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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
17984881 Basic principles for the treatment of the rheumatoid hand. 2000 Dec 30 This article discusses the overall approach to rheumatoid arthritis patients requiring surgery of the hand. Many rheumato-orthopedic operations do not require the skills of a specially trained orthopedic surgeon. What is essential is familiarity with the basic operative techniques in surgery of the rheumatoid hand. Reduced resistance to infection due to the effects of pharmaceutical agents and the progress of rheumatoid arthritis itself requires particularly delicate treatment of tissue and preventive use of antibiotics.
10728033 Clinico-immunological profile of juvenile rheumatoid arthritis at Chandigarh. 1999 May OBJECTIVE: To study the clinical and immunological profile of children with juvenile rheumatoid arthritis (JRA). DESIGN: Retrospective hospital based study. SETTING: Tertiary level center of North India. SUBJECTS: 74 patients attending the Pediatric Rheumatology and Immunology Clinic over last 5 years. RESULTS: The patients were aged between 9 months to 12 years with male female ratio of 1.8:1. Eleven (14.9%) patients had systemic onset JRA, 28 (37.8%) had polyarticular onset type and 35(47.3%) had pauciarticular onset type JRA. Uveitis was present only in one patient and rheumatoid nodules were present in 4(5.4%) patients. Rheumatoid factor was positive in 2(2.7%) and antinuclear antibody was present in one patient only. HLA-B27 was positive in 4 children. Two patients developed amyloidosis. CONCLUSION: The clinico-immunological profile of JRA at Chandigarh appears to be some what different from that reported from other centers in India.
9682891 Cerebral vasculitis in an adolescent with juvenile rheumatoid arthritis. 1998 Jul A 16-year-old girl with longstanding polyarticular juvenile rheumatoid arthritis was referred from Chuuk State, Federated States of Micronesia, for evaluation and management of weakness and joint pains. She had a right hemiparesis with central facial weakness, polyarticular arthritis, and a dense cataract of the left eye with phthisis bulbi. Extensive evaluation using magnetic resonance angiography revealed vasculitis of the anterior and middle cerebral arteries. She was treated with "pulse" doses of methylprednisolone intravenously and she improved remarkably. Repeat angiography demonstrated dramatic improvement of the vasculitis. There is a paucity of literature regarding cerebral vasculitis in juvenile rheumatoid arthritis. That literature is reviewed, and our patient is discussed with regard to the few published reports.
9458223 Torticollis as the sole initial presenting sign of systemic onset juvenile rheumatoid arth 1998 Jan We describe a 6-year-old girl with acute torticollis as the initial manifestation of systemic onset juvenile rheumatoid arthritis (JRA). She presented with isolated torticollis for 2 weeks, followed by daily intermittent fever and polyarthritis. We discuss the pathogenesis of cervical spine involvement in JRA and the clues to early diagnosis.
19078474 Coexistence of ochronosis and rheumatoid arthritis: a cause of delay in diagnosis and trea 2000 Aug Two rheumatic diseases can often coexist despite the interesting fact that gout and rheumatoid arthritis (RA) are infrequently associated. We describe a patient with familial history of alkaptonuria and rheumatoid arthritis who developed both diseases. The exact time of onset of the RA was difficult to ascertain. The RA seemed to be rapidly progressive, possibly because of the delayed recognition, overly cautious drug treatment, or additive effects of the two diseases. Physicians should keep in mind the possible coexistence of two joint diseases in patients who are not doing well.
