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ID PMID Title PublicationDate abstract
8835556 The presence of anti-Fc gamma receptor autoantibodies is related to the clinical presentat 1995 Dec OBJECTIVE: Fc gamma receptor III (Fc gamma RIII) is one of the 3 structurally distinct families of receptors for the Fc domain of IgG, and its Fc gamma RIIIb isoform is exclusively expressed in polymorphonuclear (PMN) cells. We sought to detect anti-Fc gamma RIII autoantibodies in serum from patients with primary Sjögren's syndrome (SS). METHODS: Sixty-six patients with SS and 44 healthy controls were enrolled in the study. ELISA were developed. RESULTS: IgG and IgM autoantibodies were found in 16 (10 IgG+ IgM+ and 6 IgG+ IgM-) and 24 patients (10 IgG+ IgM+ and 14 IgG- IgM+) respectively. Their frequency was higher in patients with nonerosive arthritis (p < 0.02), Raynaud's phenomenon (p < 0.003), and lung involvement (p < 0.02) than in patients without such complications. The levels of IgM and IgG antibody (p < 0.05) correlated with the content of IgA without the circulating immune complex (IC), while there was no relationship between anti-Fc gamma RIII activity and the PMN count. CONCLUSION: Anti-Fc gamma RIII autoantibodies may act as an acquired additional factor further compromising IC handling in individuals who share HLA-DR3 alloantigen.
1410668 [Psoriasis arthropathica. A review of the literature, general considerations and the autho 1992 Sep A retrospective study has been carried out on 897 psoriatic patients in order to verify the incidence and radiological patterns of psoriatic arthropathy (PA). Site of involved joints, appearance and degree of involvement were correlated with extent of skin disease and blood test results. Sixty-five patients (7%) showed "clinical" arthritis whereas only 20 cases (2.2%) were radiologically positive; among them, 35% were classified as "severe" forms. Peripheral arthritis was observed in all cases, involving the hand in 85% of patients. The distal interphalangeal joints were the most affected location in the feet (78%) and the proximal interphalangeal joints in the hands (94%). The extant small peripheral joints were involved in decreasing rates proceeding proximally. Bilateral and asymmetric involvement was observed in most of the patients; hypertrophic interphalangeal joints erosion was the typical pattern in 100% of cases, evolving in rheumatoid-like ankylosis in 23% of them. Spondylitis and/or sacroiliitis were associated in 50% of patients. No correlation between degree of arthritis and skin disease was found in our series, with the exception of proximal and axial joints arthritis, in which extensive skin disease and severe small joints involvement were associated in 80% of cases. Clear differential features were demonstrated between peripheral PA and rheumatoid arthritis, and between spinal involvement in PA and ankylosing spondylitis. Poor correlation of distal arthritis to psoriatic nail involvement was also demonstrated.
