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ID PMID Title PublicationDate abstract
8002680 [Bladder amyloidosis in a female patient with suspected bladder carcinoma]. 1994 Mar We report on a patient with a long history of rheumatoid arthritis who consulted for intense hematuria that was initially ascribed to carcinoma of the bladder. Subsequent patient evaluation, however, disclosed amyloidosis of the urinary bladder. The literature on amyloidosis of the urinary tract is reviewed. A detailed analysis of the biopsy specimens taken from a lesion that looks like a bladder carcinoma may disclose other pathologies such as amyloidosis of the urinary bladder.
7761960 Use of 20-mg Hotemin capsule and suppository in rheumatological practice. 1994 The 20 mg piroxicam (Hotemin) capsule and suppository were efficacious and tolerable according to data of literature and own clinical observations in the treatment of rheumatoid arthritis, knee and hip arthrosis, as well as ischialgia. The increase in the daily dose is not accompanied by the more frequent development or aggravation of the adverse effects. Both preparations may be used as the first choice in the mentioned diseases and, moreover according to data of references, in case of other rheumatological diseases as well.
7704394 [Tuberculous pseudochylothorax. Presentation of a case with positive Mycobacterium tubercu 1995 Feb Pseudo chylothorax is a rare form of pleural effusion. It appears in long-term effusions, generally those lasting more than 5 years. The most frequent causes are tuberculous pleuritis and pleurel effusion secondary to rheumatoid arthritis. We describe a patient with pleural effusion lasting over 20 years who developed pseudo chylothorax and Mycobacterium tuberculosis in fluid culture.
7930902 Myasthenia gravis presenting during general anaesthesia for oesophagoscopy--a cautionary t 1994 Jul We report myasthenia gravis presenting as dysphagia of acute onset in a 56-year-old female who had no other stigmata of the disease and who was generally well despite rheumatoid arthritis and hypothyroidism. She recovered respiratory function following a general anaesthetic for oesophagoscopy only when antimyasthenic treatment was instituted. She remains well to date. In patients who are known to have autoimmune diseases and who present with dysphagia, features of myasthenia gravis should be specifically sought.
8028191 [Animal models for intractable hematologic disorders]. 1994 May We describe here characteristics of animal models for intractable hematologic disorders and discuss the concept of "stem cell disorders." Using these animal models, we have found that bone marrow transplantation can be used to treat both systemic and organ-specific autoimmune diseases, and that transplantation of hematopoietic stem cells from autoimmune-prone mice induces autoimmune diseases in normal mice. Based on these findings, we have proposed that autoimmune diseases are stem cell disorders. It has recently been reported that bone marrow transplantation can be used to treat autoimmune diseases such as rheumatoid arthritis and ulcerative colitis, also in humans.
8500282 The role of the major histocompatibility complex in autoimmunity. 1993 Jun In the case of many autoimmune diseases, HLA genes are the genes most closely associated with disease susceptibility. Recent major advances in the ability to determine particular HLA genotypes in individuals now allow us to identify the precise alleles most closely associated with disease. Rheumatoid arthritis, long known to be associated with HLA-DR4, provides a good model for review of this progress, demonstrating how methodologic advances have led to an improved understanding of the immunogenetic basis of this disease, with implications for both pathogenesis and potential therapeutic interventions.
8345265 Treatment of volar instability of the metacarpophalangeal joint of the thumb by volar caps 1993 Jun The metacarpophalangeal joint bears most of the stresses to which the thumb ray is subjected. Instability of this joint results in considerable functional impairment of the hand. Volar instability may be secondary to trauma, rheumatoid arthritis, or adduction spasms in cerebral palsy. The resulting hyperextension causes pain and weakness of pinch (Fig. 1). Various techniques have been described to correct this deformity. We prefer a volar capsulodesis as first described by Filler (1976), in which the whole volar plate is reinserted. Detailed knowledge of the complicated volar anatomy is essential. We have treated eight patients (two bilaterally) with this technique, all with satisfactory results.
1343024 [Tuberculosis in systemic connective tissue diseases]. 1992 Jan Six female patients who developed tuberculosis during the treatment of connective tissue diseases are presented. Underlying disease--systemic lupus erythematosus, rheumatoid arthritis, and polymyositis--with its numerous immunopathologic processes essentially decreases resistance of the organism to infections. Tuberculosis usually accompanies chronic, exhausting diseases and tends to involve patients with the decreased immunity. The use of glucocorticoids and immunosuppressive agents has been shown to have a significant influence on the suppression of the immune system. Thus, tuberculosis is a dangerous, very often fatal complication in the course and treatment of connective tissue diseases.
