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ID PMID Title PublicationDate abstract
8750280 Severe migratory polyarthritis following in vivo CAMPATH-1G. 1995 Dec CAMPATH-1G is an IgG2b rat antihuman (CDw52) monoclonal antibody (MoAb) which is currently being used for T cell depletion in the setting of allogeneic bone marrow transplantation (BMT). In addition it elicits substantial lymphoid depletion, an effect which is being explored for remission induction in patients with lymphoid malignancies and for treating patients with various autoimmune disorders, in particular rheumatoid arthritis. Recently, in vivo CAMPATH-1G has been introduced to achieve increased immunosuppression in the pretransplant conditioning, for prevention of graft rejection following T cell depleted BMT. Here we describe a patient with T cell lymphoblastic lymphoma who received in vivo CAMPATH-1G as part of the pretransplant conditioning regimen and who, 6 days after the first dose, developed severe migratory polyarthritis. This is the first report of severe migratory polyarthritis as a very unusual complication following CAMPATH-1G MoAb administration.
8207585 Effect of animal age and chronicity of interleukin-1 exposure on cartilage proteoglycan de 1994 May Rheumatoid arthritis and osteoarthritis are characterized by an early depletion of cartilage proteoglycans, which leads to a decrease in cartilage compressibility and, eventually, to a loss of joint function. Interleukin-1, which is thought to have a role in mediating this loss of proteoglycans in arthritis, induces an acute depletion of proteoglycans from articular cartilage following intra-articular injection in rabbits. As the structure and metabolism of proteoglycans are known to change with age, my laboratory investigated the effect of age on depletion and recovery of proteoglycans in response to interleukin-1 in the rabbit. Loss of cartilage proteoglycans induced by interleukin-1 was less severe in immature animals, increased until the age of sexual maturity, and then remained constant. The rate of recovery and compensatory overshoot in the rate of proteoglycan synthesis following challenge with interleukin-1 was more rapid in immature animals and may have been responsible for the quicker return of the cartilage proteoglycan content to control levels in younger animals. With multiple exposures to interleukin-1 at time intervals too short for recovery to occur, smaller amounts of interleukin-1 induced loss of proteoglycans, and the proteoglycan content and the rate of synthesis remained depressed longer after treatment had stopped. The decreased ability of mature cartilage to replace proteoglycans rapidly after exposure to cytokines would increase the probability of subsequent inflammatory episodes before recovery is complete; this may result in increased susceptibility of adult cartilage to proteoglycan depletion.
7864517 [Longitudinal stress fractures of the tibia. Apropos of 3 cases]. 1994 Longitudinal stress fractures of the tibia are rare: only 16 cases have been published. We report three cases, in two men aged 54 and 70 years and in one women aged 73. The patients had pain when bearing weight on the affected limb. The pain increased over a few weeks. A diagnosis of arthritis of the ankle joint was entertained in 2 cases. Among the three patients, one was suffering from rheumatoid arthritis and had had Ender nails due to fracture of the femoral neck of the same limb. The longest delay for diagnosis was six months. Plain radiographs were normal in two cases. A technetium 99m MDP bone scan showed increased uptake of the whole shaft of the tibia in one patient, on the lower end of the tibia in two others. Computed tomography was performed in two cases and showed the stress fracture. Diagnosis was often delayed because clear changes at plain X-ray examination, periostal reaction often being delayed. Technetium 99m bone scan early showed increased uptake. CT scan showed callus formation and sometimes the fracture itself. MRI has been studied little.
