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PubMed2003

Reactivation of Epstein-Barr virus in patients with systemic lupus erythematosus.

A link between Epstein-Barr Virus (EBV) and systemic lupus erythematosus (SLE) has been suggested. However, recent advances in molecular technology now permit more detailed analysis. Sera from SLE patients were tested for antibodies to several EBV antigens and had a significantly higher prevalence of immunoglobulin G antibodies against EBV early antigens than in normal or disease controls. This suggests that recent EBV infection or virus reactivation was occurring in these patients.

Adult↗

PubMed2004

Calcaneus bone mineral density in Japanese women with rheumatoid arthritis.

OBJECTIVES: The aim of this study was to investigate the relationships among bone mineral densities (BMD) in the calcaneus and leg activity of daily living (L-ADL) in rheumatoid arthritis (RA) patients. METHODS: We measured and compared calcaneus BMD using single X-ray absorptiometry and lumbar spine and femoral neck BMD using dual X-ray absorptiometry in 158 Japanese female outpatients with RA and 358 normal controls (NC). RESULTS: Regardless of whether the women were premenopausal or postmenopausal, calcaneus and femoral neck BMDs in the RA group were significantly lower than in the NC group. Calcaneus BMD correlated with the modified health assessment questionnaire, L-ADL score, and 10-m walking time, regardless of whether the patients were premenopausal or postmenopausal (P<0.01). CONCLUSIONS: We conclude that calcaneus BMD reflects the L-ADL of RA patients very well and allows us to perform the same level of BMD evaluation as that with current BMD measurement methods.

Absorptiometry, Photon↗

PubMed2003

Iron status of adults in the capital area of Finland.

BACKGROUND: Enrichment of wheat flour with iron, which commenced in Finland in the mid-1970s, ceased in 1994. No data on iron status among adults have been published since 1993. AIM OF THE STUDY: To assess the iron status, adequacy of iron intake and dietary sources of iron in Finnish adults. METHODS: A random sample of adults aged 25-64 years in the capital area of Finland was stratified for sex and 10-year age groups. Food consumption was measured with 24-h recall and a 38-item food frequency questionnaire. Iron status was evaluated by haemoglobin (Hb) concentration and other haematological variables from venous blood samples in both genders (n = 239 men and 190 women), and serum ferritin (SF) for women (n = 137). RESULTS: The mean Hb concentration was 133+/-12 g/l and 137 +/- 10 g/l for women aged < 50 years and >/= 50 years, respectively, and 150 +/- 10 g/l for men. In younger women, the mean SF level was 32 +/- 30 micro g/l and 20% of women showed iron depletion (SF < 12 micro g/l),whereas in older women, the respective results were 62 +/- 59 micro g/l and 11 %. The prevalence of anaemia was 5.8 % for women (Hb < 120 g/l) and 1.3 % for men (Hb < 130 g/l). The respective mean intakes of iron were 10 mg/d and 13 mg/d. Cereals and meat were the major dietary sources of iron. CONCLUSIONS: While iron status is fairly good among Finnish males, especially in younger women it is suboptimal,with iron intake failing to reach recommended levels. Food consumption was poorly associated with iron status.

Adult↗

PubMed2000

Y chromosome STR haplotypes in four populations from northwest Africa.

The eight short tandem repeat (STR) polymorphic systems mapping on the male-specific region of the human Y chromosome, DYS19, DYS388, DYS389I, DYS389II, DYS390, DYS391, DYS392 and DYS393, were typed in four populations from northwest (NW) Africa (Moroccan Arabs, southern Moroccan Berbers, Saharawis and Mozabites). Allele frequency distributions showed statistically significant differences for all loci among all the populations except for DYS19. Complete typing was obtained for 185 chromosomes, which showed 74 different haplotypes. The two most frequent haplotypes were found in 16.2% and 15.1% of the individuals, although the latter was almost exclusively found in the Mozabites. Locus and haplotype informativeness were measured by means of the gene diversity (D). The haplotype diversity ranged from 0.856 (Mozabites) to 0.967 (southern Moroccan Berbers). For some loci, allele frequencies in NW Africans were clearly different from those in Europeans. The most common NW African haplotype was found only in one individual out of a total of 494 Europeans typed for the whole STR set. Thus, NW African and European Y chromosomes are clearly differentiated.

Africa, Northern↗

PubMed1998

Soluble intercellular adhesion molecule-1 in newborn infants.