11467948 Glycoengineering of therapeutic glycoproteins: in vitro galactosylation and sialylation of 2001 Jul 31 Therapeutic glycoproteins produced in different host cells by recombinant DNA technology often contain terminal GlcNAc and Gal residues. Such glycoproteins clear rapidly from the serum as a consequence of binding to the mannose receptor and/or the asialoglycoprotein receptor in the liver. To increase the serum half-life of these glycoproteins, we carried out in vitro glycosylation experiments using TNFR-IgG, an immunoadhesin molecule, as a model therapeutic glycoprotein. TNFR-IgG is a disulfide-linked dimer of a polypeptide composed of the extracellular portion of the human type 1 (p55) tumor necrosis factor receptor (TNFR) fused to the hinge and Fc regions of the human IgG(1) heavy chain. This bivalent antibody-like molecule contains four N-glycosylation sites per polypeptide, three in the receptor portion and one in the Fc. The heterogeneous N-linked oligosaccharides of TNFR-IgG contain sialic acid (Sia), Gal, and GlcNAc as terminal sugar residues. To increase the level of terminal sialylation, we regalactosylated and/or resialylated TNFR-IgG using beta-1,4-galactosyltransferase (beta1,4GT) and/or alpha-2,3-sialyltransferase (alpha2,3ST). Treatment of TNFR-IgG with beta1,4GT and UDP-Gal, in the presence of MnCl(2), followed by MALDI-TOF-MS analysis of PNGase F-released N-glycans showed that the number of oligosaccharides with terminal GlcNAc residues was significantly decreased with a concomitant increase in the number of terminal Gal residues. Similar treatment of TNFR-IgG with alpha2,3ST and CMP-sialic acid (CMP-Sia), in the presence of MnCl(2), produced a molecule with an approximately 11% increase in the level of terminal sialylation but still contained oligosaccharides with terminal GlcNAc residues. When TNFR-IgG was treated with a combination of beta1,4GT and alpha2,3ST (either in a single step or in a stepwise fashion), the level of terminal sialylation was increased by approximately 20-23%. These results suggest that in vitro galactosylation and sialylation of therapeutic glycoproteins with terminal GlcNAc and Gal residues can be achieved in a single step, and the results are similar to those for the stepwise reaction. This type of in vitro glycosylation is applicable to other glycoproteins containing terminal GlcNAc and Gal residues and could prove to be useful in increasing the serum half-life of therapeutic glycoproteins.
11411961 Keratonconjunctivitis sicca is not uncommon in children with juvenile rheumatoid arthritis 2001 May Keratoconjunctivitis sicca (KCS), characterised by aqueous tear deficiency, is the most common ocular complication in adult rheumatoid arthritis (RA). In juvenile rheumatoid arthritis (JRA), however, it remains under-reported. For this prospective study, 50 children with JRA were examined clinically and underwent tests for KCS (Schirmer's I and rose bengal tests, fluorescein staining, and tear film breakup time). Six children (12%) with two or more abnormal tests were diagnosed as having definite KCS, while one child with only one abnormal test was labelled with probable KCS. Five of the six (83.3%) with definite KCS were males, and three (50%) had a pauciarticular form of the disease. Two children (33.3%) with definite KCS had no ocular symptoms, five were receiving only nonsteroidal anti-inflammatory drugs, and one was additionally on methotrexate. Keratoconjunctivitis sicca appears to be a common ocular complication and all children with JRA should be screened for it with a comprehensive battery of tests.
15616621 Role of cytokines in rheumatoid arthritis. 1998 Aug Cytokines have emerged as crucial players in mediating synovial inflammation in the rheumatoid joint, where the local and systemic production of cytokines appears to account for most of the pathologic and clinical manifestations of rheumatoid arthritis. Among the cytokines, tumor necrosis factor-alpha and interleukin-1 are considered to be of great importance in the pathogenesis of the disease. Other pro-inflammatory cytokines in rheumatoid arthritis are interleukin-6, interleukin-8, leukemia inhibitory factor, granulocyte-macrophage colony-stimulating factor and transforming growth factor-beta The potent antiinflammatory cytokines interleukin-4 and interleukin-10, which are powerful inhibitors of most of these mediators, seem to be promising agents and candidates for an optimal approach to treatment.
