Browse

Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
1563119 Recombinant human erythropoietin in a patient with multiple myeloma and end-stage renal di 1992 Mar Recombinant human erythropoietin (rHuEpo) is an established, effective treatment for the anemia of chronic renal failure. Recent reports also suggest it may be efficacious in the anemias of drug toxicity, rheumatoid arthritis, and multiple myeloma without renal failure. We describe the positive response to rHuEpo in an end-stage renal disease patient with active multiple myeloma and ongoing chemotherapy. Before rHuEpo therapy, the patient was transfusion dependent, but after rHuEpo was initiated, transfusions were not required. Multiple myeloma with renal failure does not preclude a response to rHuEpo. Further trials of rHuEpo in the treatment of multiple myeloma with and without renal failure are warranted.
1640063 [Sterile corneal ulcers in dry eye. II. Treatment, complications and course]. 1992 Over a period of 6 years, 23 patients (4 males and 19 females: mean age 56 years) who presented dry eyes developed 33 sterile corneal ulcers. Treatment included occlusion of the eyes or bandage soft contact lenses, prophylactic topical administration of antibiotics, punctal occlusions and currently available tear substitutes. Seventeen eyes healed completely without any corneal opacity and 10 eyes healed with opacity. Nine of the 33 eyes developed microbial keratitis. The causes of microbial keratitis were Staphylococcus aureus in 7 cases, beta-hemolytic Streptococcus in one and Pseudomonas aeruginosa in one case. The microbial keratitis was treated with intensive topical antibiotics. In 6 eyes, corneal perforation occurred. Rheumatoid arthritis coexisted in four cases.
1640062 [Sterile corneal ulcers in dry eye. Incidence and factors of occurrence]. 1992 Sterile corneal ulceration is a serious complication in patients with keratoconjunctivitis sicca. The records of 134 patients, 19 males and 115 females, who presented with dry eyes in the Ophthalmologic Clinic were reviewed. Over a period of 6 years, 33 eyes of 23 (17%) patients developed a sterile corneal ulcer. The etiologies of dry eyes in these patients were: Primary Sjogren's syndrome: 10 cases, rheumatoid arthritis: 5 cases, ocular pemphigoid 6 cases, atopy: 1 case, local irradiation: 1 case. Patient's age and sex were not significantly associated with ulcer development (p greater than 0.05). The presence of a major underlying disease was the major contributing factor. Appropriate local treatment and patient compliance were also contributing factors. Blepharitis was found in 90% of patients.
1536529 Plasma and serum von Willebrand factor antigen concentrations in connective tissue disorde 1992 Jan Concentrations of serum and plasma von Willebrand factor antigen were measured in over 200 patients with a variety of connective tissue diseases, and in control samples from over 200 asymptomatic individuals. This comprehensive study found the highest concentrations of von Willebrand factor antigen in patients with vasculitis, Sjögren's syndrome, Felty's syndrome, giant cell arteritis and polyarteritis nodosum. Raised values were also found in rheumatoid arthritis, systemic lupus erythematosus, polymyalgia rheumatica, systemic sclerosis, Raynaud's syndrome, Takayasu's arteritis and Wegener's granulomatosis, but not in oesteoarthritis. It is possible that the difference in von Willebrand factor antigen concentrations in two sub-groups of systemic necrotising arteritis (Wegener's granulomatosis and polyarteritis nodosum) may imply different disease processes. The large numbers involved have allowed us to confirm or question smaller studies of the role of this molecule in connective tissue disease.
8885871 A dominant role for mast cell Fc receptors in the Arthus reaction. 1996 Oct Antibody-antigen complexes are central to the inflammatory response and are implicated in the development of such diverse diseases as systemic lupus erythematosis, rheumatoid arthritis, immune glomerulonephritis, and vasculitis. We recently demonstrated that experimental immune complex-mediated injury in mice, as modeled by the cutaneous Arthus reaction, requires receptors for the Fc portion of the antibody and is unaffected by deficiencies in complement components. However, the responsible cell type(s) and Fc receptor(s) were not known. We now demonstrate by differential reconstitution in vivo that Fc gamma RIII on mast cells is necessary for this inflammatory response. We propose a general model of antibody-mediated diseases as an immunopathologic spectrum whose specific manifestations are determined by the Fc receptor and cell type engaged.