UNLABELLED: The aim of this study was to evaluate the effect of increasing postnatal age on soluble intercellular adhesion molecule-1 (sICAM-1), a very early and sensitive marker of immune activation and response in the serum of newborn infants. Serum sICAM-1 was measured by EIA (T Cell Diagnostics) in 20 healthy adults (controls) and in 43 (24 females/19 males) healthy neonates, of whom 28 were full term, and 15 were born at a gestational age between 35 and 38 weeks of pregnancy, on the 1st, 5th and 30th day of life. Neonatal serum sICAM-1 values showed a very significant increase (P < 0.01) from the 1st day (137.3+/-62.0 ng/ml) to the 5th day (259.3+/-124.0 ng/ml) and then to the 30th day of life (415.0+/-114.0 ng/ml), being significantly lower on the 1st day (P < 0.01), whereas significantly higher on the 30th day of life (P < 0.05), than those in healthy adults (305+/-195 ng/ml). Serum sICAM-1 values on the 1st day of life depended on both the mode of delivery (significantly higher in neonates born vaginally) and the gestational age at birth (significantly lower in those born at a gestational age over 38 weeks). A significant strong correlation was found in sICAM-1 values between the 1st and the 5th day following delivery (rp = 0.77, P < 0.009). CONCLUSION: The results of this study demonstrate a significant rise of serum sICAM-1 during the 1st month of life in healthy neonates suggesting a progressively increased activation of the neonatal immune system.

Adult↗

PubMed1998

Does the long-term clinical course of type I diabetes mellitus differ in patients with prepubertal and pubertal onset? Results of the Berlin Retinopathy Study.

UNLABELLED: The objective of the present study was to investigate potential differences at presentation of type I diabetes and during its long-term clinical course in children and adolescents with prepubertal and pubertal manifestation. Clinical, immunological and biochemical characteristics at diabetes onset of 453 patients (320 prepubertal, 133 pubertal; median age at manifestation 7.1 years (0.7-13.9) and 13.1 years (9.2-17.6), respectively) were evaluated. Glycaemic control and exogenous insulin requirements were followed prospectively, with a median follow up of 9.4 years. At the onset of the disease no differences concerning the degree of metabolic decompensation, impairment of somatic health, and islet cell antibody status could be detected between the groups, except for a smaller body weight loss in pubertal patients (P=0.011). The duration of partial remission (insulin requirements <0.5 IU/kg body weight/day) was unrelated to age or pubertal status at onset. It was found to be longer in boys than in girls in the total cohort (median duration: 279 vs 215 days, P = 0.0071). Despite an absence of differences during the early course of the disease, glycaemic control was better, and daily insulin doses were significantly lower in patients with pubertal onset, after 6 years of diabetes. CONCLUSION: Adolescents with a pubertal onset of type I diabetes have a more benign long-term course of the disease demonstrating better glycaemic control and lower insulin requirements, although the presentation of the disease at onset and its course during the first 6 years are not different from those of children with a prepubertal manifestation of diabetes.

Adolescent↗

PubMed1999

Soluble vascular cell-adhesion molecule-1 and soluble intercellular adhesion molecule-1 correlate with lipid and apolipoprotein risk factors for coronary artery disease in children.

UNLABELLED: Atherosclerosis begins in childhood and progresses from fatty streaks to raised lesions in adolescence and young adulthood. This process is accelerated in children with risk factors for coronary artery disease (CAD). Cell adhesion molecules (CAMs) are supposed to play important roles in the initial development of atherosclerosis, which may suggest that the expression of CAMs is increased in children more than in older subjects or in CAD patients. To determine whether risk factors for CAD are associated with an increased expression of CAMs, we investigated the relationships of the serum levels of soluble vascular cell adhesion molecule-1 (VCAM-1), soluble intercellular adhesion molecule-1 (ICAM-1) and soluble P-selectin (P-selectin) with lipid and apolipoprotein parameters in children (40 boys and 45 girls). We also examined the relationships between soluble CAMs and the fractional esterification rate of cholesterol in HDL (FER(HDL)), particle size of LDL and lipoprotein containing apoA-I, but no apoA-II (LpA-I). In children, soluble VCAM-1 levels were correlated with the levels of triglyceride (in boys) and apoB, the ratio of apoB to apoA-I and FER(HDL) (in girls). Similar associations were found for soluble ICAM-1. Furthermore, the soluble ICAM-1 level was inversely correlated with LpA-I level, LDL size (in boys) and HDL cholesterol level (in girls). Soluble P-selectin levels were not correlated with these parameters. CONCLUSION: Our data indicate that intervention to normalize risk factors for coronary artery disease should be started at a young age to prevent increased expression of cell adhesion molecules.

