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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
8252006 Rheumatoid-like nodules presenting as Haglund's deformity in an adult, nonarthritic patien 1993 Sep The authors present the case of an adult female patient with bilateral posterior heel masses. These were removed and histologically found to be rheumatoid-like nodules. There was no clinical or laboratory evidence of rheumatoid disease. A review of the literature is presented.
1508470 Sjogren's syndrome. Dental role in providing relief. 1992 Aug This oftentimes underappreciated disease carries with it severe dental implications, all of which can affect the patient's quality of life. While there is no cure, it is possible to manage disease symptoms and to prevent irreversible dental damage.
7984538 [Measurement of quality of life in rheumatic practice]. 1994 Oct 1 Hard, objective data to evaluate outcome in patients with rheumatology diseases is not only difficult to obtain, but often poorly correlated with the degree of the functional incapacity caused by these non-fatal but disabilitating diseases. Soft, subjective data does not meet the traditional criteria for scientific research. However, due to important advances in the field of psychometry and its medical applications, we now have adequate instruments to evaluate quality of life, the major outcome parameter in patients with chronic rheumatic diseases. The Arthritis Impact Measurement Scales is the most widely used and is particularly adapted to patients with rheumatoid arthritis. Other scales include the Health Assessment Questionnaire, the Nottingham Health Profile, and the Sickness Impact Profile. Most of the studies conducted in the field of rheumatology concern patients with rheumatoid arthritis or osteoarthritis of the lower limbs. Quality of life measures can however be applied to most all the different clinical situations including low back pain, ankylosing spondylitis and systemic diseases. Quality of life measures will play an important role in treatment evaluation procedures. They correspond to real progress in responding to the legitimate demand of patient with chronic diseases for effective validated health care.
8803907 Antimalarials in Sjögren's syndrome--the Greek experience. 1996 Jun Sjögren's syndrome (SS) is a chronic autoimmune rheumatic disorder characterized by lymphocytic infiltration and destruction of exocrine glands, mainly of salivary and lacrimal glands, leading to dryness of mouth and eyes. It can occur either alone (primary SS) or in association with almost every systemic autoimmune rheumatic SS). Usually, SS patients have slowly progressive disease confined in exocrine glands, however, in approximately one third of primary SS patients the disorder presents a systemic and progressive course with involvement of diverse extraglandular sites and in a small but significant number of patients with lymphoid neoplasia development. Although the aetiology of SS remains unknown, chronic immune system stimulation is thought to play a central role in the pathogenesis of the disorder, as illustrated by several indices of immunological hyperactivity, including various autoantibodies, polyclonal hypergammaglobulinemia and circulating paraproteins. To date, treatment of SS remains largely empirical and symptomatic, and no clinical trial has been proved capable to change the course of the disease. Hydroxychloroquine has been successfully applied for the treatment of arthralgias, myalgias and general constitutive symptoms of SS patients. In an initial small open study, hydroxychloroquine administration has been shown to improve features of immunological hyperreactivity, such as hypergammaglobulinaemia and autoantibody levels. However, large prospective double-blind studies are still needed to assess the long-term efficacy of hydroxychloroquine in preventing extraglandular involvement and lymphoma development in primary SS patients.
7558918 A subset of Sjögren's syndrome associates with the TCRBV13S2 locus but not the TCRBV2S1 l 1995 Apr HGPSS associates with the TCRBV6S7 locus within the TCR beta-chain gene complex. However, V beta 6.7 T cells, encoded by this locus, have never been implicated in the salivary gland destruction that characterizes primary Sjögren's syndrome. Both V beta 13 and V beta 2 T cells have been implicated in glandular destruction. We therefore analyzed the association of HGPSS with both TCRBV2S1, the only TCRBV2 locus, and the TCRBV13S2 locus (the TCRBV13 family member which lies closest to TCRBV6S7). Our results show that the prevalence of TCRBV13S2*2 homozygotes is significantly increased in HGPSS and that there is a high degree of linkage disequilibrium between this locus and TCRBV6S7 not previously described across the TCR beta-chain gene complex. However, HGPSS does not associate with the TCRBV2S1 locus. These results suggest that it is the V beta 13.2 T cell which may be responsible for the autoimmune destruction that characterizes HGPSS and that the previous association of this condition with the TCRBV6S7 locus is primary due to the linkage disequilibrium that exists between it and TCRBV13S2.
