title: Soluble tumour necrosis factor receptor levels reflect coagulation abnormalities in systemic juvenile chronic arthritis.
abstract: The objective was to evaluate tumour necrosis factor (TNF) status in patients with systemic juvenile chronic arthritis (s-JCA). Plasma levels of TNF-alpha, and serum levels of soluble TNF receptor 1 and 2 (sTNFR1 and sTNFR2) were measured using specific immunoassays in 20 patients with s-JCA, 10 with polyarticular JCA and 15 with pauciarticular JCA, and in 20 controls comparable for age. In patients with active s-JCA, circulating levels of TNF-alpha, sTNFR1 and sTNFR2 were significantly (P < 0.001) higher than those of controls. The levels of sTNFR1 and sTNFR2, but not those of TNF-alpha, were associated with the persistence and severity of systemic symptoms and were significantly correlated with prolongation of partial thromboplastin time and decrease in prothrombin activity. In two patients evaluated during a s-JCA-associated macrophage activation syndrome, a marked increase in sTNFR1 and sTNFR2 was found. Our results suggest that in s-JCA, TNF is involved in systemic manifestations, in the subclinical coagulation abnormalities, and in the development of the macrophage activation syndrome.
authors.affiliation: Clinica Pediatrica, IRCCS San Matteo, Pavia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: de Benedetti
authors.forename: P
authors.initials: P
authors.lastname: Pignatti
authors.forename: M
authors.initials: M
authors.lastname: Massa
authors.forename: P
authors.initials: P
authors.lastname: Sartirana
authors.forename: A
authors.initials: A
authors.lastname: Ravelli
authors.forename: G
authors.initials: G
authors.lastname: Cassani
authors.forename: A
authors.initials: A
authors.lastname: Corti
authors.forename: A
authors.initials: A
authors.lastname: Martini
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000097:blood / Q000276:immunology; D001171:Arthritis, Juvenile / Q000097:blood* / Q000150:complications / Q000276:immunology; D001778:Blood Coagulation Disorders / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D006801:Humans; D007118:Immunoassay; D015850:Interleukin-6 / Q000097:blood; D008262:Macrophage Activation; D010314:Partial Thromboplastin Time; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood* / Q000276:immunology; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism
chemical_list: D000906:Antibodies; D015850:Interleukin-6; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha