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Biomedical subjects

R Mäkitalo

Publications and source records attributed to R Mäkitalo.

15 recordsLinked to original sources

The outcome of pregnancy in antinuclear antibody-positive women.

The significance of antinuclear antibodies (ANA) was studied in 51 ANA-positive women who had had a total of 170 pregnancies. 60 ANA-negative age- and parity-matched women with a total of 142 pregnancies served as controls. The perinatal mortality rate in the ANA-positive group was 18.6% (8/43), while there were no perinatal deaths in the ANA-negative control group. All the perinatal losses were stillbirths. The rate of spontaneous abortions was low in both groups, 2.0 vs. 3.3%, respectively. The ANA titer, complement-fixing activity and antigenic specificity did not correlate with the outcome of the pregnancy. Two infants of the ANA-positive women (3.9%) had a congenital atrioventricular heart block. In both cases the ANA was of the complement-fixing type.

Adult↗

More evidence of distinctive features of mixed connective tissue disease.

A comparison of clinical, immunological and HLA-D region antigen features was made between 22 patients with mixed connective tissue disease (MCTD) and 118 patients with systemic lupus erythematosus (SLE), scleroderma or primary Sjögren's syndrome. The MCTD patients had hypergammaglobulinemia more often than did those with SLE and scleroderma, but had less skin ulceration, serositis, nephritis, central nervous system disease and hypocomplementemia than the SLE patients. The frequencies of HLA-DR4 and its Dw4 subtype were significantly increased in MCTD as compared with both the other patient groups and healthy controls. Anti-RNP antibodies and the clinical characteristics together seem to illustrate a disease syndrome which is clinically and genetically distinct and fits with the prevailing concept of MCTD.

Adult↗

Systemic lupus erythematosus and related systemic diseases in a nationwide twin cohort: an increased prevalence of disease in MZ twins and concordance of disease features.

Concordance rates for systemic rheumatic diseases among monozygotic (MZ) and same-sex dizygotic (DZ) twin pairs ascertained from the older (twins born before 1958) and younger (twins born during the period 1958-1986) parts of the Finnish Twin Cohort were studied. Nine MZ pairs and 10 DZ pairs with at least one member affected by systemic lupus erythematosus (SLE) were identified. Only one MZ pair was concordant for definite SLE by American Rheumatism Association (ARA) criteria. In addition, two more MZ pairs that fulfilled three ARA criteria may have been concordant. None of the DZ pairs were concordant for SLE. MZ twins also had a higher concordance rate for tests of autoantibodies, but the numbers were small. Other systemic rheumatic diseases were infrequent. The cumulative incidence of systemic rheumatic diseases among MZ twin individuals (1.7/1000) was significantly higher than that among DZ twin individuals (0.7/1000).

Adult↗

Differences in HLA antigens between patients with mixed connective tissue disease and systemic lupus erythematosus.

Patients with mixed connective tissue disease (MCTD, n = 32) or systemic lupus erythematosus (SLE, n = 60) were typed for HLA-A, B, C, Dw, and DR antigens. All patients with SLE fulfilled at least four criteria of SLE and the patients with MCTD met the criteria proposed by Alarcon-Segovia (1989). The presence of antibodies to Sm was not considered as an exclusion for MCTD. In the patients with SLE, Dw3, DR3, and the associated B8 and A1 antigens were increased, whereas in the patients with MCTD an increased frequency of Dw4 was found (45 v 18% in controls v 14% in SLE). Of the subtypes of DR4, Dw4 was present in all but one of the DR4 positive patients. The frequency of DR4 in patients with MCTD (52%) differed significantly from that of controls (28%). The strong association of MCTD to one DR4 subtype was further seen in the significantly increased frequency of the B15, DR4 combination. Thus the genetic background seems to be different in patients with MCTD from that in patients with SLE. This could partly explain the clinical differences between these diseases.

Female↗

Occurrence of antinuclear antibodies in an unselected pregnancy population.