8182627 Clinical and laboratory features of Sjögren's syndrome in young women with previous postp 1994 Feb OBJECTIVE: To elucidate the possible development of Sjögren's syndrome in young women with previous postpartum thyroiditis, a clinical and laboratory case-control followup study was undertaken. METHODS: Forty female patients (mean age 36 years) with well documented postpartum thyroiditis 5 years previously and 30 healthy mothers (mean age 36 years) who all had undergone normal partus an average of 5 years previously, were included in the study. RESULTS: Symptoms of dry eyes, caries, arthralgias, swollen joints and fatigue were reported significantly more often in women with previous postpartum thyroiditis compared with healthy mothers of the same age (p < 0.05). Using an ELISA with purified (SSA)Ro and (SSB)La proteins derived from a human cell line as antigens, 34% of the women were anti-SSB positive and 46% were anti-SSA positive at followup. Furthermore, 15/35 women with a history of postpartum thyroiditis (43%) had objectively impaired tear and/or saliva production; 5 of 24 investigated women had keratoconjunctivitis sicca (KCS) and 2 of 7 salivary gland biopsies showed chronic lymphocytic sialadenitis. Three women (8.6%) had the combination of KCS and xerostomia. CONCLUSION: Laboratory and clinical features of Sjögren's syndrome are frequently seen in younger women with previous postpartum thyroiditis.
1458787 Clinical differences between ANA/anti-ENA positive or negative primary Sjögren's syndrome 1992 Sep Fifty female patients with primary Sjögren's syndrome diagnosed according to the Copenhagen criteria were evaluated for both glandular and extraglandular involvement. They were divided into two groups based on the presence or absence of antinuclear and anti-ENA antibodies (ANA/anti-ENA). ANA/anti-ENA negative patients presented with milder and later glandular and extraglandular disease and required less frequent corticosteroid treatment. No significant differences were noted in extraglandular manifestations with the exception of leukopenia which was noted only in ANA/anti-ENA positive cases.
1579839 [Rheumatological manifestations associated with myelodysplastic and myeloproliferative syn 1992 Jan In 8 patients, an inflammatory polyarthropathy simulating rhizomelic pseudo-rheumatoid arthritis or early RA was the presenting feature of a myeloproliferative or myelodysplasic syndrome. Clinical, radiological, joint cytology and synovial histology findings are analysed. They suggested a link between joint and hematological disorders. Eleven similar cases were found in the literature. The pathophysiological mechanisms are discussed. Anemia, thrombocythemia and excessive monocytosis may be suggestive of myelodysplasia, in particular if the onset of the inflammatory rheumatic disorder is atypical.
1592919 CT and MR appearances of parotid pseudotumors in Sjögren syndrome. 1992 May The radiologic findings in eight patients with parotid pseudotumors associated with Sjögren syndrome (CT in eight; MRI in two) were retrospectively analyzed and compared with the findings in three cases with malignant lymphomas. Diagnosis of pseudotumor was obtained by surgery in six cases and by fine-needle aspiration biopsy and radiologic follow-up in the remaining cases. Six cases (75%) had advanced disease and the remaining had early disease. Both solid (75%) and cystic (38%) masses were seen in the patients with pseudotumors. The masses were solitary in 25%, multiple in 75%, unilateral in 25%, and bilateral in 75%. All three lymphomas were solid masses. The lymphomatous masses were not reliably distinguished from the solid pseudotumors.
8823709 Reversible parotid enlargement and pseudo-Sjögren's syndrome secondary to hypertriglyceri 1996 Jul We describe 2 patients with a Sjögren-like syndrome apparently secondary to hypertriglyceridemia. Both had bilateral parotitis in addition to musculoskeletal and sicca symptoms. Parotid gland histology revealed fatty infiltration with no inflammation. Therapy with dietary modification and triglyceride lowering drugs resulted in resolution of symptoms and parotid swelling in one patient. In the 2nd patient, hypertriglyceridemia was resistant to triglyceride lowering drugs, and parotid symptoms and swelling continued unabated. Our findings suggest aggressive treatment of hyperlipidemia in pseudo-Sjögren's syndrome may result in amelioration of musculoskeletal and parotid symptoms.
