Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 3904440 | Modern management of rheumatoid arthritis. | 1985 Oct 25 | The management of rheumatoid arthritis can be challenging even to the most experienced and astute physician. The rheumatoid inflammatory process can be profound, ravaging, and unremitting, and the illness is notorious for its protean manifestations and capricious course. Moreover, the response to therapy is unpredictable, although it can be quite successful in many cases. Nevertheless, the intense pain, profound disability, progressive destructive arthropathy, and negative psychological milieu that haunt patients demand that something be done therapeutically. Rheumatoid arthritis responds best to a symphony of therapeutic modalities including drugs, rehabilitation, joint surgery, and attention to psychosocial issues. The foundation of any successful therapeutic venture is an educational program designed, however simply, to imbue the patient and family with an understanding of the disease and its course and treatment, and with realistic expectations. Drug therapy is often polypharmaceutical, employing analgesics, nonsteroidal anti-inflammatory agents, both local and systemic corticosteroids, and remission-inducing drugs. Pacing of lifestyle, physical and/or occupational therapy, vocational guidance, psychological and sexual counseling, and social intervention are as much a part of modern management in rheumatoid arthritis as are drugs. The extra-articular (systemic) manifestations are addressed in a variety of ways depending upon the type and severity of involvement. Although most patients can be treated by their primary care physician, some may require the expertise provided by a specialist. Finally, despite the lack of a cure for rheumatoid arthritis, most patients respond well to treatment and return to their desired activities of daily living. | |
| 6761281 | Cutaneous manifestations of rheumatoid arthritis. | 1982 Dec | Rheumatoid arthritis is a systemic disease which can have multiple cutaneous manifestations. In particular, rheumatoid vasculitis may be difficult to diagnose because of the wide array of clinical presentations. Early recognition can assist the physician in diagnosis and in determination of the proper therapy. Every physician caring for patients with rheumatoid arthritis should be aware of these common dermatologic complications. | |
| 6343438 | Dermatologic conditions reported in patients with rheumatoid arthritis. | 1983 Apr | Dermatologists, while becoming increasingly involved in the diagnosis and management of patients with connective tissue diseases, have left rheumatoid arthritis relatively unexplored. An increased awareness of possible pathomechanisms of rheumatoid arthritis may allow for generalizations that lead to increased understanding of other connective tissue disorders. The types of cutaneous disorders that occur in association with rheumatoid arthritis include: vasoreactive dermatoses (e.g., various forms of vasculitis), which may occur secondary to the circulating immune complexes present in rheumatoid arthritis; autoimmune bullous disorders, which may occur in the setting of a suppressor T cell defect in rheumatoid arthritis; and various miscellaneous cutaneous associations. Hopefully, this review will lead to an increased understanding of both rheumatoid arthritis and the wide array of cutaneous associations of rheumatoid arthritis. | |
| 58261 | Rheumatoid arthritis and alpha-1-antitrypsin. | 1976 Jun 5 | The genetic types of alpha1-antitrypsin (Pi types) were studied in 55 adults with classical or definite rheumatoid arthritis and 56 children with juvenile rheumatoid arthritis. A comparison was made with control groups of 211 healthy adults and 512 schoolchildren. Pi types MZ and SZ were significantly more prevalent in adults with rheumatoid arthritis than in the control adults. There was no difference between the patients with juvenile rheumatoid arthritis and the control children. Reduced concentrations of alpha1-antitrypsin, as associated with heterozygotes for the Z allele, may be a contributory factor to the development of rheumatoid arthritis or to the tissue destruction of rheumatoid arthritis. | |
