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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
8266979 Case report: the spectrum of autoimmune thyroid disease with urticaria. 1993 Dec Urticaria has many known etiologies. An association with autoimmune thyroid disease is described. One individual had the triad of urticaria, Hashimoto's thyroiditis, and rheumatoid arthritis, whereas the other individual had urticaria preceding Graves' disease by over 1 year.
8692300 [Diagnosis and course of early arthritis; study in a specialized clinic for early arthriti 1996 Apr 20 OBJECTIVE: To investigate the occurrence, diagnosis and course of all new inflammatory arthropathies seen in a special Early Arthritis Clinic (EAC). DESIGN: Prospective cohort study. SETTING: Academic Medical Hospital, Leiden, The Netherlands. METHODS: An Early Arthritis Clinic (EAC) was started in the outpatient clinic of rheumatology of Leiden University Hospital for diagnostic work-up according to protocol of patients with recent-onset arthritis. Inclusion criteria were: active arthritis with onset < 2 years without traumatic aetiology and no referral for a second opinion. RESULTS: In the first 18 months 276 patients were sent to the EAC, 212 met the inclusion criteria. After 2 weeks the following diagnoses were made: rheumatoid arthritis (RA) (58; 28%), psoriatic arthritis (8; 4%), reactive arthritis (11; 5%) sarcoidosis (9; 4%), crystal arthritis (30; 14%), osteoarthritis (8; 4%), other diagnosis (18; 8%). The remaining 70 patients (33%) were classified as arthritis e causa ignota (e.c.i.). After follow-up, the first diagnoses changed in 27 (12%) patients, of whom 20 patients originally had had the diagnosis of arthritis e.c.i. Persistent arthritis was found in 90% of RA and in 35% of arthritis e.c.i. Other forms of arthritis seldom showed persistent activity. CONCLUSION: In the EAC, RA, arthritis e.c.i. and crystal arthritis were seen most often. Almost all RA patients showed persistent arthritis, as against only a third of those with arthritis e.c.i. Because of the early diagnosis treatment could start early in patients with joint disease entailing irreversible joint destruction.
8605261 Mortality in the rheumatic diseases. 1995 Dec OBJECTIVE: To review mortality data in published studies of various rheumatic diseases. METHODS: A MEDLINE search of the literature on the rheumatic diseases, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, scleroderma, polymyositis, and vasculitis. RESULTS: Mortality rates higher than expected have been reported in most rheumatic conditions, considerably higher for inflammatory rheumatic diseases. The mortality rates in patients with systemic lupus erythematosus, scleroderma, polymyositis, and vasculitis are often comparable to mortality rates seen in patients with neoplastic or cardiovascular diseases, although the causes of death often are not identified as the rheumatic disease. CONCLUSION: Mortality has been found to be predicted in most instances by more severe clinical status, and therefore death should not be considered as "unrelated" to the rheumatic disease. These observations may have important implications for clinical care and health policies regarding patients with rheumatic diseases.
1391815 [Dynamic functional MRT of the cervical spine]. 1992 Sep To obtain functional studies of the cervical spine, a device has been developed which allows MRI examinations to be carried out in five different degrees of flexion. T1 and T2* weighted FFE sequences were used. Dynamic functional MRI was performed on 5 normals and 31 patients (5 disc herniation, 4 whiplash injuries, 6 spinal canal stenoses, 14 laminectomies and spinal fusions, 2 rheumatoid arthritis). The relationship of the spinal cord to the bony and ligamentous components in different degrees of flexion was particularly well shown in whiplash injury, spinal stenosis and postoperative situations.
8633112 Scintigraphy in the evaluation of arthropathy. 1996 Mar Significant progress has been made in radionuclide imaging of bones and joints. This largely is owing to advances in radiopharmaceuticals, particularly the antibodies, and in technology, particularly in the introduction of new computers and multiheaded camera systems resulting in improved imaging. These techniques have applied to the evaluation of articular and para-articular diseases including rheumatoid arthritis, septic arthritis, osteoid osteoma, transient osteoporosis, reflex sympathetic dystrophy, avascular necrosis, and facet joint syndrome. This article reviews scintigraphy in these conditions.