8309844 [Calcitonin in treating bone and joint lesions--clinical and experimental findings and per 1993 Nov Several experimental studies in the animal models and the use of calcitonin in patients with osteoarthritis, rheumatoid arthritis, and osteoporosis have shown multiple actions of this hormone, justifying its use in the wide range of osteoarthritic pathologies. We used well known animal models of tests to study chondro-tropic drugs such as: post-corticoid arthropathy, partial meniscectomy, immobilization of the lower extremity of rabbits, follow-up of the natural knee degeneration in the black mouse C57, and radiolabelled sulphates uptake by the cartilage, and have shown: (a) anticatabolic effect of salmon calcitonin as measured as GAG levels, width of articular space, and histochemical and morphologic examination of the cartilage in some model arthropathies, (b) anti-osteoporotic properties counteracting an effect of corticosteroids, (c) increased uptake of sulphates by the articular cartilage of the rat following calcitonin administration in vivo. The studies explaining mechanisms of calcitonin actions included IGF-1 assays and beta-endorphins. The former increased transiently after calcitonin administration whereas the latter increased after non-steroid anti-inflammatory agents use. Calcitonin decreased gastrin secretion with negligible effect on calcium ions and prostaglandin E2 levels in blood plasma while it potently acid secretion and increasing gastric mucus content in the stomach. The use of calcitonin in patients with arthrosis, rheumatoid arthritis, and osteoporosis with accompanying peptic and/or duodenal ulcers produced healing of peptic and/or duodenal ulcers in 75% of patients within 4 weeks with simultaneous shortening of the morning stiffness, increase in hand grip strength (in rheumatoid arthritis), and significant decrease in pain as well as an improvement in the quality of life in the majority of the treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)
8076394 The place of psoriatic arthritis in the spondarthritides. 1994 May The place of psoriatic arthritis in the spondarthritides has been examined in terms of past, present and future aspects. It is concluded that: 1. PsA is a definite entity and separate from rheumatoid arthritis. 2. The spondarthritis concept is universally accepted, although still in an evolving stage. 3. A more definitive picture of the spondarthritides and of PsA itself could arise from a number of new approaches, some entirely novel, some extensions of work already in progress. Avenues of future research that are likely to be fruitful include those involving: more refined clinical studies; further applications of molecular mapping; and, common to both, conceptual advances using mathematical models to provide a more 'three-dimensional' picture.
8978173 [Cartilage degradation and articular inflammation]. 1996 Nov 15 Osteoarthritis is mainly characterized by cartilage degradation as a result of series of pathological processus still not well understood. In recent years much interest has centered on the contribution of cytokines to cartilage degradation: characterization of cytokines extracted from normal and pathological articulation, site of production (synoviocytes, chondrocytes, osteoblasts) and their role on the production of proteases, protease inhibitors or other types of molecules implicated in osteoarthritis. Several types of cytokines such as IL 1 beta and TNF alpha, known as proinflammatory factors in rheumatoid arthritis, have been shown to be present in the synovial fluid from osteoarthritic patients. Recent experimental data allow us to better understand the cellular and molecular mechanisms of the cytokines respectively involved into rheumatoid arthritis and osteo-arthritis.
8531341 [Clinical aspects and types of Sjögren's syndrome]. 1995 Oct Sjögren's syndrome (SS) is a systemic as well as an organ-specific autoimmune disease, characterized by destructive lymphocytic infiltration of the salivary and lacrimal glands. We divided SS patients into three stages: stage I is glandular SS, stage II is extraglandular SS, and stage III is extraglandular SS with lymphoid malignancy. The lymphoaggressive nature of the disease appears to lead SS patients from stage I to II and from stage II to III. However, stage III patients made up only 5% of SS patients. Many patients remain stable in stages I or II for as long as 10 or 20 years. Therefore, we can assume that there are factors which trigger patients in stages I or II to progress to stages II or III and that only those patients who have such factors progress from stages I or II to stages II or III, respectively. Accumulation in the salivary glands or in the peripheral blood of B cells which have rearrangement of the RF-related germline gene Vg or over-expression of the bcl-2 gene in the lymphoepithelial lesion might be included among these factors.
7493452 Classification of disease manifestations in primary Sjögren's syndrome: present status an 1995 Jul Establishing a model for classification of the clinical disease manifestations in primary Sjögren's syndrome is a challenge with important implications for handling individual patients and for describing and analyzing patient materials. Based on the pathobiology of primary SS we define three (1-3) "exocrine" and four (4-7) "nonexocrine" subgroups of disease manifestations. Accordingly, 1) "surface exocrine disease" includes the diagnostic features from eyes (keratoconjunctivitis sicca) and mouth (xerostomia), and the manifestations from upper airways (rhinitis sicca, xerotracheitis) and skin (xeroderma). Involvement of the excretory parenchyma of the lungs, hepatobiliary system, pancreas, intestinal tract and kidneys is designated 2) "internal organ exocrine disease". These manifestations are potentially severe, do not lead to subjective dryness, and none of them are diagnostic for the disease. We suggest 3) "monoclonal B-lymphocyte disease" (lymphoma) to be an exocrine disease manifestation because it originates mostly from the immunoinflammatory foci of the autoimmune exocrinopathy. The nonexocrine manifestations are subgrouped into: 4) "inflammatory vascular disease" (vasculitis and perivasculitis), 5) "noninflammatory vascular disease" (Raynaud), 6) "mediator-induced disease" (hematologic cytopenia, fever and fatigue) and 7) "autoimmune endocrine disease". Subdividing the seven subgroups leads to a third order of classification in which single and separate manifestations are placed. The descriptive and analytic power of the proposed model for classification of disease manifestations in primary Sjögren's syndrome should be evaluated in clinical studies.