| 7459796 | Canine rheumatoid arthritis. | 1980 Nov | A miniature poodle was presented with a history of a chronic, insidious hind limb lameness. As part of the clinical approach to the case, a serum electrophoresis was done which revealed a polyclonal hypergammaglobulinemia. Analysis of stife and carpal joint fluid revealed an elevated white cell count, that consisted of about 75% neutrophils and 25% monocytes. The joint fluid was sterile on bacteriological culture. Radiographs of the carpal joints indicated some narrowing of joint spaces and subchondral lucencies. Rheumatoid factor was identified on serological testing. Histopathology of carpal joint biopsies indicated a nonsuppurative synovitis. These findings are consistent with a diagnosis of rheumatoid arthritis. The dog was treated with prednisone on a long term basis. Response to treatment has been good. | |
| 364612 | Drug therapy and circulating immune complexes in rheumatoid arthritis. | 1978 | Circulating immune complexes have been shown to be common in rheumatoid disease and to relate to severe systemic manifestations of disease. Hypocomplementaemia and complexes detected by anticomplementary activity are found in systemic rheumatoid vasculitis and in other complications such as Felty's syndrome. By contrast elevated complement levels and complexes detected by platelet aggregating activity are common in early and in continuing active rheumatoid disease. The common presence of circulating immune complexes suggests some therapeutic manoeuvres which might be helpful in systemic rheumatoid disease. Direct attempts to alter the levels of complexes by plasmapheresis, an effective treatment for acute exacerbations of systemic lupus erythematosus (SLE), have been disappointing in rheumatoid disease. Treatment with penicillamine and with cyclophosphamide may be effective in systemic manifestations and alter the levels of circulating immune complexes. An interesting paradox exists with penicillamine which may also induce a nephropathy with all the features of an immune complex deposition disease. The mechanism may relate to an alteration in the type of immune complex circulating, with a loss of the "protective" effect of rheumatoid factor. | |
| 6696515 | Rheumatoid arthritis in Lesotho. | 1984 Feb | Thirty-nine black African patients were seen with probable, definite or classical rheumatoid arthritis (RA); 32 of these were seen in a prospective study out of a total of 15 834 new patients 15 years and older at presentation seen in a 12-month period. The diagnosis was based on the American Rheumatism Association criteria for RA or the Rome criteria for inactive RA. The high incidence of severe disease as well as the occurrence of advanced disease in young patients is notable. 80% of the patients came from rural areas. Radiological lesions were found in 74% and serological abnormalities in 92%. Rheumatoid factor (RF) was found to be positive in 12% of an age and sex matched control group and in 19% of a group of patients suffering from tuberculosis. | |
| 6093663 | NIH conference. Rheumatoid arthritis: evolving concepts of pathogenesis and treatment. | 1984 Dec | Rheumatoid arthritis is a chronic inflammatory synovitis that primarily involves peripheral diarthrodial joints. Immunohistologic analysis of diseased synovium has shown a spectrum of abnormalities that resemble various stages of a cell-mediated, or delayed-type, immune reaction. The infiltrating mononuclear cells produce various factors that modulate adjacent tissues and appear to produce the characteristic destructive features of the disorder. Our understanding of the mechanisms of action of various therapeutic modes also indicates that the disease is primarily mediated by activated mononuclear cells. All effective therapies have been shown to affect either mononuclear cell function or the rates of production or elimination of these cells. The disorder likely represents the pathologic expression of a genetically controlled host immune response to an undefined causative stimulus. The stimulus could be an infectious agent(s), a product(s) derived from an infectious agent(s), a constituent(s) of synovial or connective tissue, or a combination of these. | |
| 6356909 | Evaluation of pathophysiology and drug effects on rheumatoid arthritis. | 1983 Oct 31 | The treatment of rheumatoid arthritis has been divided into symptomatic or anti-inflammatory drug therapy, and disease-modifying or remission-inducing drug therapy. A more useful classification may be one that correlates the therapy with the component of the disease process that it affects. In general, nonsteroidal drugs do not affect cells as much as they do some of the mediators that cells produce. The effects of gold and D-penicillamine, although used later in the disease because of their toxicity, probably act early in the cascade of development of the disease by affecting the macrophages and lymphocytes. Prednisone may be effective in inhibiting synthesis by macrophages and fibroblasts of proteinases as well as arachidonic acid metabolites. Retinoids may be prototypes of drugs that selectively inhibit collagenase/proteinase production but do not affect production of normal connective tissue components. | |