8966773 [Anti-inflammatory and anti-allergic oral vaccines?]. 1996 Sep 16 Recent data suggest clinical efficacy of specific antigens delivered at mucosal sites in the treatment of certain organ specific autoimmune diseases. This approach appears non-toxic and has no side effects. Phase I/II human trials on multiple sclerosis and rheumatoid arthritis show positive outcomes. Furthermore, animal studies point to beneficial effects on uveitis, diabetes mellitus, transplantation reactions and allergic diseases. The immunological mechanism is oral tolerance, a well known principle for induction of a systemic hyporesponse to specific antigens. The tolerance is most pronounced on delayed type hypersensibility and IgE-mediated reactions. At least three different mechanisms mediate the tolerance. Low doses of antigen induce active suppression, intermediate doses induce clonal T-cell anergy, and high doses induce clonal T-cell deletion. The recent improvements in the understanding of the mechanisms of oral tolerance have fueled an interest in manipulating this principle to develop anti-inflammatory vaccines.
8784895 Obstructive sialadenitis caused by intraparotid deposits of gold salts: a case report. 1996 Jun A case of obstructive sialadenitis caused by deposits of gold salt compound in the intraparotid lymphoid tissues in a woman with classic rheumatoid arthritis is presented. The patient had been treated with a parenteral gold salt compound (sodium aurothiomalate) for 10 years with chrysotherapy balance of 7525 mg. She presented with swelling of both parotid glands on eating, and computed tomography images showed accumulation of high density spots. Obstructive sialadenitis most probably was caused by local compression on the excretory ducts of the parotids. This clinical disorder should be classified as a case of mechanical, nontumoral, obstructive sialadenitis caused by gold salt compound.
8796977 Corticosteroids in the treatment of rheumatologic diseases. 1996 May Studies and reviews published over the past year have emphasized the benefits, risks, and risk-benefit ratios of corticosteroid use in the chronic rheumatic diseases. British researchers have repeated and confirmed studies done over 30 years ago that revealed a reduction in the new erosion rate in corticosteroid-treated rheumatoid arthritis patients with early-onset disease. Is 7.5 mg/d of prednisolone as safe as it is effective? The accuracy of new techniques for measuring bone density now allows us to assess the small differences that may result from "low" doses of corticosteroids as well as to address the confounding issues resulting from disease activity and severity variables. Recent studies confirm the deleterious effect on bone mineral density resulting from doses as low as 5 mg/d. Because we now have a better idea of the benefits as well as the risks, it has been strongly suggested that risk-benefit ratios be estimated and potentially enhanced by prophylactic strategies for bone preservation. Proof for the benefit of these strategies as well as for their ability to reduce fracture rates awaits another review cycle.
17372408 Paterson-Brown Kelly syndrome. 1996 Mar Over a five-year period (September 1987 to August 1992), eight patients, one male and seven females, with a characteristics history of dysphagia due to cervical esophageal webs (Paterson-Brown Kelly syndrome) were encountered. The patients, all Arabs, comprised six Saudi females, one Yemeni female and an Eygptian male. All the patients, except two, were in middle age. The webs, single in five patients and multiple in three, and present at the levels of the 5th, 6th and 7th cervical vertebrae, were located in the anterior wall of the esophagus in four patients, circumferential-producing stenosis in three patients, while one patient with multiple webs had both types of location. Associated iron-deficiency anemia was present in all patients, three of them with evident koilonychia. One patient had associated nodular goiter and rheumatoid arthritis while another had a fatal complicating postcricoid carcinoma. The only male patient had associated ulcerative protocolitis. All seven patients without malignant complication of their webs had marked or total resolution of their dysphagia with iron therapy, pharyngoscopy/esophagoscopy, and dilatation. The Paterson-Brown Kelly syndrome of postcricoid dysphagia is discussed briefly.
8603285 Atopic dermatitis and allergic diseases with thrombocytosis: a possible link. 1995 Dec BACKGROUND: Thrombocytosis can be present in patients with myeloproliferative disorders or can accompany various conditions, in particular chronic inflammatory diseases, namely chronic bowel diseases, rheumatoid arthritis, and nephritis. OBJECTIVE: We report our experience in 55 patients younger than 45 years of age with increased platelet counts (over 500 X 10(9)/L). Thirty-three were affected by essential thrombocytemia in agreement with polycytemia vera study group criteria and 22 by reactive thrombocytosis. Serotonin concentration has been determine in all the patients. RESULTS: Serotonin was decreased as expected in 23 out of the 33 patients with essential thrombocytemia. In the remaining ten subjects, serotonin was within normal limits as in reactive thrombocytosis. Eight of these subjects had positive histories for allergic rhinitis and two for atopic dermatitis. CONCLUSIONS: Chronic inflammation, present in patients with diseases of the immune system may cause an increased platelet number. One should consider with caution patients with thrombocytosis and positive histories for diseases of the immune system; probably a diagnosis of essential thrombocytemia is not justified.
