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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
12826065 Association between the expression of inducible nitric oxide synthase by chondrocytes and 2003 May Inducible nitric oxide synthase (iNOS) is one of the clinical targets in rheumatoid arthritis. Synoviocytes, macrophages, and chondrocytes in the joints of patients with rheumatoid arthritis appear to express iNOS, but the contribution of iNOS molecules to rheumatoid arthritis is not yet clear. This study used adjuvant-induced arthritis in rats as a model to examine the association between the iNOS expression and its activity in rheumatoid arthritis. In adjuvant-injected rats, arthritic changes in the paw were first observed between days 10 and 12. NO-generation activity was precisely determined by combining an electron spin resonance/nitric oxide (NO)-trapping method with the method of standard addition using an NO generator, and we found that the activity in the joint samples was extremely high on day 10. The administration of S-(2-aminoethyl)isothiourea, a selective iNOS inhibitor, from day 0 to day 10, effectively reduced the paw swelling. Immunohistological studies showed that chondrocytes expressed iNOS on days 7-14 and that nitrotyrosine residues, a footprint of NO generation, were produced on day 10. This indicates that NO generation by iNOS induced in chondrocytes is a key event in the induction of adjuvant arthritis.
17987169 Is manual therapy a rational approach to improving health-related quality of life in peopl 2002 Jul BACKGROUND: People with arthritic disease are advised to participate in gentle exercise on a regular basis, and pursue long-term medication regimes. Alternative therapies are also used by people with arthritis, and may sometimes be recommended by rheumatologists and other medical personnel. Alternative therapies may be divided into two types: active therapies, in which the patient takes a driving role, and passive therapies, in which the therapy cannot proceed unless driven by a therapist. OBJECTIVE: To review the effectiveness of manual therapy in improving the health-related quality of life (HRQOL) of people with two common arthritis conditions: Osteoarthritis and rheumatoid arthritis. DISCUSSION: Massage, and other passive (practitioner-driven) manual therapies, have been anecdotally reported to improve health-related quality of life (HRQOL) in people with arthritis. Many manual therapists consult with patients who have arthritic diseases, receive referrals from rheumatologists, and consider the arthritic diseases to be within their field of practise. Although there is empirical evidence that manual therapy with some types of arthritis is beneficial, the level of effectiveness however is under-researched. Medical authorities are reluctant to endorse manual therapies for arthritis due to a lack of scientific evidence demonstrating efficacy, safety, and cost effectiveness.
11747262 Pulmonary fibrosis and other clinical manifestations of small vessel vasculitis in a famil 2002 Jan We report on a family (mother, daughter, and son) suffering from progressive pulmonary fibrosis associated with deforming arthritis, sinusitis, glomerulonephritis, and cutaneous vasculitis. We suggest that these clinical features display the variable expressions of small-vessel vasculitis in juvenile rheumatoid arthritis.
12022352 Anti-TS1-RNA: characterization of novel antibodies against sequence-specific RNA by random 2002 May OBJECTIVE: To define a novel RNA epitope recognized by serum from a patient with Sjögren's syndrome (SS) from a randomized RNA epitope library and investigate the epitope reactivity of the anti-RNA antibodies in patients with various connective tissue diseases. METHODS: Serum from a patient with SS was used to select ligands from a library of RNA oligomers with a central region of 25 degenerate nucleotides. Bound RNA was recovered by reverse transcription, PCR amplification, and subcloning. The relationship between the antibodies to the selected RNA and disease specificity was studied using immunoprecipitation. RESULTS: From the random RNA library, several unique RNA sequences were obtained. Sera from 32 of 61 patients with SS (52.5%) precipitated with one of the selected RNA (TS1-RNA), whereas sera from 8 of 41 patients with systemic lupus erythematosus (19.5%) and 3 of 25 patients with rheumatoid arthritis (12.0%) precipitated. Although the frequency of reactivity to the TS1-RNA was higher in anti-SSA/Ro positive sera, the presence of either native or recombinant SSA/Ro antigen showed no detectable competition, and no apparent sequence homology was found between the TS1-RNA and hY RNA. CONCLUSION: These data suggest that anti-TS1-RNA is a novel antibody against sequence-specific RNA in many patients with SS.