Adolescent↗

PubMed2005

Evidence for genetic anticipation in hereditary non-polyposis colorectal cancer.

Hereditary non-polyposis colorectal cancer (HNPCC) is an autosomal, dominantly inherited, colorectal cancer (CRC) predisposition syndrome caused by germline mutations in DNA mismatch repair (MMR) genes, predominantly MLH1 and MSH2. Thus far, only limited data exist on the occurrence of genetic anticipation in HNPCC, i.e. the earlier age at diagnosis of CRC in successive generations. Performing nonparametric distribution-free statistical analyses, we investigated 55 parent-child pairs who had been diagnosed with CRC and who came from 21 Swiss HNPCC families with characterised MMR germline mutation (15 in MLH1 and 6 in MSH2). The overall median age at diagnosis was 43 years, with an interquartile range (IQR) of 14 and incidence ages ranging from 18 to 62 years. Descendants of HNPCC patients (median age at diagnosis 39 years, IQR=12) were found to be diagnosed with CRC significantly earlier than their parents (47 years, IQR=10), with the median of the paired age difference amounting to 8 years (IQR=15; P<0.0001). Birth cohort effects could be excluded, since the same, statistically significant, age difference was also observed in the oldest offspring birth cohort (birth year <1916; P=0.01). Genetic anticipation appeared to be more pronounced when the disease allele was transmitted through the father than through the mother (median age difference 11 vs. 4 years, respectively; both P<0.01). If confirmed in larger, ideally prospective studies, these results may have important implications for genetic counselling and clinical management of HNPCC families.

Adolescent↗

PubMed1996

Are men carrying the apolipoprotein epsilon 4- or epsilon 2 allele less fertile than epsilon 3 epsilon 3 genotypes?

The epsilon 3 allele in the human gene coding for apolipoprotein E (apoE) is the most common worldwide, but epsilon 4 is probably the ancestral allele. Since apoE is involved in many important biological processes, selection forces could have favoured epsilon 3. We hypothesized that apoE genotypes may affect reproductive efficiency, and we therefore compared the distributions of 40-year-old married men with known genotypes by the numbers of their biological children. The distributions were statistically significantly different (P = 0.0026). On average, men with the epsilon 3 epsilon 3 genotype (n = 212) had 1.93 children, men with the epsilon 3 epsilon 4 or epsilon 4 epsilon 4 genotype (n = 105) had 1.50, and men with the epsilon 3 epsilon 2 or epsilon 2 epsilon 2 genotypes (n = 53) had 1.66 children. Of the men in the three groups, 6%, 26% and 19%, respectively, reported being childless. These findings are unlikely to be due to gross error in the reported prevalence of childlessness, differences in socioeconomic status or other likely sources of bias. They are compatible with higher fertility in men with the epsilon 3 epsilon 3 genotype than in those with the other common apoE genotypes.

Adult↗

PubMed2006

Pooled data analysis of laparoscopic vs. open ventral hernia repair: 14 years of patient data accrual.

BACKGROUND: The purpose of this study was to analyze the published perioperative results and outcomes of laparoscopic (LVHR) and open (OVHR) ventral hernia repair focusing on complications and hernia recurrences. METHODS: Data were compiled from all English-language reports of LVHR published from 1996 through January 2006. Series with fewer than 20 cases of LVHR, insufficient details of complications, or those part of a larger series were excluded. Data were derived from 31 reports of LVHR alone (unpaired studies) and 14 that directly compared LVHR to OVHR (paired studies). Chi-squared analysis, Fisher's exact test, and two-tailed t-test analysis were used. RESULTS: Forty-five published series were included, representing 5340 patients (4582 LVHR, 758 OVHR). In the pooled analysis (combined paired and unpaired studies), LVHR was associated with significantly fewer wound complications (3.8% vs. 16.8%, p < 0.0001), total complications (22.7% vs. 41.7%, p < 0.0001), hernia recurrences (4.3% vs. 12.1%, p < 0.0001), and a shorter length of stay (2.4 vs. 4.3 days, p = 0.0004). These outcomes maintained statistical significance when only the paired studies were analyzed. In the pooled analysis, LVHR was associated with fewer gastrointestinal (2.6% vs. 5.9%, p < 0.0001), pulmonary (0.6% vs. 1.7%, p = 0.0013), and miscellaneous (0.7% vs. 1.9%, p = 0.0011) complications, but a higher incidence of prolonged procedure site pain (1.96% vs. 0.92%, p = 0.0469); none of these outcomes was significant in the paired study analysis. No differences in cardiac, neurologic, septic, genitourinary, or thromboembolic complications were found. The mortality rate was 0.13% with LVHR and 0.26% with OVHR (p = NS). Trends toward larger hernia defects and larger mesh sizes were observed for LVHR. CONCLUSIONS: The published literature indicates fewer wound-related and overall complications and a lower rate of hernia recurrence for LVHR compared to OVHR. Further controlled trials are necessary to substantiate these findings and to assess the health care economic impact of this approach.