8731234 Interleukin-6 and soluble interleukin-2 receptor in juvenile chronic arthritis: correlatio 1996 Mar We sought to determine whether levels of interleukin-6 and soluble interleukin-2 receptor were correlated with clinical parameters including functional capacity indices such as Steinbrocker's class and the Juvenile Arthritis Functional Assessment Report (JAFAR) score, with tests for inflammation, and/or with immunological parameters in 24 patients with active polyarticular or pauciarticular juvenile chronic arthritis. Levels of interleukin-6 and soluble interleukin-2 receptor were significantly higher in juvenile chronic arthritis patients than in healthy controls (p < 0.005 and p < 0.00005, respectively). Interleukin-6 levels were correlated with the following parameters: number of painful joints (p < 0.025); Ritchie's index (p < 0.025); visual analog scale pain score (p < 0.025); Steinbrocker's class (p < 0.025); JAFAR score determined by patients (p < 0.05); JAFAR score determined by parents (p < 0.05); erythrocyte sedimentation rate (p < 0.0002); and serum levels of C-reactive protein (p < 0.0003), hemoglobin (p < 0.05), albumin (p < 0.025), and alpha 2-globulins (p < 0.025). Levels of soluble interleukin-2 receptor did not correlate with any of the parameters studied. Levels of interleukin-6 and soluble interleukin-2 receptor were not correlated with each other. Abnormal levels of interleukin-6 or soluble interleukin-2 receptor were not significantly associated with the presence of antinuclear antibodies, IgM-rheumatoid factor, IgA rheumatoid factor or anticardiolipin antibodies. Our findings suggest that interleukin-6 is a useful parameter for assessing juvenile chronic arthritis and that the potential clinical value of elevated levels of soluble interleukin-2 receptor in this disease needs to be further evaluated in longitudinal studies.
7567684 Limited TCR V beta usage of infiltrating T cells in synovial tissues from patients with HT 1995 Mar Human T cell lymphotropic virus type-I (HTLV-I) is the etiologic agent of adult T cell leukemia/lymphoma and recently has also been suggested to be involved in chronic arthritis. The synovia of patients with rheumatoid arthritis (RA) contains activated T lymphocytes, with a restricted expression of T cell receptor (TCR) variable (V) beta gene segments. To characterize the T-cell populations of RA among HTLV-I carriers and noncarriers, we performed the immunohistochemical staining of CD4 and CDB, as well as a reverse transcription polymerase chain reaction (RT-PCR) to estimate the proportion of TCR beta RNA containing any particular V elements on the synovial specimens. In all but one HTLV-I carrier, the proviral DNA and/or RNA expression of HTLV-I was detected in the synovium. The CD4-positive cells proliferated markedly in the HTLV-I carriers compared with the noncarriers. In contrast to mononuclear cells in the peripheral blood, synovial T cells expressed only a few V beta transcripts, and no definite difference was observed between the carriers and the noncarriers. These results suggest that a common major antigen associated with the pathogenesis of RA may thus selectively interact with the V beta component of the TCR. Using RT-PCR, we studied the expression of the recombination-activating gene-1 (RAG-1), which was used in the V(D)J recombination of immunoglobulin and TCR genes. In all cases, RAG-1 was transcripted. The results supported the possibility that the extrathymic development of the selected TCR V beta T cells occurred in the synovia.
8852550 Autoantibodies following parvovirus B19 infection. 1996 Jan This study was undertaken to assess the incidence and significance of autoantibody production following B19 infection, 53 patients with acute B19 infection (positive for serum anti-B19 IgM) were studied; symptoms were rash and arthralgia (n = 26), rash (n = 7), arthralgia (n = 16), aplastic crisis (n = 3), and intrauterine death (n = 1). These patients were followed for 26-85 months (mean 57 months) and re-assessed for persistent symptoms, serum anti-B19 antibodies, and serum autoantibodies. At follow-up, 14 test and two control patients had one or more serum autoantibodies (anti-nuclear antibody, anti-smooth muscle antibody, gastric parietal cell antibody, anti-reticulin antibody, anti-mitochondrial antibody, rheumatoid factor) at a titre of > or = 40 (P = 0.004). Seven test patients and no control patients had serum autoantibody at a titre > or = 160. Of these seven test patients, only one had persistent symptoms. At follow-up assessment, this woman was 48-year-old, had persistent arthralgia for 4 years following acute B19 infection, rheumatoid factor at a titre of 160 (1920 IU/ml), and had been independently diagnosed as having rheumatoid arthritis. In conclusion, results of the present study showed that low titre autoantibody production was common following symptomatic B19 infection, however, while interesting from a virological standpoint, this finding may be of little significance for future development of autoimmune disease.
