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ID PMID Title PublicationDate abstract
8531363 [Immunohistochemical identification of infiltrating mononuclear cells in tubulointerstitia 1995 Oct Using monoclonal antibodies, Immunoperoxidase analysis was performed on renal biopsy samples obtained from patients with Sjögren's syndrome associated with tubulo-interstitial nephritis. In all cases the interstitial infiltrates were predominantly CD5-positive T cells (mean 66%), whereas both B cell (CD19-positive) and monocyte (CD15-positive) populations participated to a lesser degree. CD16-positive NK/K cells were rarely encountered. The CD4/CD8 ratio was consistently higher than 1.0 (mean 2.08). The lymphocyte which invaded the tubular epithelial cells to present a feature of tubulitis were CD8 positive, suggesting that they were cytotoxic T cells. These results were in general accord with those obtained in the salivary glands of patients with Sjögren's syndrome. It was thus concluded that the same immunological process was probably operative in the renal tubulointerstitial tissue as in the salivary glands to induced the characteristic tissue changes of Sjögren's syndrome.
7553033 [A male case of primary Sjögren's syndrome with interstitial pneumonitis and interstitial 1995 Feb Here we report a case of primary Sjögren's syndrome with hilar lymphadenopathy, interstitial pneumonitis and interstitial tubulo-nephritis. A 60-year old man was admitted to our hospital in May 1993 because of general fatigue and fever. He was noted to have hypergammaglobulinemia and had positive antibodies to nuclear antigens since 1990 in the absence of clinical manifestations. Since 9 months before admission, he presented with general fatigue, low grade fever and uveitis. On admission, chest X-ray and CT scan showed bilateral hilar lymphadenopathy and interstitial pneumonitis. The negative results for both serum angiotensin converting enzyme and histological findings of the cervical lymph node and the lung excluded the diagnosis of sarcoidosis. Serological examination exhibited marked elevation of polyclonal IgG level and anti-nuclear antibody, but neither anti-SS-A (Ro) nor anti-SS-B (La) antibody was detected. He did not have symptoms of xerophthalmia and xerostomia. Keratoconjunctivitis sicca was diagnosed by positive Schirmer's and rose bengal tests. His labial gland biopsy demonstrated severe mononuclear cell infiltration around the ducts. MRI findings of the parotid glands revealed heterogeneous and dotted high signal intensity similar to those in fat tissues in the T1- and T2-weighted images. These findings depicted that bilateral parotid gland was extensively destructed and was replaced by lipid tissue. Renal biopsy showed interstitial tubulo-nephritis. On the basis of the above findings, he was diagnosed to have primary Sjögren's syndrome and uveitis. Therefore, MR image of the parotid gland is considered to be a noninvasive and useful method for diagnosis of Sjögren's syndrome.
7894206 Neurophysiological assessment of peripheral neuropathy in primary Sjögren's syndrome. 1994 Nov Peripheral nervous system complications are rare in patients with primary Sjögren's syndrome. We investigated a group of six women aged 43-64 years who complained of pain and sensory symptoms. Conventional neurophysiological tests reflecting large nerve fiber function revealed normal motor conduction in all patients, whereas sensory nerve action potentials were absent in two. On the other hand, quantitative thermometry and autonomic nerve function tests indicating small nerve fiber function were more sensitive in the assessment of nerve dysfunction; these showed abnormalities in all cases. Vibrametry showed dysfunctions in four patients. The latter methods possess great sensitivity in discovering sensory disturbances. Neurophysiological assessment of the sensory and autonomic nervous system demonstrating sensory neuropathy contributes to early diagnosis of primary Sjögren's syndrome.
7792482 [Multiple and recurrent paralysis of cranial nerves: primary Gougerot-Sjögren syndrome]. 1994 Oct Over a period of 10 years, a 49-year-old man had 3 episodes of recurrent cranial nerve palsy regressing within a few weeks. Each episode was accompanied with acute inaugural headache and diplopia and once with sensory impairment of the trigeminal nerf and once with tinnitus. The diagnosis of Goujerot-Sjögren's syndrome was retained after demonstration of hypergammaglobulinaemia, a positive Rose Bengale test and histological examination of biopsy specimens from the accessory salivary glands which revealed advanced typical lesions. Clinically, impaired secretion was not obvious.