| 6678688 | Rheumatoid type of psoriatic arthritis. | 1983 Jun | Psoriatic arthritis can sometimes have a rheumatoid character, manifested especially by symmetrical involvement of the small joints of the hands. This finding was present in 23 out of a total of 150 patients with diagnosed psoriatic arthritis. The association of the rheumatoid joint syndrome and positivity of tests for rheumatoid factors in 4 patients suggest a suspected coincidental association of rheumatoid arthritis and psoriasis. In 2 patients the originally positive tests for rheumatoid factors became negative, simultaneously with the occurrence of sacro-iliitis. The remaining 17 patients had rheumatoid-like joint involvement associated with negative tests for rheumatoid factors. All 17 patients had changes in the spine. | |
| 6566359 | Rheumatoid arthritis. | 1984 Jun | Rheumatoid arthritis is a very common disease with potentially serious disability in patients of all ages. Therefore, early suspicion of the diagnosis, appropriately aggressive therapy, and close follow-up of patients are essential. | |
| 6639480 | Rheumatoid arthritis. | 1983 Jul | Rheumatoid arthritis is a disease of variable natural history. It may be mild, remit completely, and produce no long term damage to joints. In a few patients, however, it may progress inexorably and produce widespread joint destruction. This article highlights important points in the diagnosis, natural history, and management of the disease. | |
| 6269144 | Rheumatoid arthritis and pseudo-rheumatoid arthritis in calcium pyrophosphate dihydrate cr | 1981 Sep | Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease can lead to many clinical syndromes. One syndrome simulates rheumatoid arthritis and is thus called "pseudo-rheumatoid arthritis." Since some patients have true rheumatoid arthritis with CPPD crystal deposition disease, the clinician may have difficulty differentiating those patients from others who have the pseudo-rheumatoid syndrome. Such a diagnostic problem can be solved radiographically. Eleven patients with CPPD crystal deposition disease were studied; five had true rheumatoid arthritis and six had pseudo-rheumatoid arthritis. Because osseous erosions were not apparent in the arthropathy of uncomplicated CPPD crystal deposition disease, the detection of skeletal erosive changes indicated a true rheumatoid arthritis process. | |
| 434943 | Rheumatoid arthritis in Kenya. II. Serological observations. | 1979 Feb | Sera from 48 Kenyan Africans with rheumatoid arthritis, 43 patients with other diseases, and 98 blood donors were tested for the presence of rheumatoid factor by latex fixation tests using human European, human African, and rabbit immunoglobulin, and a sheep cell haemagglutination test. In the patients with rheumatoid arthritis the frequency of rheumatoid factor was comparable to that reported in series from Europe and the USA, thus differing from the findings in West Africa. In the control patients and blood donors a high frequency of positive tests for rheumatoid factor was found; a similar result has been obtained from population studies in other African countries. Broadly similar results were obtained with each of the latex tests, and these were found to be less specific for rheumatoid arthritis than the sheep cell haemagglutination test. | |
| 942269 | Thrombocytosis in rheumatoid arthritis. | 1976 Apr | Of 75 patients with rheumatoid arthritis, 39 had a thrombocytosis and 36 normal platelet count. A highly significant relationship existed between the platelet count and disease severity and an inverse correlation with level of haemoglobin. An association appeared to exist between thrombocytosis and extra-articular manifestations of rheumatoid disease. By 75Selenomethionine labelling platelet and fibrinogen survival and turnover were determined. In 3 rheumatoid patients with thrombocytosis platelet survival was decreased and turnover increased. In these and a further rheumatoid patient with a normal platelet count there was reduced fibrinogen survival and increased fibrinogen turnover, and in addition excess fibrin degradation products were detected. The results suggest that thrombocytosis accompanies the more severe cases of rheumatoid disease and is due to a compensatory increase in platelet production associated with active intravascular coagulation. | |