The occurrence of antinuclear antibodies (ANA) in an unselected population of pregnant women was studied by an indirect immunofluorescence method. Six women out of 116 were ANA-positive (5.2%), 2 of them having a moderately high titre (1:160 and 1:320) and 1 complement-fixing ANA. The antigenic specificity of ANA was anti-single-stranded DNA in 2 cases and RNAase-sensitive anti-extractable nuclear antigen in 1 case. Two of the ANA-positive women had pre-eclampsia laevis and 1 had a premature delivery. None of the infants of the ANA-positive women had symptoms of connective tissue disease. The occurrence of ANA among pregnant women was not significantly higher than among 70 non-pregnant female control subjects (7.1%).

Adolescent↗

Antinuclear antibodies heralding the onset of systemic lupus erythematosus.

On the basis of record linkage with the Social Security Institution's population register, 16 specimens from healthy subjects who subsequently developed systemic lupus erythematosus or mixed connective tissue disease could be traced from stored sera collected in connection with nationwide maternity welfare program in Finland. The sera were tested for antinuclear antibodies (ANA) using an immunofluorescence technique. Ten of the 16 specimens were positive. Eight of 11 cases were positive when the interval from taking the blood specimen to the onset of the first symptoms of disease was 2 years or less and 2 of 5 cases were positive when the interval was over 3 years. Eighteen of 21 sera with established disease and 5 of 85 control sera from the same serum collection were positive. Thus, ANA as detected by a sensitive technique frequently precede the onset of disease indicating that they are not a secondary manifestation of inflammation or tissue destruction.

Adult↗

Monitoring of smooth muscle antibodies in hypertensive complications during pregnancy.

Smooth muscle antibodies (SMA) were monitored in terms of titer, immunoglobulin class and staining pattern by indirect immunofluorescence assay during the pregnancies of 32 women with pregnancy induced hypertension (PIH), 21 with essential hypertension (EH), and 43 with a normal pregnancy. The mean SMA titer was higher both in PIH and EH than in normal pregnancy. SMA were mainly of the IgG class and gave a "vessel wall" staining pattern in immunofluorescence. The tendency for the mean SMA titer to increase was observed in PIH, whereas a falling tendency was found in EH and normal pregnancy. These tendencies suggest that hypertension, the duration of which has been shorter in PIH, induces SMA production. The observed staining pattern suggests the same kind of non-actin specificity for SMA as in our previous study of complications in early pregnancy.

Adult↗

Significance of false positive syphilis reactions and anticardiolipin antibodies in a nationwide series of pregnant women.

The highly sensitive rapid plasma reagin (RPR) and Treponema pallidum hemagglutination tests were used to determine the frequency of false positive syphilis reactions in a nationwide series of pregnant women in Finland. The frequency found was 14/10,000. Two cases of systemic lupus and 2 of undefined connective tissue disease were found during a 20-month period among 134 false positive reactors in a series of 110,000 separate pregnancies. The risk of subsequent fetal loss among false positive syphilis reactors was 7%, similar to the risk in RPR negative controls. Half of the sera in the highest RPR titer groups and 1/3 in the lowest titer groups had elevated levels of anticardiolipin antibodies in solid-phase enzyme immunoassay. This assay did not increase the risk of clinical disease or subsequent fetal loss above the risk of RPR test alone.

Adult↗

Rheumatoid arthritis with pleural effusion includes a subgroup with autoimmune features and HLA-B8, Dw3 association.

