Introduction TNF-α plays an important role in host defense against various infections and in the ... more Introduction TNF-α plays an important role in host defense against various infections and in the pathogenesis of chronic inflammatory diseases. Therapeutic blockade of TNF-α could be an effective treatment in such cases. However, anti-TNF-α therapy increases the risk of reactivation of serious infections, including tuberculosis (TB). Thus, screening for TB became mandatory, prior to the initiation of TNF-α inhibitor therapy. Aim of the study To assess the performance and characteristics of the Quantiferon TB Gold test (QFT) by screening for TB in three different populations in Hungary: patients with inflammatory rheumatic diseases (RD), health-care workers who serve homeless people (HW) and homeless clients (HL). Methods Between April 2011 and March 2014, samples of 1430 consecutive RD patients, who required or already underwent TNF-a blocking therapy, were screened for latent TB. Two untreated groups, (i) 120 HL and (ii) 46 HW, both considered to be at high risk for TB, were also tested. The QFT was performed according to the manufacturer instructions. The amount of released IFN-g was measured by ELISA in samples stimulated by TB Antigen, saline (NIL) and phytohemagglutinin A (PHA). Results In the RD group, the QFT was negative in 87%, positive in 11%, and indeterminate in 2%. Of the 265 patients, 36 (13.6%) showed inconsistent results on repeat testing. In the HW group, the QFT was negative in 63% and positive in 37%. In the HL group, the QFT was negative in 50.8%, positive in 46.7% and indeterminate in 2.5%. In the RD group, low mitogen response (caused mainly by low lymphocyte count and/or improper specimen handling) and positive results close to the cut-off value of 0.35 IU/mL account for 86% of inconsistent results, while true reversions or conversions only for 14%. Conclusions Based on our results, for better differentiation of non-specific variations, we suggest that a grey zone close to the cut-off value of 0.35 IU/mL (0.35–0.800 IU/mL) should be defined. As for the mitogen response, results higher than 0.5 IU/mL (cut-off), but lower than 2 IU/mL should be interpreted carefully. Repeat testing in such cases could prevent misinterpretations caused by technical errors.
Objectives Rheumatoid factor (RF) is a well-established marker for the diagnosis and classificati... more Objectives Rheumatoid factor (RF) is a well-established marker for the diagnosis and classification of rheumatoid arthritis (RA). Most studies evaluated IgM RF or isotype-nonspecific total RF assays. We evaluated the added value of IgA RF in this context. Methods An international sample cohort consisting of samples from 398 RA patients and 1073 controls was tested for IgA RF with 3 commercial assays. For all RA patients and 100 controls essential clinical and serological data for ACR/EULAR classification were available. Results The sensitivity of IgA RF for diagnosing RA was lower than the sensitivity of IgM RF. Differences in numerical values between IgA RF assays were observed. With all assays, the highest IgA RF values were found in patients with primary Sjögren’s syndrome. Double positivity for IgM RF and IgA RF had a higher specificity for RA than either IgM RF or IgA RF. The sensitivity of double positivity was lower than the sensitivity of either IgA RF or IgM RF. Single posi...
ObjectiveOne‐third of the Hungarian population suffers from xerostomia. Since there is no evidenc... more ObjectiveOne‐third of the Hungarian population suffers from xerostomia. Since there is no evidence of the actual prevalence of Sjögren's syndrome (SS) in Hungary, this study aimed to evaluate the same.Materials and MethodsData were collected from the Faculty of Dentistry, Semmelweis University from 2008 to 2015. A diagnosis of SS was established based on the American College of Rheumatology and European League Against Rheumatism criteria.ResultsOf the 1076 patients examined with sicca symptoms, 188 patients had confirmed SS. Primary SS (pSS) was diagnosed in 135 patients and secondary SS (sSS) was confirmed in 53 patients. According to the available statistical records of the public health service of Hungary, there were an average of 16 (0.0014%, 5–26) newly diagnosed SS cases in the entire population and 141 SS patient‐practitioner consultations (49–232) per 100,000 inhabitants in the country over the past 10 years (based on the past 10 years: 2011–2020).ConclusionResults revea...
Background: Osseous hydatid cyst is an uncommon disease with weak response to treatment.hydatid d... more Background: Osseous hydatid cyst is an uncommon disease with weak response to treatment.hydatid disease should be included in the differential diagnosis of cystic lesions of bone in endemic regions. Bone cysts account for only 0.5 to 2.5% of all hydatid cysts in humans. Objectives: To report a case of osseous hydatid disease extended on hip and femur Methods: We report a case of osseous hydatid disease Results: A 49 YEAR OLD BRICKLAYER, with no past-medical history and no animal contact, was admitted to our department for a left hip pain. the patient was apyretic and in a good general health condition. He had a very painful walk. the mobilility of the left hip joint was very painful and restricted. The pelvis X-rays showed osteolytic lesions in the ischiopubic branch and in the left femur and proximal extremity of the tibia. The C-Reactive protein value, the protein electrophoresis were normal. tumor markers test was negative. An ultrasound of the hip showed a low abondance intra-ar...