| 7377853 | Osteomalacia in rheumatoid arthritis. | 1980 Feb | Fifty-four patients with rheumatoid arthritis and severe osteomalacia were found to have considerable bone and general deficiency problems. In 46 of them 14 stress fractures occurred and 32 minimal trauma fractures necessitating admission to hospital. Radiological abnormalities of absorption were found in nearly 25% of the total, implying that dietary factors alone are not always responsible for osteomalacia in patients with rheumatoid arthritis. A high index of suspicion is necessary in the diagnosis of osteomalacia in patients with rheumatoid arthritis, so they may benefit from treatment. | |
| 6639237 | Seronegative rheumatoid arthritis. Fact or fiction? | 1983 Nov | Patients with clinical features of rheumatoid arthritis (RA) but negative rheumatoid factor (RF) present a diagnostic challenge. The seronegative spondyloarthropathy (SNSA) syndromes, previously believed to be "rheumatoid arthritis variants," eg, Reiter's syndrome and psoriatic arthritis, are now considered to be genetically separate from RA and have been shown to be closely associated with HLA-B27. This syndromic discrimination has raised question as to the validity of RF negative RA (ie, seronegative RA). Demographic, clinical, and roentgenologic features of seronegative RA and SNSA are compared. Also, more common diagnoses that may stimulate seronegative RA are outlined according to onset age of arthritis. Recent concepts of RF positivity and HLA-DR4 correlations are reviewed. Multiple unknown factors contribute to the currently recognized syndrome of RA. Its diagnosis continues to rest on an aggregate of host, clinical, immunologic, and radiologic features. | |
| 65805 | HLA-B27 in rheumatoid arthritis and amyloidosis. | 1977 Feb | To study the role of genetically determined immune responsiveness in the pathogenesis of systemic amyloidosis complicating rheumatoid arthritis the HLA antigens were identified in 26 patients with rheumatoid arthritis complicated by secondary amyloidosis, in 44 patients with rheumatoid arthritis, and in 11 patients with secondary amyloidosis of non-rheumatoid origin. Subjects with ankylosing spondylitis, sacroiliitis without peripheral polyarthritis, Reiter's disease, reactive arthritis, erosive osteoarthritis, psoriatic arthropathy, systemic lupus erythematosus or arthritis associated with a gastrointestinal involvement were excluded from the study. Patients with amyloidosis secondary to rheumatoid arthritis had a high frequency of the HLA specificity B27 and of the haplotype likely to bear A2, B27. The association with B27 was closest in the group of male patients with amyloidosis whose rheumatoid arthritis had begun at an early age and who lacked demonstrable rheumatoid factor in serum. These patients may represent a genetically determined subentity of rheumatoid arthritis. | |
| 7110643 | Pathophysiology of rheumatoid arthritis. | 1982 Jun | Understanding the pathophysiologic joint changes of rheumatoid arthritis will help the nurse practitioner educate clients in therapeutic modalities such as drugs, exercise, rest, heat and cold, and splints. Uncontrolled inflammation of the affected joints is the client's worst enemy. If inflammation could be controlled early in the disease process and thus limited to synovial tissue without pannus formation and subsequent cartilage destruction, normal joint function could be more optimally maintained. But once fibrotic tissue has formed, the resulting damage to the cartilage and joint destruction cannot be reversed. The earlier treatment is initiated and the sooner the client is educated, the less advanced and crippling this disease could be physically, psychologically, emotionally and socially. | |
| 6655034 | Is rheumatoid arthritis becoming less severe? | 1983 | Clinical and laboratory data from 2088 successive outpatient attenders with rheumatoid arthritis (RA) were analysed to determine whether there is a trend to decreasingly severe disease. The results, after allowing for the difficulties in this type of analysis suggest that successive generations of patients with RA are decreasingly likely to become seropositive, erosive or develop subcutaneous nodules. There are no obvious explanations for these findings. |