1395240 Long-term results of total arthroplasty in adolescents with debilitating polyarthropathy. 1992 Oct The authors retrospectively reviewed 29 hip and 13 knee arthroplasties performed in 17 adolescents and young adults from 1973 through 1979. Most patients had severe multiple joint involvement; 16 had juvenile rheumatoid arthritis. Clinical and roentgenographic evaluations were performed before operation and at routine intervals for up to 11 years after operation. The average final follow-up evaluation was at ten years seven months. The modified Harris rating improved from 17 before operation to 68 at final evaluation. A dramatic improvement was noted in the ambulatory ability of 13 patients in whom increased joint motion and reduced deformity was observed at follow-up evaluation. At the 11-year roentgenographic review, 32% of hips had gross loosening, and an additional 39% had radiolucent lines greater than 2 mm in thickness in more than two radiographic zones. No lucency greater than 2 mm was noted in any of the knee replacements. Complications included one immediate collapse of the medial tibial plateau, four femoral fractures, one hip dislocation, and one case of arthrofibrosis. Despite untoward roentgenographic results and the high incidence of complications, total arthroplasty has dramatically improved the quality of life for these patients with multiple joint pathology. For this reason, the authors continue to recommend joint replacement in these individuals and the use of new prosthetic designs and surgical techniques.
8258032 Cytokines: an overview. 1993 Aug This review is an introduction to cytokines and their involvement in various mechanisms of immune defense. These features are then exemplified by reference to cytokines in sepsis, malaria, rheumatoid arthritis and schistosomiasis. In so doing the different functions of T-helper-1 and T-helper-2 lymphocytes become apparent, and how the balance is manipulated by the body in response to particular invading agents. Finally the prospect of therapy to reinforce or negate particular cytokines is illustrated by examples.
8788609 Becoming familiar with fibromyalgia. 1996 Mar Although the term "fibromyalgia" has appeared in the literature for 90 years, the disease may go unrecognized by clinicians. It is a devastating disease, more common than rheumatoid arthritis, yet its cause remains a mystery. There is no cure for fibromyalgia; however, nurses may be able to help improve the quality of life for the patients who live with this disease. This article explores theories of causation, treatment modalities, and the potential role of nurses in their work with these patients.
8252794 Pyoderma gangrenosum--a complication of chronic venous leg ulceration? 1993 Nov Three patients whose chronic venous leg ulcers were complicated by pyoderma gangrenosum are reported. Illnesses which may have predisposed to the development of pyoderma gangrenosum included Crohn's colitis, rheumatoid arthritis and small bowel perforation. Pyoderma gangrenosum should be suspected in susceptible patients whose venous leg ulcers undergo inexplicable and painful deterioration.
8098940 Cytokines in health and disease. 1993 Apr Research into cytokines has reached a challenging stage. Their importance to physiological and pathological processes is undoubted and the clinical application of both the molecules and their antagonists is of increasing importance. Every month more novel cytokine molecules are identified, each with a perplexing multiplicity and redundancy of action. In talks that ranged from rheumatoid arthritis, oncology and lymphocyte subsets, to transcription factors and xenopus mesoderm, a recent meeting* in London discussed the latest cytokine news.
7634044 Primary cemented total hip arthroplasty: five to twelve year clinical and radiographic fol 1995 A retrospective clinical and roentgenographic study was completed on 131 primary cemented total hip arthroplasties with a minimum of five years follow-up (mean, seven years; range, five to twelve years). Second generation cement technique including plugging of the medullary canal, cement gun filling, and pressurization of the canal was used. Acetabular cement was also pressurized. The total mechanical failure rate of the acetabular components was 18.4% compared to that of the femoral components which was 3.1%. There was a significantly higher incidence of acetabular component failure in rheumatoid arthritis patients (38.9%) compared to a preoperative diagnosis of primary osteoarthritis (14.1%) (p = 0.013). Yet there were no rheumatoid arthritis patients in the femoral component revision group. There were no differences in revision rates for metal-backed versus nonmetal-backed cups (p = 0.113). The average thickness of the proximal medial cement mantle was 2.8 millimeters in the loosening group and 5.4 millimeters in the nonloosening group (p = 0.333). All failures occurred in those patients whose proximal medial cement mantle was less than five millimeters. The authors strongly endorse the use of hybrid total hip arthroplasty and emphasize the need for meticulous surgical technique especially in obtaining a cement mantle of sufficient thickness in the proximal medial aspect of the femur.