8568163 [HTLV1 infection and sicca syndrome]. 1995 PURPOSE OF THE STUDY AND MATERIAL: A search for sicca syndrome was performed in 54 HTLV 1 positive patients. Cases of sicca syndrome due to associated pathologies, or iatrogenic, were eliminated from this study. RESULTS: Lacrimal hyposecretion was found in 79% of the cases. Defective lacrimal quality was found in 86% of patients and a variable intensity coloration with the Fluorescine and/or with Rose Bengale was positive in 83% of cases. Histological study of the conjunctival print showed ocular dryness in 65% of the patients. Biopsy of the labial minor salivary glands showed a Gougerot-Sjögren syndrome in 71% of the cases. CONCLUSION: In our study, a sicca syndrome with varied gravity was found in 78% of cases.
8019538 Benign rheumatoid nodule versus subcutaneous granuloma annulare: a diagnostic dilemma--are 1994 Mar The authors differentiate benign rheumatoid nodules from similar subcutaneous lesions based on location and pathologic characteristics. Although many of these lesions spontaneously resolve, recurrence rates may be high. Various therapeutic modalities are therefore suggested. An illustrative case study is presented.
8160565 7S IgG rheumatoid factor and hidden 19S IgM rheumatoid factor in juvenile chronic arthriti 1993 Sep Hidden 19S IgM rheumatoid factor (RF) and 7S IgG RF were assayed in 24 children with juvenile chronic arthritis (JCA) and 26 controls, in whole sera and in the IgM and IgG containing fractions of the serum after separation by acid gel filtration. When non-fractioned serum was used, IgM RF detection was positive in 4.2% by latex fixation test and 4.2% by ELISA. IgG RF was positive in 91.7% by ELISA. In the IgM containing fraction of the serum, the positivity for IgM RF was 41.7% by LFT and 54.2% by ELISA. In the IgG containing fraction the positivity for IgG RF was 100%. These results suggest toward the need of previous serum dissociation before hidden 19S IgM RF is assayed and demonstrate high prevalence of 7S IgG RF.
8371209 Adult onset Still's disease and pregnancy. 1993 Jul The interactions between pregnancy and adult onset Still's disease (AOSD) are unclear. Between 1983 and 1990, 5 pregnancies occurred in 4 women with AOSD. AOSD occurred at the 5th and 6th month of the 1st pregnancy in 2 patients; a 2nd pregnancy occurring in one of them was not associated with a flare. In the other 2 patients pregnancy occurred 36 and 44 months after the AOSD; during gestation only transient arthralgia were observed in both cases. Pregnancy seems to have no effect on AOSD, and conversely, in our experience, AOSD has no influence on pregnancy, fetal growth or infant health.