8555015 Chrysiasis revisited: a clinical and pathological study. 1995 Nov Chrysiasis is a distinctive and permanent pigmentation of light-exposed skin resulting from the administration of parenteral gold salts. We report a study of 40 Caucasian patients with rheumatoid arthritis, treated with intramuscular sodium aurothiomalate, of whom 31 had chrysiasis. Visible changes develop above a threshold, equivalent to 20 mg/kg gold content, and their severity depends upon cumulative dose. Focal aggregates of particulate gold are deposited in the reticular and papillary dermis in amounts that correlate with the degree of pigmentation. Characteristically, initially the periorbital region is affected by a mauve discoloration, which intensifies and deepens into a blue/slate-grey colour, while extending to involve the face, neck and upper limbs. Although chrysiasis develops insidiously and patients may be unaware of the changes, positive identification is important in order to avoid misdiagnosis and medical mismanagement, and afford appropriate reassurance. Prevention is difficult, but measures to reduce sunlight exposure may be helpful.
7634205 Giant synovial cyst of the hip: an unusual presentation with compression of the femoral ve 1995 Aug A case of synovial cyst of the hip with symptomatic compression of the femoral vessels is described. A 75-year-old woman with severe unilateral osteoarthritis of the right hip was referred because of an intermittent, unpleasant sensation of coolness in the right foot and hip pain. A large mass was palpable in the femoral triangle. Computed tomography and arthrography revealed a large cyst communicating with the hip joint and compressing the femoral vessels ventrally. Total hip arthroplasty was carried out, and the stalk communicating with the cyst was ligated and divided. The unpleasant sensation of coolness in the right foot disappeared postoperatively. The authors concluded that iliopsoas bursitis should be considered in the evaluation of a patient with nonspecific pelvic or groin pain. As demonstrated in this rare case, the main symptom may be misleading and the typical syndrome of a tender groin mass with an underlying history of rheumatoid arthritis may be absent. Treatment should be directed to the underlying joint disease.
7673903 Use of patellar allograft to reconstruct a patellar tendon-deficient knee after total join 1995 Jun A catastrophic complication after total knee arthroplasty (TKA) is rupture of the patellar tendon. Several techniques for treatment have been described, including cast immobilization with or without operative repair, the use of a semitendinosus, fascia lata, or hamstring tendon autogenous graft, the use of a Dacron 4-mm vascular graft (U.S. Catheter and Instrument, Glen Falls, NY), the use of bovine xenograft and even transplantation of an entire allograft extensor mechanism. Treatment results of patellar tendon rupture after TKA can be discouraging. Altered tissue quality secondary to connective tissue diseases, diabetes, rheumatoid arthritis, lupus erythematosus, secondary hyperparathyroidism, or concurrent steroid medications contributes to poor results. Additionally, no one treatment has provided consistent clinical success. Successful treatment of a patient with a ruptured patellar tendon after TKA using the bone-patellar tendon-bone allograft commonly used for anterior cruciate ligament reconstruction is reported.
18475625 Nitric oxide mediates interleukin-1 induced inhibition of glycosaminoglycan synthesis in r 1995 Interleek-1beta (IL-1) is a key mediator of cartilage matrix degradation in osteoarthritis and rheumatoid arthritis. It was found that the IL-1-induced suppression of glycosaminoglycan (GAG) synthesis in rat articular cartilage occurred simultaneously with the accumulation of nitrite (a metabolite of nitric oxide (NO) in aqueous milieu) in the culture medium. NO-synthase inhibitors, L-NMMA and L-NIO, inhibited both these IL-1 effects. Dexamethasone suppressed GAG synthesis additively to IL-1, but did not alter nitrite accumulation. Three NO-donors (GEA 3175, SNAP and SIN-1) also had an inhibitory effect on cartilage GAG synthesis. Therefore, it is concluded that IL-1 induced suppression of GAG synthesis in rat articular cartilage is mediated by the production of NO.
8178604 [Implantation of 110 total hip joint endoprosthesis using the Zweymüller method]. 1994 The authors discuss in the submitted paper the advantages and disadvantages of cemented and non-cemented endoprostheses, type Zweymüller. They evaluate the medium-term results (one half to 5 years) after surgery in 92 patients from a total of 121 operations in 110 patients (11 bilateral). As to indications, the first place was held by so-called dysplastic coxarthroses, followed by post-traumatic coxarthroses and rheumatoid arthritis incl. the juvenile type. The results of these operations were after an average of 18.27 months following operation according to the DMS evaluation of Merle d'Aubigné and Postel excellent and good in 89%. The authors recorded a relatively small percentage of complications, associated in particular with the replacement of the acetabulum in three patients and the replacement of the femoral component in two patients.