8143761 The effects of hydrocortisone on in vitro lymphocyte proliferation and interleukin-2 and - 1993 Dec Corticosteroids (CS) are potent immunosuppressive and anti-inflammatory agents which are frequently used to treat a number of conditions such as rheumatoid arthritis (RA), asthma, and renal allograft rejection. Patients taking corticosteroids can be divided into 'steroid-sensitive' (SS) and 'resistant' (SR) groups on clinical and laboratory criteria. Corticosteroid 'resistance' has been extensively documented in asthma and renal allografting. The underlying mechanisms are unknown. Using the inhibition by hydrocortisone of concanavalin-A induced lymphocyte proliferation in vitro, we have divided rheumatoid arthritis patients (RA) and normal controls (HC) into SS and SR groups. The SS and SR phenotypes were stable over several months in RA and HC subjects. Inhibition of Con-A induced production of interleukin-2 and -4 by corticosteroids in vitro correlated with the in vitro defined SS and SR phenotype. When highly purified T-cells were stimulated via the CD3 and CD28 receptor pathways, corticosteroids did not inhibit cell proliferation in SS and ST subjects. It may be concluded that the SS and SR phenomenon is a stable intrinsic property of the individual which is dependent primarily on the inhibitory effects of corticosteroids on accessory cell function and only secondarily on T-cell function. This is a novel observation for the inhibitory effects of corticosteroids on T-lymphocytes.
8143990 Platelets circulate in an activated state in inflammatory bowel disease. 1994 Apr BACKGROUND/AIMS: Platelets show proinflammatory as well as prothrombotic properties. Patients with inflammatory bowel disease are at increased risk of systemic thromboembolism, and multifocal microvascular infarction has been proposed as a pathogenetic mechanism in Crohn's disease. The aim of this study was to determine if inflammatory bowel disease is associated with abnormal platelet behavior. METHODS: Platelet activation and aggregability were assessed using flow cytometry, Born aggregometry, and the modified method of Wu and Hoak. Serum beta-thromboglobulin was measured in patients with Crohn's disease and ulcerative colitis and, as controls, in healthy volunteers and patients with active rheumatoid arthritis. RESULTS: Platelet surface expression of P-selectin and GP53 (markers of activation) were increased in Crohn's disease (13 of 30 patients abnormal for P-selectin; 9 of 28 abnormal for GP53) (P < 0.01) and ulcerative colitis (9 of 21 for P-selectin; 10 of 21 for GP53) (P < 0.01) compared with healthy controls. Increased circulating platelet aggregates (15 of 24 patients with Crohn's disease and 8 of 16 with ulcerative colitis) (P < 0.01), platelet aggregability in vitro, and serum beta-thromboglobulin were detected in active inflammatory bowel disease compared with healthy controls. Platelet behavior in active rheumatoid arthritis resembled that in healthy controls. CONCLUSIONS: Increased platelet activation and aggregation are features of inflammatory bowel disease and may contribute to the risk of systemic thromboembolism and the pathogenesis of mucosal inflammation. Therefore, antiplatelet agents may be valuable in the management of inflammatory bowel disease.
7894636 Arthrodesis of the ankle with lateral plating. 1994 Dec A modification of internal fixation compression arthrodesis for ankle fusion is described using two 6.5-mm cancellous bone screws and a lateral T plate. Using this technique, 20 consecutive arthrodeses by one surgeon were reviewed. Solid union was attained in 19 of 20 patients (95%). Average follow-up was 18 months (range 6-59 months). Time to obtain solid arthrodeses averaged 18 weeks. In 11 patients who returned for follow-up, clinical grading using the Mazur scale score averaged 70 of 90 points. Diagnoses included posttraumatic degenerative arthritis, failed ankle arthrodesis and rheumatoid arthritis (2 each), failed ankle arthroplasty, and post-tuberculous arthritis (1 each). Complications included one malunion and one asymptomatic screw malposition. All patients attaining union were pleased with the procedure.
