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ID PMID Title PublicationDate abstract
8590381 Binding of human IgM from a rheumatoid factor to IgG of 12 animal species. 1995 Dec The binding of IgM from a rheumatoid factor (RF-IgM) to IgG from 12 animal species was analyzed by an ELISA system. The RF-IgM bound various animal IgG with dissimilar affinities. The binding of RF-IgM to animal IgG was inhibited by addition of protein A, which binds some animal IgG by recognizing the junctional site on CH2-CH3 domains in the Fc region. As previously reported, no significant correlation was observed between the binding of RF-IgM to IgG and the content of galactose-free oligosaccharides, which is increased in IgG of rheumatoid arthritis patients or autoimmune mice. We suggest that the crucial epitope of IgG for RF-IgM binding is not the oligosaccharide structure generated specifically in IgG of autoimmune diseases but that RF-IgM may recognize a certain protein conformation of a region in IgG near the binding site of protein A.
8938869 Is collagenous colitis a new etiology of sicca syndrome? 1996 Oct We conducted a prospective cross-sectional study of seven patients with collagenous colitis to determine the clinical, immunologic and histologic features of sicca syndrome associated with this condition. Four patients reported dryness of the mouth and/or eyes. No laboratory evidence of autoimmune disease was found, except in one patient with ankylosing spondylitis. Collagenous infiltration of the salivary glands was quantified in each patient as the percentage of the total gland surface examined. Histologic studies of salivary glands demonstrated significantly more collagen in the group of patients with collagenous colitis than in the group of age-matched controls (30.52% versus 11.8%, p < 0.05). No inflammatory infiltrates were seen. Our data suggest that a common mechanism may underlie the various lesions found in patients with collagenous colitis. However, the mechanism that initiates the fibrotic process in the colon and salivary glands remains unknown.
8585386 [Neuropathy of the fibular nerve in Sjögren's disease]. 1995 The clinical case of Sjogren's disease in late stage with subacute course in 53 year old woman was described. The peculiarity of the case presented was its complication with left fibular nerve neuropathy. The supposed cause of neuropathy was microcirculatory disturbances, cryoglobulinemic purpura.
8075437 Characterization of the amyloid fibril from primary localized cutaneous nodular amyloidosi 1994 BACKGROUND: Primary localized cutaneous nodular amyloidosis (PLCNA) is a rare disease, and its pathogenesis of amyloid deposition is still unknown. OBJECTIVE: The purpose of this study was to know the origin of amyloid in PLCNA. METHODS: Water-soluble amyloid fibrils were isolated from the skin and resolved on SDS-PAGE, then subjected to immunoblot analysis. RESULTS: The major amyloid fibril protein was a 29-kD peptide which reacted with both anti-lambda- and anti-kappa-light-chain antibodies. CONCLUSION: Amyloids in this particular case of PLCNA are derived from the polyclonal immunoglobulin light chain and some cases of PLCNA could be reactive diseases rather than neoplastic ones.
8462626 Fc-gamma receptor III shedding by polymorphonuclear cells in primary Sjögren's syndrome. 1993 Feb A sandwich enzyme-linked immunosorbent assay was developed to assess Fc-gamma receptor III (Fc gamma RIII), based on a combination of two non-competing monoclonal antibodies. This receptor was detectable in the serum of eight out of 23 patients with primary Sjögren's syndrome and two out of 23 normal controls. The proportion of Fc gamma RIII-carrying polymorphonuclear (PMN) cells was lower (P < 0.05) in the patients with cell-free Fc gamma RIII (90.4 +/- 7.5%) than in the remainder (84.8 +/- 8.3%). The PMN cell functions were evaluated and the diminished adherence (71.7, geometric mean) and chemotaxis (1.23) paralleled the Fc gamma RIII release. The relative inefficiency of PMN cells in SS might be due to phagocytosis of immune complexes.