Female↗

PubMed2001

Septic complications of elective laparoscopic colorectal resection.

BACKGROUND: We set out to determine the rate and pattern of septic complications of the surgical wound, abdominal cavity, and urinary and respiratory tracts following laparoscopic colorectal resection. METHODS: A longitudinal database of 500 consecutive cases of colorectal resections was reviewed. RESULTS: The total wound infection rate was 7.2% (36/500) and included infections of the abdominal wall wounds (32/500, 6.4%) and the perineal wounds (4/50, 8%). The anastomotic leak rate in 418 patients who underwent resection with primary anastomosis was 3.3% (14/418). Intraabdominal abscesses were diagnosed in 1% (5/500) of patients. Urinary tract infections were rare (3/500, 0.6%), as was postoperative pneumonia (6/500, 1%). CONCLUSIONS: This study confirms the low rate of postoperative pneumonia observed with all other minimally invasive procedures. Intraabdominal abscesses, urinary tract infections, and postoperative pneumonia occur considerably less frequently than in reported historical controls for open surgery. The rates of abdominal wound infection and anastomotic leak in laparoscopic colorectal resection appear to be equivalent to traditional surgery, whereas the rate of perineal wound sepsis is lower. Comparative studies are needed to determine the differential costs of the septic episodes associated with the two approaches.

Abscess↗

PubMed2005

Prediction of success in the first-year exam in the study of medicine--a prospective survey.

OBJECTIVE: To identify predictors of students' success in the first-year exam in a new curriculum in the study of medicine in Vienna. DESIGN: We tested 11 topics (including socio-demographic variables, family background, school performance, economic situation, living conditions, social integration and health, learning capacity, study motivation and ability to cope with stress) for their relevance in terms of study success in a prospective study of an unselected student sample. Data were collected from questionnaires filled in by 674 first-year students (50.8% of the total number of 1327 new students) who enrolled in the academic year 2002/03. MAIN OUTCOME: Comparison of students who passed the first-year exam with students who failed identified four predictors: male sex, German mother tongue, performance in secondary school and learning capacity. CONCLUSIONS: The new curriculum exerted subliminal selectivity; the predictive powers of school marks and subjective learning capacity were confirmed; the influence of a student's sex should be investigated further; the influence of mother tongue requires modification of pre-study courses for foreign students.

Age Distribution↗

PubMed2000

Hepatectomy for hepatitis B-, hepatitis C-, and dual hepatitis B- and C-related hepatocellular carcinoma in Taiwan.

To evaluate the surgical results of patients with hepatitis B-, hepatitis C- and dual hepatitis B- and C-related hepatocellular carcinoma (HCC), we reviewed the clinical records 252 patients (196 men and 56 women) with complete profiles of hepatitis B and hepatitis C infection who had hepatectomies to treat HCC from March, 1992, to August, 1998. The patients were divided into four groups, 30 patients (11.9%) without either hepatitis B surface antigen or anti-hepatitis C antibody (N-HCC group), 133 patients (52.8%) with hepatitis B infection only (B-HCC group), 66 patients (26.2%) with hepatitis C infection only (C-HCC group), and 23 patients (9.1%) with dual hepatitis B and C infection (BC-HCC group). Compared with the patients in the other groups, the patients in the C-HCC group were older and had more severe cirrhotic change of the liver. The surgical complication rates and hospital mortalities in the C-HCC and BC-HCC groups were 30.3% and 12.1% and 30.4% and 17.4%, respectively, which were higher than those in the N-HCC (13.3%, 3.3%) and B-HCC (15.8%, 3.8%) groups. The mean disease-free survivals for the N-HCC, B-HCC, C-HCC, and BC-HCC groups were 31.4, 25.4, 38.9 and 13.8 months, respectively, with the difference between the four groups being significant (P < 0.05). However, the mean overall survival times, 38.3 months for the N-HCC group, 37.2 months for the B-HCC group, 52.1 months for the C-HCC group, and 32.7 months for the BC-HCC group, were not significantly different (P = 0.146). In conclusion, surgical treatments for HCC related to hepatitis C or dual hepatitis B and C infection were associated with a higher surgical complication rate and hospital mortality. Hepatocellular carcinoma related to dual hepatitis B and C infection recurred earlier after hepatectomy, but the overall survival of the four groups was not significantly different.