8335675 The halo-Ilizarov distraction cast for correction of cervical deformity. Report of six cas 1993 Jul Six patients were managed with gradual reduction of a deformity of the cervical spine, before operative stabilization, with use of a modified halo cast with adjustable distraction components that allowed the patient to sit and walk while the deformity was being corrected. The distraction components were constructed from the distractors, hinges, and connectors of an Ilizarov apparatus. The diagnoses were atlanto-axial subluxation secondary to rheumatoid arthritis, atlanto-axial rotatory subluxation secondary to juvenile rheumatoid arthritis, post-traumatic atlanto-axial rotatory subluxation, ankylosing spondylitis with an angulated fracture of the seventh cervical vertebra, atlanto-occipital and atlanto-axial subluxation secondary to familial cervical dysplasia, and cervicothoracic kyphosis secondary to laminectomy and radiation for astrocytoma. All of the deformities were corrected initially, but the deformity partially recurred in three patients: in the lower cervical area because of pseudarthrosis in one, and between the occiput and the first cervical vertebra after arthrodesis between the first and second cervical vertebrae in two. Complications included an infection at the site of the halo pin, which led to replacement of the pin (one patient); pressure sores under the body cast (two patients); dislodgment of the halo secondary to a fall, which necessitated reapplication of the halo (one patient); and pneumonia (one patient). Spinal distraction with halo-cast traction is a useful adjunct in the treatment of selected complex cervical and high thoracic deformities. Gradual three-dimensional correction may be obtained in a controlled fashion, while the patient is allowed out of bed to sit and walk.
8723413 Absence of antineutrophil cytoplasmic antibodies in relatives of UK patients with primary 1996 Feb OBJECTIVE: Perinuclear antineutrophil cytoplasmic antibodies (ANCA) have been reported in patients and relatives of patients with ulcerative colitis and primary sclerosing cholangitis, suggesting that ANCA may be a genetic marker of disease susceptibility. The reported frequency of ANCA in relatives has varied greatly, between 0 and 30%. We therefore studied the prevalence of ANCA in unaffected first-degree relatives of British patients with primary sclerosing cholangitis and ulcerative colitis. DESIGN: Thirty-six patients with ulcerative colitis, 33 with primary sclerosing cholangitis and 187 relatives were studied. Ninety-seven relatives were from the primary sclerosing cholangitis proband and 90 were from the ulcerative colitis proband. As an environmental control, 32 spouses were included: 14 from the primary sclerosing cholangitis group and 18 from the ulcerative colitis group. Eighteen healthy volunteers were additional controls. METHODS: ANCA was detected using immunoalkaline phosphatase method. RESULTS: Only 3 of 97 (3%) of the primary sclerosing cholangitis proband relatives had ANCA. One of these had ulcerative colitis, one had rheumatoid arthritis and the third systemic lupus erythematosus. Both rheumatoid arthritis and system lupus erythematosus are known to exhibit ANCA. All other sera were negative. CONCLUSION: ANCA was found only in patients with primary cholangitis and ulcerative colitis and not in their healthy first-degree relatives. ANCA is therefore not a genetic marker for increased disease susceptibility to primary sclerosing cholangitis or ulcerative colitis in the British population.
