Case 17-2022: A 17-Year-Old Boy with Chest Pain

Case 17-2022: A 17-Year-Old Boy with Chest Pain

To the Editor: In the Case Record, Arya et al. (June 9 issue) 1 describe a 17-year-old boy with chest pain who received a diagnosis of undifferentiated autoimmune rheumatic disease. In their discussion of the pathological findings, the authors state that the positive titer for anti-Smith antibodies...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 387; no. 11; pp. 1051 - 1052
Main Authors: Taheri, Saeed, Natter, Marc D., Arya, Puneeta D., Murali, Mandakolathur R.
Format: Journal Article
Language:English
Published: United States Massachusetts Medical Society 15-09-2022
Subjects:
Adolescent
Antibodies
Arthritis
Chest
Chest Pain - etiology
Conflicts of interest
Diagnosis
Epitopes
Humans
Lupus
Male
Pain
Rheumatic diseases
Systemic lupus erythematosus
Taxonomy
United States > US
Massachusetts
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Summary:To the Editor: In the Case Record, Arya et al. (June 9 issue) 1 describe a 17-year-old boy with chest pain who received a diagnosis of undifferentiated autoimmune rheumatic disease. In their discussion of the pathological findings, the authors state that the positive titer for anti-Smith antibodies can be explained by the phenomenon of epitope spreading and, together with the absence of antibodies against double-stranded DNA (dsDNA), rules out a diagnosis of systemic lupus erythematosus (SLE). However, both of the mentioned antibodies are specific to SLE, yet neither is sensitive. In addition, the patient fulfills four required criteria for a diagnosis . . .
Bibliography:SourceType-Other Sources-1
content type line 63
ObjectType-Correspondence-1
ObjectType-Commentary-2
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJMc2209478