18031130 Recent advances in anti-tumour necrosis factor (TNF) therapy in rheumatoid arthritis: focu 1999 Mar Tumour necrosis factor (TNF) is the dominant mediator of the cytokine cascade that causes inflammation and joint detruction in rheumatoid arthritis. A new class of agents under investigation, the biological TNF inhibitors, inhibit the activity of TNF. Recombinant human TNF receptor p75 Fc fusion protein (TNFR:Fc; etanercept) blocks the activity of the cytokine TNF. The preclinical and pivotal trials evaluating etanercept in rheumatoid arthritis are reviewed in this article.
10865017 Left ventricular diastolic functions in juvenile rheumatoid arthritis. 2000 Jul Cardiac involvement as pericarditis, myocarditis, and endocarditis is common in juvenile rheumatoid arthritis (JRA). Though there are many reports concerning systolic and diastolic functions of adults with rheumatoid arthritis, there are no studies on children with JRA. Thirty patients with JRA without any cardiac symptoms and 30 sex- and age-matched controls were included in the study. M-mode and pulsed-wave Doppler echocardiography were performed on each participant to assess the systolic and diastolic functions of the left ventricle. Left ventricular end-systolic diameter and volume were larger and ejection fraction and fractional shortening were decreased in the JRA group. Among the diastolic parameters, increased late flow velocity, decreased early flow velocity, and prolonged isovolumic relaxation time reflected an abnormal relaxation form of diastolic dysfunction. Mortality rate is increased in adults with rheumatoid arthritis, and ischemic heart disease is the leading cause of cardiovascular mortality. The abnormal relaxation form of diastolic dysfunction found in children with JRA is seen in ischemic heart disease. These children can therefore be candidates for ischemic heart disease in the future even though they are fully asymptomatic at present. In conclusion, children with JRA should be assessed for systolic and diastolic functions with serial echocardiography. In this way it may be possible to reduce the mortality and morbidity of the disease from cardiac causes.
9515428 Sjögren's syndrome: a challenge for dentistry. 1997 May Sjögren's syndrome presents dentists with many challenges, from diagnosis to therapy. The secondary effects of xerostomia cause a spectrum of oral problems, including caries, candidal infection, and inflammation of the oral mucosa. The oral signs and symptoms may be the first manifestations of systemic aspects of the disease. Sjögren's syndrome requires both dental and medical management, and a program of home care.
9292811 Juvenile rheumatoid arthritis in African Americans. 1997 Sep OBJECTIVE: To examine racial differences in disease expression in African American and Caucasian children with pauciarticular and polyarticular juvenile rheumatoid arthritis (JRA). METHODS: A retrospective chart review was conducted of 35 African American and 137 Caucasian children with pauciarticular and polyarticular JRA. RESULTS: African American children were significantly older than Caucasian children at the time of presentation. This was true both for the group as a whole and for each of the disease onset subtypes. African American children were less likely to have positive antinuclear antibody tests than Caucasian children. This finding paralleled a low incidence of uveitis in African American children. African American children were also more likely to have IgM rheumatoid factors (detected by latex agglutination) than Caucasian children. This was true even for African American children with pauciarticular JRA. CONCLUSION: There are significant phenotypic differences between African American and Caucasian children with JRA.
10092159 Treatment adherence in juvenile rheumatoid arthritis--a review. 1999 Adherence to long-term complex treatment in children with Juvenile Rheumatoid Arthritis (JRA) is a major problem. This article reviews psychosocial factors that compromise treatment adherence and discusses ways to improve long-term adherence. Child-centred information, therapy management, behaviour modification, and parental monitoring are described as adherence facilitating strategies for clinical and non-clinical settings. Finally, the implications for further practice and research are discussed.
10382216 Juvenile rheumatoid arthritis and lymphoedema: lymphangiographic aspects. 1999 May We report a 5 1/2-year-old boy with juvenile rheumatoid arthritis (JRA) and lower-limb lymphoedema. US, MRI and lymphangiography were performed. Based on the lymphangiographic study, we propose a pathogenesis based on obstruction of normal superficial lymphatic vessels in the affected limb. This is discussed with other pathogenetic factors proposed in the 16 previously reported cases of lymphoedema complicating JRA.