8987239 Drug use and aplastic anaemia: the French experience. French Cooperative Group for the Epi 1996 The cause of the rare and severe condition of aplastic anaemia is largely unknown, although certain drugs have been implicated as possible aetiological factors, mostly through the evidence of case reports. A case-control study was conducted in metropolitan France between 1985 and 1988 to investigate aetiological factors in aplastic anaemia. It was conducted in parallel with the establishment of a national register of the incidence of aplastic anaemia, which started in May 1984. The controls used in the study consisted of 2 hospitalized controls (i.e. patients admitted to hospital at the same time as the case) and a neighbour control named by the case. All three controls were matched for age and sex, and were interviewed by the same investigator as the case. A total of 147 cases, 287 hospitalized controls and 108 neighbour controls were interviewed. An association of varying degrees was noted between aplastic anaemia and the following conditions or treatments: clinical hepatitis during the past 6 months; history of chronic immune disorder (mainly rheumatoid arthritis); gold salts and D-penicillamine; colchicine and allo-thiopurinol; acetaminophen and salicylates. This survey confirmed the vanishing role of previously known toxic agents in the aetiology of aplastic anaemia. Some differences observed between the results of the present study and those published previously suggest that targeted studies on each category of drug according to specific disease areas should be initiated.
8475237 Psychiatric symptoms in systemic lupus erythematosus: an update. 1993 Mar Twenty-one studies on the prevalence and type of psychiatric symptoms in systemic lupus erythematosus (SLE) are reviewed and evaluated. Substantial differences in prevalence of psychiatric symptoms in SLE-patients (from 17%-71%) have been reported. Of the investigated methodological aspects, differences in assessment techniques appeared to be the main source of the variability in findings. Although various types of psychiatric symptoms have been observed, depression is most frequently reported. There was no consistent relationship between the occurrence of psychiatric symptoms and other symptoms of SLE. However, the data suggest an association with (the patient's perception of) illness severity and with the experience of psychosocial stressors. Studies applying control groups (patients with other chronic diseases (e.g., rheumatoid arthritis) showed striking similarities between both patient groups with respect to prevalence and type of psychiatric symptoms. There is some evidence, however, indicating that a small proportion of the psychiatric symptomatology, in particular psychosis, is related to neurological dysfunction in SLE.
7578877 Restricted expression of T cell receptor V beta and lymphokine genes in arthritic joints o 1995 Type II collagen-induced arthritis (CIA) is an animal model of inflammatory polyarthritis with clinical and pathological features resembling rheumatoid arthritis (RA). We compared the expression of T cell receptor (TCR) V beta genes in T cells isolated from the inflamed joints, draining lymph nodes and the spleens of BUB/BnJ (H-2q) mice (BUB) during the early phase of CIA. We also investigated the profiles of cytokine gene expression in T cells obtained from the same tissues. We found that the expression of TCR V beta s, in arthritic joints of mice, during the early phase of the disease was limited to TCR V beta 3 and 10 gene families. In contrast, TCR V beta 4, 7, and 15 were predominant in the draining lymph nodes (LNs) and TCR V beta 2, 6, and 14 were predominant in the spleens of arthritic mice. Molecular cloning and sequence analysis revealed that the T cell populations in the arthritic joints were oligoclonal as determined by the limited N-D-N region diversity observed in the sequenced clones. These results demonstrate, for the first time, that (1) joint infiltrating T cells in TCR V beta a genotype mice use a restricted repertoire of TCR V beta genes; (2) there was oligoclonal expansion of infiltrating T cells in arthritic joints in mice with collagen-induced arthritis. Our results on cytokine gene expression in the arthritic joints of BUB mice indicate that Th-1-like T cell derived cytokines may be the predominant cytokines in the arthritic joints as illustrated by the presence of transcripts for IL-2 and IFN-gamma but not IL-4. In summary, our results provide evidence that T cells with restricted specificities, and more specificially, Th-1 type T cells, are crucial in the early phase of collagen induced arthritis in mice.
