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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
10638236 [Rheumatologic manifestations of chronic graft vs host disease. 4 case reports]. 1999 Nov A description is given of four patients with the diagnosis of chronic graft-versus-host disease (cGVHD) who developed articular manifestations during the clinical course. One of the patients developed advanced lesions of scleroderma. The rheumatologic changes of the disease as well as other affections of organs, complications and prophylaxis are reviewed.
9894388 Catastrophic hypoadrenalism in a case of Sjögren's syndrome. 1998 Sep We describe a patient with Sjögren's syndrome who died from undiagnosed adrenocortical failure. A positive test for adrenocortical antibody, performed pre-terminally, suggested the underlying diagnosis, which was subsequently confirmed at post-mortem. This case highlights the rare association of Sjögren's syndrome with occult adrenocortical failure. Perhaps a greater awareness of this association and more frequent serological screening are necessary to prevent a fatal outcome.
11410076 DHEA. Monograph. 2001 Jun Dehydroepiandrosterone (DHEA) is a steroid hormone secreted primarily by the adrenal glands and to a lesser extent by the brain, skin, testes, and ovaries. It is the most abundant circulating steroid in humans and can be converted into other hormones, including estrogen and testosterone. It has been characterized as a pleiotropic "buffer hormone," with receptor sites in the liver, kidney, and testes, and has a key role in a wide range of physiological responses. Circulating levels of DHEA decline with age and a relationship has been suggested between lower DHEA levels and heart disease, cancer, diabetes, obesity, chronic fatigue syndrome, AIDS, and Alzheimer's disease. Other research suggests that autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis, and multiple sclerosis might be associated with declining DHEA levels.
11232403 Arthrodesis procedures for salvage of the hallux metatarsophalangeal joint. 2000 Sep First metatarsophalangeal (MTP) fusion has been recommended as a means to salvage various great toe deformities. These deformities include failed hallux valgus procedures, failed silicon implants, previous infection, rheumatoid arthritis, post-traumatic conditions, hallux rigidus, severe hallux valgus deformities, and neuromuscular disorders. A variety of complications, such as hallux varus, first MTP joint instability, infection, recurrent hallux valgus, and avascular necrosis of the first metatarsal head can develop from hallux valgus deformity treatment procedures.
9031381 Obstetric complications and rheumatic disease. 1997 Feb This article summarizes common fetal and maternal complications of pregnancy and emphasizes special problems in women who have systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, dermatomyositis, polymyositis, and Sjögren's syndrome. Joint management of pregnancies in these women requires an understanding of the obstetric management of the complications. Pathophysiology and treatment options for preterm-labor, preterm premature rupture of membranes, abnormal fetal growth, and hypertensive disorders of pregnancy are reviewed.
21340925 Bovine retinal microvascular pericytes : isolation, propagation, and identification. 2001 The growth of new capillaries from existing vessels (angiogenesis) is of fundamental importance in wound healing and in pathological situations such as proliferative diabetic retinopathy (1), rheumatoid arthritis (2), and tumor growth. Consequently, considerable interest in vascular cell biology has arisen in apparently disparate clinical and experimental fields. Held in common, however, is the hope that an understanding of the cellular and molecular mechanisms that regulate angiogenesis will lead to novel therapeutic agents and targets.
11774443 [Investigation of the clinical value of total salival flow rates]. 1998 Nov OBJECTIVE: To investigate clinical value of total saliva flow rates. METHODS: The symptom of dry mouth was correlated with unstimulated (UWSFR) and stimulated (SWSFR) whole saliva flow rates on chewing medical paraffin in 62 patients with dry mouth complaints (30 with Sjögren's syndrome, 32 with sialosis) and 23 controls. The symptom of dry mouth was classified into 0,1,2,3,4 according to a treatment emergent symptom scale (TESS). UWSFR and SWSFR were determined after fasting in the morning. RESULTS: UWSFR was (0.070 +/- 0.089) ml/min in Sjögren's syndrome, (0.175 +/- 0.115) ml/min in sialosis, (0.330 +/- 0.188) ml/min in controls. SWSFR was (0.709 +/- 0.720) ml/min in Sjögren's syndrome, (1.561 +/- 0.867) ml/min in sialosis, (1.894 +/- 0.661) ml/min in controls. A highly significant correlation was found between TESS score and UWSFR and between TESS score and SWSFR. Only UWSFR was decreased in the patients with a TESS score of 1 or 2, while both UWSFR and SWSFR were significantly decreased in patients with TESS scores of 3,4. CONCLUSION: It is concluded that UWSFR is more sensitive in relation to dry mouth complaints than SWSFR, and that a mild dry mouth is mainly related to decreased UWSFR.
