Browse

Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
7709952 A controlled study of the long-term prognosis of adult Still's disease. 1995 Apr PURPOSE: To assess the long-term prognosis of patients with adult Still's disease for physical and psychological disability, pain, social functioning, social support, medication use, formal education, occupation, time lost from work, and family income, and to contrast these results with those of same-sex sibling controls. PATIENTS AND METHODS: Patients were recruited from medical center-based cohorts in Pittsburgh and Eastern Canada and from a national survey of rheumatologists. Patients and same-sex sibling controls completed the Health Assessment Questionnaire for physical disability, the psychological and social function domains of the Arthritis Impact Measurement Scales, and the Interpersonal Skills Evaluation List questionnaire for social support, and replied to questions on medication use, formal education, occupation, time lost from work, and family income. RESULTS: One hundred four of 111 eligible adult Still's patients (94%) provided data. They identified 86 same-sex sibling controls, of whom 60 (70%) participated. The mean duration of adult Still's disease was 10 years. Approximately half of patients continued to require medication even 10 years after diagnosis. Patients had significantly higher levels of pain, physical disability, and psychological disability when compared with the controls. However, the levels of pain and physical disability were low compared to patients with other rheumatic diseases. Educational achievement, occupational prestige, social functioning and support, time lost from work, and family income were similar for both patients and controls. CONCLUSIONS: Despite causing disability, pain, and, in many, the need for long-term medication, patients with adult Still's disease are resilient. The disease did not interfere with educational attainment, occupational prestige, social functioning and support, time lost from work, or family income.
7493451 Vth International Symposium on Sjögren's syndrome. Clinical aspects and therapy. 1995 Jul There is increasing awareness that sicca syndrome can lead to ocular, oral and systemic complications. However, a wide variety of pathogenetic processes may lead to the same end result of diminished glandular secretion. Recognition of these different etiologies will lead to improved therapies. On the one hand, an active inflammatory/autoimmune process may respond to immunomodulatory drugs. On the other hands, processes that predominantly involve "neuroendocrine" dysfunction (unrelated to immune activity) of the gland will require a different approach.
1392186 Adult Still's disease with myocarditis and peritonitis. 1992 Jun A 26-year-old woman had myocarditis and peritonitis during an acute multisystem attack of Still's disease. To our knowledge, these complications are rare manifestations of adult Still's disease. Treatment with high-dose adrenocorticosteroids was rapidly successful in controlling these manifestations.
7923746 Estrogen, progesterone, and testosterone: can they be used to treat autoimmune diseases? 1994 Jul BACKGROUND: Sex hormones have marked immunomodulatory properties and may play important roles in the etiology of various autoimmune diseases. OBJECTIVE: To review the immunomodulatory effects of sex hormones, their roles in the etiology of autoimmune diseases, and their potential therapeutic applications. DISCUSSION: Progesterone and androgens suppress the immune system, prolactin stimulates it, and estrogens can do either. Rheumatoid arthritis tends to improve during pregnancy, during estrogen replacement therapy, and during treatment with estrogen-containing oral contraceptives. Systemic lupus erythematosus is aggravated by pregnancy and probably by estrogens. Therapy of rheumatoid arthritis with estrogens has not been promising, but testosterone replacement in men has shown modest benefits. In lupus, 19-nortestosterone has had little or no benefit, but danazol has been helpful in some patients, and encouraging preliminary results were obtained with dehydroepiandrosterone. CONCLUSIONS: We strongly recommend estrogen replacement therapy to prevent postmenopausal osteoporosis in women with rheumatoid arthritis. Younger women with rheumatoid arthritis can undergo pregnancy or use estrogen-containing contraceptives. Estrogens can be used in lupus only with great caution. Recommendations regarding other hormones and other diseases are less firm, but research is continuing in this area.