7791159 Prevalence of primary Sjögren's syndrome in China. 1995 Apr OBJECTIVE: To determine the prevalence rate of primary Sjögren's syndrome (SS) in a community population of 2066 adults in a Beijing suburban village, and 100 inpatients, who were not necessarily admitted for rheumatic diseases. METHODS: Questionnaire and serological studies of antinuclear antibodies, rheumatoid factor, and anti-SSA, anti-SSB antibodies were done. Possible positive subjects were given eye and oral examinations for objective evidence of xerostomia and keratoconjunctivitis sicca. RESULTS: According to the Copenhagen criteria, the prevalence rate of primary Sjögren's syndrome in China was 0.77%, and it was 0.33% by modified San Diego criteria. In 100 inpatients, we found 4 cases of primary Sjögren's syndrome by Copenhagen criteria, and one case by modified San Diego criteria. CONCLUSION: Primary Sjögren's syndrome is not a rare disease in China, but most cases are overlooked or misdiagnosed.
7996035 Pulmonary nodular amyloidosis in a patient with Sjögren's syndrome diagnosed by transthor 1994 Sep A variety of pulmonary diseases may accompany Sjögren's syndrome. We report a rare case of pulmonary nodular amyloidosis in a woman with Sjögren's syndrome that was diagnosed by fluoroscopic transthoracic needle biopsy.
8740826 Effectiveness of formula ophiopogoins in the treatment of xerostomia and pharyngoxerosis. 1996 A multicenter study was carried out in 24 institutions in Kanagawa Prefecture, Japan. The subjects were 113 male and 145 female patients, ranging in age from 28 to 86 years (mean 63.7) who complained of dryness of the mouth and throat. The following illnesses were diagnosed: xerostomia and pharyngoxerosis in 161, radiation xerostomia and pharyngoxerosis in 56, chronic pharyngitis with dry mouth and throat in 22, and Sjögren's syndrome in 7. Eleven patients had other symptoms. The subjects were given a 3-g pack of granules of formula ophiopogoins three times a day before a meal. Their subjective symptoms and objective signs were examined prior to, 2, and 4 weeks after the beginning of therapy.
8531368 [Autoimmune liver disease complicating Sjögren's syndrome]. 1995 Oct Sjögren's syndrome (SjS) has been well known to complicate autoimmune liver diseases such as autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC). In addition, it has been recently described that chronic viral hepatitis type C could be accompanied by a sialadenitis resembling SjS. Among 98 patients with SjS at our clinic, 7 AIH, 1 PBC, and at least 11 hepatitis C virus (HCV) infection were noted. However, occurrence of SjS was not always associated with the severity of chronic liver diseases. Our present study suggested that three mechanisms might contribute to the pathogenesis of HCV-related SjS: 1) direct infection and proliferation of HCV in salivary glands, 2) molecular mimicry between HCV and salivary glands, and 3) formation of immune complex containing HCV. Further investigation would be indispensable to elucidate immunological systems to regulate these phenomena.
8756970 Balneotherapy for rheumatic diseases at the Dead Sea area. 1996 Jul The Dead Sea region is the major spa area in Israel for patients with various types of arthritis. The unique climatic conditions in this area, and the balneologic therapy-which is based primarily on mud packs and bathing in sulfur baths and in Dead Sea water-combine to alleviate the symptoms of arthritis. Controlled studies conducted over the last 10 years have demonstrated that treatments provided at the Dead Sea have a positive effect on patients with inflammatory arthritides such as rheumatoid and psoriatic arthritis, and on non-inflammatory arthritides such as osteoarthritis. In addition, the use of mud packs and Dead Sea salts dissolved in regular bath water outside the Dead Sea region are also effective, although to a lesser degree than when applied at the Dead Sea area itself.
8668966 Sudden onset unilateral renomegaly as an initial manifestation of primary Sjögren's syndr 1996 An 18-year old girl suddenly developed left-sided abdominal pain with otherwise normal clinical and urine examination. Ultrasound and computed tomography demonstrated a left renomegaly with uniformly normal structure without hydronephrosis, abnormal renal venous flow or ruptured extrauterine pregnancy. Renal biopsy showed lymphocytic interstitial nephritis, compatible with exocrine gland focus score abnormalities, consistent with those found in patients with Sjögren's syndrome. The renomegaly started to diminish after 10 days and the kidney reached normal size after 2 months. All objective tests for keratoconjunctivitis sicca and xerostomia were abnormal, although daily persistent dry eyes and dry mouth symptoms were absent. Serological tests showed high levels of anti-nuclear antibodies, anti-SS-A and anti-SS-B antibodies. Thus the patient fulfils the classification criteria for primary Sjögren's syndrome. The suddenly developed unilateral renomegaly may be an early clinical manifestation of this disease.