8129761 High frequency of silent inflammatory bowel disease in spondylarthropathy. 1994 Jan OBJECTIVE: To search for an association between gut infection, gut inflammation, and spondylarthropathies. METHODS: Ileocolonoscopy was performed in 118 patients with various inflammatory and noninflammatory joint diseases and in 24 patients with uncomplicated acute bacterial gastroenteritis. RESULTS: Endoscopic lesions were more frequent in patients with spondylarthropathy (44%) compared with those with other inflammatory arthritides (6%; P = 0.001). Ileal changes were observed only in patients with spondylarthropathy (20% versus 0%; P = 0.01). Inflammatory bowel disease was the endoscopic diagnosis in 19% of the arthritis patients. Possible or definite Crohn's disease was diagnosed in 26% of patients with chronic spondylarthropathy, and ulcerative colitis in 1 patient with rheumatoid arthritis and in 1 with chronic uroarthritis. Histologic evidence of inflammation differed less distinctly than endoscopy findings between patients groups. There was no association of gut lesions with the use of nonsteroidal antiinflammatory drugs or with the presence of HLA-B27. CONCLUSION: Gut inflammation is frequent in patients with spondylarthropathy, and one-fourth of the patients who have chronic disease have early features of Crohn's disease.
8933278 Limiting dilution analysis of the frequency of autoreactive lymph node cells isolated from 1996 Oct Antigen-induced arthritis (AIA) in mice occurs after the single injection of methylated bovine serum albumin (mBSA) into the knee joint of animals preimmunized with the same antigen in complete Freund's adjuvant. A short acute reaction is followed by a chronic inflammation which shows similar histological features to human rheumatoid arthritis. The mechanisms leading to the chronicity of arthritis are not yet clear. Previous data suggest that autoimmune responses to cartilage components contribute to the persistence of arthritis. In the present study we estimate the frequency of autoreactive cells in the draining lymph nodes of arthritic mice by means of limiting dilution analysis. Graded concentrations of lymph node cells were stimulated for 7 days with type II collagen (CII) or cartilage proteoglycans (PG) in the presence of irradiated syngeneic feeder cells, and the frequency of responding cells was calculated. In the draining lymph nodes of immunized mice without arthritis induction, the frequency of CII reactive lymph node cells ranged from 1/41,182 to 1/57,424 whereas only 1 out of 3 experiments revealed a detectable frequency of PG reactive cells (1/136,128). For comparison, no CII or PG reactive cells were detected in the lymph nodes of normal mice. Intra-articular challenge of immunized mice with mBSA resulted in chronic destructive arthritis and caused a significant increase in the frequencies of CII and PG reactive lymph node cells (1/12,776 to 1/24,611 and 1/79,964 to 1/93,075, respectively). When using incomplete Freund's adjuvant for immunization, a comparable acute arthritis developed after the intra-articular injection of antigen, but the transition into the chronic stage was missing. The frequencies of autoreactive cells in the lymph nodes of these animals were below the level of detection and were judged to be below 1/150,000. The results suggest that autoimmune reactions against cartilage constituents might contribute to the perpetuation of joint inflammation, and that the mycobacteria in the complete Freund's adjuvant play an essential role in this process.
8384456 Autoimmune reactivity in sheep induced by the visna retrovirus. 1993 Feb Sheep, either naturally or experimentally infected with visna virus, were examined for the production of autoantibodies. Elevated titres of IgM and IgG antiglobulins and rheumatoid factors as well as antibodies to ssDNA, cardiolipin or histones were found in serum of both groups of animals using ELISA techniques. IgA autoantibodies were usually absent or present in low titres. The specificity of the autoantibody reactivities was confirmed by inhibition assays, affinity chromatography, Western blotting and agglutination methods. Antiglobulin titres were slightly elevated in synovial fluids, although the levels of the other autoantibodies were not raised. No significant correlations were observed between autoantibody and immunoglobulin concentrations. In a separate group of sheep infected experimentally, small but significant rises in the levels of all IgM autoantibodies, except anti-histone antibodies, were observed during and subsequent to the primary immune response to the virus. The autoantibody profiles tended to parallel each other, suggesting a common stimulus for their induction and/or a high degree of polyreactivity. The results thus show that the visna retrovirus induces, either directly or indirectly, autoimmune reactivities that are commonly observed in human autoimmune diseases such as rheumatoid arthritis or systemic lupus erythematosis.
7967374 Genetic polymorphism of HLA-DR in the Japanese population. 1993 Apr As a result of carrying out sequence analyses on the HLA-DR genes of several Japanese donors, we found three new DRB1 alleles, DRB1-12b, DRB1-14c, and DRB1-JX6, that had not been identified using immunological procedures. Sequence-specific oligonucleotide (SSO) probes directed against various DRB1 alleles, including the above three, enabled DNA typing of all the DRB types in the Japanese population and calculation of their gene frequencies based on this typing to be carried out for the first time. The SSO-DNA typing yielded higher DR13 and DR14 gene frequencies than those reported by serological workshops. Next, we applied this DR-DNA typing to the analysis of Japanese patients with juvenile rheumatoid arthritis (JRA) and found that DRB1*0405 was the allele susceptible to rheumatoid factor-positive polyarticular JRA, which is one of the four types of JRA that has been classified clinically. Analysis of the DR types of patients who suffered unexplained recurrent spontaneous abortion (URSA) using DNA typing demonstrated that 1) URSA is not correlated with any particular DR type and 2) no difference between the DR sharing rate of patients and normal couple was detected, which contradicts the results obtained in some serological studies.