7755716 Polyserositis in adult Still's disease with onset during pregnancy [corrected]. 1994 Sep We report about a 25-year-old female patient, who met all the criteria of adult-onset Still's disease except for the typical nonpruric rash. The disease exacerbated during pregnancy. Polyserositis was the predominant clinical manifestation. The histological examination of the bone marrow biopsy revealed changes similar to those seen in a myelodysplastic syndrome. The clinical condition improved after therapy with high-dose steroids and cyclophosphamide.
8148449 Chronic fatigue syndrome and a disorder resembling Sjögren's syndrome: preliminary report 1994 Jan Chronic fatigue syndrome (CFS), as currently described in the working criteria proposed by the Centers for Disease Control and Prevention (Atlanta), may be associated with multiple, distinct, and possibly unique clinical and/or etiopathogenic subsets. Sjögren's syndrome (SS) is a disease of unknown etiology that is characterized by dryness of the mucous membranes and a variety of autoimmune phenomena and conditions. Subjective manifestations of SS such as neurocognitive dysfunction and fatigue have been stressed by some observers. We have detected a large number of patients with unrecognized SS-like illness in a clinical specializing in CFS and believe the relationship to be more than casual. From January 1991 through April 1992, 172 patients were evaluated for CFS; the SS cohort consisted of 27 females (mean age, 41.9 years). Sixteen of these patients had previously been found to have CFS by a physician, and 11 were self-referred. All patients complained of severe, dominating, chronic fatigue. Complaints of myalgia were prominent; 20 of 27 patients met the criteria for fibromyalgia. Neurocognitive complaints and/or a history of neuropsychiatric disease was frequent. Results of Schirmer's test were abnormal for 16 of 27, and results of minor salivary-gland biopsy were abnormal for 20 of 25. Antibodies to nuclear antigen were present in 16 of 27, but anti-Ro was present in only 1 of 21. In the SS group, 13 of 27 patients met eight or more CDC minor criteria for CFS, and 18 of 27 met six or more of the criteria.(ABSTRACT TRUNCATED AT 250 WORDS)
1427471 [Composite lymphoma in Sjogren's syndrome with mixed cryoglobulinemia]. 1992 Sep A 44-year-old woman with Sjogren's syndrome and mixed cryoglobulinemia developed nodal and pulmonary lymphoma 15 years after the initial diagnosis. The nodal lymphoma was of the composite type and included both monoclonal monocytoid and lymphoplasmacytoid B-cells. The extranodal pulmonary lymphoma included only lymphoplasmacytoid lymphocytes. Complete resolution of the lymphoma was achieved following 3 months of chlorambucil, 5 mg/day, and prednisone, 30 mg/day. Composite lymphoma and monocytoid lymphoma are being encountered more commonly among patients with Sjogren's syndrome. Physicians must therefore become more aware of the existence of both entities.
