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

ID PMID Title PublicationDate abstract
18475445 ICAM-1 expression on chondrocytes in rheumatoid arthritis: induction by synovial cytokines 1992 The intercellular adhesion molecule-1 (ICAM-1) was found by immunostaining chondrocytes in cartilage from three patients with rheumatoid arthritis. Expression of ICAM-1 was restricted to chondrocytes in areas of erodedcartilage adjacent to the invading synovial tissue. Toluidine blue staining of these areas demonstrated severe depletion of the cartilage extracellular matrix. In areas of undamaged cartilage there was no ICAM-1 expression. Since ICAM-1 is not constitutively expressed on normal human articular cartilage, but could be induced in vitro by exogenous IL-1alpha, TNFalpha and IFNgamma or by co-culturing cartilage with inflammatory rheumatoid synovium, we conclude that the induction of ICAM-1 on rheumatoid chondrocytes results from the synergistic action of a variety of cytokines produced by the inflammatory cells of the invading pannus.
7727554 A descriptive study of foot problems in children with juvenile rheumatoid arthritis (JRA). 1994 Sep In this study, we evaluated the feet of 144 consecutive children with juvenile rheumatoid arthritis (JRA) during a routine outpatient visit to discover patterns of foot problems. We found that all but nine subjects had at least 1 of 21 foot problems, categorized as inflammation, limitation of motion, and abnormal alignment. Overall, pronated rearfoot and midfoot were observed in 73% and 72% of JRA patients, respectively. Additionally, 36% had splayfoot, whereas 35% of subjects had ankle limitation of motion. Other common foot problems included pronated forefoot, rearfoot and forefoot synovitis, forefoot limitation of motion, and toe valgus. Significant differences in the occurrence of various foot problems were observed among JRA onset/course subgroups and were influenced by both age and disease duration. Specifically, subjects with polyarticular JRA had more forefoot limitation and toe valgus, whereas subjects with pauciarticular JRA had pronated forefoot more often. Ankle limitation of motion, although unrelated to the JRA sub-group, was related to the duration of JRA. Subjects with longer disease histories also had toe valgus more often. Conversely, forefoot limitation of motion seemed to be more a function of age than of disease duration. These results indicate that foot problems are common in the JRA population, and they underscore the need for thorough evaluation and physical therapy management.
8496876 Positive serology for Lyme borreliosis in patients with juvenile rheumatoid arthritis in a 1993 Apr Juvenile rheumatoid arthritis (JRA) and the arthritis of Lyme borreliosis in children can mimic each other. As false positive reactions are frequent in ELISA for Lyme borreliosis, they cannot be used reliably to make the distinction. Ninety-nine children diagnosed as having JRA at a children's hospital in an endemic area were evaluated by ELISA and immunoblot for antibodies to Borrelia burgdorferi. Sera from 9% were positive by ELISA, 5 of which showed bands on immunoblot. None met criteria for positive immunoblot. The antigenic basis of false positive ELISA was most frequently a reactivity to both 21 and 41 kDa. Analysis by immunoblot can help to definitively exclude Lyme borreliosis in children presenting with JRA in an endemic area.
27665899 Simple solution to stop arthritis damage. 1993 Dec 1 Drugs based on common substances such as sugars and carbohydrates may stop the damage caused by rheumatoid arthritis, Australian researchers believe.
1363792 [Clinical assessment of a group of children with juvenile rheumatoid arthritis receiving l 1992 Dec The authors assess the efficacy of gold salt treatment for juvenile rheumatoid arthritis. The study was carried out on 16 children suffering from mono-pauciarticular, polyarticular and systemic arthritis. Treatment consisted of the administration of auranofin alone in a group of 8 children and auranofin associated to corticosteroids in a second group of 8 children. A marked improvement in clinical conditions was observed with slight transitory side effects at follow-up after 12 and 24 months.