8826677 Current status of wrist arthrodesis and wrist arthroplasty. 1996 Jul A variety of techniques are available for reconstruction of the wrist. The efficacy of wrist arthroplasty, however, is met with narrowed indications and does not enjoy the success that total joint replacement in other joints, such as the hip and knee, has enjoyed. With design improvements during the last decade, good short-term results from total wrist arthroplasty can be expected in the low-demand patient with rheumatoid arthritis. Wrist arthrodesis, either pancarpal or limited, is considered the primary surgical alternative in patients with most arthritic conditions of the wrist. The pancarpal arthrodesis is a predictable, durable alternative to a variety of post-traumatic, degenerative, or neoplastic conditions of the wrist; however, some authors report that complications may be prevalent. This procedure also may be modified and applied to the destroyed rheumatoid wrist. Overall, selection of fixation mode depends on bone quality. In an attempt to preserve motion, various limited arthrodeses of the carpus have been described. Although technically demanding, successful results may be expected, especially in conditions of carpal instability. With the current wide array of surgical alternatives, the surgeon must consider each case carefully and select the procedure that best applies to each particular situation. Furthermore, it is extremely important that the surgeon educate the patient on the limitations of each procedure.
8887042 Development of Sjögren's syndrome during treatment with recombinant human interferon-alph 1996 Oct A 63-year-old woman with type C chronic active hepatitis developed Sjögren's syndrome after being treated with recombinant interferon-alpha-2b. After 3 months' interferon-alpha administration, serum levels of gamma-globulin (4.5 g/dl) and titers of antinuclear and anti-SS-A antibodies were greatly increased, anti-SS-B antibody appeared, and the erythrocyte sedimentation rate was elevated. Although no xerostomia was exhibited, the patient experienced conjunctival dryness. Schirmer's test showed reduced lacrimal gland function and a gum test showed reduced salivary gland function. Sialography revealed scattered pools of retained contrast media with a diameter of around 1-2 mm. Based on these findings, a diagnosis of Sjögren's syndrome was made. This present case may provide important information regarding the pathogenesis of Sjögren's syndrome.
7744295 [Myocardiopathy diagnosed in utero in a mother with SS-A antibodies treated with plasmaphe 1995 Mar We report a 36 years old patient with Sjogren's syndrome, who during her second pregnancy, the product developed a miocardiopathy with complete heart block that was diagnosed in utero at 26 weeks of pregnancy. Simultaneously, laboratory data reported a SS-A/Ro titer of 1:50,000 with positive antiphospholipids antibodies. Patient was subjected three times to plasmapheresis with three blood volume exchange each time. During the procedures, we had monitor the product and no hemodinamic changes were observed. Unfortunately, 25 days later the patient reported absence of fetal movement and by ecosonography and Doppler was not observed fetal movement or cardiac function. This pregnancy ends in cesarea. The patient is in perfect clinical conditions under control using prednisone and methotrexate.
7936587 Early dental loss in Sjögren's syndrome. Histologic correlates. European Community Study 1994 Aug Early dental loss is a well-known complication of Sjögren's syndrome. Forty percent (n = 16) of 39 consecutive patients with the syndrome had early dental loss. Dental loss correlated positively with histologic grading at lip biopsy. There was no significant correlation with any other feature of Sjögren's syndrome, including saliva flow. In 11 partially edentulous or completely edentulous patients, dental loss occurred 9 years on average before the first symptom of xerostomia. Early dental loss may reflect a silent involvement of the salivary glands and suggests that changes in saliva biochemistry occur long before xerostomia.
7803921 Sjögren's syndrome in one of two sisters with idiopathic renal hypouricemia. 1994 Aug Concomitance of idiopathic hypouricemia and Sjögren's syndrome is reported. A 37-year-old Japanese woman with Sjögren's syndrome and her 39-year-old sister without this syndrome both had extremely low levels of serum uric acid. Markedly increased urinary excretion of uric acid and poor response to the pyrazinamide suppression test revealed that the hypouricemia in these sisters was caused by a defect in the pre-secretory reabsorption of uric acid. It is categorized as idiopathic renal hypouricemia than hypouricemia rather secondary to Sjögren's syndrome. Thus, idiopathic renal hypouricemia should be considered even in cases with autoimmune diseases.