18020613 Cyclosporin in rheumatoid arthritis: monitoring for adverse effects and clinically signifi 1998 Dec While cyclosporin has an established role in the treatment of rheumatoid arthritis there is concern about adverse effects, mainly related to renal function. With new interest being generated in cyclosporin combination therapy, and the availability of a new form of cyclosporin (cyclosporin microemulsion), focus on adverse effects and drug interactions of this compound remains important. Over the years, rheumatologists have been aware of these adverse effects and consensus meetings have resulted in guidelines for the use of cyclosporin. If these guidelines are followed, structural renal damage can be minimal. Cyclosporin should be started at a low dose and titrated against the highest acceptable increase in serum creatinine, that is, a 30% increase over the pretreatment value. At present, there is no evidence that cyclosporin in combination with other antirheumatics leads to increased toxicity. With regard to long term unwanted effects, neither the pattern nor the risk of malignancies associated with the use of cyclosporin seems to differ from other antirheumatics. The place of cyclosporin in the treatment of rheumatoid arthritis seems to be established. The most promising results will come from early rheumatoid arthritis combination studies involving cyclosporin with other antirheumatics, especially methotrexate.
17039141 Vasculitis following treatment of rheumatoid arthritis with extracorporeal staphylococcal 2001 Aug We report a case of vasculitis after Prosorba treatment in a patient with rheumatoid arthritis. The patient is a 66-year-old white male with long standing rheumatoid arthritis and hepatitis B. He was treated with the standard regimen for Prosorba treatment. He improved and met criteria for an American College of Rheumatology (ACR) 20% response. While on therapy he developed a nonhealing ulcer. Approximately 2 weeks after treatment was completed, he developed palpable purpura and mononeuritis multiplex. Deep dermal biopsy confirmed the presence of both small and medium vessel vasculitis. Nerve conductions studies were consistent with neuropathic conduction delays. He was treated with 1mg/kg/day of oral prednisone. Prosorba has been reported to cause leukocytoclastic vasculitis during treatment, but has not been noted to involve medium sized vessels. This patient's history and presentation are most consistent with rheumatoid arthritis associated vasculitis, though the Prosorba treatment cannot be ruled out as a cause or a contributing factor. Importantly, although Prosorba treated his synovitis, it did not prevent concomitant vasculitis.
9085447 Mycoplasmas and arthritides. 1997 Feb Rheumatoid arthritis and other autoimmune diseases might be triggered by infectious agents. We have reviewed the evidence suggesting that mycoplasmas may play a role in the genesis of arthritis. Mycoplasmas are a common cause of spontaneous arthritis in many animal species. Numerous experimental models of mycoplasma-induced arthritis have been developed, some with mycoplasmas known to cause disease in humans. Mycoplasmas entertain complex relationships with the immune system of their hosts and frequently induce autoimmune events such as rheumatoid factor production. However, the potential role of mycoplasmas in human joint disease remains unknown. Mycoplasmas can be responsible for septic arthritis in patients with immune deficiencies, especially hypogammaglobulinemia. Whether mycoplasmas can incite or perpetuate inflammatory joint diseases such as rheumatoid arthritis remains controversial. Advances in molecular biology techniques for detecting infectious agents can be expected to settle this issue in the near future.