1411081 The clinical effects of electrostimulation on salivary function of Sjögren's syndrome pat 1992 A multi-center double-blind study of an electro-stimulator device was conducted to evaluate its ability to increase the production of saliva and reduce clinical symptomatology. A total of 77 Sjögren's syndrome patients at three centers were assigned to active devices (n = 40) or to placebo devices (n = 37). There were 2 male and 32 female patients assigned to active devices, and 1 male and 36 female patients assigned to placebo devices. The age range with the greatest number of patients was 60-69 years making up more than 31% of the study population. The selection criteria required the patients to have no greater than 0.2 g/min of whole salivary production (approximately 19% of normal salivary production). At the start of the study, the patients assigned the active device had a mean salivary production of 0.06 ml per min (6% of normal) and patients assigned placebo devices had a mean salivary production of 0.07 ml per min (7% of normal). There were three scheduled visits, 2 weeks apart, over a treatment period of 4 weeks. At all visits, the patients using active devices showed a statistically greater (P = 0.005 to 0.02) increase in the production of saliva than placebo patients. The study also evaluated the reduction of patients symptoms associated with xerostomia. Patients showed significant improvement in (1) difficulty in swallowing and (2) burning tongue (P = 0.008). Some patients on their initial visit had no response to the active device and did not show a significant response at subsequent visits.(ABSTRACT TRUNCATED AT 250 WORDS)
8810937 Systemic amyloidosis in a patient with hypogammaglobulinaemia. 1996 Aug A 49-year-old patient with an 18-year history of hypogammaglobulinaemia presented with nephrotic syndrome due to systemic amyloidosis. Recurrent infections as a consequence of an inadequate gammaglobulin substitution therapy were regarded as the main reason for the development of amyloidosis. When a high-dose intravenous immunoglobulin therapy was started, the clinical symptoms declined and the patient felt moderately well. Later the patient developed symmetrical polyarthritis clinically suggestive of rheumatoid arthritis. Although the incidence of arthritis is increased in hypogammaglobulinaemia, arthritis has not been reported in any of the few previously described patients with hypogammaglobulinaemia-associated amyloidosis. Moreover, this case provides further evidence that, in these patients, the amyloid fibrils may be of the AA type.
7699641 Crosscultural reliability of the Childhood Health Assessment Questionnaire. 1994 Dec OBJECTIVE: To translate into Portuguese the Childhood Health Assessment Questionnaire and to evaluate the reliability of the Portuguese version. METHODS: The original questionnaire was translated into Portuguese, without modifications, and it was administered to 53 children with juvenile rheumatoid arthritis and their parents. The reproducibility and construct validity were studied. RESULTS: We observed satisfactory Spearman's correlation coefficients among the instrument's score, a pain score (visual analog scale) and conventional clinical variables commonly used by the pediatric rheumatologists: disease activity index, number of involved joints, American College of Rheumatology functional class, and erythrocyte sedimentation rate. The test-retest reliability was established. CONCLUSION: Our results provide evidence of the reliability of the Portuguese version of the Childhood Health Assessment Questionnaire.
8797949 Sjoegren's syndrome: MR imaging of the parotid gland. 1996 To date, myoepithelial sialoadenitis (Sjoegren's syndrome) has been diagnosed with sialography and other techniques. First results of MR imaging offer new possibilities in the diagnostic imaging of this disease. Thirty-six patients with immunohistologically and serologically confirmed Sjoegren's syndrome and 25 patients suffering from other diseases, included as a control group, were examined by MR in transverse and coronal orientation. T-2-weighted sequences (TR/TE 1600/25/90) and T1-weighted sequences (TR/TE 500/25 ms) plain and after Gd-DTPA administration were obtained. In all patients the parotid gland showed characteristic internal patterns and abnormalities in gland size. There was a nonhomogeneous internal pattern with a characteristic speckled, honeycomb-like appearance visible especially on T2-weighted sequences. Enhancement with Gd-DTPA yielded no additional information. A staging system with four stages of Sjoegren's syndrome (no characteristic changes to a nodular and swollen gland) was developed. Magnetic resonance has become an important new tool in assessing parotid gland changes in patients suffering from Sjoegren's syndrome, and could well replace the more invasive and unpleasant diagnostic methods in the near future.
8533045 Tracheo-bronchial mucociliary clearance in patients with primary and secondary Sjögren's 1995 We determined the tracheo-bronchial mucociliary clearance (MCC) in order to evaluate a possible impairment of this function in patients affected by Sjögren's syndrome (SS) with or without overt clinical symptoms of xerotrachea. The MCC was expressed as flow rate (mm/min) and studied in 22 non-smoking SS patients (10 pSS and 12 sSS) and in 8 control subjects by specifically adapted ventilation lung scintigraphy (VLS). The MCC in the control group was 5.9 +/- 1.1 mm/min. No values were produced for MCC in 16 SS patients (8 pSS and 8 sSS) in the time interval considered and were reduced in the remaining 6 SS patients (3.3 +/- 1.2 mm/min). In all nine cases with clinical evidence of xerotrachea no values for MCC were obtained. A significant correlation was found between the MCC values and the rate of stimulated salivary excretion determined by dynamic scialoscintigraphy in the same patients (p < 0.001). These preliminary data show that the majority of SS patients studied presented with MCC impairment, always found when clinical symptoms of xerotrachea were present.