7667221 [Primary Gougerot-Sjogren syndrome. Spontaneous one-year course of clinical, biological an 1995 Jun 10 OBJECTIVES: The natural clinical course of primary Sjögren's syndrome was followed in 8 patients to identify the concomitant functional, clinical, biological, scintigraphic and histological manifestations of the disease. METHODS: The diagnosis of primary Sjögren's syndrome was made on the basis of functional signs (ocular or salivary sicca syndrome) and 2 positive tests among the 3 objective ocular tests (Schirmer's test, break-up time, Rose Bengale). Work-up included recording of functional and clinical signs, ophthalmologic examination and laboratory tests at diagnosis and every 3 months for 12 months. Scintigraphy of the salivary glands was performed together with a biopsy at diagnosis and at 12 months. RESULTS: No one parameter varied significantly over a 1 year period demonstrating the lack of need for renewed examinations for diagnosis or regular follow-up. CONCLUSION: This is the first report providing a homogeneous series studied by one team over a determined period of time. It demonstrates that clinical, biological and anatomic criteria for primary Sjögren's syndrome do not show any correlation between functional signs and objective ocular tests.
8588124 Autonomic cardiovascular neuropathy in primary Sjögren's syndrome. 1995 The case of a 65-year-old female with primary Sjögren's syndrome and severe autonomic cardiovascular neuropathy, manifested by incapacitating postural hypotension, is presented. It is postulated that the patient's Sjögren's syndrome was responsible for the autonomic neuropathy, probably via a vasculitic mechanism. Treatment with hydrocortisone resulted in improvement in the patient's symptoms but it did not significantly alter the objective findings of autonomic dysfunction. We suggest that it is probably worth studying Sjögren's patients for evidence of autonomic neuropathy.
9355677 Chemiluminescence of peripheral blood leukocytes and activity of an inflammatory process i 1994 The oxidative metabolites have been implicated in the aetiology and pathology of rheumatoid arthritis. In our work we endeavoured to deal with polymorphonuclear leukocytes (PMNLs) ability to generate oxygen free radicals (OFRs). PMNLs metabolic activity was assessed by the means of chemiluminescence (CL) method. We observed significantly higher PMNLs metabolic activity in children suffering from JCA in comparison to the healthy group. Greater activity of the rheumatoid process was accompanied by an increased PMNLs activity. The results constitute another piece of evidence confirming the role of PMNLs in the pathogenesis of JCA.
10830005 Juvenile rheumatoid arthritis in India--rarity of antinuclear antibody and uveitis. 1996 May Juvenile chronic arthritis is a heterogeneous disease, having different subtypes. Among our 89 patients with juvenile chronic arthritis, we did not find even one patient with early onset pauciarticular disease with uveitis and antinuclear antibody positivity. Further, the prevalence of anti-nuclear antibodies and anti-histone antibodies was very low whereas the prevalence of rheumatoid factor was similar to that reported from Western countries. Thus, the spectrum of juvenile chronic arthritis in India differs from that seen in the west. Larger population based studies of the disease are thus needed.
19077941 Acute monosynovitis or oligoarthritis in patients with quiescent rheumatoid arthritis: som 1995 Feb Joint manifestations in patients with rheumatoid arthritis (RA) are usually caused by the rheumatoid disease or, less often, by secondary osteoarthritis or an infection. Effusions related to crystal deposits have been reported but are uncommon. We report on seven patients with quiescent RA who presented with incompletely explained, acute, mostly monoarticular, joint or bursal exacerbations that may have been caused by apatite or lipid crystals or by reactions to tissue and cell debris. In one of these patients, the joint symptoms were related to the development of pigmented villonodular synovitis. Whether or not our hypothesized mechanisms are correct, it is important to be aware that exacerbations in a single or a few sites out of proportion to the rest of the RA need not be because of activity of the RA or infection. This awareness can prevent inappropriate aggressive treatment of the rheumatoid disease or extensive antibiotic therapy. In our cases, careful analysis of the synovial fluid was helpful in ascertaining that active RA was less likely and in identifying some possible causes of the effusions.
19078002 Septic Arthritis of the Knee with Toxoplasma gondii in a Patient with Rheumatoid Arthritis 1995 Oct Toxoplasmosis is a parasitic infection that may affect several viscera. The locomotor system is rarely involved, and no case has been published of a septic arthritis in which Toxoplasma gondii was identified in the cultures of the joint fluid and of the synovial specimen.We describe a patient with septic arthritis of the knee in which Toxoplasma gondii was found by culture in a patient with seropositive rheumatoid arthritis treated with corticosteroids and gold salts who developed multi-visceral toxoplasmosis.