1550417 Mastocytosis and Sjögren's syndrome. 1992 Feb A 61 year old man with dryness of the eyes and mouth, constitutional and musculoskeletal symptoms is described. A diagnosis of fibromyalgia with Sjögren's syndrome was made elsewhere. Further examination, however, disclosed diffuse mast cell infiltration in several organs, including the labial accessory salivary glands.
1314271 Sjogren syndrome: comparison of sialography and ultrasonography. 1992 Feb Ultrasonography and sialography of parotid glands were prospectively performed on 30 patients with Sjogren syndrome and follow-up ultrasonography was done on 12 patients. Ultrasonography revealed multiple hypoechoic areas (MHA) 2 mm to 5 mm in diameter within the glands in 43% of the patients with intermediate severity of the disease, either homogeneous or slightly nonhomogeneous parotid glands in patients with early stage of the disease, and marked nonhomogeneous glands in patients with advanced diseases. Follow-up ultrasonography showed MHA in one patient, reduction in nonhomogeneity in another three, and no interval changes in the remaining cases. Pathologic studies suggested that MHA represent enlarged parotid lobules replaced by lymphocytic infiltration. We suggest that MHA are characteristic of Sjogren syndrome and that ultrasonography is useful in following the course of the disease and response to treatment.
20086953 Nontraumatic hip pain in active children: a critical differential. 1996 Jan A case report of an 8-year-old baseball player who was diagnosed with Legg-Calvé-Perthes (LCP) disease gives an opportunity to consider the many nontraumatic causes of hip pain. Possibilities include slipped capital femoral epiphysis, septic arthritis, transient synovitis, juvenile rheumatoid arthritis, and bone tumor. Radiographs and bone scans are used to document and stage LCP, and to evaluate the effectiveness of treatment. Though the aggressiveness of treatment depends on the disease stage, the treatment of choice is generally nonsurgical containment of the femoral epiphysis with a cast or orthosis.
8265828 Is central nervous system involvement a systemic manifestation of primary Sjögren's syndr 1993 Nov Central nervous system involvement in primary Sjögren's syndrome (pSS) is a controversial issue. Without an international criteria for the diagnosis of pSS, each research center must establish, publish, and strictly adhere to their own criteria. Therefore, patients should be made aware of professional uncertainties, particularly when therapeutic decisions are involved.
1460882 [Still's disease in adults and polymyositis. An infrequent association]. 1992 Oct 3 A case of coexistence of adult onset Still's disease and idiopathic inflammatory myopathy is reported in a patient with antecedent of Graves-Basedow disease. Although myalgias are common during the flares of adult onset Still's disease, a review of literature only disclosed two previous cases of polymyositis associated to adult onset Still's disease. A high index of suspicion is needed in order to diagnose such a rare association which has relevant prognostic and therapeutic implications. Treatment with methotrexate was started in order to control myopathy, resulting in improvement of both polymyositis and adult onset Still disease. A possible role of methotrexate in the management of adult onset Still's disease is suggested.
8894363 HLA antigens in polymyalgia rheumatica in northern Sweden. 1996 Sep The HLA-A, B and DR antigens were analyzed with serological methods in 75 patients with polymyalgia rheumatica (PMR). In PMR patients the frequency of the HLA-DR4 antigen was significantly higher (62.1%) compared to blood donors (40%), p < 0.05, but did not differ from patients with seropositive rheumatoid arthritis (RA) from the same area (63.1%). In contrast, the frequency of HLA-B27 in the PMR patients (9.3%) was significantly lower compared to RA (27.2%), p < 0.01, but did not differ from blood donors (16.9%). There was no association between DR4 and disease affliction or severity in PMR. The increased frequency of HLA-B27 in RA but not in PMR in the population of northern Sweden suggests an immunogenetic difference between these two HLA-DR4 associated diseases.