8531371 [Clinical and pathological features of Sjögren's syndrome associated with autoimmune thyr 1995 Oct Sjögren's syndrome (SS) is a chronic inflammatory disease of the exocrine glands accompanied by mononuclear cell infiltration. The histopathological features of the salivary and lacrimal glands of SS resemble those of the thyroid glands of autoimmune thyroiditis (chronic thyroiditis; CT). In addition, both SS and CT frequently recognized in the patients with other organ-specific or systemic autoimmune diseases (collagen-vascular diseases; CVD). We analyzed the incidences of CT among patients with SS or CVD, and compared clinical, immunological and endocrinological profiles between the SS patients with and those without CT. CT was the most frequent organ-specific auto-immune disease recognized in both primary and secondary SS patients. The thyroid disease similarly associated with CVD patients, regardless of the presence of SS. Several studies have also suggested that subclinical diseases are frequent in both CT and SS patients. The clinical and immunohematological features were almost identical between SS patients with and those without CT. Furthermore, the clinical, serological and endocrinological profiles of thyroid disease were very similar between SS patients with CT and CT patients without SS. These results indicate that CT and SS are independent autoimmune diseases, and the thyroid involvement observed in patients with primary or secondary SS is not an extraglandular manifestation of SS.
1419499 New developments in Sjögren's syndrome. 1992 Oct Sjögren's syndrome is an autoimmune exocrinopathy with characteristics of both organ-specific and generalized autoimmune disease. The main features are keratoconjunctivitis sicca and xerostomia, but patients may also show signs of extraglandular involvement. Sjögren's syndrome can occur in the absence (primary Sjögren's syndrome) or in the presence of other connective tissue disease (secondary Sjögren's syndrome). Sjögren's syndrome has often been considered a link in the spectrum between autoimmune disease and lymphoproliferative disorders. The cause of Sjögren's syndrome is still unknown, although the role of viruses in the pathogenesis is disputed. There is still no consensus about the diagnostic criteria, due to lack of specificity and sensitivity of the diagnostic procedures performed thus far. Recent studies using immunohistochemical and molecular biologic techniques highly suggest that disturbances in the target organs, such as salivary glands, are the consequence of local processes, rather than the reflection of systemic alterations. This underlines the importance of implementing these techniques for diagnostic purposes. Based on increasing understanding of the pathogenetic processes, new therapeutic possibilities will come into the picture. Over the past few years, interesting studies have contributed to our knowledge of the disease.
1738887 Lyme arthritis with subarticular cyst formation in metacarpal and metatarsal bones. 1992 Feb A young woman was treated for seronegative rheumatoid arthritis for more than 9 years, without clinical improvement, before the diagnosis of chronic Lyme arthritis of the metacarpal and metatarsal phalangeal joints was made. Roentgenograms showed subarticular cyst formation in the metacarpal and metatarsal bones. The patient's response to treatment with a 2-week course of ceftriaxone was dramatic.
27447773 Optimizing Exercise Programs for Arthritis Patients. 1993 Apr In brief As part of a comprehensive brief treatment plan, exercise can decrease pain and improve function in people who have rheumatoid arthritis or osteoarthritis. The physician must prescribe an individualized, realistic, and enjoyable exercise program that helps the affected joints and builds fitness. Well-tailored recommendations can also help maximize patient compliance. The physician must also provide appropriate follow-up care, adjusting the exercise program and medications as needed.
7788157 Sulphasalazine-induced lupus in psoriatic arthritis. 1995 Apr Lupus syndromes have been described in rheumatoid arthritis and inflammatory bowel diseases treated with sulphasalazine. We describe two cases of lupus with clinical and serological disease, developing in seronegative, immunologically nude psoriatic arthritis following sulphasalazine treatment. On cessation of sulphasalazine the clinical and serologic features of lupus disappeared. This suggests that the lupus syndrome was induced by sulphasalazine rather than unmasked by it.
21221318 Radiologic Findings in Children with Seronegative Spondyloarthropathies: Distinguishing th 1992 Aug Radiologic findings in the seronegative spondyloarthropathies are described and illustrated, and the presence, pattern, and usual distribution of peripheral and axial arthritis are discussed. Enthesitis and a family history are often present. Although some features are relatively specific, such as associated psoriatic nail or skin changes, inflammatory bowel disease, or eye and urogenital inflammation, it is difficult to distinguish the different spondyloarthropathies from one another and from juvenile rheumatoid arthritis.