8720268 [A case of Sjögren's syndrome and systemic lupus erythematosus complicated with necrotizi 1995 Dec A 71 year-old man with Sjogren's syndrome and systemic lupus erythematosus was admitted to our hospital because of abdominal pain and fever. Laboratory investigation showed an ESR of 76 mm/hr, elevation of CRP and marked leukocytosis. Abdominal ultrasound and CT scan showed enlargement of the gallbladder and intravesicular sludge without stones. With a clinical diagnosis of acute cholecystitis and pan-peritonitis, the surgical procedures including cholecystectomy were performed. Histological examination of the gallbladder showed a presence of necrotizing angiitis of small arteries. The postoperative course was uneventful with daily administration of 10 mg of prednisolone.
8000827 Case report: sicca syndrome due to primary amyloidosis. 1994 Oct Sicca syndrome consists of two major clinical findings: keratoconjunctivitis sicca and xerostomia due to destruction of the lacrimal and salivary gland parenchyma. Although it is most often due to Sjögren's syndrome, a variety of other diseases causes sicca syndrome. We report the rare case of a patient with gland infiltration in primary amyloidosis. Sonographic, computed tomographic and magnetic resonance findings are presented.
8378640 [Multiple autoimmune syndrome]. 1993 Mar Report a case of multiple auto-immune syndrome with auto-immune thyroiditis, Sjögren's syndrome, primary biliary cirrhosis. Moreover the patient suffered from neuropsychiatric symptoms and anti-cardiolipid antibodies were significantly elevated.
1445457 Heavy and light chain composition of serum IgA and IgA rheumatoid factor in Henoch-Schönl 1992 Nov OBJECTIVE: To characterize the heavy and light chain composition of serum IgA and IgA rheumatoid factor (RF) in 34 children with Henoch-Schönlein purpura (HSP). METHODS: Serum IgA and IgA subclass concentrations were measured by radial immunodiffusion. IgA-RF and the light chain composition of serum IgA and IgA-RF were determined by enzyme immunoassay. RESULTS: Serum IgA and IgA1 concentrations were higher in HSP patients than controls (P = 0.0001), but there was no difference in IgA2 concentrations between the two groups. IgA-RF was present in 19 of 34 HSP patients; it was composed predominantly of IgA1. The kappa:lambda ratio of serum IgA was virtually identical in patients and controls, but the kappa:lambda ratio of IgA-RF was significantly higher than that of the serum IgA from the 19 IgA-RF seropositive patients (P = 0.0003). CONCLUSION: Serum IgA1 is preferentially increased in children with HSP, but the light chain composition of IgA is not different from that in controls. IgA-RF is common in HSP; it is composed predominantly of IgA1 and it is enriched in kappa light chains.
7582708 Arthropathy, leucopenia and recurrent infection associated with a TcR gamma delta populati 1995 Oct This report documents the presence of clonal gamma delta T-cell receptor (TcR) population in the blood of a patient who presented with an arthropathy of undetermined cause, leucopenia and splenomegaly. There was no evidence for lymphoid malignancy clinically or at post-mortem. The phenotype and genotype of the clonal T-cell population were not associated with the predominant TcR delta rearrangement found in peripheral blood gamma delta cells, but were similar to those found in gamma delta TcR cells infiltrating rheumatoid synovium. The data indicate the presence of a monoclonal population of gamma delta cells TcR cells which in the face of continued immunosuppression behaved benignly. The case may represent a cytomorphologically atypical example of the large granular lymphocytes, neutropenia and arthropathy syndrome/lymphoproliferative disease of granular lymphocytes and, although the patient's clinical features were not 'classical', rheumatoid arthritis (RA) may have been the underlying primary disorder.