17041978 Rehabilitation in rheumatoid arthritis: a critical review. 2004 This article considers the evidence for effectiveness and timing of rehabilitation for people with rheumatoid arthritis (RA). The Cochrane Library, DARE, Medline, Embase, CINAHL and AMED were searched to identify systematic reviews and randomized controlled trials evaluating rehabilitation interventions for people with rheumatoid arthritis. Many trials identified had methodological limitations (e.g. short follow-up periods, small sample sizes). Evidence to date is that symptomatic relief results from thermotherapy, laser therapy, acupuncture and assistive devices. In the short-term, comprehensive occupational therapy (in established rheumatoid arthritis), orthoses, and mind-body approaches can help maintain function. Over at least a one-year period, the following are effective in reducing pain and maintaining function: patient education and joint protection training using behavioural approaches; dynamic exercise therapy, hand exercises and hydrotherapy; and cognitive-behavioural therapy (in people with poorer psychological status). Many trials have recruited people with moderate to severe, established RA and relatively little is known about the long-term effectiveness of early rehabilitation, although this is becoming much more common in practice. Despite the increased availability of guidelines and systematic reviews, most conclude there is insufficient evidence for many areas of rheumatology rehabilitation. Further well-designed clinical trials are needed recruiting people with early disease using patient-centred outcomes.
14770094 Comorbid conditions in patients with rheumatic diseases: an update. 2004 Mar PURPOSE OF REVIEW: This review summarizes recent literature (September 2002 to September 2003) on three comorbid conditions (infection, cardiovascular disease, and malignancy) in patients with rheumatic disease. RECENT FINDINGS: Infection risk in rheumatoid arthritis is increased as a result of treatment and the disease itself. Atherosclerotic cardiovascular events are increased in rheumatoid arthritis. Although cardiovascular events also are increased in lupus, screening for cardiovascular risk factors in these patients is suboptimal. The incidence of malignancy overall and specifically the incidence of lymphoma are not increased in patients with rheumatoid arthritis on antitumor necrosis factor therapy compared with patients with rheumatoid arthritis in general. SUMMARY: Rheumatologists must be aware of the risk of infection, atherosclerotic events, and cancers in their patients. As prognosis for rheumatic disease patients continues to improve, the impact of comorbid conditions on morbidity and mortality is more apparent. Further research is needed to elucidate the relative contributions of the underlying autoimmune diseases and their treatments on these conditions that affect long-term patient survival.
17657007 Benign rheumatoid nodules. 2002 Nov Rheumatoid nodules occur usually in advanced seropositive rheumatoid arthritis, signifying poor prognosis. However rarely rheumatoid nodules can be encountered in patients with no antecedent evidence of arthritis. Herein a case of an arthritic benign rheumatoid nodules is described.
15775145 [Preventing effects of COX-2 inhibitors on rheumatoid joint destruction]. 2003 Jun Nonsteroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase (COX) -2 inhibitors with the potential to reduce the risk of gastrointestinal bleeding, have their crucial role in the control of inflammation. However, they have recently been shown to have a preventing effect against joint destruction by basic studies related to pathophysiology in rheumatoid arthritis. Here we summarize the current knowledge on anti-proliferative action due to apoptosis, suppression of angiogenesis, and suppression of osteoclastic bone resorption by NSAIDs. COX-2-dependent and/or -independent mechanisms for these actions have been suggested. Several NSAIDs including selective COX-2 inhibitors have been suggested to possess the in vivo preventing effects on joint destruction in animal models of rheumatoid arthritis. However, clinical evidence on the disease modifying effects of COX-2 inhibitors in patients with rheumatoid arthritis remains to be studied.
17041363 Sudden death in rheumatoid arthritis: pulmonary embolism--a fatal complication of iliopsoa 2002 Aug Sudden death resulting from embolic complications of iliopsoas bursitis has not been previously reported. This case report deals with a 48-year-old woman with seropositive rheumatoid arthritis who presented with symptoms suggestive of deep vein thrombosis. She was found to have complete occlusion of the femoral vein secondary to iliopsoas bursal inflammation and swelling. She died suddenly. At autopsy, a large pulmonary embolism was identified as the cause of death. This report should increase awareness of the incidence of iliopsoas bursitis in rheumatoid arthritis and its potential danger. Early and aggressive management approaches described herein might have prevented this fatality.
17041441 Examination of the risk of continuous leflunomide treatment on the incidence of infectious 2003 Apr To determine whether the risk of infectious complications after total joint arthroplasty is increased in rheumatoid arthritis patients who are treated continuously with leflunomide, the incidences of infectious complications in 41 rheumatoid arthritis patients who received continuous leflunomide treatment (leflunomide group) and in 41 patients who did not receive leflunomide within 4 weeks of surgery (nonleflunomide group) were compared. The incidence (6.1%) of local infection after surgery in the leflunomide group (82 procedures) was slightly lower than that (6.3%) in the nonleflunomide group (79 procedures). There were no systemic or deep infections. None of the other variables analyzed were identified as risk factors for postoperative complications. The results indicate that there is no dramatically increased risk of postoperative infectious complications in rheumatoid arthritis patients who continue to be treated with low doses of leflunomide perioperatively.