1563111 Vaccination and genetic experiments demonstrate that adjuvant-oil-induced arthritis and ho 1992 Apr The DA rat is highly susceptible to induction of arthritis after immunization with homologous type II collagen (CII) emulsified in Freund's incomplete adjuvant (FIA), resulting in collagen-induced arthritis (CIA). The DA rat also develops arthritis after injection of FIA alone (oil-induced arthritis (OIA)). This finding allows a direct comparison of two different models for rheumatoid arthritis; one induced with a defined auto-immunogen and one with a pure adjuvant. Both CIA and OIA develop approximately 2 weeks after induction but OIA is a self-limited acute disease whereas CIA induced with homologous CII follows a chronic disease course. Immunization with CII leads to a strong autoantibody response to CII while injection of FIA leads to no or very limited anti-CII antibody response. The Lewis rat develops neither CIA nor OIA while F1 (DA x Lewis) rats develop CIA but not OIA. Olive oil or CII emulsified in olive oil does not induce arthritis in DA rats. Pretreatment with CII in olive oil vaccinates against CIA but not OIA whereas pretreatment with FIA vaccinates against OIA but not CIA. These findings demonstrate that inclusion of CII in the adjuvant leads to a disease distinct from OIA which is characterized by a CII autoimmune response and chronicity of the disease course.
7604699 Boneloc cemented total hip prostheses. Loosening in 28/43 cases after 3-38 months. 1995 Jun We report our early results with 43 total hip prostheses (25 Charnley and 18 LMT) inserted during 1991 with Boneloc cement. The indication was primary arthrosis (38) and rheumatoid arthritis (5). After 18 (3-38) months, 28 stems were loose and 18 hips have been revised 1-4 years after primary surgery.
8310207 Abnormal T-cell function in patients with psoriatic arthritis: evidence for decreased inte 1993 Psoriatic arthritis (PSA) is an inflammatory arthritis associated with psoriasis. Although not considered an autoimmune process, there is evidence for humoral and cellular immune abnormalities similar to autoimmune diseases such as rheumatoid arthritis and systemic lupus (SLE). We investigated mitogen-induced proliferation and interleukin 2 (IL-2) production by peripheral blood mononuclear cells in patients with PSA. Both IL-2 production and proliferation were significantly decreased in PSA patients when compared to controls. Increased arachidonic acid metabolism has been reported in skin and peripheral mononuclear cells of patients with psoriasis and PSA. We therefore also investigated the effect of indomethacin and prostaglandin E2 (PGE2) on IL-2 production. Addition of indomethacin to cultures did not significantly change IL-2 production in patients with PSA, but did so in controls. PGE2 produced a significant reduction in IL-2 production in PSA and in controls.
7918713 Pain measurement in arthritis. 1993 Dec Objective. This paper reviews the major pain measurement methods used with adult patients with rheumatoid arthritis, osteoarthritis, and fibromyalgia. Methods and Results. The most frequently used measures are numerical and verbal rating (category) scales of pain intensity and affect. However, visual analogue scales and composite measures are preferable to category scales because they may be subjected to parametric statistical analyses and may be associated with greater sensitivity to treatment-related changes over time. Measurement of overt motor behaviors and pain threshold levels provides important information that cannot be assessed with rating scales. It also allows one to determine whether there are discrepancies between patients' ratings of their pain experiences and their behaviors. Measurement of psychophysiologic parameters are used to understand better how markers of immune system activity may mediate the relationships between psychological and environmental factors and patients' pain experiences. Conclusions. It is necessary to use multiple pain measurement methods for clinical and research purposes. These should include at least two measures of pain intensity and affect as well as a measure of pain behavior.
1543666 Immunopathology, rheumatic features, and therapy of sarcoidosis. 1992 Feb A spectrum of immune alterations underlies the clinical syndrome of sarcoidosis. There is an increase in the number of helper T lymphocytes at sites of disease activity. Both macrophages and T cells are in a state of activation. Inflammation in sarcoidosis probably attracts specific T lymphocytes, as has been shown by the preferential usage of the C beta 1 elements of the T-cell antigen receptor. Acute sarcoid arthritis is distinctly different in its HLA association and clinical outcome than chronic sarcoid arthritis. Muscle and osseous lesions are well described but are usually asymptomatic. Childhood sarcoidosis may be confused with juvenile rheumatoid arthritis because of the similarity of eye and articular involvement. Nonsteroidal anti-inflammatory drugs and corticosteroids are effective for most patients. Hydroxychloroquine, methotrexate, and cyclosporine have been tried with success in patients with refractory sarcoidosis.
1540017 Selective IgA deficiency associated with glomerulonephritis and oligoarthritis. 1992 Jan A 59 year old woman with selective IgA deficiency associated with oligoarthritis and glomerulonephritis is described. She was seropositive for rheumatoid factor and renal histological examination showed a focal glomerulonephritis. High titre rheumatoid factor and a focal glomerulonephritis were also present in the only other well documented report of selective IgA deficiency and renal disease. Histological examination of the kidney suggested that the glomerulonephritis was mediated by immune complexes.