11524032 CNS involvement in primary Sjögren's syndrome: prevalence, clinical aspects, diagnostic a 2001 Among the systemic manifestations of primary Sjögren's syndrome, neurological involvement is still an intriguing and debated issue. Although peripheral nervous system abnormalities are a well documented occurrence with a reported prevalence ranging from 10 to 20%, opinions differ as to the prevalence of CNS disease, with suggestions from 'nonexistent' to 'very common'. The lack of agreement probably reflects the different populations selected, different inclusion criteria and lack of rigorous epidemiological studies. In our experience, CNS involvement was detected in 7 of 87 (8%) unselected consecutive patients observed over a period of 5 years. The spectrum of CNS involvement is wide, including focal, diffuse, neuropsychiatric and spinal cord symptoms, frequently characterised by insidious onset, remitting course and, sometimes, progressive evolution. The diagnostic approach enabling early recognition of this complication relies on careful clinical assessment using history and physical examination combined with neuropsychological testing and instrumental, laboratory and imaging investigations such as magnetic resonance imaging, single photon emission computed tomography, electrophysiological testing and CSF analysis. The clinical picture often shows spontaneous remission, but when overt neurological symptoms occur or become progressive, therapeutic interventions with high dose corticosteroids and cytotoxic agents, such as intravenous cyclophosphamide pulse therapy, may be indicated.
15775559 [Application of biochemical markers of bone metabolism in the assessment of secondary oste 2001 May Assessment of abnormality of bone mineral metabolism in osteoporosis is made easier by means of newly developed bone metabolic markers. In primary osteoporosis, patients who show high turnover of bone metabolism have high risk of fracture. In RA patients, as bone metabolism is usually high turnover and incidence of insufficiency stress fracture is very frequent, assessment of bone metabolism is more important. Because of poor activity of daily living of RA patients, development of convenient method to collect specimen for examination of bone metabolism and to measure local bone metabolism are important.
10965578 [Bladder amyloidosis: report of 2 cases]. 2000 May Two cases of amyloidosis of the bladder are reported: 1) a 45 year old man with haematuria. Cystoscopic examination reveals several tumours in the wall of the bladder. Transuretral resection was performed and histopathological examination revealed primary amyloidosis. Systemic amyloidosis was excluded. He was treated with oral colchicine with success. 2) a 71 year old male with diagnosis of rheumatoid arthritis and systemic amyloidosis visited our hospital with massive haematuria. Transuretral resection was unsuccessful and was necessary surgical ligation of hypogastric arteries.
10460297 [Nail changes in rheumatic disease]. 1999 Aug Clinically the nail organ ist easy to investigate. When estimating dermato-rheumatological diseases, knowledge of important associated nail symptoms is extremely helpful. In some diseases like osteoarthropathia psoriatica and special variants, Reiter's syndrome and connective tissue disease, typical or even characteristic symptoms can be found. In other disorders like rheumatoid arthritis, goal and systemic vasculitis, associated nail disorders are not uncommon, but of less diagnostic specificity. We review data from the literature and from our dermato-rheumatological outpatient clinic.
10078022 [Gene therapy in autoimmune rheumatic diseases]. 1999 Feb Several investigators have reported the possibility of gene therapy for experimental autoimmune diseases such as type-1 insulin-dependent diabetes (IDDM), experimental allergic encephalomyelitis (EAE), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). Although there are no reports about gene therapies for human autoimmune rheumatic diseases including RA and SLE, we reviewed these experimental therapies for model animals and discussed the possibility of gene therapy for human autoimmune rheumatic disorders as a new therapeutic strategy.