Twenty-eight patients with rheumatoid pleural effusion were investigated to examine the frequency of HLA antigens as compared with 56 rheumatoid arthritis (RA) patients without this intrathoracic manifestation of RA and with 283 healthy controls. HLA-B8 was strongly associated with the presence of pleural effusion (PE) in RA patients. A high prevalence (71%) of B8/Dw3 was found among male RA patients of the PE group in whom the joint disease had begun at an age over 50 years and who also had besides pleuritis other intrathoracic manifestations of RA associated with high rheumatoid factor titres and low complement (C4) levels in sera. Actually, the HLA-B8 association was not seen in the rest of the PE group. The finding may be related to the heterogeneity of RA, a male subgroup of the disease being characterized by multiple intrathoracic manifestations and genetically associated with the large group of autoimmune disorders, such as SLE, characterized by high prevalences of HLA-B8 and D(R)3.

Adult↗

Diffuse interstitial lung disease in rheumatoid arthritis. Views on immunological and HLA findings.

Immunological parameters including HLA typing were studied in 32 patients with rheumatoid arthritis (RA) associated diffuse interstitial lung disease (DILD) and in 32 age- and sex-matched RA control patients. The male RA patient group with DILD also included patients with other intrathoracic manifestations and had a higher prevalence of HLA-B8 and Dw3 than did healthy controls, thus agreeing with our earlier results that RA patients with this antigen combination are prone to multiple intrathoracic complications. Patients with DILD had higher titres of rheumatoid factor (RF) and lower complement (C4) levels than matched RA controls. The RF titre was in inverse correlation with C3 and C4 levels, suggesting that RF immune complexes may also promote rheumatoid lung disease via activation of the classical pathway of complement.

Aged↗

Smooth muscle antibodies in pre-eclampsia of pregnancy.

Sera from 176 patients with hypertensive disorders of pregnancy, intrahepatic cholestasis of pregnancy, and oedema of pregnancy, and from 51 normal pregnant control subjects were tested for smooth muscle antibodies (SMA) by indirect immunofluorescence. An increased incidence of SMA positivity was found in cases of pre-eclampsia and in superimposed pre-eclampsia of pregnancy, oedema of pregnancy and intrahepatic cholestasis of pregnancy combined with oedema of pregnancy. In the pre-eclampsia group, SMA positivity occurred only in cases of pre-eclampsia levis and was often accompanied by mild proteinuria. This indicates that SMA are a result rather than a cause of an (immuno)pathological process, the short duration of which in severe forms is not enough for the development of the antibodies. The increased incidence of positive SMA titres in oedematous pregnant patients may be a sign of imminent pre-eclampsia, although oedema is often regarded as being a feature of otherwise normal pregnancies.

Antibodies↗

Mitochondrial, nuclear and smooth-muscle antibodies in intrahepatic cholestasis of pregnancy.

Serum mitochondrial, nuclear and smooth-muscle antibodies were assayed by the immunofluorescence method in a series of 42 patients with intrahepatic cholestasis of pregnancy and a control series of 15 normal pregnant subjects. None of the subjects examined had mitochondrial antibodies, and nuclear antibodies were only found in one patient with intrahepatic cholestasis of pregnancy. Smooth-muscle antibodies were noted altogether in four patients with intrahepatic cholestasis of pregnancy, in three at a titre of 1 : 40 and in one at 1 : 80; in two controls at titres of 1 : 20, and in two at 1 : 40. In the differential diagnosis of intrahepatic cholestasis of pregnancy the smooth-muscle antibodies particularly may be helpful in differentiating viral hepatitis and intrahepatic cholestasis of pregnancy.

Adolescent↗

Smooth muscle antibodies in complicated early pregnancies.

The titer, immunoglobulin class, and staining pattern of smooth muscle antibodies (SMA) were assayed by indirect immunofluorescence in 15 patients with threatened abortion, 46 patients with spontaneous abortion, and 45 normal pregnant women in the first trimester to investigate possible abnormality of humoral immunity. An increased incidence of moderate and high titer SMA was found in both abnormal groups. SMA were mainly of the IgG class and gave a "vessel wall" staining pattern in immunofluorescence. This staining pattern suggests non-actin specificity of SMA. The more precise characterization of the antigen specificity of SMA in complications during pregnancy requires further investigation.

Abortion, Spontaneous↗