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ID PMID Title PublicationDate abstract
1381993 Acute phase reactants in predicting disease outcome. 1992 Jun From the studies which are reviewed above, it is generally apparent that in terms of the acute phase response, the initial findings in early inflammatory arthritis (particularly rheumatoid arthritis, with which the majority of such studies are concerned) have little predictive value for either the functional outcome or mortality. The wide interindividual variability in these measurements is also likely to limit their clinical usefulness as predictors of disease outcome. The trend in certain acute phase reactants may be more useful in indicating disease activity, although the number of satisfactory studies in this area is very limited.
8575151 Immune complexes from sera of patients with juvenile rheumatoid arthritis reveal novel 40 1995 Sep OBJECTIVE: Immune complexes (IC) have been detected in the majority of sera of patients with juvenile rheumatoid arthritis (JRA). Our aim was to determine the possible constituents of these IC. METHODS: One hundred and four sera from patients with JRA were separated on a Sepharose 4B column to which were bound F(ab')2 fragments of goat anti-human IgM antibody to separate IgM-containing IC. The column was sequentially eluted with 1 M ammonia and 0.1 M glycine-HCl buffer, pH 3. The eluted material was treated with sodium dodecyl sulfate (SDS) and simultaneously reduced with 2-mercaptoethanol. Individual components were then separated by SDS-gradient polyaclylamide gel electrophoresis and were transferred to nitrocellulose by Western blotting. The nitrocellulose strips were overlaid with the patient's own serum and developed with specific antiserum to human IgM and IgG. RESULTS: Four bands were noted in the majority of JRA patients, including a band in the 70-80 kD area to the IgM heavy chain and in the 50 kD area to the IgG heavy chain. Additional bands specific for JRA patients' sera were noted in the 40 kD and 60 kD areas. Overall, 61 of 104 sera demonstrated all four bands; 78 showed the 40 kD band and 73 the 60 kD band. CONCLUSION: These IC were previously shown to contain IgM rheumatoid factor (RF), IgG-RF, and IgG in addition to the 40 and/or 60 kD constituents present in the isolates. Preliminary studies on these constituents suggest the possibility of the 60 kD band being the human 60 kD mitochondrial heat shock protein. Further investigations of these immune complex components may aid in the understanding of the pathophysiology of JRA.
1735815 Prognostic indicators of joint destruction in systemic-onset juvenile rheumatoid arthritis 1992 Feb We retrospectively reviewed the charts and radiographs of 38 patients with systemic-onset juvenile rheumatoid arthritis, attempting to identify early in the disease course the clinical and laboratory observations most predictive of the later development of destructive arthritis. In 12 of the patients, destructive arthritis developed within 2 years of disease onset. When first examined, these patients could not readily be differentiated from those in whom joint destruction did not develop, but they more commonly had hepatosplenomegaly (p less than 0.04), serositis (p less than 0.01), and a lower mean serum albumin concentration (26.7 vs 31.3 gm/L; p less than 0.02). However, by 6 months after onset, patients with destructive arthritis more frequently had persistent systemic symptoms (92% vs 12%; p less than 0.0001), polyarthritis (67% vs 19%; p less than 0.0005), a lower mean hemoglobin level (95 vs 114 gm/L; p less than 0.001), a higher mean leukocyte count (21.2 vs 10 x 10(9)/L; p less than 0.0003), a higher mean platelet count (794 vs 400 x 10(9)/L; p less than 0.0001), and a higher mean erythrocyte sedimentation rate (43 vs 24 mm/hr; p less than 0.05). Multivariate analysis of the results at 6 months revealed that persistent systemic symptoms and a platelet count greater than or equal to 600 x 10(9)/L were the variables most highly predictive of the later development of joint destruction. We conclude that patients at high risk for the development of destructive arthritis may be identified within 6 months of disease onset, thereby indicating the need for more aggressive early therapy.