9543700 Effects of 2-chlorodeoxyadenosine and gold sodium thiomalate on human bcl-2 gene expressio 1998 Feb Aberrant expression of apoptosis-related genes, including the "cell death suppressor gene" bcl-2, may play an important pathogenetic role in cancer and autoimmune diseases, In vivo upregulation of bcl-2 mRNA in synovial lining cells of patients with rheumatoid arthritis but not in patients with osteoarthritis has been recently found. In the present study we investigated whether agents exerting beneficial effects in patients with rheumatoid arthritis, namely the long used Gold Sodium Thiomalate (GST) and the novel immunosuppressive, purine analogue 2-chlorodeoxyadenosine (2-CdA), a lymphocyte apoptosis-inducing agent interfere directly with induction of bcl-2 mRNA expression. The phytohemagglutinin (PHA)-induced in vitro proliferation of normal human peripheral blood lymphocytes was significantly inhibited by non-toxic concentrations of 2-CdA and GST which are within the range of in vivo plasma concentrations in patients receiving the respective treatment. Using mRNA dot-blot analysis and hybridization with an IL-2-specific probe we found that GST, similarly to dexamethasone that served as control, suppressed the PHA-induced IL-2 mRNA accumulation dose-dependently. In contrast, 2-CdA (0.1 microgram/ml) at concentrations that inhibit by 80-90% the PHA-induced proliferative responses of lymphocytes did not affect IL-2 mRNA accumulation. Hybridization with a bcl-2-specific probe showed that the activation-induced accumulation and kinetics of bcl-2 mRNA were not changed in the presence of a wide range of concentrations of either GST or 2-CdA. Similarly, the mRNA accumulation of the "house-keeping" control gene beta-action remained unchanged by both agents. These findings indicate that biosynthesis of bcl-2 is not specifically affected by GST and CdA, suggesting that the immunomodulating effects of these agents, including their efficacy in suppressing chronic arthritis, are not related with a bcl-2-dependent mechanism.
11407690 Elevated serum B lymphocyte stimulator levels in patients with systemic immune-based rheum 2001 Jun OBJECTIVE: To determine whether serum levels of B lymphocyte stimulator (BLyS) are elevated in patients with systemic immune-based rheumatic diseases and correlate with serum Ig levels and/or autoantibody titers. METHODS: Sera from 185 patients with various systemic immune-based rheumatic diseases (95 with systemic lupus erythematosus [SLE], 67 with rheumatoid arthritis [RA], 23 with other diagnoses) were assayed for BLyS and Ig. In 7 patients who required arthrocentesis of a swollen knee, coincident serum and synovial fluid samples were assayed for BLyS. Medical charts were retrospectively reviewed for elevated autoantibody titers and proteinuria within a 1-month period before or after collection of sera for BLyS and Ig determination. Sera concurrently collected from 48 normal healthy subjects served as controls. RESULTS: Serum BLyS levels were elevated in 38 of 185 patients (21%) and correlated significantly with serum IgG levels. Serum BLyS levels did not correlate with the patients' age, sex, race, or medications, but correlated positively with anti-double-stranded DNA antibody titers among SLE patients and with rheumatoid factor titers among seropositive RA patients. In contrast, serum BLyS levels correlated inversely with nephrotic-range proteinuria among SLE patients. In every case tested, BLyS levels in clinically inflamed synovial fluids were greater than those in simultaneously obtained sera. CONCLUSION: BLyS may be an important factor in driving polyclonal hypergammaglobulinemia and elevated autoantibody titers in patients with systemic immune-based rheumatic diseases. Local production of BLyS in the joints may contribute to joint pathology. Patients with elevated serum BLyS levels may be ideal candidates for therapeutic targeting of BLyS.
