Allogeneic transplantation of umbilical cord-derived mesenchymal stem cells for diffuse alveolar hemorrhage in systemic lupus erythematosus
Identifieur interne : 002662 ( Istex/Corpus ); précédent : 002661; suivant : 002663Allogeneic transplantation of umbilical cord-derived mesenchymal stem cells for diffuse alveolar hemorrhage in systemic lupus erythematosus
Auteurs : Dongyan Shi ; Dandan Wang ; Xia Li ; Huayong Zhang ; Nan Che ; Zhimin Lu ; Lingyun SunSource :
- Clinical Rheumatology [ 0770-3198 ] ; 2012-05-01.
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Abstract
Abstract: Umbilical cord-derived mesenchymal stem cell transplantation (UC-MSCT) has been proved to be effective in the treatment of systemic lupus erythematosus (SLE), based on animal experiments and clinical trials. Diffuse alveolar hemorrhage (DAH) is a rare complication of SLE with a high mortality usually over 50%. This study aimed to assess the efficacy of UC-MSCT in the treatment of SLE-associated DAH. Four SLE patients complicated with DAH, who underwent UC-MSCT, were included. Clinical changes before and after transplantation were assessed by measurements of hemoglobin, platelet level, oxygen saturation, and serological factors. High-resolution CT (HRCT) scans of the chest were performed to evaluate pulmonary manifestation. All the four patients showed dramatic improvements of their clinical manifestations. Hemoglobin was elevated after UC-MSCT and was sustained at a normal level 6 months after UC-MSCT in the four patients. Platelet level was upregulated in two patients who had thrombocytopenia at baseline. Oxygen saturation appeared to be normal at 1 month after UC-MSCT, and this result was confirmed by the HRCT scan of the chest. Serum albumin elevated to 3.5 g/dl 6 months after transplantation. Our findings suggest that UC-MSCT results in amelioration of oxygen saturation as well as hematological and serologic changes, which revealed that UC-MSCT could be applied as a salvage strategy for DAH patients.
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DOI: 10.1007/s10067-012-1943-2
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uniqKey="Li X" first="Xia" last="Li">Xia Li</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Zhang, Huayong" sort="Zhang, Huayong" uniqKey="Zhang H" first="Huayong" last="Zhang">Huayong Zhang</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Che, Nan" sort="Che, Nan" uniqKey="Che N" first="Nan" last="Che">Nan Che</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Lu, Zhimin" sort="Lu, Zhimin" uniqKey="Lu Z" first="Zhimin" last="Lu">Zhimin Lu</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Sun, Lingyun" sort="Sun, Lingyun" uniqKey="Sun L" first="Lingyun" last="Sun">Lingyun Sun</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: lingyunsun2001@yahoo.com.cn</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:0B5C0DD84E6EF00FC5EC43147F1B08211D94FB17</idno><date when="2012" year="2012">2012</date><idno type="doi">10.1007/s10067-012-1943-2</idno><idno 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and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Li, Xia" sort="Li, Xia" uniqKey="Li X" first="Xia" last="Li">Xia Li</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Zhang, Huayong" sort="Zhang, Huayong" uniqKey="Zhang H" first="Huayong" last="Zhang">Huayong Zhang</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Che, Nan" sort="Che, Nan" uniqKey="Che N" first="Nan" last="Che">Nan Che</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Lu, Zhimin" sort="Lu, Zhimin" uniqKey="Lu Z" first="Zhimin" last="Lu">Zhimin Lu</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation></author><author><name sortKey="Sun, Lingyun" sort="Sun, Lingyun" uniqKey="Sun L" first="Lingyun" last="Sun">Lingyun Sun</name><affiliation><mods:affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: lingyunsun2001@yahoo.com.cn</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Clinical Rheumatology</title><title level="j" type="sub">Journal of the International League of Associations for Rheumatology</title><title level="j" type="abbrev">Clin Rheumatol</title><idno type="ISSN">0770-3198</idno><idno type="eISSN">1434-9949</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>London</pubPlace><date type="published" when="2012-05-01">2012-05-01</date><biblScope unit="volume">31</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="841">841</biblScope><biblScope unit="page" to="846">846</biblScope></imprint><idno type="ISSN">0770-3198</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0770-3198</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Diffuse alveolar hemorrhage</term><term>Mesenchymal stem cells</term><term>Systemic lupus erythematosus</term><term>Transplantation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Umbilical cord-derived mesenchymal stem cell transplantation (UC-MSCT) has been proved to be effective in the treatment of systemic lupus erythematosus (SLE), based on animal experiments and clinical trials. Diffuse alveolar hemorrhage (DAH) is a rare complication of SLE with a high mortality usually over 50%. This study aimed to assess the efficacy