8844914 Recreational exercise in arthritis. 1996 Aug For the person with arthritis, the consequences of prolonged inactivity add measurably, and unnecessarily, to disease-related impairments, functional limitation, and disability. Inadequate levels of regular physical activity also increase the risk of cardiovascular disease, hypertension, diabetes, and obesity. This article reviews the benefits of regular physical activity for general health as well as the literature on conditioning exercise in rheumatoid arthritis and osteoarthritis. Recommendations and guidelines are given for including conditioning exercise in comprehensive management.
8335882 Rheumatologic disease and associated ocular manifestations. 1993 Jun BACKGROUND: Ocular involvement is a common manifestation of rheumatic disease. Recognition of associated systemic findings strengthens our diagnostic armamentarium. METHODS: The previous ophthalmic and medical literature was reviewed and synthesized into a focused review of rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa; the seronegative spondyloarthropathies, including ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis, ulcerative colitis and Crohn's disease. RESULTS: New and improved diagnostic and therapeutic measures have added a great deal to our understanding of the ocular manifestations of rheumatologic disease and the systemic management of rheumatologic disease. CONCLUSIONS: Optometry can fill an important role in the health care of patients with rheumatologic disease. Regular optometric care and coordination with the patient's rheumatologist can significantly benefit the patient's care.
29286898 Managing Fibromyalgia With Exercise. 1992 Oct Although its cause remains obscure and no laboratory test confirms its diagnosis, fibromyalgia is a well-defined condition, more common than rheumatoid arthritis. Exercise is an essential component of treatment, helping patients cope with this painful disease.
1604227 [Giant synovial cyst of the shoulder. Apropos of a case]. 1992 Feb Synovial cysts of the shoulder are rare. The case described illustrates the particular problems encountered at this site. As at other joints, these cysts appear during arthropathies of various types: degenerative or inflammatory (rheumatoid arthritis). They are often associated with rupture of the rotator cuff. Their essential characteristic is an expansive and recurrent tendency which leads to striking giant swellings, capable of causing vascular compression. Treatment involves surgical excision. This suffices when the cyst does not communicate with the joint cavity. In contrast, when there is a breach in the capsule through which the cyst derives its synovial fluid supply, repair is necessary to prevent recurrence.
8398612 Spondyloarthropathies and psoriatic arthritis in children. 1993 Sep Data that are relevant to the general understanding of the juvenile-onset spondyloarthropathies are reviewed here. Seronegative enthesopathy and arthropathy syndrome is considered the earliest recognizable form of juvenile-onset spondyloarthropathy, from which other syndromes and diseases emerge. The group also includes juvenile-onset ankylosing spondylitis, a disease defined in adult-based terms when definite changes have occurred in the axial joints; ankylosing tarsitis, a complex disorder in which foot problems resemble those of the spine in ankylosing spondylitis; Crohn's disease and ulcerative colitis-related peripheral and, especially, HLA-B27 axial disease; reactive arthritis and Reiter's syndrome, which might be further classified according to its cause; and juvenile psoriatic arthritis, a disease that resembles juvenile rheumatoid arthritis more than does juvenile-onset spondyloarthropathy.
8322166 Modulation of secretory processes of phagocytes by IX 207-887. 1993 In chronic inflammation, the mediators released by phagocytes are in part responsible for the initiation and perpetuation of the disease. IX 207-887, which is a novel antiarthritic drug, inhibits the release of cytokines from mononuclear cells at concentrations which are achieved therapeutically in human rheumatoid arthritis and in animal models of arthritis. Furthermore, the production of superoxide and release of azurophil and specific granules by N-formyl-Met-Leu-Phe-stimulated neutrophils are significantly reduced. As a consequence, IX 207-887 may break the vicious circle which is manifest in chronic inflammation. In a recent double-blind placebo controlled study IX 207-887 has been shown to be an effective slow-acting drug for use in rheumatoid arthritis.