9637186 Prehistoric juvenile rheumatoid arthritis in a precontact Louisiana native population reco 1998 Jun Descriptions of skeletal pathological conditions evident in the prehistoric Tchefuncte adolescent 16ST1-14883b are clarified. The basis is reaffirmed for assigning to the described pathological conditions a diagnostic perspective of juvenile rheumatoid arthritis or juvenile Lyme disease--a disease that mimics juvenile rheumatoid arthritis in its arthritic presentation--rather than of assigning them as representative of juvenile onset ankylosing spondylitis or other juvenile spondyloarthropathies. A hypothesis (Lewis [1994] Am. J. Phys. Anthropol. 93:455-475) is restated that 1) the spirochete Borrelia burgdorferi was the infectious agent responsible for prevalence of adult rheumatoid arthritis in prehistoric southeastern Native American populations, 2) that B. burgdorferi is a possible cause of the arthritis evident in individual 16ST1-14883b, and 3) that antibodies to B. burgdorferi provided partial immunity to the related spirochete Treponema pallidum for the 16ST1 precontact Tchefuncte population from Louisiana, protecting them from severe treponemal response. Given the probable widespread existence of Ixodid tick vectors for B. burgdorferi in prehistoric North America, coupled with the existence of treponematosis, it follows that the transition of Native American hunting-gathering economies to more sedentary economies would predictably be linked to an increased incidence of treponematosis due to the loss of benefits of the above-stated partial immunity. In other words, as prehistoric Native American exposure to tick vectors for B. burgdorferi decreased, susceptibility to treponematosis increased. Inferences regarding biological controls interacting with and influencing prehistoric Native American migration patterns are suggested from the link of B. burgdorferi to an Ixodid tick common to northeast Asia.
9558909 [Chronic lymphatic leukemia and large granular lymphocytes]. 1998 Feb Chronic large granular lymphocyte leukemia is a rather rare disorder (less than 5% of LLC). Its subtype CD3+/CD8+ is often a clonal disease and without malignant characteristics. This kind of disease shows a clinical and laboratory heterogeneity, probably due to the immunological and functional variety of granular lymphocytes. In some cases of LGL leukemia an associated pathology, especially rheumatoid arthritis and chronic infections, has been reported. On the contrary, the relationship with neoplasms has been rarely proved in literature: only occasional studies have been reported and anyway they are not supported by a sufficient number of cases. Two cases of LGL leukemia are here delineated: a woman with advanced breast adenocarcinoma and another one with Sjögren disease. The first one had a rapidly fatal course, while the other one had a prolonged clinical course with chronic neutropenia (13 years follow-up). The association between carcinoma and LGL leukemia may be just a casual finding but the hypothesis of a possible relationship is however very interesting on account of the important role of granular lymphocytes in controlling tumoral growth. Moreover, both patients had concomitant chronic HCV-correlated infection: maybe it will worth making a prevalence study with a greater number of cases, in order to evaluate a probable relationship between these pathologies. The growth factor G-CSF may be useful in the treatment of infections that often occur in patients with severe neutropenia.
11303308 The nosology-taxonomy of recent-onset arthritis: the experience of early-arthritis clinics 2001 Apr OBJECTIVE: To compare the conclusions of studies addressing the outcome of early-arthritis cohorts. METHODS: The methodologies of previous reports on early-arthritis cohorts were examined, and their results and conclusions were compared. RESULTS: Thirty-four reports on 23 cohorts of early arthritis were found. The methodology was poor in most studies, with numerous inclusion and exclusion biases, frequently short follow-up periods, and a lack of precision about the rationale for diagnosis. However, similar conclusions were reached on several points: a large number of cases of early arthritis remained undifferentiated and/or resolved spontaneously, about 80% of cases initially classified as undifferentiated or rheumatoid arthritis retained this diagnosis during follow-up, and the incidence of psoriatic arthritis in most studies was similar (2% to 4%). Conversely, there were striking discrepancies among studies concerning the frequency of crystal arthropathies (0% to 18%), spondyloarthropathy (1% to 33%) and rheumatoid arthritis (15% to 47%). CONCLUSIONS: There appears to be a lack of agreement among researchers about the nosology and/or taxonomy of many cases of mild arthritis, despite the existence of classification criteria. RELEVANCE: Recognition of cultural bias in the diagnosis of early arthritis could be a prerequisite for the optimization of new sets of criteria for the diagnosis of early rheumatoid arthritis and spondyloarthropathy.