China
Africa
Explore chapters and articles related to this topic
Systemic Lupus Erythematosus
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Vaneet K. Sandhu, Neha V. Chiruvolu, Daniel J. Wallace
One of the first known attempts to classify SLE was made in 1971 by the American Rheumatism Association (ARA) Committee on Diagnostic and Therapeutic Criteria. These criteria were intended for classification use in population surveys, studies on natural history, and therapeutic clinical trials, and the criteria were never intended to be used as diagnostic criteria. Furthermore, formal statistics were not used in the formation of the criteria, which were entirely evidence-based. The proposed criteria included twenty-one items covering fourteen manifestations: facial erythema (butterfly rash), discoid lupus, Raynaud’s phenomenon, alopecia, photosensitivity, oral or nasopharyngeal ulceration, arthritis without deformity, LE cells, chronic false-positive standard tests for syphilis, profuse proteinuria (>3.5 g/day), cellular casts, pleuritis or pericarditis, psychosis or convulsions, and either hemolytic anemia, leukopenia, or thrombocytopenia.2, 4 It is important to note that LE cells and a false-positive syphilis test were included in the original criteria as SLE patients frequently tested positive for the venereal disease research laboratory test (VDRL). This observation was first noted in the early twentieth century and later confirmed by multiple studies. Shortly after the ARA criteria were published, several well-known groups published their own data demonstrating that ≥ 94% of their own patient populations met four or more of the criteria, which indicated potential promise for this new set of criteria (Table 6.1).2
Dementia
Published in Henry J. Woodford, Essential Geriatrics, 2022
There are no laboratory tests to diagnose the common forms of dementia. Investigations may help to exclude potentially reversible causes. The standard ‘dementia screen' bloods: ESR, vitamin B12 and TSH should be performed (to exclude vasculitis [see page 431], combined degeneration and hypothyroidism). Syphilis serological testing (venereal disease research laboratory test [VDRL]) may be considered – see Box 6.1. Although, none of these is likely to be the cause.
Syphilis
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
These detect non-specific antibodies associated with syphilis infection. Venereal disease research laboratory test (VDRL).Rapid plasma reagin (RPR) test.Toluidine red unheated serum test (TRUST).
Persistent shoulder pain as a first manifestation of vasculo-Behçet
Published in Scandinavian Journal of Rheumatology, 2023
M Seabra Rato, R Miriam Ferreira, L Costa
A 37-year-old Caucasian female developed an asymmetric polyarthritis involving the wrists, metacarpophalangeal joints, right shoulder, and left knee, recurrent oral and genital ulcers, and extensive pseudofolliculitis lesions, accompanied by weight loss and generalized weakness. The initial laboratory results showed mild normocytic anaemia (10.7 g/dL), leucocytosis with polymorphonuclear predominance, and marked elevation of C-reactive protein (98 mg/L) and erythrocyte sedimentation rate (67 mm/h). The complement C3 and C4 levels were within normal limits and autoantibodies (including antinuclear antibody, anti-double-stranded DNA, anti-extractable nuclear antigen, and rheumatoid factor) were negative. The Venereal Disease Research Laboratory test and serologies for human immunodeficiency virus and viral hepatitis were negative. Testing for human leucocyte antigen-B51 and the pathergy test were also negative. An ophthalmological screen did not reveal features of uveitis. A diagnosis of BD was made on clinical grounds and the patient started prednisolone 20 mg/day and colchicine 1 mg/day, with good response. A few weeks later, she had no more arthritis on physical examination, which was confirmed by articular ultrasound. Azathioprine (AZA) was introduced and steroid weaning was possible until 7.5 mg/day. However, she presented angioedema, nausea, and vomiting with AZA, for which it was withheld. Treatment with colchicine (1 mg/day) and prednisolone (7.5 mg/day) was maintained.
Presumed Recurrent MEWDS following Covid-19 Vaccination
Published in Ocular Immunology and Inflammation, 2021
Hematologic parameters including a serum complete blood count, angiotensin I converting enzyme test (ACE), T-SPOT test, a venereal disease research laboratory test (VDRL) and an antinuclear antibody test (ANA) were all negative. Colloidal gold immunochromatography test was negative for SARS-CoV-2 antibody (48 days after the first dose of Covid-19 vaccination). A trial of prednisone 20 mg per day was administered for 1 week, then tapered gradually. Although there was no direct evidence, considering the possibility that the vaccine resulted in a latent viral infection, antiviral drug (acyclovir) combined with Vitamin B2 and Vitamin C were prescribed as well. The patient was asked to follow up every 2 weeks (Figure 3a–h). Eight weeks after the initial evaluation, her BCVA had improved to 20/20 in the left eye, with both symptoms and signs resolved.
Ocular syphilis
Published in Clinical and Experimental Optometry, 2021
Grace L Tsan, Richard T Claiborne
Patients with ocular syphilis should have their cerebrospinal fluid tested using either a non-treponemal test, usually the Venereal Disease Research Laboratory test, or the fluorescent treponemal antibody absorbed test. The cerebrospinal fluid fluorescent treponemal antibody absorbed test is less specific for neurosyphilis than the cerebrospinal fluid Venereal Disease Research Laboratory test, but is highly sensitive. Patients with ocular syphilis should also be screened for human immunodeficiency virus co-infection.10,13,18