Differential diagnosis of systemic lupus erythematosus and rheumatoid arthritis with complements C3 and C4 and C-reactive protein

Li,Wenhui; Li,Hui; Song,Wuqi; Hu,Yunlong; Liu,Yanhong; Da,Rong; Chen,Xiaobei; Li,Yang; Ling,Hong; Zhong,Zhaohua; Zhang,Fengmin

doi:10.3892/etm.2013.1304

November 2013 Volume 6 Issue 5

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

November 2013 Volume 6 Issue 5

Full Size Image

Article

Differential diagnosis of systemic lupus erythematosus and rheumatoid arthritis with complements C3 and C4 and C-reactive protein

Authors:
- Wenhui Li
- Hui Li
- Wuqi Song
- Yunlong Hu
- Yanhong Liu
- Rong Da
- Xiaobei Chen
- Yang Li
- Hong Ling
- Zhaohua Zhong
- Fengmin Zhang
View Affiliations / Copyright

Affiliations: Department of Microbiology, Harbin Medical University, Heilongjiang Key Laboratory of Infection and Immunity and Pathogenic Biology, Harbin, Heilongjiang 150081, P.R. China, Department of Laboratory Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China, Department of Rheumatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
Pages: 1271-1276
|
Published online on: September 17, 2013

https://doi.org/10.3892/etm.2013.1304
Expand metrics +

Abstract

The aim of this study was to analyze the changes in complements C3 and C4 and C-reactive protein (CRP) in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), and to evaluate the role of these indices in the differential diagnosis of SLE and RA. The first 347 patients with SLE, 382 patients with RA and 66 patients with erythema nodosum were selected for the measurement of complement and CRP levels in the serum, the erythema nodosum patients were the control group. The roles of the complements and CRP in the differential diagnosis and disease activity evaluation of SLE and RA were analyzed with SPSS 13.0. Complement C3 and C4 levels were significantly reduced in patients with SLE compared with those in the control group. However, in RA patients, the CRP level was increased. In addition, the levels of complements C3 and C4 in patients with SLE were much lower than those in patients with RA and the level of CRP in RA patients was much higher than that in patients with SLE. The reduction of complement C3 levels in SLE patients, and increase of CRP and complement C4 in patients with RA were associated with a higher risk of joint pain, butterfly rash and oral ulcer. These results show that the disease activity of SLE was negatively correlated with complement C3 and C4, and the disease activity of RA was positively correlated with CRP. With the increase in disease activity, the levels of complements C3 and C4 in patients with SLE were gradually reduced and the level of CRP in patients with RA was increased. There were distinctive differences in the levels of complements C3 and C4 and CRP between SLE and RA patients. The differences are useful in disease activity evaluation and the differential diagnosis of the two diseases that have similar symptoms.