8975279 [MR imaging in seronegative spondyloarthritis]. 1996 Aug In twenty-five patients with a clinical diagnosis of suspected sacroiliitis conventional radiography, CT and MRI were performed. In ten patients no abnormalities were demonstrated. In thirteen cases CT and MRI revealed sacroiliitis. In two patients with normal plain films and CT para- and intraarticular changes of signal intensity suggested suspicious sacroiliitis. MRI can be considered as an important imaging modality for early diagnosis of sacroiliitis. In eighteen patients with a firm diagnosis of ankylosing spondylitis and plain films of the thoracolumbar junction suggesting destructive Romanus and Anderson inflammatory lesions MRI was done. Two distinct groups of inflammatory changes were found. In ten patients MRI findings compatible with active inflammatory enthesitis were revealed at the disco-vertebral junction. In eight cases focal and linear changes of signal intensity within the intervertebral disks suggested an active inflammation. Using MRI the spectrum of inflammatory changes in sero-negative spondylitis can be presented. In sixteen patients with definite clinical diagnosis (psoriatic arthritis--thirteen cases and Reiter's syndrome--three cases) plain films and MRI of small hand joints were performed. The patients fell into two distinct groups. In the first MRI findings could not be differentiated from those seen in rheumatoid arthritis. In nine cases the distribution and extent of soft tissue findings were different, similar to changes seen in enthesitis. Therefore, on the basis of MRI findings in small peripheral joints easier differential diagnosis between sero-negative spondyloarthritides and rheumatoid arthritis is possible. In five patients with a diagnosis of Reiter's syndrome having clinical signs of enthesitis plain films and MRI of calcaneus were done. MRI revealed findings compatible with active inflammation which resembled those seen at the attachment of the annulus fibrosus and collateral ligaments of the small hand joints.
8068169 Immunology of the eye and the joint. 1994 Jun It is well known that polyarticular joint diseases such as rheumatoid arthritis, HLA-B27-associated arthritis and Borreliosis can be associated with eye diseases, such as uveitis, scleritis and keratitis. However, the mechanisms underlying the involvement of these tissues remain unclear. A recent meeting examined the immunoregulation of the eye and the joint in an attempt to determine their similarities and differences.
8563128 Sjögren's syndrome with pleural effusion. 1995 Aug Sjögren's syndrome (Sjs) can cause many organic changes, but is rarely accompanied by pleuritis. We report here a 62-year-old patient with subclinical Sjs who developed unilateral pleuritis with moderate effusion. He was diagnosed to have subclinical Sjs based on the positivity of anti SS-A/SS-B antibodies and the biopsy findings of minor salivary glands which revealed lymphocyte infiltration around the duct. In the pleural effusion, both increased lymphocytes and anti SS-A/SS-B antibodies were observed. He showed no signs of infection nor malignancy. There was no direct evidence that he had other collagen diseases which cause pleuritis. We conclude that the pleuritis was caused by Sjs. In patients with Sjs, activated polyclonal B lymphocytes and autoantibodies are considered to cause systemic tissue damage. This case indicates that these factors can cause pleuritis in Sjs patients.
7519040 Successful reversal of neutropenia in Felty's syndrome with recombinant granulocyte colony 1994 Mar We report two patients with Felty's syndrome and chronic skin ulcers treated successfully with recombinant granulocyte colony stimulating factor (GCSF). In both cases granulocytes returned to the normal range within days of starting treatment, and their cutaneous ulcers improved. In one patient granulocytes were maintained at normal levels with a regimen of GCSF 3 micrograms/kg twice weekly for 14 months.
8124274 [Still disease in the adult and in pregnancy]. 1993 Jun The interactions between pregnancy and adult-onset Still's disease are unclear. Nine pregnancies which occurred from 1983 through 1991 in seven women (mean age 27.7 years; range 23-40) were studied retrospectively. Five patients had one pregnancy and two had two pregnancies. Onset of the joint disease occurred before or during pregnancy. The joint disease occurred at the 5th or 6th month of the first pregnancy in two patients; one of these patients had a second pregnancy which was not associated with a flare. In five patients, onset of the joint disease occurred 4, 15, 42, 44 and 58 months before the first pregnancy, respectively; any effects of the joint disease on the pregnancy were extremely variable. 6 infants were full-term and two were premature (35 weeks); the remaining pregnancy was electively terminated; Apgar scores were normal in all eight infants, who were all male. Adult-onset Still's disease did not influence the outcome of the pregnancy in our patients; no clear-cut effects of pregnancy on adult-onset Still's disease were seen.
