No abstract

SUMMARYSodium antimony gluconate (SAG) is the mainstay of treatment for visceral leishmaniasis (VL) or kalaazar. In view of the increasing incidence of refractoriness to SAG in India, we compared the levels of parasite-specific IgG and IgG subclasses in 20 longitudinally followed up kala-azar patients. In both SAG-responsive (n ¼ 10) and unresponsive patients (n ¼ 10), the levels of total IgG, IgG1, IgG2, IgG3 and IgG4 were increased, the rank order being IgG1 > IgG2 > IgG3 ¼ IgG4. Following treatment, a significant decrease in total IgG and the four subclasses occurred in the SAG-responsive group, whereas in the SAG-unresponsive group these levels were unchanged or slightly increased. Therefore, monitoring of IgG1 and IgG2 levels in Indian kala-azar patients is a good serologic alternative to monitoring the disease status.

Serial ultrasonographic determination of DCS, tophi, or HES during hypouricemic therapy is a noninvasive, effective method to detect the lowering of burden of urate load in gouty joints.

MSUS is useful for diagnosis of gout in intercritical or chronic stages, especially in patients with persistently high SUA level.

Evidence for treating rheumatoid arthritis to target: results of a systematic literature search updateWe read with interest a recent paper by Stoffer et al 1 on treat to target (T2T) evidence for rheumatoid arthritis (RA) published in the current issue of the journal.The systematic literature review provided newer evidence by building on the existing 2010 T2T recommendations for RA.