19078078 Open pilot study of the addition of sulfasalazine to methotrexate in patients with rheumat 1996 Oct The safety and efficacy of the sequential addition of sulfasalazine to baseline methotrexate was assessed in patients with active rheumatoid arthritis inadequately controlled by methotrexate alone. Nineteen patients were recruited in a pilot, prospective, open label, uncontrolled clinical trial. One patient was lost to follow-up, four dropped out due to toxicity, one dropped out due to inefficacy, and five violated the protocol. A modified intent-to-treat analysis was performed by carrying forward the clinical data before drop-out or protocol violation to the final visit for the 18 evaluable patients. Swollen and tender joint counts, physicians's and patient's global scores were significantly improved (p < 0.021 to 0.001). Forty-two percent of patients (8/19) demonstrated >/= 20% improvement and 26% (5/19) showed >/= 50% improvement in 4 or more clinical parameters at 6 month's follow-up. Rheumatoid factor negative patients were more likely (p < 0.025) to complete the trial. A controlled clinical trial will be necessary to determine the effectiveness of this combination and the value of sequential addition chemotherapy in patients with recalcitrant rheumatoid arthritis.
8620298 Arthritis associated with monoclonal gammapathy: clinical characteristics. 1996 Mar We report nine cases of arthritis associated with a monoclonal gammapathy. Joint involvement was noted simultaneously or after the diagnosis of monoclonal gammapathy was made. The cases had oligoarthritis or polyarthritis mimicking rheumatoid arthritis. However, rheumatoid factor was absent in all patients, and distal interphalangeal joints were involved in two cases and sacroiliitis in one. The plasma cell dyscrasia was a multiple myeloma in two cases and monoclonal gammapathy of undetermined significance in the other patients. The light chain isotype was kappa in eight of our patients. A type I cryoglobulinaemia was associated in four cases; it was detected in the synovial fluid of two of them. We suggest that the occurrence of paraproteinaemia with chronic arthritis is more than a chance association. Moreover, a monoclonal gammapathy should be searched for in patients presenting with atypical seronegative arthritis.
7774101 Undifferentiated arthritis in an early synovitis out-patient clinic. 1995 Jan OBJECTIVE: To describe the features of undifferentiated arthritis in an early synovitis out-patient clinic. METHODS: In a two-year prospective cohort study 320 patients with rheumatic symptoms of less than one year were investigated in an early synovitis out-patient clinic. Besides the clinical parameters, an intensive laboratory program was performed, including routine blood and serum parameters, immunological investigations (CRP, IgG,A,M,C3C4,RF,ANA, DNA, HLA B-27), and a microbiological program to search for reactive arthritis-inducing infections. RESULTS: 217 patients had inflammatory rheumatic diseases, of whom only 100 (46%) could be given a definite diagnosis, whereas 117 (54%) were considered as having undifferentiated arthritis (UA). Patients with UA had a mean age of 41 +/- 15 years, the sex-ratio was 1.8:1.0 (f/m), joint manifestations were oligoarticular in 68%, monarticular in 14%, and polyarticular in 18%. Rheumatoid factor was positive in 17%, HLA-B27 was found in 27%, and 21% of the patients had a history of recent infection. Follow up over 26 (range 4-38) months of 28 (24%) patients with UA revealed complete remission in 15 patients (54%), while 10 patients (36%) had further UA with partial remission, unchanged activity or progressive disease, and only 2 (7%) developed rheumatoid arthritis (RA) and 1 (4%) was diagnosed as having ankylosing spondylitis. CONCLUSION: Most patients with early synovitis followed at our clinic remain unclassified with a good prognosis.
1439843 Primary Sjögren's syndrome--clinical and laboratory markers of disease activity. 1992 Oct Primary Sjögren's syndrome is a chronic autoimmune disorder of the lacrimal and salivary glands, reflecting general involvement of the exocrine tissues and leading to functional impairment. This polyglandular disease is often associated with systemic extraglandular manifestations, and laboratory tests usually indicate polyclonal B-lymphocyte hyperactivity. Clinical and laboratory markers monitoring the disease processes are needed for improved management of primary Sjögren's syndrome. However, incomplete knowledge of the long-term course of inflammation as well as of clinical manifestations makes precise and simple directions for monitoring disease activity in primary Sjögren's syndrome difficult. This review describes potential primary (eg, salivary gland histopathology, autoantibodies, soluble interleukin-2 receptors, and beta 2-microglobulin) and secondary disease activity markers (clinical and laboratory signs of glandular and extraglandular organ damage) and their known associations. The importance of genetic characteristics, patient age, and symptom duration for the disease activity markers is indicated. The systematic use of primary and secondary disease activity markers will improve our understanding of primary Sjögren's syndrome and help create better guidelines for monitoring the disease.