7484051 Central nervous system disease in primary Sjögren's syndrome. 1995 Primary Sjogren's syndrome is a systemic autoimmune disorder whose main characteristics are dryness of the eyes and mouth, caused by lymphocytic infiltration of the exocrine glands. Patients may also show signs of extraglandular involvement of lung, liver, kidney and vessel walls, as well as of central and peripheral nervous system, muscles and joints. We present a review of the literature on the involvement of the central nervous system in primary Sjögren's syndrome, which may mimic many other neurologic disorders, especially multiple sclerosis. Features that may help in distinguishing these two entities are presented.
8300943 Acral ichthyosiform mucinosis in association with Sjögren's syndrome: a peculiar form of 1993 Nov Two Japanese women developed well-demarcated ichthyosiform plaques on the lateral aspect of their lower legs. Deposition of mucin was demonstrated throughout the papillary dermis, unlike the site of mucin deposition seen in pretibial myxedema. Their thyroid function was normal. The condition of both women was complicated by Sjögren's syndrome. One of them who presented with positive anti-microsomal and anti-thyroglobulin antibodies had goiter, suggesting that her malady was also complicated by Hashimoto's thyroiditis. Their skin manifestations differed from those described in cutaneous mucinosis including pretibial myxedema, specifically with regard to the well-demarcated ichthyosiform appearance, the mucin deposition in the papillary dermis, and the association with Sjögren's syndrome. To the best of our knowledge, our cases may thus be considered to be a previously undescribed form of cutaneous mucinosis associated with Sjögren's syndrome.
1433011 Hyperferritinemia in adult onset Still's disease and the hemophagocytic syndrome. 1992 Sep Increments in serum ferritin levels in adult onset Still's disease (AOSD) were reported to be higher than one could expect for a simple inflammatory state. When we analyzed the scores of 40 patients with various severe inflammatory diseases aside from AOSD, we recorded no serum ferritin values higher than 3,300 ng/ml (N less than 200 ng/ml). In 3 of 10 consecutive patients with AOSD, the ferritin levels were higher than 3,500. Among these 3 patients, one case had a ferritin value of 3,600 ng/ml and bone marrow aspirate showed a marked hyperplasia of mature appearing histiocytes, and the 2 other patients (serum ferritin levels of 65,000 ng/ml and 250,000 ng/ml) displayed the features of a hemophagocytic syndrome. In 2 patients with normal or mildly increased levels of ferritin, the bone marrow examination was normal. We suggest that very high serum ferritin levels encountered in AOSD reflect the presence of histiocytic hyperactivity that sometimes leads to a hemophagocytic syndrome.
1515571 Mono-arthritis in a chronic hepatitis B patient after alpha-interferon treatment. 1992 Jul A 28 year old woman with hepatitis B (HB) related chronic active hepatitis was treated with a 12 week course of alpha-interferon (alpha-IFN). She developed acute mono-arthritis 1 week after completion of treatment. Her rheumatoid factor (RF) was positive before alpha-IFN and fell steadily during therapy. This was followed by a rebound of RF level with the associated arthritis occurring 1 week after completion of the course of alpha-IFN. In absence of any medication RF gradually fell and became negative at the end of 1 year. This observation is thought to be related to the immunomodulatory effect of alpha-IFN either directly on RF production or indirectly through the control of hepatitis.