Adult↗

PubMed2002

Risk factors for infections in cirrhotic patients with and without hepatocellular carcinoma.

BACKGROUND: Patients with liver cirrhosis (LC) frequently have complications with bacterial infections, and these infections increase the mortality rate. However, a detailed analysis of infections associated with LC patients has not yet been performed. METHODS: We analyzed 325 patients with LC with and without hepatocellular carcinoma (HCC) who were hospitalized between 1997 and 1999. RESULTS: Infections developed in 70 (21.5%) patients and 48 (68.6%) of these developed infections during hospitalization. The mortality rate of 28.6% (20/70) in patients with infectious complications was higher than that of 12.5% (32/255) in patients without infectious complications. Forty (57.1%) of the 70 patients had infections of unknown causes; 11 (15.7%) had sepsis; 6 (8.6%) had intravenous hyperalimentation (IVH) infection; 3 (4.3%) each had spontaneous bacterial peritonitis (SBP), liver abscess, and cholecystitis; and 4 (5.7%) had other infections. Bacterial cultures of blood were prepared from 73 of the 325 patients (22.5%), and were positive in 22 of the 73 patients (30.1%). Of these 22 culture-positive patients, 11 had sepsis, 6 had IVH infection, 2 had liver abscess, 1 had cholecystitis, 1 had pneumonia, and 1 had decubitus ulcer. Gram-positive bacterial strains were detected most frequently, in 16 of the 24 strains isolated. Univariate analysis revealed significant differences between the groups with and without infectious complications with regard to hepatitis B virus infection, Child-Pugh classification, ascites, esophageal varices, survival rate, total-bilirubin (T-Bil), albumin (Alb), lactate dehydrogenase (LDH), total cholesterol (T-chol), and prothrombin time (PT). On multivariate analysis, the Alb level was selected as a significant independent factor contributing to the development of infections. CONCLUSIONS: Patients with advanced cirrhosis with low Alb levels should be carefully treated, and the administration of broad spectrum antibiotics covering gram-positive bacteria needs to be considered in the treatment of infections.

Age Distribution↗

PubMed2004

Potentially curative resection for locoregional recurrence of colorectal cancer.

PURPOSE: Local recurrence after curative surgery for colorectal cancer may be treated by potentially curative surgery, defined as resection of all macroscopic disease. We conducted this retrospective study to show the effectiveness of potentially curative resection for patients with locoregional recurrence (LRR). METHODS: We reviewed the records of 242 patients who underwent curative resection of colorectal cancer in our unit between 1988 and 2000. Locoregional recurrence developed in 50 (20.6%) patients, and was treated by R0 resection in 10 (20%) patients (group R0), by R1 resection in 8 (16%) patients (group R1), by R2 resection in 13 (26%) patients (group R2), and by surgery without resection in 12 (24%) patients (group NR). Seven (15%) patients did not undergo surgery (group NS). RESULTS: The mean survival periods were 48, 36, 10, 5.6, and 5 months in groups R0, R1, R2, NR, and NS, respectively. There was no significant difference in survival between groups R0 and R1 (P = 0.5), but survival was significantly longer in groups R0 and R1 than in groups R2, NR, and NS (P = 0.001). CONCLUSION: These findings show that surgeons should aim to achieve at least macroscopic clearance of the recurrent tumor. Potentially curative surgery improves survival in selected patients with LRR after curative resection of colorectal cancer.

Adolescent↗

PubMed2005

Clinicopathologic features and outcome after liver resection for hepatocellular carcinoma in patients with concurrent versus previous chronic hepatitis B.