8963552 [Diagnosis of active inflammatory process in juvenile rheumatoid arthritis]. 1996 Jul Assessment of the laboratory parameters of the activity of an inflammatory process (red cell sedimentation rate, C-reactive protein, sialic acids, seromucoid, protein fractions) and the parameters of the hemostasis system in 128 patients with juvenile rheumatoid arthritis (JRA) showed that the traditional laboratory parameters are not sufficiently sensitive in JRA, and the absence of positive responses is not a reliable criterion for discontinuing antiinflammatory therapy. The following hemostasis system tests are proposed for detecting and assessing the activity of inflammation in JRA patients: Hageman-dependent fibrinolysis (HDF), level of Willebrand's factor in the blood (WF), and leukocyte-platelet aggregation. The tests are highly sensitive to low-active and latent inflammatory processes in JRA and are nonspecific. In addition, HDF and WF permit the detection of proliferative inflammation.
20470494 [Results of surgical synovectomy of the knee joint in patients with rheumatoid arthritis.] 1995 The authors evaluate the results of synovectomy of the knee in 216 patients (83 men and 133 women) with rheumatic arthritis (RA); 35 patients with juvenile chronic arthritis (JCA) in the evaluated group account for 16,2%. On average 2.3 years have elapsed since the operation. They evaluate the peroperative macroscopic appearance of the synovial membrane, the damage of intraarticular structures, the effect of surgery on the range of movements. Comprehensive evaluation according to Aidem -Baker revealed very good results in 52.8%, good results in 36.1%, satisfactory results in 7.4% and poor results in 3.7%. Key words: surgical synovectomy, synovectomy of the knee, rheumatoid arthritis (RA), juvenile chronic arthritis (JCA).
8006899 Development of a self-report functional status index for juvenile rheumatoid arthritis. 1994 Mar OBJECTIVE: There are few functional indices available for juvenile rheumatoid arthritis (JRA). Our goal was to develop a reliable, valid and responsive self-report physical functional status index for individuals with JRA, ages 8-18 years. METHODS: Activity (item) generation by interview of children, parents, teachers, clinicians yielded 280 items. Categories of self-care, domestic, mobility, school, and extracurricular were chosen by clinicians. Twelve clinicians sorted the items into categories. Item reduction was by these clinicians who rated items for common problems in JRA, importance of performance, and potential for change. RESULTS: Ninety-nine items were retained. A separate section was designed for respondents to identify their priority activities. Content validity of the questionnaire, the Juvenile Arthritis Self-Report Index (JASI), was evaluated by 17 different clinicians. One item was added and none eliminated; all rated the index as a credible functional measure for JRA. CONCLUSION: The JASI has been rigorously developed, and has demonstrated content validity. Index validation is being completed.
1285895 Problem areas of the rheumatic mother. 1992 Oct The extent to which women with rheumatic diseases are disabled in caring for their children is unknown. Fifty-seven women with rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or systemic lupus erythematosus, all of whom had children under 6 years of age born during the disease, were interviewed. Patients with different diseases differed in their disabilities, but lifting, carrying, transporting, and bathing the child were difficult for most patients. Attention to these problem areas is necessary in the care of young mothers with rheumatic illness.
1496167 Comparison of diagnosis and treatment of Sjögren's syndrome in Japan and United States. 1992 Aug Today, as with western countries, diagnosis and treatment of Sjögren's syndrome (SS) patients in Japan are carried out by a team effort. The clinical manifestations of Japanese SS patients are quite similar also. There are, however, several minor modifications in the diagnosis and treatment of SS patients in Japan, which are presented in this article.