View Figures

View References

1.	Rodríguez-Carrio J, Prado C, de Paz B, et al: Circulating endothelial cells and their progenitors in systemic lupus erythematosus and early rheumatoid arthritis patients. Rheumatology (Oxford). 51:1775–1784. 2012.PubMed/NCBI
2.	Shi YH, Li R, Chen S, Su Y and Jia Y: Analysis of clinical features and the outcome in 91 cases of mixed connective tissue diseases. Beijing Da Xue Xue Bao. 44:270–274. 2012.(In Chinese).
3.	Turgeman Y, Atar S, Suleiman K, et al: Diagnostic and therapeutic percutaneous cardiac interventions without on-site surgical backup - review of 11 years experience. Isr Med Assoc J. 5:89–93. 2003.PubMed/NCBI
4.	Li H, Song W, Li Y, et al: Diagnostic value of anti-cyclic citrullinated peptide antibodies in northern Chinese Han patients with rheumatoid arthritis and its correlation with disease activity. Clin Rheumatol. 29:413–417. 2010. View Article : Google Scholar
5.	Goldring SR: Pathogenesis of bone and cartilage destruction in rheumatoid arthritis. Rheumatology (Oxford). 42(Suppl 2): ii11–ii16. 2003. View Article : Google Scholar : PubMed/NCBI
6.	Hochberg MC: Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 40:17251997. View Article : Google Scholar : PubMed/NCBI
7.	Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH, et al: Derivation of the SLEDAI. A disease activity index for lupus patients. Arthritis Rheum. 35:630–640. 1992. View Article : Google Scholar : PubMed/NCBI
8.	Gladman DD, Urowitz MB, Kagal A and Hallett D: Accurately describing changes in disease activity in Systemic Lupus Erythematosus. J Rheumatol. 27:377–379. 2000.PubMed/NCBI
9.	DAS-Score: NL. http://www.das-score.nl/das28/en/difference-between-the-das-and-das28/importance-of-das28-and-tight-control/eular-response-criteria.htmluri. Accessed May 3, 2013.
10.	Ahmed TA, Ikram N, Hussain T, et al: Clinical and laboratory features of systemic lupus erythematosus (SLE) in Pakistani patients. J Pak Med Assoc. 52:12–15. 2002.PubMed/NCBI
11.	Pisetsky DS, Ullal AJ, Gauley J and Ning TC: Microparticles as mediators and biomarkers of rheumatic disease. Rheumatology (Oxford). 51:1737–1746. 2012. View Article : Google Scholar : PubMed/NCBI
12.	Wang H, Peng W, Ouyang X, Li W and Dai Y: Circulating microRNAs as candidate biomarkers in patients with systemic lupus erythematosus. Transl Res. 160:198–206. 2012. View Article : Google Scholar : PubMed/NCBI
13.	Almeida Mdo S, Bértolo MB, Da Silva BB, De Deus Filho A, Almeida MM, Veras FF and Mendes LC: Epidemiological study of patients with connective tissue diseases in Brazil. Trop Doct. 35:206–209. 2005.PubMed/NCBI
14.	Patel RM and Marfatia YS: Lupus panniculitis as an initial manifestation of systemic lupus erythematosus. Indian J Dermatol. 55:99–101. 2010. View Article : Google Scholar : PubMed/NCBI
15.	Molenaar ET, Voskuyl AE, Familian A, van Mierlo GJ, Dijkmans BA and Hack CE: Complement activation in patients with rheumatoid arthritis mediated in part by C-reactive protein. Arthritis Rheum. 44:997–1002. 2001.PubMed/NCBI
16.	Chou CT and Hwang CM: Changes in the clinical and laboratory features of lupus patients after the big earthquake in Taiwan. Lupus. 11:109–113. 2002. View Article : Google Scholar : PubMed/NCBI
17.	Lee SS, Singh S, Link K and Petri M: High-sensitivity C-reactive protein as an associate of clinical subsets and organ damage in systemic lupus erythematosus. Semin Arthritis Rheum. 38:41–54. 2008. View Article : Google Scholar : PubMed/NCBI
18.	Yildiz M: Arterial distensibility in chronic inflammatory rheumatic disorders. Open Cardiovasc Med J. 4:83–88. 2010.PubMed/NCBI
19.	Plant MJ, Williams AL, O’Sullivan MM, Lewis PA, Coles EC and Jessop JD: Relationship between time-integrated C-reactive protein levels and radiologic progression in patients with rheumatoid arthritis. Arthritis Rheum. 43:1473–1477. 2000. View Article : Google Scholar : PubMed/NCBI
20.	Gonnet-Gracia C, Barnetche T, Richez C, et al: Anti-nuclear antibodies, anti-DNA and C4 complement evolution in rheumatoid arthritis and ankylosing spondylitis treated with TNF-alpha blockers. Clin Exp Rheumatol. 26:401–407. 2008.PubMed/NCBI
21.	Petri M, Purvey S, Fang H and Magder LS: Predictors of organ damage in systemic lupus erythematosus: the Hopkins Lupus Cohort. Arthritis Rheum. 64:4021–4028. 2012. View Article : Google Scholar : PubMed/NCBI
22.	Hoff M, Bøyesen P, Haugeberg G, et al: High disease activity is a predictor of cortical hand bone loss in post-menopausal patients with established rheumatoid arthritis: a 5-year multicentre longitudinal study. Rheumatology (Oxford). 49:1676–1682. 2010.
23.	Kawashiri SY, Kawakami A, Okada A, et al: CD4+CD25(high) CD127(low/-) Treg cell frequency from peripheral blood correlates with disease activity in patients with rheumatoid arthritis. J Rheumatol. 38:2517–2521. 2011.

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Differential diagnosis of systemic lupus erythematosus and rheumatoid arthritis with complements C3 and C4 and C-reactive protein

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Related Articles