10966208 Giant cell myocarditis: most fatal of autoimmune diseases. 2000 Aug OBJECTIVE: To increase awareness of giant cell myocarditis (GCM), its pathogenesis, and treatment. METHODS: Review of relevant publications from the English-language literature. RESULTS: GCM is a rare, frequently fatal inflammatory disorder of cardiac muscle of unknown origin, characterized by widespread degeneration and necrosis of myocardial fibers.Congestive heart failure and ventricular tachycardia are common clinical manifestations. GCM occurs primarily in previously healthy adults, although it is frequently associated with various systemic diseases, primarily of autoimmune causes. The inflammatory infiltrate is characterized by the presence of multinucleated giant cells and is distinct from cardiac sarcoidosis. Animal models of GCM are similar to models of other autoimmune disorders such as rheumatoid arthritis. The prognosis, which is poor despite partial responsiveness to immunosuppressive medications, is improved with cardiac transplantation. CONCLUSIONS: The clinical and immunopathogenetic similarities with classical rheumatologic diseases, the differential diagnosis with sarcoidosis and other inflammatory conditions, and the use of standard immunosuppressive medications make GCM a disease process that should be added to the rheumatologist's expertise.
19078489 Infusion therapies in rheumatic practice. 2000 Oct Infusion therapies have been used in rheumatology practice for many years. However, the recent approval of infliximab for rheumatoid arthritis and the development of a host of i.v. treatments for inflammatory rheumatic and metabolic bone disorders will likely have a significant impact on the use of infusion therapies by rheumatologists. Current i.v. therapies for rheumatic disorders include pulse corticosteroids, infliximab, cyclophosphamide, i.v. gammaglobulin, and pamidronate. This review discusses specific indications, adverse events and general requirements for administration of each of these therapies. Appropriate screening generally includes a CBC and evaluation of past allergies, renal and liver function, and cardiac status. Supplies for treatment of possible anaphylaxis should be available.
11569015 Hemiarthroplasty of the shoulder. Clinical experience in 18 cases treated by the Neer mono 1999 Jan The authors report the results of 18 hemiarthroplasties of the shoulder performed between 1990 and 1994 using the Neer II monoblock prosthesis, emphasizing the technical and surgical problems encountered. The patients treated numbered 13 for traumatic pathology (acute fractures: 7; sequelae of fracture of the proximal epiphysis of the humerus: 6), and 5 for degenerative lesions (arthrosis: 3; rheumatoid arthritis: 2). An evaluation of the results was based on the Constant method and isokinetic testing. Results based on follow-up obtained after 2 to 6 years were satisfactory in 83% of the cases.
22049009 Researcher Knows Best?: Toward a Closer Match between the Concept and Measurement of Copin 2000 Mar Missing from recent critiques of coping measurement are data demonstrating whether concepts used by researchers are understood by study participants. We asked 101 rheumatoid arthritis patients to complete a structured coping checklist and provide descriptions of their coping for each item checked. Trained researchers coded these open-ended descriptions using the original checklist categories. In general, patients' descriptions of their coping matched researcherderived definitions; however, patients were less likely to interpret cognitive and affective coping strategies in the manner intended by researchers. Patients' descriptions often crossed multiple categories, suggesting complex patterns not captured by most data analytic techniques. Whether they assess coping through structured measures or not, researchers must find ways to examine the multiple meanings and combinations of strategies that constitute the coping process. Keywords.
12879121 Rofecoxib: a specific cyclooxygenase inhibitor. 2000 Apr Rofecoxib is a new specific cyclooxygenase-2 inhibitor. The efficacy of rofecoxib has been established in the treatment of osteoarthritis, rheumatoid arthritis and acute pain. Rofecoxib has been approved in the United States for the treatment of osteoarthritis and acute pain. Endoscopically proven gastrointestinal ulceration is much less with rofecoxib than standard nonsteroidal antiinflammatory drugs (NSAIDs) and the ulceration rate with rofecoxib is similar to that seen with placebo. Rofecoxib appears to provide clinical benefit equivalent to standard NSAIDs with less toxicity.
10408464 Lymphocytic hypophysitis associated with dacryoadenitis: an autoimmunologically mediated s 1999 Jul We report a rare case of lymphocytic hypophysitis followed by dacryoadenitis. Lymphocytic hypophysitis is a rare disease that can easily be mistaken for neoplastic proliferation. Because combination with rheumatoid arthritis, thyroiditis, or pernicious anemia is frequent, an immunological pathogenesis is likely.