8004725 Variation of lymphocytes in peripheral blood and bone marrow in collagen-induced arthritis 1994 Mar Collagen-induced arthritis (CIA) was found to be useful as an animal model to investigate the mechanism by which rheumatoid arthritis is developed. We therefore studied variations of T and B lymphocytes in peripheral blood and bone marrow in order to ascertain the importance of T and B lymphocytes in the development of CIA. T lymphocyte, which is considered to be associated with the onset and deterioration of CIA, was not changed during the course of CIA, whereas B lymphocyte, which produces anti-type II collagen antibody regarded as an indispensable factor in CIA induction, was significantly decreased in peripheral blood and bone marrow at 10 days after the 2nd immunization when arthritis was able to be detected. In bone marrow, although two cell populations of Ly5/B220-positive cells were detected, only the cell population with lower fluorescence intensity was decreased transiently. These results suggest that B lymphocyte in both bone marrow and peripheral blood is intimately involved in the course of CIA.
7699643 Cytokine levels in serum and synovial fluid of patients with juvenile rheumatoid arthritis 1994 Dec OBJECTIVE: Cytokines play an important role in mediating inflammation and in regulating the immune response of many rheumatological diseases. In patients with juvenile rheumatoid arthritis (JRA), levels of 6 cytokines, interleukin 1 alpha (IL-1 alpha), IL-1 beta (IL-1 beta), IL-2, IL-2 receptor (IL-2R), IL-6, and tumor necrosis factor alpha (TNF-alpha) were measured in serum and synovial fluid (SF) in an effort to evaluate their significance. METHODS: Serum concentrations of the 6 cytokines were measured in 62 patients with JRA including 22 pauciarticular onset, 26 polyarticular onset, and 14 systemic onset patients, and 29 disease and healthy controls using enzyme-linked immunoabsorbent assays (ELISA). Seventeen SF from patients with JRA were examined for cytokine levels. RESULTS: Elevated serum levels of IL-2R were found in patients with systemic onset and elevated IL-2 levels in pauciarticular and polyarticular onset JRA as compared to controls. Pauciarticular and polyarticular onset patients also had elevated IL-1 alpha and IL-6 levels. There were no statistical differences found between the groups for TNF-alpha and IL-1 beta. SF revealed elevated levels of IL-1 beta, IL-2R, and IL-6; however, correlation was noted between serum and SF levels only for IL-1 alpha, not for the other cytokines. Mean serum levels of IL-2R in all onset types with active disease and IL-6 levels in active polyarticular and pauciarticular onset were elevated when compared with mean inactive levels. CONCLUSION: Our studies indicate that (1) IL-1 alpha, IL-2, IL-2R, and IL-6 levels are increased in serum of patients with JRA with different onset types; (2) elevated levels of IL-1 beta, IL-2R, and IL-6 are found in their SF compared to serum levels; (3) a correlation exists between serum and SF levels only for IL-1 alpha; (4) mean IL-2R levels are elevated with active disease in all onset types and mean IL-6 levels with active polyarticular and pauciarticular onset disease are elevated compared to mean levels of inactive patients; and (5) cytokines may thus play a role as inflammatory mediators in JRA.
1410900 [Current aspects of paraneoplastic acute polyarthritis]. 1992 May Paraneoplastic acute polyarthritis (PAP) is a recognized rheumatological entity with semeiological features that are based only on a few published cases. We thought that it would be of interest to review the literature and present the current characteristics of PAP, taking into account only those cases where the acute polyarthritis and a neoplastic disease followed parallel courses. The clinical manifestations of PAP are extremely varied, making it difficult to distinguish this disease from some forms of rheumatoid arthritis, the RS3 PE syndrome or polymyalgia rheumatica. Clinicians must be vigilant when they are faced with a particularly progressive acute polyarthritis in a patient aged over 60, and particularly when this patient's general condition is altered and when fever and a clear-cut inflammatory syndrome are present. In such circumstances, it is mandatory to investigate for an underlying neoplasia.