8502782 Parvovirus B19 infection. 1993 May Human parvovirus B19 is a recently discovered and characterized DNA virus. B19 infection in the community is common and widespread. A number of well-known clinical syndromes have now been ascribed to B19 infection. Of rheumatologic interest, B19 infection causes adult erythema infectiosum which may be associated with a rheumatoid-like syndrome of symmetric polyarthralgia and polyarthritis. Presenting symptoms and signs may be limited to the joints. Some adults develop a chronic arthropathy that needs to be differentiated from early classic rheumatoid arthritis. Evidence for persistent B19 infection suggests that human parvovirus B19 infection may serve as a model for the study of virus-host interactions and the role of viruses in the pathogenesis of rheumatic diseases.
8452583 Allotypic dependency of the specificity and avidity of human monoclonal IgM rheumatoid fac 1993 Mar OBJECTIVE: To better understand the genetic derivation and pathogenicity of rheumatoid factor (RF) molecules in rheumatoid arthritis (RA), we have focused our studies on rheumatoid synovial cells (RSC). METHODS: Five monoclonal human IgM rheumatoid factor (mRF)-secreting hybridomas were produced from the RSC of an RA patient. Fine subclass specificities and avidities of these RSC mRFs were compared with several paraprotein monoclonal IgM RFs using direct binding (reactivity) and competitive inhibition (specificity and avidity) enzyme-linked immunosorbent assays. RESULTS: The following observations were made: 1) RSC mRF had greater avidity for IgG than did paraprotein mRF; 2) 4 of the 5 RSC RF were highly avid for IgG3; and, 3) the avidity of RSC RF binding for IgG3 was highest for IgG molecules expressing the G3m(5) allotype. CONCLUSION: We conclude that RSC RF have different specificities and avidities than do paraprotein RF. This may suggest an antigen-driven process in RA synovium, with the production of higher-avidity IgG3m(5)-specific RSC RF, which could have special pathogenetic importance.
7992106 Progressive pseudorheumatoid chondrodysplasia: a report of nine cases in three families. 1994 Aug Nine cases of progressive pseudorheumatoid chondrodysplasia in subjects aged 7-60 years are reported. Six of them were members of one large family with several consanguineous marriages. Evaluation of six generations of this family suggested an autosomal recessive mode of inheritance. The presentation of the disease was between the ages of 3 and 8 years with waddling gait and fusiform swelling of the interphalangeal joints of the hands, clinically resembling juvenile rheumatoid arthritis. Most of the other joints become progressively involved, with crippling disability. One of the patients had typical features of Blount disease at presentation.
8507227 Serum amyloid P component scintigraphy and turnover studies for diagnosis and quantitative 1993 Jun OBJECTIVE: To evaluate aspects of the natural history of AA amyloidosis complicating juvenile rheumatoid arthritis (JRA), and its response to therapy with chlorambucil. METHODS: Scintigraphy and 7-day turnover studies were performed in JRA patients with histologically proven (n = 35) or clinically suspected (n = 30) AA amyloidosis, following intravenous injection of 123I and 125I-labeled serum amyloid P component (SAP). Prospective monitoring studies were performed over 2-3 years in 20 patients with amyloidosis. All but 2 amyloidosis patients were treated with chlorambucil. RESULTS: Positive scanning results were obtained in all patients in whom imaging was performed within 12 years of positive biopsy findings of amyloid and in 5 patients with clinically suspected amyloidosis. Negative scanning results with normal SAP metabolism, indicating regression of amyloid, were obtained in 4 patients whose amyloidosis had been in full clinical remission for more than 12 years. Prospective monitoring studies in patients whose JRA-associated inflammatory activity was in remission demonstrated regression of amyloid in 8 patients and no substantial changes in 8 others; however, in 4 further patients with active inflammation, there was accumulation of amyloid. There was a very poor correlation between the amount of amyloid present at a particular site and the resultant organ dysfunction. CONCLUSION: Radiolabeled SAP scintigraphy and turnover studies are useful complementary tools in the diagnosis, screening, and quantitative monitoring of type AA amyloidosis in JRA. The amyloid deposits may progress and/or regress at different rates in different anatomic sites over short periods.