1596706 Adult-onset Still's disease in India. 1992 Jun Adult onset Still's disease was provisionally diagnosed in 31 patients from northern India over a period of five years, in 27 of whom the diagnosis was subsequently felt to have been confirmed. This report describes the clinical characteristics of these patients along with the different therapeutic measures used and their response. Adult onset Still's disease should be considered in the differential diagnosis of 'pyrexia of unknown origin'.
8103962 Sulphasalazine in rheumatic diseases. 1993 Sulphasalazine has been used world wide for the treatment of inflammatory bowel diseases for over 40 years. Since the late seventies, sulphasalazine has in addition, been shown to have positive effects in rheumatic diseases e.g. rheumatoid arthritis and spondylarthropathy. Whatever its mechanism of action, the high concentration of sulphasalazine in the gut might explain its beneficial effects on the articular symptoms. Sulphasalazine can be considered as a Disease Modifying Antirheumatic Drug in rheumatoid arthritis and, probably, in spondylarthropathy.
22959643 The source of shoulder pain in rheumatoid arthritis: Usefulness of local anesthetic inject 1994 Mar Clinical symptoms and radiologic appearances are often poor indicators of the source of pain in the shoulder joint complex in patients with rheumatoid arthritis. In 75 rheumatoid shoulders, injections of 1 ml of 1 % local anesthetic were placed in the acromioclavicular joint, the subacromial bursa, and the glenohumeral joint, following a standard sequence. Forty-one shoulders were relieved of pain from subacromial or acromioclavicular injections even when there were advanced radiologic changes in the glenohumeral joint. However, if the sphericity of the humeral head had been lost, an injection of the glenohumeral joint usually confirmed this site as the source of pain. The results of local anesthetic injections allow decisions to be made about the most appropriate form of surgical or nonsurgical treatment.
8881381 [Involvements of the peripheral nervous system and primary Gougerot-Sjögren syndrome]. 1996 Peripheral neuropathy in primary Sjögren's syndrome is common although often unrecognized in mild forms of this affection. They are characterized by a predominently sensory deficiency and can be divided in several entities, of which the most important are: axonal distal symmetric polyneuropathy, either of sensory or sensory-motor presentation, which are supposed to be consecutive to ischemia induced by the vasculitis of the vasa nervorum; sensory neuronopathy mimicking the paraneoplastic syndromes from a clinical and electrophysiological point of view which are supposed to be linked to neuronal degeneration secondary to a lymphocytic infiltration of the dorsal root and ganglia; trigeminal sensory neuropathy, either alone or associated with one of the previously cited forms. The prescribed courses of etiological treatment consisting of corticosteroids and immunosuppressive agents are only effective in some acute forms. Tracking down systematically these peripheral neuropathies in patients affected by Sjögren's syndrome is the best way to recognize them. Alternatively, patients with unexplained neuropathies should be evaluated for the presence of Sjögren's syndrome.
7668903 Epidemiology of adult Still's disease: estimate of the incidence by a retrospective study 1995 Jul OBJECTIVES: To estimate the incidence of adult Still's disease (ASD) and to specify, if possible, associated factors. METHODS: A retrospective study of the populations of the Brittany and Loire regions in west France was made from 1 January 1982 to 31 December 1991. All internal medicine and rheumatology practitioners of these regions were consulted. RESULTS: Sixty-two (62) cases were reported (93% response). The disease incidence calculated over five years was 0.16 per 100,000 inhabitants in the study population. There was no sex bias (sex ratio 1.06 in ASD v 1.05 in the overall population. The mean age of the study population was 36 years, with two peaks of distribution at 15-25 and 36-45 years. A history of allergy was present in 23% of patients (n = 14). In two patients, it was possible to correlate an environmental allergen to exacerbation of ASD. CONCLUSION: The yearly incidence of ASD was estimated to be 0.16 per 100,000 inhabitants. However, it was not possible to incriminate any infectious, toxic, or genetic factors in exacerbation of the disease.