of UC-MSCT in the treatment of SLE-associated DAH. Four SLE patients complicated with DAH, who underwent UC-MSCT, were included. Clinical changes before and after transplantation were assessed by measurements of hemoglobin, platelet level, oxygen saturation, and serological factors. High-resolution CT (HRCT) scans of the chest were performed to evaluate pulmonary manifestation. All the four patients showed dramatic improvements of their clinical manifestations. Hemoglobin was elevated after UC-MSCT and was sustained at a normal level 6 months after UC-MSCT in the four patients. Platelet level was upregulated in two patients who had thrombocytopenia at baseline. Oxygen saturation appeared to be normal at 1 month after UC-MSCT, and this result was confirmed by the HRCT scan of the chest. Serum albumin elevated to 3.5 g/dl 6 months after transplantation. Our findings suggest that UC-MSCT results in amelioration of oxygen saturation as well as hematological and serologic changes, which revealed that UC-MSCT could be applied as a salvage strategy for DAH patients.</div></front></TEI><istex><corpusName>springer-journals</corpusName><author><json:item><name>Dongyan Shi</name><affiliations><json:string>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</json:string></affiliations></json:item><json:item><name>Dandan Wang</name><affiliations><json:string>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</json:string></affiliations></json:item><json:item><name>Xia Li</name><affiliations><json:string>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</json:string></affiliations></json:item><json:item><name>Huayong Zhang</name><affiliations><json:string>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</json:string></affiliations></json:item><json:item><name>Nan Che</name><affiliations><json:string>Department of Immunology and Rheumatology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China</json:string></affiliations></json:item><json:item><name>Zhimin Lu</name><affiliations><json:string>Department of Immunology and Rheumatology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China</json:string></affiliations></json:item><json:item><name>Lingyun Sun</name><affiliations><json:string>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</json:string><json:string>E-mail: lingyunsun2001@yahoo.com.cn</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Diffuse alveolar hemorrhage</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Mesenchymal stem cells</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Systemic lupus erythematosus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Transplantation</value></json:item></subject><articleId><json:string>1943</json:string><json:string>s10067-012-1943-2</json:string></articleId><arkIstex>ark:/67375/VQC-LMZ72GCF-0</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>OriginalPaper</json:string></originalGenre><abstract>Abstract: Umbilical cord-derived mesenchymal stem cell transplantation (UC-MSCT) has been proved to be effective in the treatment of systemic lupus erythematosus (SLE), based on animal experiments and clinical trials. Diffuse alveolar hemorrhage (DAH) is a rare complication of SLE with a high mortality usually over 50%. This study aimed to assess the efficacy of UC-MSCT in the treatment of SLE-associated DAH. Four SLE patients complicated with DAH, who underwent UC-MSCT, were included. Clinical changes before and after transplantation were assessed by measurements of hemoglobin, platelet level, oxygen saturation, and serological factors. High-resolution CT (HRCT) scans of the chest were performed to evaluate pulmonary manifestation. All the four patients showed dramatic improvements of their clinical manifestations. Hemoglobin was elevated after UC-MSCT and was sustained at a normal level 6 months after UC-MSCT in the four patients. Platelet level was upregulated in two patients who had thrombocytopenia at baseline. Oxygen saturation appeared to be normal at 1 month after UC-MSCT, and this result was confirmed by the HRCT scan of the chest. Serum albumin elevated to 3.5 g/dl 6 months after transplantation. Our findings suggest that UC-MSCT results in amelioration of oxygen saturation as well as hematological and serologic changes, which revealed that UC-MSCT could be applied as a salvage strategy for DAH patients.</abstract><qualityIndicators><score>7.855</score><pdfWordCount>3359</pdfWordCount><pdfCharCount>20942</pdfCharCount><pdfVersion>1.4</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595.276 x 790.866 pts</pdfPageSize><refBibsNative>false</refBibsNative><abstractWordCount>208</abstractWordCount><abstractCharCount>1437</abstractCharCount><keywordCount>4</keywordCount></qualityIndicators><title>Allogeneic transplantation of umbilical cord-derived mesenchymal stem cells for diffuse alveolar hemorrhage in systemic lupus erythematosus</title><genre><json:string>research-article</json:string></genre><host><title>Clinical 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Diffuse alveolar hemorrhage (DAH) is a rare complication of SLE with a high mortality usually over 50%. This study aimed to assess the efficacy