20444372 [Mineralization of the Coxa (DPX) before Implantation of TEP.]. 1994 The authors point out that when TEP are planned more attention is paid to the type of prosthesis, its composition and technical parameters and less attention to the quality of osseous tissue which is the subject of the present work. The authors examined at the First Orthopaedic Clinic Medical Faculty Comenius University Bratislava by means of a densitometer LUNAR DPX L the neck of the femur in patients before implantation of a TEP. They examined 96 coxae in patients with an average age of 57 years. Primary coxarthrosis accounted for 48%, bionecrosis of the head for 21%, deforming coxarthrosis (condition following LCC) 12%, rheumatoid arthritis 9%, conditions after fractures of the neck of the femur 9%. In the first group the bone density - BMD per g/cm2 in the neck of the femur (K) was 0.996 (109%), of Ward's triangle (W) 0.902 (118%), of the trochanter (T) 0.748 (106%). Values in the other groups: Group 2: K = 0,823 (93 %), W = 0,702 (91 %), T = 0,587 (76 %). Group 3: K = 0,987 (107%), W = 0,814 (99%), T = 0,684 (89 %). Group 4: K = 0,740 (83 %), W = 0,586 (74 %), T = 0,479 (64 %). Group 5: K = 0,604 (66 %), W = 0,533 (68 %), T = 0,513(63%). The results indicate that in idiopathic coxarthrosis the density is normal or elevated, in deforming coxarthrosis the coxa is difficult to examine by means of our software. In rheumatoid arthritis bionecrosis and mainly after fractures is density reduced. Reduced bone density is associated with the firmness of the fixation of TEP. Key words: DEXA, DPX, bone density, total endoprosthesis.
1503877 Viral infections, acquired immunodeficiency syndrome, and rheumatic diseases. 1992 Aug There is increasing evidence of a role for viruses in the pathogenesis and etiology of rheumatic diseases. Although definitive evidence of any involvement in diseases such as rheumatic arthritis and systemic lupus erythematosus is currently lacking, there is increasing evidence that viruses may be involved in the pathogenesis of related diseases. In particular, the recent world-wide epidemic of human immunodeficiency virus infection has been associated with the identification of a wide variety of rheumatic manifestations, most notably oligoarthropathies, psoriatic arthropathies, and Reiter's-like syndromes. The spectrum of rheumatic diseases associated with human immunodeficiency virus infection appears to be expanding at a considerable rate. Other viruses have also been shown to be associated with rheumatic disorders, most notably hepatitis viruses, human T lymphotropic virus type I, and parvoviruses. In the latter case, acute arthropathies and those resembling rheumatoid arthritis and Lyme arthritis have recently been identified. This review presents some of the evidence in the recently published literature on the role of different viruses and their implications in the pathogenesis of various rheumatic diseases.
8150635 [Wissler's allergic subsepsis]. 1994 Feb A 20-year-old female patient with the typical signs of Wissler's subsepsis allergica (Wissler-Fanconi syndrome) is described. This rare disease is characterized by four typical symptoms: polymorphous exanthemas, recurrent high fever, leucocytosis and arthralgia. In the early stages it is difficult to differentiate from septicaemia. This syndrome has sometimes been considered equivalent to or an initial stage of Still's disease (juvenile rheumatoid arthritis) progressing to degenerative arthritis in many patients, whereas other authors have classified it as a separate entity with good prognosis. The present case demonstrates that Wissler's subsepsis allergica should be considered when ever transient polymorphous exanthema is accompanied by high recurrent fever, leucocytosis and arthralgia.
8983319 Methotrexate in the treatment of children with chronic arthritis--long-term observations o 1996 Sep In a study to investigate the efficacy and toxicity of long-term methotrexate (MTX) therapy in children with chronic arthritis, the medical records of 26 children (seven boys and 19 girls) with juvenile rheumatoid arthritis (JRA) were reviewed retrospectively. The patients received MTX therapy for a mean of three years (range, six months to six years). A clinically significant response occurred in 19 children (73.1%): remission in ten (38.5%) and improvement (25% reduction in the number of actively inflamed joints) in nine (34.6%). Concomitant prednisolone therapy was reduced in 13 out of 14 children (93%). Haemoglobin levels and erythrocyte sedimentation rates were statistically significantly improved over baseline after MTX therapy. Six (23%) children experienced toxic effects during MTX therapy. One patient discontinued the MTX treatment after 18 months because of jaundice and raised liver enzymes. It is concluded that the study confirms the efficacy, and acceptable toxicity profile, of MTX given over a period of several years to children with JRA.