8587097 ARAMIS and toxicity measurement. (Arthritis Rheumatism and Aging Medical Information Syste 1995 May Side effects of medications make up an important part of adverse outcomes experienced by patients with rheumatic diseases. Quantitative measures to assess toxicity, however, have not been available, and this lack has limited estimates of the magnitude of effects and of differences in side effects among different drugs. This paper describes the development of the Arthritis, Rheumatism and Aging Medical Information System (ARAMIS) Toxicity Index and the issues arising in construction of such an index, and reviews early results in comparing toxicities of antirheumatic drugs. Findings have had major value in revising therapeutic strategies for rheumatic diseases, particularly rheumatoid arthritis, and have set the stage for development of toxicity-therapeutic ratios for different drugs.
8496877 Inflammatory arthropathies in children with chromosomal abnormalities. 1993 Apr There are few observations of inflammatory synovitis in association with specific chromosomal abnormalities in children or adults. We review the genetic and rheumatic disease literature and describe the clinical, radiologic and pathologic features of a 14-year-old boy with trisomy 5q, terminal 2p deletion, developmental delay, and a 5-year course of a polyarticular, symmetrical arthropathy similar to juvenile rheumatoid arthritis. He was treated with multiple nonsteroidal antiinflammatory drugs, intramuscular gold, and oral methotrexate, but developed iridocyclitis, joint space narrowing with erosions, and multiple flexion contractures; disease progression slowed after addition of chlorambucil. The frequency and manner of association of genetic disorders with inflammatory arthropathies is presently unknown. Additionally, children with 2 major disabilities often require aggressive medical intervention to maximize their potential for adult independence.
7525955 Specificity of antibodies to type II collagen in early rheumatoid arthritis. 1994 Jul OBJECTIVE: To analyze the antibody response to native type II collagen in early rheumatoid arthritis (RA), examining the immunoglobulin isotypes, and polypeptide epitopes recognized, in patients followed over a 2-year period from within 6 months of the first occurrence of symptoms. METHODS: Sera from 16 patients were studied, of whom 10 had antibodies to native type II collagen and 6 did not. The clinical and laboratory assessment, carried out initially and at 6 monthly intervals included the number of 1958 ARA criteria fulfilled, Ritchie index, erythrocyte sedimentation rate, rheumatoid factor and radiological assessment. An ELISA was used to measure IgG, IgA and IgM antibodies, and immunoblotting to identify the number and location of epitopes, using polypeptides prepared by cyanogen bromide digestion of human type II collagen. RESULTS: Antibodies to type II collagen were present in all sequential serum samples for the 10 antibody positive patients. None of the 6 patients who initially lacked antibodies developed them. The antibodies were of IgG isotype in 9, of IgA isotype in 8, and of IgM isotype exclusively in one. At the initial clinical assessment patients with antibodies to collagen were indistinguishable from those without. At 12 and 24 months patients with antibodies fulfilled significantly more ARA criteria than antibody negative patients. The patterns of antibody reactivity to collagen polypeptides by immunoblotting were constant over time but differed from patient to patient. CONCLUSION: The presence of an established and persisting IgG antibody response to type II collagen in early RA before cartilage destruction is evident points to a subset of RA, perhaps equivalent to the collagen induced model in animals, in which this immune response is intrinsic to pathogenesis.
8327862 Antibody response of restricted isotype to heat shock proteins in juvenile chronic arthrit 1993 Jul Synovial fluid and peripheral blood mononuclear cells from juvenile chronic arthritis (JCA) patients have previously been shown to exhibit substantial proliferative responses to both human and mycobacterial heat shock protein (hsp) 65. We investigated the nature of the antibody response to mycobacterial and E. coli hsp 65 and human and E. coli hsp 70 in 56 JCA patients using an ELISA. Elevated levels of antibodies to both human and E. coli hsp 70 were demonstrated. With hsp 65, raised levels of antibodies to the mycobacterial but not the E. coli protein were detected. Overall, 48% of patient serum samples contained antibodies of at least one isotype to mycobacterial hsp 65. These antibodies were predominantly of IgG and IgM isotype, a finding in contrast to adult rheumatoid arthritis, where IgA and IgG isotypes are most often detected.