8404760 Neurogenic inflammation and sensitivity to environmental chemicals. 1993 Aug Neurogenic inflammation as a pathway distinct from antigen-driven, immune-mediated inflammation may play a pivotal role in understanding a broad class of environmental health problems resulting from chemical exposures. Recent progress in understanding the mediators, triggers, and regulation of neurogenic inflammation is reviewed. Evidence for and speculations about a role for neurogenic inflammation in established disorders such as asthma, rhinitis, contact dermatitis, migraine headache, and rheumatoid arthritis are presented. The sick building syndrome and multiple chemical sensitivity syndrome have been defined as clinical entities in which exposure to chemical inhalants gives rise to disease. Current data on the existence of chemical irritant receptors in the airway and skin are discussed; neurogenic inflammation arising from stimulation of chemical irritant receptors is a possible model to explain many of the aspects of chemical sensitivities.
1539391 [Osteoporotic fractures of the spine in elderly women. Risk factors, inducing factors and 1992 Feb 24 Forty-seven women with osteoporotic fractures of the spine were examined consecutively. The age range was 64-91 years with a median of 77 years. Risk factors for osteoporosis such as induced menopause or gastric resection were not present. Four patients had had rheumatoid arthritis. 19% had been treated with glucocorticoid. Only one patient had received long-term oestrogen treatment. The patients had been physically very active at a younger age and 91% had been occupationally employed. The symptoms frequently commenced with a fall or strain by lifting at home. The average period of hospitalization was 22 days. Thirty-four patients were followed-up after 6-12 months. All of them experienced pain and 74% still took analgesics. Fifteen out of the 19 patients who had been fitted with a supportive corset still employed this.
1457317 Are non-steroidal anti-inflammatory drugs always necessary? A general practice survey. 1992 Summer The number of patients receiving long-term 'repeat prescriptions' for non-steroidal anti-inflammatory drugs (NSAIDs) was examined in a General Practice; a group of them with osteoarthritis or musculoskeletal pain attempted to withdraw their NSAID treatment and substitute alternative analgesics. Thirty-eight randomly selected patients, with conditions other than rheumatoid arthritis, were interviewed and alternative analgesics prescribed to replace their NSAID therapy. After one month, 22 had very satisfactory pain relief without their NSAID but 16 had resumed therapy, with four of them on a reduced dosage; three others wished to try an alternative analgesic again. Five initially with gastro-intestinal symptoms were asymptomatic within a month of discontinuing their NSAID. After four months, 24 of the 38 had discontinued NSAIDs, including one who had an upper gastrointestinal haemorrhage during the study; two others were taking a reduced dosage.
22959608 Late complications with the Pritchard Mark II elbow prosthesis. 1994 Jan Twenty-three consecutive patients with rheumatoid arthritis who had 26 Pritchord Mark II elbow prostheses were followed prospectively with a mean follow-up of 75 months (range 52 to 101 months). Two patients with three elbow prostheses have died, leaving 21 patients with 23 elbow prostheses for review. At the latest follow-up all the nonrevised elbows had achieved good or excellent results concerning pain relief and elbow motion. According to the data analyzed by a survivorship function-a Kaplan-Meier curve-the early results were promising with 92% of the prostheses surviving the first 5 years; however, only 43% of the prostheses have survived 8 years. Seven prostheses have been revised; the reasons for revision include one infection, one humeral fracture, one loosening of the humeral component, and four disconnections of the hinge. The number with disconnection of the hinge is increasing. Of 16 prostheses still not revised, the x-ray film reveals migration of the pin axle in six. Radiographic signs of component loosening or migration of the axle are not reflected in pain, function, or total score of the elbow.
7620866 Giant synovial cyst of the shoulder presenting as a chest wall mass. 1995 May Synovial cysts are most frequently found about the knee. Less commonly they have been described at the shoulder, elbow, ankle, and hip joints. Synovial cysts of the shoulder are associated with rheumatoid arthritis, osteoarthritis, chronic steroid use, Charcot joint disease, and long-standing rotator cuff tears. Although often asymptomatic, patients may present complaining of pain, loss of joint motion, or presence of an unexplained mass. The authors present the case of an elderly man with a very large synovial cyst presenting as an anterior chest wall mass.