8096069 Little evidence for anti-endothelial cell antibodies in microscopic polyarteritis and Wege 1993 We studied sera from patients with vasculitis and controls for the presence of anti-endothelial cell antibodies (AECA) and correlated these with disease type, anti-neutrophil cytoplasmic antibodies (ANCA) and anti-myeloperoxidase (MPO) antibodies. AECA were detected by a cellular ELISA on cultured human umbilical vein endothelium. AECA were found in the sera of one of 43 patients with microscopic polyarteritis (2%), five of 27 patients with Wegener's granulomatosis (19%), three of 23 patients with an idiopathic glomerulonephritis (13%), none of eight patients with rheumatoid arthritis and three of 12 patients with rheumatoid vasculitis (25%). In patients with a vasculitis AECA titres were higher in sera with a positive ANCA as compared with ANCA negative sera although the difference was not significant (P = 0.0702) and there was no correlation between AECA and anti-MPO titres (r = 0.1171 P = 0.114). AECA binding was not enhanced following upregulation of endothelial ICAM-1 and ELAM-1 by TNF alpha. This study shows that AECA occur infrequently in microscopic polyarteritis and Wegener's granulomatosis, and are not a major antibody system in these vasculitides.
1499205 Posterior cruciate condylar total knee arthroplasty. Average 11-year follow-up evaluation. 1992 Aug Forty-two total knee arthroplasties (TKAs) of the posterior cruciate condylar design performed from 1975 until 1978 were reviewed. Follow-up evaluations averaged 11 years. There were 21 knees each of osteoarthrosis and rheumatoid arthritis. The average postoperative knee score was 85.4 points. Thirty-nine knees (92.8%) were rated good or excellent, one (2.4%) was judged fair, and two (4.8%) were considered failures. Postoperative flexion averaged 104 degrees. Analysis of osteoarthritic versus rheumatoid arthritic subgroups demonstrated no significant differences in motion, alignment, or knee score. Roentgenographic review demonstrated no cases of femoral or tibial loosening, but one case of patellar component dislodgement was observed. Nonprogressive radiolucent lines were observed in 75% of the cases. Good results can be expected if satisfactory lower-extremity alignment is attained. Posterior cruciate ligament retention has provided a slightly improved postoperative range of motion. Residual problems appear to be centered about the patellofemoral joint.
7505347 [A case of type II cryoglobulinemia involving glomerulopathy associated with hepatitis C a 1993 Oct We reported a case of type II cryoglobulinemia involving glomerulopathy associated with HCV-induced liver cirrhosis. The patient was a 57-year-old woman. Her past history included chronic hepatitis at 51 years and rheumatoid arthritis at 53 years of age. At 46 years, an erythematous lesion appeared on her legs, which was diagnosed as allergic vasculitis by skin biopsy. At 50 years, proteinuria, hematuria and hypertension were recognized. The next year, the first renal biopsy was performed and showed membranoproliferative glomerulonephritis (MPGN). Recently, the edema of her legs has progressed, and the laboratory data showed proteinuria, hematuria, hypocomplementemia, rheumatoid factor positivity, and increase of monoclonal IgG kappa chain. The second renal biopsy revealed an endocapillary proliferative glomerulonephritis-like lesion with marked infiltration of monocytes and macrophages. The subendothelial deposit showed a fine fibril-like pattern. She was treated with steroids and double filtration plasmapheresis (DFPP) therapy, but the treatment was not very effective. She died of liver cirrhosis, which was probably induced by hepatitis C virus (HCV), and sepsis. Generally, the patients of type II cryoglobulinemia often showed HCV antibody positivity, pointing to HCV as an etiological factor. In this case, renal biopsy was performed twice in the same patient, and the histologic findings suggest the clinicopathological course of cryoglobulinemia.