RESUMEN
Pseudo-pseudo Meigs' syndrome (PPMS) has been reported to be a rare presentation of patients with systemic lupus erythematosus (SLE). However, such a presentation is not common in other forms of connective tissue disease. We presented a case of gross ascites, pleural effusion, and marked elevation of CA-125 level (PPMS-like features) that led to a diagnosis of MCTD. The patient responded to systemic steroid therapy.
Asunto(s)
Síndrome de Meigs/diagnóstico , Enfermedad Mixta del Tejido Conjuntivo/diagnóstico , Enfermedad de Raynaud/patología , Adulto , Antiinflamatorios/administración & dosificación , Diagnóstico Diferencial , Femenino , Humanos , Lupus Eritematoso Sistémico/patología , Síndrome de Meigs/diagnóstico por imagen , Síndrome de Meigs/tratamiento farmacológico , Síndrome de Meigs/patología , Metilprednisolona/administración & dosificación , Enfermedad Mixta del Tejido Conjuntivo/tratamiento farmacológico , Enfermedad Mixta del Tejido Conjuntivo/patología , Prednisolona/administración & dosificación , RadiografíaRESUMEN
AIM: The purpose of this study is to compare the prevalence of rheumatoid factor (RF) isotypes and second generation anti-cyclic citrullinated peptides (anti-CCP) in Malaysian rheumatoid arthritis (RA) patients. METHODS: In this cross-sectional study, 147 established RA patients from three ethnic groups were recruited from a major rheumatology clinic in Malaysia. Enzyme-linked immunosorbent assays (ELISA) for serum RF isotypes IgA, IgG and IgM as well as second-generation anti-CCP were performed and the prevalence of each auto-antibody was compared in the three ethnic groups. RESULTS: The anti-CCP was the most prevalent auto-antibody in each of the ethnic groups, followed closely by RF IgM and RF IgG. Rheumatoid factor IgA was the least prevalent across all three ethnic groups. The anti-CCP-RF IgM combination provided the best test sensitivity. Seroprevalence of anti-CCP was strongly associated with the presence of each of the RF isotypes. The seroprevalence of RF and anti-CCP did not increase or decrease with advancing age, age at onset and disease duration. CONCLUSION: When used alone, anti-CCP provides a diagnostic advantage over RF IgM on the basis of test sensitivity. Considering the high cost of the anti-CCP assay, step-wise serum testing with IgM RF followed by anti-CCP may provide a more economically sensible option to optimize test sensitivity for RA.