1599810 Novel immunomodulating and immunotherapies, and novel therapies and strategies for inflamm 1992 Jun During the past year, another disease possibly influenced by intravenous gammaglobulin was identified as dermatomyositis/polymyositis. Additional studies provided further information regarding the use of monoclonal anti-CD4 antibody and combination therapy in rheumatoid arthritis, antithymocyte globulin in scleroderma, and intravenous gammaglobulin in juvenile rheumatoid arthritis. New therapeutic horizons also emerged including the novel immunosuppressant FK-506, the removal of disease incitants by medical arthroscopy, antiarthritic T-cell receptor V beta-specific antibodies, and the potential of achieving tolerance via peroral administration of autoantigens.
8991997 Bicipital synovial cysts in juvenile rheumatoid arthritis: clinical description and sonogr 1995 Oct OBJECTIVE: To describe the presentation and clinical course of bicipital synovial cysts in 6 patients with juvenile rheumatoid arthritis (JRA) and to elucidate their anatomy using ultrasonography. METHODS: A clinical description of the cyst, JRA subtype, activity of concurrent arthritis, systemic disease features, and erythrocyte sedimentation rate was recorded for each patient. Ultrasonographic examination of the cyst was performed for each patient. RESULTS: Bicipital cysts generally presented as a sudden painless swelling on the flexor aspect of the upper arm, but on was in the forearm. Five of 6 patients had systemic disease. All patients had active arthritis when the cysts developed. Five of 6 cysts resolved spontaneously in less than 12 weeks. Ultrasonography confirmed a cystic structure in all patients, and in all cases was associated with thickening of the biceps tendon. Fluid was found within or adjacent to the biceps tendon in all cases. CONCLUSION: Bicipital synovial cysts should be considered a cause of acute arm swelling in patients with JRA, especially those with systemic disease. Ultrasonography is a useful diagnostic adjunct in this condition. This condition is generally self-resolving.
7582694 The antiperinuclear factor in spondylarthropathies. 1995 Oct The aim of the present study was to evaluate the prevalence of antiperinuclear factor (APF) in patients with spondylarthropathy and the relationships between this autoantibody and a variety of clinical, radiological and serological findings. We conducted a retrospective review of the medical records of all patients first admitted to the Rheumatology Unit of the Brest University Medical School Hospital from 1 January 1986 to 31 December 1994, and who met the European Spondylarthropathy Study Group (ESSG) criteria at admission. Each patient had a standard battery of tests. Serum samples from 123 of 126 patients suffering from spondylarthropathy were examined for the presence of APF. Thirty-three patients (26.8%) had APF at a titre > or = 1/80. There were no significant relationships between various demographic, clinical or radiological characteristics and the presence of APF. However, the subgroup of APF-positive patients had a higher prevalence of both rheumatoid factors (RF), although not significant, and antikeratin antibody-positive serum than the rest. These results suggest that some patients had rheumatoid arthritis (RA) and three patients with APF > 1/100 and who were RF positive met ACR criteria for RA. APF should thus be used only as an additional serological marker in cases where clinical features suggest the association of spondylarthropathy with RA.
9087070 You are what you eat: healthy food choices, nutrition, and the child with juvenile rheumat 1996 Sep Children with juvenile rheumatoid arthritis (JRA) often experience nutrition related concerns. Growth abnormalities are common. Protein-calorie malnutrition and inadequate intake of other nutrients result from aspects of the disease process, treatment (including drug treatment), and dietary choices. Mechanical feeding difficulties can also compromise adequate intake. Because nursing assessments usually explore eating habits and family issues, the registered nurse is in a good position to identify nutrition concerns, to provide intervention recommendations, or to act as a referral source.
7731481 Evaluation of growth hormone secretion in children with juvenile rheumatoid arthritis and 1995 Mar Children with juvenile rheumatoid arthritis (JRA) often exhibit delayed skeletal development. Previous evaluations of growth hormone (hGH) levels in these children have used single-value blood determinations. We sought to extend information on possible hGH deficiency in children with short stature and JRA by measuring 24-hour hGH pulsatile secretion. Five children with JRA were identified as having a height less than the 3rd percentile, and one child with a height at the 25th percentile. Three of these had abnormally low 24-hour serum hGH secretion. Two underwent a 24-month trial of human recombinant hGH; both exhibited only marginally accelerated growth. These results suggest that children with JRA and persistent short stature may have low hGH secretion without an adequate physiologic response to exogenous hGH administration.