Introduction TNF-α plays an important role in host defense against various infections and in the ... more Introduction TNF-α plays an important role in host defense against various infections and in the pathogenesis of chronic inflammatory diseases. Therapeutic blockade of TNF-α could be an effective treatment in such cases. However, anti-TNF-α therapy increases the risk of reactivation of serious infections, including tuberculosis (TB). Thus, screening for TB became mandatory, prior to the initiation of TNF-α inhibitor therapy. Aim of the study To assess the performance and characteristics of the Quantiferon TB Gold test (QFT) by screening for TB in three different populations in Hungary: patients with inflammatory rheumatic diseases (RD), health-care workers who serve homeless people (HW) and homeless clients (HL). Methods Between April 2011 and March 2014, samples of 1430 consecutive RD patients, who required or already underwent TNF-a blocking therapy, were screened for latent TB. Two untreated groups, (i) 120 HL and (ii) 46 HW, both considered to be at high risk for TB, were also tested. The QFT was performed according to the manufacturer instructions. The amount of released IFN-g was measured by ELISA in samples stimulated by TB Antigen, saline (NIL) and phytohemagglutinin A (PHA). Results In the RD group, the QFT was negative in 87%, positive in 11%, and indeterminate in 2%. Of the 265 patients, 36 (13.6%) showed inconsistent results on repeat testing. In the HW group, the QFT was negative in 63% and positive in 37%. In the HL group, the QFT was negative in 50.8%, positive in 46.7% and indeterminate in 2.5%. In the RD group, low mitogen response (caused mainly by low lymphocyte count and/or improper specimen handling) and positive results close to the cut-off value of 0.35 IU/mL account for 86% of inconsistent results, while true reversions or conversions only for 14%. Conclusions Based on our results, for better differentiation of non-specific variations, we suggest that a grey zone close to the cut-off value of 0.35 IU/mL (0.35–0.800 IU/mL) should be defined. As for the mitogen response, results higher than 0.5 IU/mL (cut-off), but lower than 2 IU/mL should be interpreted carefully. Repeat testing in such cases could prevent misinterpretations caused by technical errors.
Objectives Rheumatoid factor (RF) is a well-established marker for the diagnosis and classificati... more Objectives Rheumatoid factor (RF) is a well-established marker for the diagnosis and classification of rheumatoid arthritis (RA). Most studies evaluated IgM RF or isotype-nonspecific total RF assays. We evaluated the added value of IgA RF in this context. Methods An international sample cohort consisting of samples from 398 RA patients and 1073 controls was tested for IgA RF with 3 commercial assays. For all RA patients and 100 controls essential clinical and serological data for ACR/EULAR classification were available. Results The sensitivity of IgA RF for diagnosing RA was lower than the sensitivity of IgM RF. Differences in numerical values between IgA RF assays were observed. With all assays, the highest IgA RF values were found in patients with primary Sjögren’s syndrome. Double positivity for IgM RF and IgA RF had a higher specificity for RA than either IgM RF or IgA RF. The sensitivity of double positivity was lower than the sensitivity of either IgA RF or IgM RF. Single posi...
ObjectiveOne‐third of the Hungarian population suffers from xerostomia. Since there is no evidenc... more ObjectiveOne‐third of the Hungarian population suffers from xerostomia. Since there is no evidence of the actual prevalence of Sjögren's syndrome (SS) in Hungary, this study aimed to evaluate the same.Materials and MethodsData were collected from the Faculty of Dentistry, Semmelweis University from 2008 to 2015. A diagnosis of SS was established based on the American College of Rheumatology and European League Against Rheumatism criteria.ResultsOf the 1076 patients examined with sicca symptoms, 188 patients had confirmed SS. Primary SS (pSS) was diagnosed in 135 patients and secondary SS (sSS) was confirmed in 53 patients. According to the available statistical records of the public health service of Hungary, there were an average of 16 (0.0014%, 5–26) newly diagnosed SS cases in the entire population and 141 SS patient‐practitioner consultations (49–232) per 100,000 inhabitants in the country over the past 10 years (based on the past 10 years: 2011–2020).ConclusionResults revea...
Background: Osseous hydatid cyst is an uncommon disease with weak response to treatment.hydatid d... more Background: Osseous hydatid cyst is an uncommon disease with weak response to treatment.hydatid disease should be included in the differential diagnosis of cystic lesions of bone in endemic regions. Bone cysts account for only 0.5 to 2.5% of all hydatid cysts in humans. Objectives: To report a case of osseous hydatid disease extended on hip and femur Methods: We report a case of osseous hydatid disease Results: A 49 YEAR OLD BRICKLAYER, with no past-medical history and no animal contact, was admitted to our department for a left hip pain. the patient was apyretic and in a good general health condition. He had a very painful walk. the mobilility of the left hip joint was very painful and restricted. The pelvis X-rays showed osteolytic lesions in the ischiopubic branch and in the left femur and proximal extremity of the tibia. The C-Reactive protein value, the protein electrophoresis were normal. tumor markers test was negative. An ultrasound of the hip showed a low abondance intra-ar...
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