7552066 Rheumatoid factors, B cells and immunoglobulin genes. 1995 Apr The paradigm of self, non-self discrimination in the immune system is under review as autoreactive B or T cells are increasingly delineated within normal individuals. The products of autoreactive B cells are, mostly, polyspecific IgM antibodies of low affinity. These 'natural' antibodies include rheumatoid factors (RF) encoded by unmutated germline immunoglobulin genes. In rheumatoid arthritis (RA) the RF may be of the IgM, IgG or IgA isotype, show evidence of somatic mutation and have increased affinity; consistent with maturation of an antigen driven immune response. This response could be initiated or driven by an auto-immunogenic form of IgG or an exogenous cross-reactive antigen. Changes in galactosylation of IgG have been reported to be a valuable diagnostic and prognostic indicator in RA. Speculation that these changes may precipitate some of the disease processes is critically reviewed.
1366146 [Prevalence of rheumatoid factor in a single sampling of the urban population in Croatia]. 1992 The prevalence of rheumatoid factor (RF) in urban population was examined. A random sample was taken according to the register of voters and included 5% of the population. Among them 60% suffered from various rheumatic symptoms. Out of 500 persons invited to an examination, 231 examinees responded. None of the examinees in that moment showed signs of rheumatoid arthritis. RF is determined in serum according to Waaler-Rose and it was positive in 12 out of 231 examinees (5.2%) about equally in men and women (P > 0.05). The majority of examinees was over 50 years old. Titar RF increased with the age of the examinee, but difference is not significant (P > 0.05). RF is not only a characteristic of RA, but it could also be found during the other diseases which are accompanied by, first of all, hypergammaglobulinemia and fibrosis.
7940338 [The incidence of Lyme arthritis and of antibodies to Borrelia burgdorferi in rheumatology 1994 The examination of 231 rheumatic patients, 159 patients with reactive arthritis and 117 rheumatoid arthritis patients identified diagnostic titers of polyvalent antibodies to Borrelia in 6.6% of all the examinees with rheumatism, 11.9% with reactive arthritis and in 7.7% with RA. Lyme arthritis was diagnosed in 1.3% of reactive arthritis patients. To diagnose Lyme arthritis accurately, it is recommended to rest upon clinical symptoms which must be associated with high titers of IgG antibodies to Borrelia growing still higher in the follow-up period.
1395225 Spondyloepiphyseal dysplasia tarda simulating juvenile arthritis: clinical and molecular g 1992 Jul A sibship is reported in which two of three children developed a symmetrical polyarthropathy associated with a mild spondyloepiphyseal dysplasia. Although the physical findings resembled juvenile arthritis, laboratory investigations for inflammatory disease were entirely negative. Molecular studies in members of this family showed that none of them had any structural rearrangements or other major abnormality of the type II procollagen gene (COL2A1). The laboratory findings in this family with "pseudo-rheumatoid arthritis" do not exclude the possibility of a minor mutation of the type II procollagen gene or a defect in the processing of articular cartilage collagens.
8453802 Arthritis associated with primary agammaglobulinemia: new clues to its immunopathology. 1993 Jan Primary agammaglobulinemia is a rare disorder which is associated with articular symptoms in 11% of patients. Septic arthritis may occur, but often patients complain of chronic oligoarthritis and have a clinical presentation similar to rheumatoid arthritis. We report 2 cases of primary agammaglobulinemia in adults, associated with non-erosive chronic arthritis. Peripheral blood lymphocyte phenotyping showed a predominance of CD8 lymphocytes with a CD4/CD8 ratio < 1. We did not find any abnormalities in cellular immunity. A histological study of the synovium showed chronic synovitis with perivascular CD8 lymphocyte infiltrates. Intravenous infusion of immunoglobulins resulted in a dramatic improvement in the arthritis in both cases. In one patient we noticed a decrease in CD8 lymphocytosis. These results suggest that CD8 lymphocytes are involved in the pathogenesis of the arthritis associated with agammaglobulinemia.
1609235 [Incidence of signs indicating psoriatic rheumatism in radiological involvement of fingers 1992 Mar On the basis of 193 cases of psoriatic arthropathy, the authors sought the incidence and rapidity of onset of signs suggestive of this type of rheumatic disorder when there are radiological lesions of the fingers and toes. They conclude that when such radiological lesions exist, signs suggestive of psoriatic arthropathy are frequent (90%), early (85% of cases of psoriatic arthropathy present for less than 5 years) and predominantly involve the distal parts of the fingers and toes (85.5%). The authors consider that the signs which distinguish psoriatic arthropathy from rheumatoid arthritis are due to an extrasynovial process of enthesopathic origin.