8355406 [Rheumatoid factors--recent advances in measurement techniques, their fine specificities a 1993 Jan Rheumatoid factors (RF) are autoantibodies directed to the Fc of IgG. RF are present in the blood and synovial fluid of most patients with rheumatoid arthritis, and are also commonly detected in Sjögren syndrome and other autoimmune diseases, in chronic infectious diseases such a viral hepatitis and subacute bacterial endocarditis, and even in healthy individuals at low titers. Although vast studies have been made so far, the precise mechanisms leading to RF production and the fine specificity of human RF have not been well delineated. In this report, we present recent observations of RF concerning the following items: 1) changes in measurement techniques, 2) biological significance of RF in diseased and healthy states, 3) analysis of specificity of RF, and 4) mechanisms inducing RF production.
1485135 [Post-traumatic psoriatic rheumatism. Clinical and medico-legal aspects]. 1992 Jul The possibility that injury may play a role in the development of some forms of chronic inflammatory rheumatic disease has been a subject of debate for many years. Such a role is accepted for some cases of rheumatoid arthritis, remains controversial for spondylarthropathies, and is poorly understood in psoriatic arthritis. Three cases of post-traumatic psoriatic arthritis are reported herein. The difficulty of establishing the causative role of the injury (despite precise criteria) is underlined, the pathophysiologic mechanism is discussed (deep Koebner phenomenon?), and possible legal consequences are reviewed.
7794985 Physical activity in children with juvenile rheumatoid arthritis: quantification and evalu 1995 Jun OBJECTIVE: To measure daily physical activity in patients with juvenile rheumatoid arthritis (JRA) and in healthy controls, and to identify variables that may influence physical activity in JRA patients. METHODS: Twenty-three prepubertal children, ages 5-11 years, with mild to moderate JRA and no prior exposure to systemic glucocorticosteroids, were compared to 23 healthy children of similar age. Physical activity was measured for 3 days (minimum of one weekend day) using 3 standardized methods simultaneously. Total body movement was assessed by the Caltrac accelerometer and the University of Cincinnati Motion Sensor (UCMS). The Caltrac measured movement in the vertical plane; the UCMS measured movement of 10 degrees or more from the horizontal plane. The type and intensity of daily physical activity was measured by the 3-day activity record, which also recorded the number of hours of daily sleep. Participation and duration of involvement in organized sports was ascertained by questionnaire. RESULTS: The mean physical activity was significantly lower in JRA patients than in controls for the activity diary (P = 0.05). However, daily body movement measured by the Caltrac and UCMS were similar for both groups. Differences were seen in the number of hours of sleep per day (P = 0.02) and participation in strenuous activities (P < 0.01). JRA patients had significantly less participation in organized sports (P = 0.01). CONCLUSION: There was less daily physical activity by this group of JRA patients than for healthy age- and sex-matched control subjects.
8425372 Cementless total knee arthroplasty in juvenile onset rheumatoid arthritis. 1993 Jan Twenty-two total knee arthroplasties with at least one cementless component were performed in 14 patients with juvenile rheumatoid arthritis (JRA) from 1985 to 1989. All 22 femoral components and ten tibial components were implanted cementless. The mean age at operation was 26 years. All 14 patients were available for follow-up evaluation at an average of 3.9 years (range, two to 6.2 years). Using The Knee Society's scoring system, the knee score improved from an average of 18 points (range, 0-47 points) preoperatively to 92 points (range, 58-100 points) at follow-up evaluation. The functional score improved from 28 points (range, 0-55 points) to 76 points (range, 40-100 points). Nonprogressive radiolucencies of less than 1 mm were observed in two knees. One reoperation was performed for failure of a metal-backed patellar component. Knee arthroplasty with cementless components in selected JRA patients can give results comparable with a fully cemented knee at the two- to six-year follow-up evaluation.