12679681 Transoral approach using the mandibular osteotomy for atlantoaxial vertical subluxation in 2003 Apr We report a case of atlantoaxial vertical subluxation with mandibular micrognathia associated with juvenile rheumatoid arthritis. The patient was treated by odontoidectomy via the transoral approach and required a sagittal split mandibular osteotomy because of the mandibular micrognathia. The clinical outcome was excellent.
12097219 A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis: rehabilitatio 2002 Jun 15 PURPOSE: A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis is presented, and strategies to approach a patient with multiple paediatric onset disabling conditions with possible overlaps are discussed. CONCLUSION: The value of multidisciplinary team approach including physiatrist, physical therapist, occupational therapist, rehabilitation nurse, prosthetist-orthotist, psychologist, speech-language pathologist, paediatric rheumatologist, social worker, kinesiotherapist, dietitian, recreation therapist, dentist and other disciplines as required is emphasized.
15580219 Thalidomide for severe systemic onset juvenile rheumatoid arthritis: A multicenter study. 2004 Dec Thirteen children with difficult systemic onset juvenile rheumatoid arthritis were treated with thalidomide. At 6 months, 11 of the 13 were able to reduce their use of prednisone ( P < .002), with a concurrent improvement in erythrocyte sedimentation rate ( P < .0001) and an increase in hemoglobin level ( P < 0.005). Juvenile rheumatoid arthritis improvement scores >/=50% were obtained by 10 of the 13 children.
15232441 Patellar resurfacing reduces pain after TKA for juvenile rheumatoid arthritis. 2004 Jun Influence of patellar resurfacing after knee replacement and the frequency of patella infera and its relation to the postoperative appearance of the knee pain were assessed in patients with juvenile rheumatoid arthritis. Seventy-seven total knee arthroplasties using the AGC prosthesis with nonconstrained components were done on 52 patients with a mean followup of 7.3 years (range, 3-13 years). Anterior knee pain was present in 14 of 30 patients (47%) with an unreplaced patella and in two of 18 patients (11%) with patella resurfacing. The patella was replaced in 18 patients (35%) and in 23 of 77 knees (30%). Neither revision surgery of implanted patellar components nor any later resurfacing of an unreplaced patella were done during the followup. Preoperatively using the Insall-Salvati ratio, the majority of knees (54 of 77) had a low-riding patella. Patella infera occurred commonly in patients with juvenile rheumatoid arthritis. No connection between patella infera and anterior knee pain was found.
14521561 Harlequin ichthyosis in association with hypothyroidism and juvenile rheumatoid arthritis. 2003 Sep Harlequin ichthyosis is a rare and severe congenital erythrodermic ichthyosis characterized at birth by hyperkeratotic plates covering the entire body, ectropion, eclabium, poorly developed ears, and contractures of the hands and feet. Two Chinese children, a 2-year-old boy and an 11-year-old girl, presented with these classic features as well as alopecia and loss of eyebrows and eyelashes. The boy was small for his age and was found to have hypothyroidism at the age of 18 months; he is currently on thyroxine replacement therapy. At 6 years of age, the girl developed symmetrical polyarthritis associated with positive rheumatoid factor and radiologic evidence of erosive arthritis, suggestive of juvenile rheumatoid arthritis. She received prednisolone, nonsteroidal anti-inflammatory drugs (NSAIDs), and subsequently methotrexate for her arthritis, with clinical and radiologic improvement. Early therapy with oral retinoids in both children accelerated shedding of the hyperkeratotic plates as well as improved ectropion and eclabium. There was no major adverse reaction to oral retinoids. The development of juvenile rheumatoid arthritis in survivors with harlequin ichthyosis has not been previously described. The use of prednisolone and NSAIDs in the girl did not affect the skin condition, but the addition of methotrexate led to a decrease in erythema. The association with autoimmune disease is probably coincidental. The psychosocial impact of this severe lifelong disease on the two families was enormous. Early retinoid therapy may improve the disorder and help increase survival rates. A multidisciplinary approach, including psychosocial support of the affected families, is vital in the management of this lifelong disease.
12483016 Adult-onset Still's disease with vesiculopustules on the hands and feet. 2002 Dec Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology characterized by an evanescent rash, intermittent spiking high fever, arthralgia, and a variety of systemic features. We describe a 46-yr-old woman with Still s disease who presented with a 2-month history of a symmetrical vesiculopustular eruptions only on both hands and feet. Skin biopsy specimens of both vesicle and pustule revealed fibrin thrombi deposition in the small dermal vessels with little inflammation, subepidermal bulla, and ischemic necrosis of the overlying epidermis, which were consistent with a vasculopathic reaction. Her skin lesions gradually disappeared in response to conventional AOSD therapy, as elevated serum ferritin levels, an index of disease activity, decreased. To the best of our knowledge, this is the first case of vesiculopustular lesions as a skin manifestation of AOSD.