of UC-MSCT in the treatment of SLE-associated DAH. Four SLE patients complicated with DAH, who underwent UC-MSCT, were included. Clinical changes before and after transplantation were assessed by measurements of hemoglobin, platelet level, oxygen saturation, and serological factors. High-resolution CT (HRCT) scans of the chest were performed to evaluate pulmonary manifestation. All the four patients showed dramatic improvements of their clinical manifestations. Hemoglobin was elevated after UC-MSCT and was sustained at a normal level 6 months after UC-MSCT in the four patients. Platelet level was upregulated in two patients who had thrombocytopenia at baseline. Oxygen saturation appeared to be normal at 1 month after UC-MSCT, and this result was confirmed by the HRCT scan of the chest. Serum albumin elevated to 3.5 g/dl 6 months after transplantation. Our findings suggest that UC-MSCT results in amelioration of oxygen saturation as well as hematological and serologic changes, which revealed that UC-MSCT could be applied as a salvage strategy for DAH patients.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Diffuse alveolar hemorrhage</term></item><item><term>Mesenchymal stem cells</term></item><item><term>Systemic lupus erythematosus</term></item><item><term>Transplantation</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Medicine & Public Health</head><item><term>Rheumatology</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2011-11-04">Created</change><change 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Grant="Restricted"></ESMGrant></ArticleGrants></ArticleInfo><ArticleHeader><AuthorGroup><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Dongyan</GivenName><FamilyName>Shi</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Dandan</GivenName><FamilyName>Wang</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Xia</GivenName><FamilyName>Li</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Huayong</GivenName><FamilyName>Zhang</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>Nan</GivenName><FamilyName>Che</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>Zhimin</GivenName><FamilyName>Lu</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1" CorrespondingAffiliationID="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Lingyun</GivenName><FamilyName>Sun</FamilyName></AuthorName><Contact><Phone>+86-25-83105219</Phone><Fax>+86-25-83105209</Fax><Email>lingyunsun2001@yahoo.com.cn</Email></Contact></Author><Affiliation ID="Aff1"><OrgDivision>Department of Immunology and Rheumatology</OrgDivision><OrgName>The Affiliated Drum Tower Hospital of Nanjing University Medical School</OrgName><OrgAddress><City>Nanjing</City><State>Jiangsu</State><Country Code="CN">People’s Republic of China</Country></OrgAddress></Affiliation><Affiliation ID="Aff2"><OrgDivision>Department of Immunology and Rheumatology</OrgDivision><OrgName>Drum Tower Clinical Medical College of Nanjing Medical University</OrgName><OrgAddress><City>Nanjing</City><State>Jiangsu</State><Country Code="CN">People’s Republic of China</Country></OrgAddress></Affiliation></AuthorGroup><Abstract ID="Abs1" Language="En" OutputMedium="All"><Heading>Abstract</Heading><Para>Umbilical cord-derived mesenchymal stem cell transplantation (UC-MSCT) has been proved to be effective in the treatment of systemic lupus erythematosus (SLE), based on animal experiments and clinical trials. Diffuse alveolar hemorrhage (DAH) is a rare complication of SLE with a high mortality usually over 50%. This study aimed to assess the efficacy of UC-MSCT in the treatment of SLE-associated DAH. Four SLE patients complicated with DAH, who underwent UC-MSCT, were included. Clinical changes before and after transplantation were assessed by measurements of hemoglobin, platelet level, oxygen saturation, and serological factors. High-resolution CT (HRCT) scans of the chest were performed to evaluate pulmonary manifestation. All the four patients showed dramatic improvements of their clinical manifestations. Hemoglobin was elevated after UC-MSCT and was sustained at a normal level 6 months after UC-MSCT in the four patients. Platelet level was upregulated in two patients who had thrombocytopenia at baseline. Oxygen saturation appeared to be normal at 1 month after UC-MSCT, and this result was confirmed by the HRCT scan of the chest. Serum albumin elevated to 3.5 g/dl 6 months after transplantation. Our findings suggest that UC-MSCT results in amelioration of oxygen saturation as well as hematological and serologic changes, which revealed that UC-MSCT could be applied as a salvage strategy for DAH patients.</Para></Abstract><KeywordGroup Language="En" OutputMedium="All"><Heading>Keywords</Heading><Keyword>Diffuse alveolar hemorrhage</Keyword><Keyword>Mesenchymal stem cells</Keyword><Keyword>Systemic lupus erythematosus</Keyword><Keyword>Transplantation</Keyword></KeywordGroup><ArticleNote Type="Misc"><SimplePara>Dongyan Shi and Dandan Wang are co-first authors.