7727885 Adult-onset Still's disease with submassive hepatic necrosis. 1995 Feb We present a 74-year old woman who was hospitalized because of typical spiking fever, evanescent rash, polyarthralgia, lymphadenopathy, and marked elevation of serum transaminases and lactate dehydrogenase (LDH) due to adult-onset Still's disease (AOSD) with submassive hepatic necrosis. All of the symptoms and abnormal laboratory findings were dramatically improved after treatment with prednisolone. The clinical course of this patient indicates that AOSD with severe hepatic necrosis can successfully be treated with early administration of corticosteroid, although it remains unknown whether the disease can remain in remission with no or minimal treatment.
8060826 Sjögren's syndrome. 1994 Jun This article reviews the diagnostic criteria for Sjörgen's syndrome (SS), as well as some of the more common associated signs and symptoms. Dermatological manifestations associated with SS will be evaluated. Finally, general treatment strategies will be discussed.
8164226 Still's disease in a 72-year-old man. 1993 Sep Adult onset Still's disease is an uncommon clinical entity, usually found in young adults. Occasionally it can be seen in patients over 55 years old. Our clinical report illustrates that Still's disease may occur even in a 72-year-old man.
8519614 Sjögren's syndrome. 1995 Sep The literature published over the past year on Sjögren's syndrome is reviewed, including epidemiology, genetic, environmental, and clinical features. The criteria for the classification of Sjögren's syndrome remain controversial, potentially leading to confusion in clinical practice and in research publications. Dryness of the eyes and mouth can result from either interruption of the neurovascular innervation of the glands or from any infiltrative process that affects the ability of the glands to secrete. Recent studies have demonstrated that sicca symptoms also can result from autonomic neuropathy in patients with diabetes, multiple sclerosis, or systemic lupus erythematosus. It is suggested that the term Sjögren's syndrome be used to describe one subset of patients with sicca symptoms who exhibit particular major histocompatibility complex antigens, the presence of T cell lymphoid infiltrates on glandular biopsy, and specific autoantibodies in their sera. Even using these restrictive criteria for classification, no single environmental factor has been shown as necessary or sufficient for pathogenesis. Recent studies on Epstein-Barr virus have indicated a novel deleted virus in some Chinese Sjögren's syndrome patients. Other patients with sicca symptoms and autoimmune features may have infections with HIV or hepatitis C virus.
8932830 Treatment of the neutropenia of Felty syndrome. 1996 Sep This review sets out to synthesize and critically evaluate the current reported data regarding therapeutic options for the neutropenia associated with Felty syndrome (Felty neutropenia). A MEDLINE search and bibliographies from recent reviews were used to identify trials and case reports that provided sufficient data to evaluate the effect of various interventions on both the neutropenia and the clinical course of patients with Felty syndrome. Data were obtained on baseline hematologic profiles, bone-marrow biopsies, and patient characteristics; length of follow-up; hematologic and clinical responses to the various interventions; and side-effect profiles. Treatment with hemopoietic growth factors or methotrexate can produce sustained hematologic and clinical responses with an acceptable side-effect profile. Splenectomy produces a long-term hematologic response in 80% of patients. Patients who do not respond hematologically have a higher incidence of non-fatal infections, but a significant minority (46%) do not experience any infections; the incidence of fatal infections is 12%, regardless of whether a hematologic response occurs. Of the patients who had infections prior to surgery, 55% did not experience further infections after splenectomy. Initial treatment of Felty neutropenia should consist of hemopoietic growth factors because of their rapid onset of action and relatively low incidence of side-effects. Splenectomy is a reasonable option if growth factors are ineffective and rapid amelioration of neutropenia is needed. Methotrexate offers a potentially promising alternative for the treatment of both the rheumatologic and the hematologic manifestations of Felty syndrome.
8186120 Adult Still's disease. 1994 Apr Adult Still's disease (ASD) is a rare disorder of unknown aetiology, characterized by an evanescent, erythematous, maculopapular rash, fever, arthralgia, and a variety of systemic features. We report a case which illustrates the typical features of ASD, and manifests the hitherto unreported complication of diffuse cutaneous mucinosis.