PURPOSE: We compared the clinicopathologic features affecting outcome after surgery for hepatocellular carcinoma (HCC) between patients with concurrent and previous chronic hepatitis B. METHODS: Group A consisted of 58 patients with concurrent chronic hepatitis B, defined by seropositivity for the hepatitis B surface antigen (HBsAg), and group B consisted of 18 patients whose HCC was detected after disappearance of the HBsAg. We assessed the influence of various characteristics on outcome. RESULTS: The mean age and percentage of patients suffering from alcohol abuse or diabetes mellitus were significantly greater in group B than in group A, whereas histologic hepatitis activity, hepatic fibrosis, and alanine aminotransferase activity were significantly lower in group B than in group A. The tumor-free survival rates were similar between the two groups, but the risk factors of recurrence differed. In group A, relative youth, high aspartate aminotransferase activity, low platelet count, multiple tumors, large tumor size, portal invasion, cirrhosis, nonanatomic resection, and positive surgical margin were risk factors. In group B, large tumor size and poor differentiation were risk factors. CONCLUSION: Hepatitis B status, tumor factors, and the type of operation affected cancer recurrence after surgery for HCC in patients with concurrent chronic HBV, as opposed to only tumor factors in patients with previous chronic hepatitis B.

Age Distribution↗

PubMed2003

Management of recurrent inguinal hernias: a prospective study of 163 cases.

There remains debate as to how recurrent inguinal hernias should be managed. This study aimed to establish a management plan for recurrent hernias. From 1991-2000, 163 patients were operated on for recurrent inguinal hernias. The average interval from the initial surgery to recurrence was 46 months (range 10 days-13 years). The initial surgery prior to recurrence was Shouldice and other techniques without mesh in 142 cases, a Stoppa or a Lichtenstein procedure in ten and three cases, respectively, and laparoscopic repair in eight cases. The recurrent hernias were treated with a Shouldice repair in 52 cases (31.9%), the Lichtenstein technique in 48 cases (29.4%), a totally extraperitoneal laparoscopic repair in 40 cases (24.5%), and a Stoppa procedure in 23 (14.1%). The approaches to management evolved with time: the use of prostheses for recurrent hernia repair increased from 10% in 1991 (2/10) to 100% in 2000 (22/22). In contrast, the Shouldice repair decreased from 90% (18/20) in 1991 to 0% (0/22) in 2000. The Lichtenstein technique was first employed in 1993, in patients with a history of a conventional, laparoscopic, or Stoppa repair and has increased to represent 77% of cases (17/22) in 2000. The Stoppa technique has not been used since 1998. The use of a totally extraperitoneal laparoscopic approach went from 11% (2/18) in 1992 (introduction of the technique) to 23% (5/22) in 2000 and is reserved for recurrence after a Lichtenstein procedure or after conventional repair in working and/or physically active patients without any contraindications to general anesthesia. Prosthetic reinforcement has become the norm in the treatment of recurrent hernias. Given a previous conventional repair, the prosthesis can be placed by either an anterior or posterior approach. The approach is dependent on the level of activity and operability of the patient. If the recurrence follows a totally extraperitoneal or a Stoppa procedure, then the Lichtenstein intervention is recommended. A recurrence after a Lichtenstein procedure should be treated by a totally extraperitoneal approach.

Adult↗

PubMed2003

Cardiac valvular disease in patients with systemic lupus erythematosus. Relationship with anticardiolipin antibodies.

We performed two-dimensional and Doppler echocardiography in 52 patients with systemic lupus erythematosus and in 34 healthy controls. In 25 patients (48.1%) echocardiographic disturbances were found (25/52 vs 2/34, p<0.001). Valvular abnormalities were detected in 18 patients (34.6%) but in only two controls (18/52 vs 2/34, p<0.01). The mitral valve was involved in 12 patients (23.1%). The most frequent finding was mild (13.5%) and moderate (9.6%) regurgitation or valvular thickening (9.6%). The aortic valve was involved in six and the tricuspid valve in three patients (11.5% and 5.8%, respectively). Only one patient had echocardiographic non-infective verrucous vegetation affecting the tricuspid valve. We did not observe significant hemodynamic valve disease. Endocardial findings were related to disease duration (p<0.05) but not to disease activity. Twenty-eight SLE patients (53.8%) had increased anticardiolipin antibodies (aCL). Patients with aCL (particularly those with IgG class) were characterized by a high incidence of echocardiographic abnormalities (p<0.001), mainly valvular (mitral or aortic) regurgitation (p<0.05). We found a relationship between anticardiolipin antibodies and disease activity (p<0.05). In conclusion, we postulate a prominent role for anticardiolipin antibodies in the pathogenesis of heart valve disease in patients with SLE.

Adolescent↗