12476751 [Still's disease in adulthood--case report of a female patient and review of the literatur 2002 A 29-year old women with adult onset Still's disease (AOSD) was presented. On addmision to hospital the patient was febrile, with sore throat, arthralgia/arthritis and myalgia. The patient had lymphadenopathy on the neck, and laboratory findings showed leukocytosis with neutrophilia, accelarated erythrocyte sedimation rate (ESR), increased reactants of acute inflammation and normocytic anemia. During the diagnostic process, infectious, hematologic and neoplastic diseases were ruled out and the diagnosis of AOSD was made. The therapy with metilprednisolone 1 mg/kg of body weight was started. One month latter, the clinical status of the patient improved as well as laboratory findings. The dose of steroids was tappered to 16 mg per day. After 6 months of therapy, steroids were stopped and patient was followed further one year and she was free of symptoms of disease.
17041465 Cavitary necrobiotic nodule imitating malignant lung disease in a patient without articula 2003 Aug Pulmonary involvement is a serious complication of rheumatoid arthritis (RA) and may be seen as airway disease, rheumatoid nodules, interstitial lung disease, and pleurisy. However, cavitary rheumatoid nodules without articular manifestations are rare. We describe a male patient presenting with pleurisy and multiple rheumatoid necrobiotic nodules in the absence of arthritis or subcutaneous nodules. One of the nodules was quite large (5 x 8 cm in diameter) and cavitary, imitating bronchial carcinoma radiologically and bronchoscopically. Definite histopathologic diagnosis was obtained by open lung biopsy. The patient was given methylprednisolone and methotrexate, and significant regression was observed in clinical and radiologic findings. He has been followed for 14 months with no articular manifestations yet, receiving 4 mg/d methylprednisolone and 20 mg/wk methotrexate. The diagnosis of rheumatoid pulmonary involvement without articular manifestations can be difficult. Rheumatoid nodules may imitate bronchial carcinoma, or bronchial carcinoma may coexist in RA patients. Open lung biopsy may be necessary for differential diagnosis of pulmonary lesions in RA.
12014867 The rheumatoid cervical spine: signs of instability on plain cervical radiographs. 2002 Apr The cervical spine is a common focus of destruction from rheumatoid arthritis, second only to the metacarpophalangeal joints. Joint, bone and ligament damage in the cervical spine leads to subluxations which can cause cervical cord compression resulting in paralysis and even sudden death. Because many patients with significant subluxations are asymptomatic, the radiologist plays a key role in recognizing the clinically important clues to instability on plain radiographs of the cervical spine-often difficult in rheumatoid arthritis when the bony landmarks are osteoporotic or eroded. This review focuses on the signs of instability on plain radiographs of the cervical spine, using diagrams and clinical examples to illustrate methods of identifying significant subluxations in rheumatoid arthritis.
12571668 Nutrient intake in women with primary and secondary Sjögren's syndrome. 2003 Feb OBJECTIVE: Recently, it has been proposed that dietary factors may contribute to the etiology and progression of Sjögren's syndrome, and that nutritional intervention may modify the severity of pathological abnormalities. The objective of this study was to determine whether the nutrient intake of women with primary (1 degrees SS) or secondary (2 degrees SS; ie with systemic lupus erythematosus (2 degrees SS/SLE) or rheumatoid arthritis (2 degrees SS/RA) Sjögren's syndrome is significantly different than that of age- and gender-matched controls. DESIGN: Women with Sjögren's syndrome were asked to complete the 97 General Purpose Semi-Quantitative Food Frequency Questionnaire, which consists of a list of 147 separate food items that represent the major sources of multiple nutrients. Nutritional data were evaluated in terms of absolute and energy-adjusted nutrient amounts and analyzed by ANOVA. RESULTS: Our results showed: (a) greater intake of energy, glutamate, carbohydrates, lactose, phosphorus, caffeine and unsupplemental thiamin and riboflavin in 1 degrees SS, as well as supplemental calcium in 2 degrees SS/SLE, compared with controls; (b) greater nutrient intake of energy, protein, glutamate, methionine, tryptophan, carbohydrates, lactose, supplemental calcium and phosphorus, sodium, caffeine and unsupplemental calcium, riboflavin and thiamin in 2 degrees SS/RA, relative to 1 degrees SS and/or 2 degrees SS/SLE; (c) higher energy-adjusted values for supplemental calcium in 2 degrees SS/SLE, and for vitamin A and supplemental iron and zinc in 2 degrees SS/RA, compared with other groups; and (d) higher energy-adjusted intake of supplemental calcium, and a lower energy-adjusted intake of unsupplemental vitamin C, polyunsaturated fat, linoleic acid, omega-3 fatty acid, and specific other unsaturated fatty acids, in the Sjögren's syndrome group as a whole, relative to controls. CONCLUSIONS: Our findings demonstrate that nutrient intake is altered in Sjögren's syndrome.