Volume 7, Number 27;  March 7, 2007

Patient:

Session Handout:

Readings:

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Unique Identifier [PMID]: 11889413

Authors: Ferri C. Valentini G. Cozzi F. Sebastiani M. Michelassi C. La Montagna G. Bullo A. Cazzato M. Tirri E. Storino F. Giuggioli D. Cuomo G. Rosada M. Bombardieri S. Todesco S. Tirri G. Systemic Sclerosis Study Group of the Italian Society of Rheumatology (SIR-GSSSc).

Institution: Rheumatology Unit, Department of Internal Medicine, University of Pisa, Italy. c.ferri@int.med.unipi.it

Title: Systemic sclerosis: demographic, clinical, and serologic features and survival in 1,012 Italian patients. [Review] [37 refs]

Source: Medicine. 81(2):139-53, 2002 Mar.

Publication Type: Journal Article. Multicenter Study. Review.
 

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Unique Identifier [PMID]: 11600743

Authors: Sato S. Hamaguchi Y. Hasegawa M. Takehara K.

Institution: Department of Dermatology, Kanazawa University School of Medicine, Kanazawa, Ishikawa, Japan.

Title: Clinical significance of anti-topoisomerase I antibody levels determined by ELISA in systemic sclerosis.

Source: Rheumatology. 40(10):1135-40, 2001 Oct.

Abstract: OBJECTIVE: To determine the clinical associations of the levels of anti-topoisomerase I (topo I) antibody in patients with systemic sclerosis (SSc). METHODS: Anti-topo I antibody levels were determined by enzyme-linked immunosorbent assay. In a longitudinal study, 125 sera from 21 patients were analysed during a follow-up period of 0.2-4.7 yr. RESULTS: Anti-topo I antibody levels were correlated positively with skin thickness score and renal vascular resistance, and inversely with percentage vital capacity. In the longitudinal study, five patients with a low anti-topo I antibody level at their first visit exhibited a stable antibody level or a small decrease in the level during the follow-up period, and their skin sclerosis was stable. Of 16 patients with a high anti-topo I antibody level at their first visit, seven showed a stable level, four had an increasing level and five had a decreasing level. The decreasing levels were accompanied mainly by atrophic skin change during the follow-up period, whereas the increasing levels were associated with new onset or worsening of organ involvement. CONCLUSIONS: These results suggest the potential clinical significance of anti-topo I antibody levels in evaluating disease severity and the prognosis in SSc.

Publication Type: Journal Article.
 

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Unique Identifier [PMID]: 9316557

Authors: Spencer-Green G. Alter D. Welch HG.

Institution: Division of Rheumatology, Dartmouth Medical School, Hanover, New Hampshire 03756, USA.

Title: Test performance in systemic sclerosis: anti-centromere and anti-Scl-70 antibodies. [Review] [52 refs]

Source: American Journal of Medicine. 103(3):242-8, 1997 Sep.

Abstract: PURPOSE: To determine the sensitivity and specificity of anti-centromere (ACA) and anti-Scl-70 antibodies in systemic sclerosis (SSc). METHODS: Four-hundred ninety-seven English language articles published from 1966 to 1994 were identified by structured MEDLINE search. Articles in which either ACA or anti-Scl-70 antibodies were measured in both SSc patients and a non-SSc control group were reviewed and rated using a previously published diagnostic testing scale. Reported sensitivity and specificity from each study was converted into a 2 x 2 table, and combined across studies to calculate summary rates for each antibody. Author's clinical classification criteria for SSc served as the gold standard for disease diagnosis. RESULTS: In 30 articles that fulfilled inclusion criteria, ACA were found in 441 of 1,379 SSc patients (sensitivity 32%, range 17% to 56%). This increased to 57% (332 of 585) in patients with the limited cutaneous, or CREST, subset of SSc (IcSSc). Anti-Scl-70 antibodies were found in 366 of 1,074 SSc patients (sensitivity 34%, range 3% to 75%), and this increased slightly to 40% in patients with the diffuse cutaneous form of SSc (dcSSc). Both antibodies were measured in 670 patients, and either test was positive in 58% (range 29% to 86%), but in only 3 patients were both antibodies present. The specificity of each antibody was high, but varied by control group. ACA were present in 5% and anti-Scl-70 antibodies were present in 2% of patients with other connective tissue diseases, but fewer than 1% of disease free controls had either antibody present. CONCLUSIONS: As individual diagnostic tests in SSc, both ACA and anti-Scl-70 antibodies are highly specific. Each performs somewhat better as discriminators of clinical subsets for patients in whom a diagnosis of SSc has already been established. Clinicians can rely on a positive test result as being specific in the detection of disease, but 40% of SSc patients are likely to have neither antibody present, and a negative result does not exclude the diagnosis. Measurement of these antibodies should be considered secondary to the clinical features when making a diagnosis of SSc. [References: 52]

Publication Type: Journal Article. Research Support, U.S. Gov't, Non-P.H.S.. Review.

Resident Report / Department of Medicine & Grady Branch Library

Emory University School of Medicine

2006 Edition

Participating Faculty:  Carlos Del Rio MD  / Joyce Doyle MD / Lorenzo Difrancesco MD / Joel Mermis MD / Maunank Shah MD

Contact: Karl Woodworth