</SimplePara></ArticleNote></ArticleHeader><NoBody></NoBody></Article></Issue></Volume></Journal></Publisher></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Allogeneic transplantation of umbilical cord-derived mesenchymal stem cells for diffuse alveolar hemorrhage in systemic lupus erythematosus</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Allogeneic transplantation of umbilical cord-derived mesenchymal stem cells for diffuse alveolar hemorrhage in systemic lupus erythematosus</title></titleInfo><name type="personal"><namePart type="given">Dongyan</namePart><namePart type="family">Shi</namePart><affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dandan</namePart><namePart type="family">Wang</namePart><affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xia</namePart><namePart type="family">Li</namePart><affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Huayong</namePart><namePart type="family">Zhang</namePart><affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nan</namePart><namePart type="family">Che</namePart><affiliation>Department of Immunology and Rheumatology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Zhimin</namePart><namePart type="family">Lu</namePart><affiliation>Department of Immunology and Rheumatology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Lingyun</namePart><namePart type="family">Sun</namePart><affiliation>Department of Immunology and Rheumatology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China</affiliation><affiliation>E-mail: lingyunsun2001@yahoo.com.cn</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="OriginalPaper" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Springer-Verlag</publisher><place><placeTerm type="text">London</placeTerm></place><dateCreated encoding="w3cdtf">2011-11-04</dateCreated><dateIssued encoding="w3cdtf">2012-05-01</dateIssued><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract lang="en">Abstract: Umbilical cord-derived mesenchymal stem cell transplantation (UC-MSCT) has been proved to be effective in the treatment of systemic lupus erythematosus (SLE), based on animal experiments and clinical trials. Diffuse alveolar hemorrhage (DAH) is a rare complication of SLE with a high mortality usually over 50%. This study aimed to assess the efficacy of UC-MSCT in the treatment of SLE-associated DAH. Four SLE patients complicated with DAH, who underwent UC-MSCT, were included. Clinical changes before and after transplantation were assessed by measurements of hemoglobin, platelet level, oxygen saturation, and serological factors. High-resolution CT (HRCT) scans of the chest were performed to evaluate pulmonary manifestation. All the four patients showed dramatic improvements of their clinical manifestations. Hemoglobin was elevated after UC-MSCT and was sustained at a normal level 6 months after UC-MSCT in the four patients. Platelet level was upregulated in two patients who had thrombocytopenia at baseline. Oxygen saturation appeared to be normal at 1 month after UC-MSCT, and this result was confirmed by the HRCT scan of the chest. Serum albumin elevated to 3.5 g/dl 6 months after transplantation. Our findings suggest that UC-MSCT results in amelioration of oxygen saturation as well as hematological and serologic changes, which revealed that UC-MSCT could be applied as a salvage strategy for DAH patients.</abstract><note>Original Article</note><subject lang="en"><genre>Keywords</genre><topic>Diffuse alveolar hemorrhage</topic><topic>Mesenchymal stem cells</topic><topic>Systemic lupus erythematosus</topic><topic>Transplantation</topic></subject><relatedItem type="host"><titleInfo><title>Clinical Rheumatology</title><subTitle>Journal of the International League of Associations for Rheumatology</subTitle></titleInfo><titleInfo type="abbreviated"><title>Clin Rheumatol</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>Springer</publisher><dateIssued encoding="w3cdtf">2012-04-26</dateIssued><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><subject><genre>Medicine & Public Health</genre><topic>Rheumatology</topic></subject><identifier type="ISSN">0770-3198</identifier><identifier type="eISSN">1434-9949</identifier><identifier type="JournalID">10067</identifier><identifier type="IssueArticleCount">22</identifier><identifier type="VolumeIssueCount">12</identifier><part><date>2012</date><detail type="volume"><number>31</number><caption>vol.</caption></detail><detail type="issue"><number>5</number><caption>no.</caption></detail><extent unit="pages"><start>841</start><end>846</end></extent></part><recordInfo><recordOrigin>Clinical Rheumatology, 2012</recordOrigin></recordInfo></relatedItem><identifier type="istex">0B5C0DD84E6EF00FC5EC43147F1B08211D94FB17</identifier><identifier type="ark">ark:/67375/VQC-LMZ72GCF-0</identifier><identifier type="DOI">10.1007/s10067-012-1943-2</identifier><identifier type="ArticleID">1943</identifier><identifier type="ArticleID">s10067-012-1943-2</identifier><accessCondition type="use and reproduction" contentType="copyright">Clinical Rheumatology, 2012</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</recordContentSource><recordOrigin>Clinical Rheumatology, 2012</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-LMZ72GCF-0/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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