. Synovial hypertrophy, tenosynovitis and erosions were evaluated according to a semiquantitative grading system with a 0-3 rating. US findings were correlated with serum levels of CXCL13, other serological parameters and disease activity index. Results Synovitis was found in 25/64 patients (39%) and tenosynovitis in 14/64 (22%). These findings were more frequent in SLE patients with Jaccoud's arthropathy, particularly tenosynovitis ( p = 0.002) and synovitis ( p = 0.01). Median serum level of CXCL13 was 20.16 pg/ml in the whole population (23.21 pg/ml in the Jaccoud's arthropathy group and 11.48 pg/ml in the group without). There was an association between the presence of disease activity and high level of CXCL13 ( p = 0.004). However, no association was found between high levels of CXCL13 and "arthritis" in SLEDAI, swollen joints on physical examination or synovitis on US. Conclusions US findings in joints of SLE patients with Jaccoud's arthropathy confirm that synovitis and tenosynovitis are common in these patients. In addition, serum level of CXCL13 is associated with disease activity in SLE but does not seem to be a biomarker for arthritis in these patients.
目的 本文旨在对两组年龄和病程相匹配的系统性红斑狼疮（SLE）患者的手部和腕部进行超声检查（US）分析，一组有雅库关节病，另一组无雅库关节病，并将其与CXCL13水平、临床特征、实验室检查及疾病活动评分进行关联分析。方法 纳入64例SLE患者，其中32例有雅库关节病，32例无雅库关节病。每位患者均接受体格检查、实验室检查（包括通过酶联免疫吸附测定法检测CXCL13）及双侧超声检查。根据0 - 3级半定量分级系统评估滑膜肥厚、腱鞘炎和糜烂情况。将超声检查结果与CXCL13血清水平、其他血清学参数及疾病活动指数进行关联分析。结果 64例患者中25例（39%）发现滑膜炎，14例（22%）发现腱鞘炎。这些表现在有雅库关节病的SLE患者中更为常见，尤其是腱鞘炎（p = 0.002）和滑膜炎（p = 0.01）。总体人群中CXCL13血清中位数水平为20.16 pg/ml（有雅库关节病组为23.21 pg/ml，无雅库关节病组为11.48 pg/ml）。疾病活动的存在与CXCL13高水平之间存在关联（p = 0.004）。然而，在SLE疾病活动指数（SLEDAI）中的“关节炎”、体格检查时肿胀关节或超声检查的滑膜炎与CXCL13高水平之间未发现关联。结论 有雅库关节病的SLE患者关节的超声检查结果证实滑膜炎和腱鞘炎在这些患者中很常见。此外，CXCL13血清水平与SLE疾病活动相关，但似乎不是这些患者关节炎的生物标志物。