7846707 [The clinical picture, diagnosis and treatment of the stomatological manifestations of Sjà 1994 Jul Eighty-three patients with Sjogren's disease, 23 with chronic parotitis and periodontitis, 325 controls were examined by general clinical, dental, X-ray, microbiological, immunological, and morphological methods. A clinico-pathogenetic analysis of dental manifestations of Sjogren's disease was carried out: atrophy and inflammatory process in the buccal mucosa, multiple caries. A pathogenetically based program of therapeutic and prophylactic measures making use of encad, bensilol, bensilol+trimecain is suggested for patients with Sjogren's disease.
8161740 [Color-coded duplex sonography of the parotid gland in Sjögren's syndrome]. 1994 Apr 27 patients with confirmed Sjögren's syndrome were examined prospectively by means of colour coded duplex sonography and pulsed Doppler sonography in order to determine blood flow in the parotid gland in this condition. Organ perfusion was divided semi-quantitatively into 4 groups: grade 0 (no intraglandular perfusion recognised) to grade 3 (numerous intra-glandular flow signals). Low perfusion values (grade 0 or grade 1) were found in normals and this was also observed in 13 patients (48%). 6 patients (22%) showed moderate increase (grade 2), and 8 patients (30%) showed gross increase (grade 3) in glandular perfusion. The increase in perfusion correlated with the severity of the sono-morphological glandular changes, such as reduced echogenicity, increased size and heterogeneous structure. Increased perfusion was associated with intra-glandular flow velocity as measured by Doppler sonography; maximal systolic flow velocity was significantly higher in patients with markedly increased perfusion than in normals.
8162482 Primary T cell lymphoma of the liver in a patient with Felty's syndrome. 1994 Feb We describe a case of primary T cell lymphoma of the liver developing in a patient with Felty's syndrome (FS). We discuss the possible relationship of the two conditions with particular reference to liver disease in FS, and the role of the T cell in RA.
8335784 Sjogren's syndrome: oral and dental considerations. 1993 Mar Patients with Sjogren's syndrome have many oral health needs. Due to the extensive oral involvement, dentists may be the first to recognize this condition. Characteristics and treatment options for this disorder are discussed and three case histories are presented.
8724308 Intravenous immunoglobulin therapy in systemic onset juvenile rheumatoid arthritis: a foll 1996 May OBJECTIVE: To report the short and longterm effect of intravenous immunoglobulin (IVIG) in patients with systemic onset juvenile rheumatoid arthritis (SOJRA). METHODS: A retrospective chart review of 27 patients with SOJRA treated with IVIG and followed for 37.1 +/- 18.2 months was undertaken. Indications for treatment were fever, arthritis, or steroid dependency. RESULTS: We treated 27 patients with SOJRA with IVIG monthly for 3-54 months. Six months after IVIG therapy, 20 patients had a least a 50% decrease in at least one of the following: the number of days of fever; prednisone dose; or the number of active joints. Five patients failed to respond to IVIG, and 2 dropped out after 3 and 4 months. At last followup visit (mean 37.6 +/- 18 months), 11 of the initial 20 responder group patients were in remission, while 3 had significantly improved but still had active arthritis, and 6 were now unresponsive. Of the initial 5 patients in the nonresponder group, 4 had nonresponsive arthritis and 1 had improved at last followup. Three patients in the responder group subsequently developed other diseases. CONCLUSION: The main benefit of IVIG therapy to most of our patients was a significant improvement in the systemic features, with resolution of fever and a significant reduction in the steroid dose. The efficacy of IVIG in altering the course of arthritis was less predictable. We suggest that IVIG has a role in the management of SOJRA, but it should be limited to patients with severe SOJRA in whom prolonged unresponsiveness to standard therapy is present.