Browse

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

ID PMID Title PublicationDate abstract
16327935 [The prevalence of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic art 2005 Nov OBJECTIVES: To assess the presence of anti-cyclic citrullinated peptide antibodies in a cohort of patients with juvenile idiopathic arthritis. METHODS: Anti-cyclic citrullinated peptide antibodies was tested for with an enzyme linked immunoabsorbent assay (ELISA) in serum samples of patients from the Hospital de Clínicas de Porto Alegre, all less than 18 years old and with previous diagnosis for at least 6 months. IgMRF (rheumatoid factor) and antinuclear antibodies in Hep-2 cells were also assayed. RESULTS: Serum samples were analyzed from 45 patients. The presence of high levels of anti-cyclic citrullinated peptide antibodies was found in the serum of just one child (2%), who presented sero-positive polyarthritis. CONCLUSIONS: Anti-cyclic citrullinated peptide antibodies can be detected in children with juvenile idiopathic arthritis, but much less frequently than in adults with rheumatoid arthritis. It still remains to be determined whether anti-cyclic citrullinated peptide antibodies can identify a subset of juvenile idiopathic arthritis patients with the potential to progress to adult rheumatoid arthritis.
16268969 Anti-cyclic citrullinated peptide antibodies in type 1 autoimmune hepatitis. 2005 Nov 15 BACKGROUND: Besides the autoantibodies included in the diagnostic criteria of type 1 autoimmune hepatitis, many other autoantibodies have been described in this condition. Recently, antibodies against cyclic citrullinated peptide have been validated as specific diagnostic and prognostic markers of rheumatoid arthritis. AIM: To assess whether these antibodies are part of the autoantibody repertoire of type 1 autoimmune hepatitis and correlate with rheumatological manifestations. METHODS: Antibodies against cyclic citrullinated peptide were tested by a commercially available enzyme-linked immunosorbent assay. RESULTS: The antibodies were found in 12 of 133 (9%) type 1 autoimmune hepatitis, two of 49 (4%) with primary biliary cirrhosis, one of 80 (1%) with hepatitis C virus-related chronic liver disease and 53 of 89 (60%) with rheumatoid arthritis serum samples. High titres were found only in rheumatoid arthritis and type 1 autoimmune hepatitis. No clinical (in particular rheumatological manifestations), biochemical or immunoserological differences were detectable between antibodies against cyclic citrullinated peptide positive and negative type 1 autoimmune hepatitis sera, with the exception of rheumatoid factor, always negative in the positive ones. CONCLUSIONS: Antibodies against cyclic citrullinated peptide can be detected in a subgroup of patients with type 1 autoimmune hepatitis. They might be part of the wide range of autoantibody production characteristic of this condition and/or, less probably, be predictive of future rheumatoid arthritis development.
17062441 Long-term follow-up of patients with adult-onset Still's disease. 2006 Sep OBJECTIVE: To evaluate the long-term outcome of patients with adult-onset Still's disease (AOSD). METHODS: Eleven patients with AOSD who were regularly followed-up during the past 13 years, even after discontinuation of treatment, were evaluated for the long-term prognosis of the disease and its possible complications. RESULTS: No exacerbation of the symptoms was noted during therapy. Only two of the 11 patients exhibited relapse of the systemic disease after discontinuation of treatment. Both patients had previously been on corticosteroids and responded well to reinitiation of therapy. Progressive deforming arthritis was not noted in any patient. Hepatic failure, central nervous system involvement, renal involvement or systematic amyloidosis did not complicate the course of any of the patients. CONCLUSIONS: Long-term prognosis of AOSD may be benign in a significant subset of patients. Further studies should clarify characteristics of the subset of patients for whom disease-modifying therapy is warranted.
17173765 [Adult Still's disease with atypical skin manifestations]. 2006 Nov Adult Still's disease (ASD) is an uncommon inflammatory disease of unknown etiology. It is characterized by the triad of intermittent high fever, evanescent rash and polyarthralgia or polyarthritis. We present the case of a 29-year-old woman with ASD and persistent erythematous papule on neck and upper part of the trunk. The presence of fixed lesions is not characteristic of ASD, but its appearance during development of the disease suggests that they are a manifestation of it. Recently, other skin manifestations of ASD have been published, but they are not well-known.
16503880 Primary Gougerot-Sjögren syndrome: a dermatological approach. 2006 Mar Gougerot-Sjögren syndrome (GSS) is a chronic heterogeneous non-organ-specific autoimmune disease, encompassing a wide spectrum of clinical manifestations. It is characterized by a lymphocytic infiltration of the exocrine glands, also called epitheliitis, resulting in xerostomia and keratoconjunctivitis sicca. The skin can also be involved; for example, xerosis is a consequence of epitheliitis. Dermatological consequences of polyclonal reactivity are vasculitis and manifestations of B-cell proliferation vary from plasma cell infiltrates to B-cell lymphoma.
18360649 Abatacept in the treatment of rheumatoid arthritis. 2006 Dec Abatacept (CTLA4-Ig) is a new agent which targets T-cell activation, an event which is thought to be critical to the onset and maintenance of rheumatoid arthritis (RA). Abatacept now has substantial evidence from phase III trials for efficacy in patients with RA who have failed to respond to disease-modifying antirheumatic drugs (DMARDs) and antitumor necrosis factor-alpha (TNF-alpha) biologic agents. Safety profile is favorable in combination with DMARDs. The mechanism of action and available evidence of its efficacy and safety are reviewed in this article.
16341347 Treatment with etanercept for patients with juvenile rheumatoid arthritis in Taiwan--a pre 2005 Dec Tumor necrosis factor (TNF) is a major inflammatory cytokine involved in the pathogenesis of juvenile rheumatoid arthritis (JRA). Etanercept, approved in the United States and in Europe for use in patients with rheumatoid arthritis (RA) and JRA, is an effective inhibitor of TNF that has been shown to provide rapid and sustained improvement in both diseases. Here we report the preliminary results of etanercept use in 3 cases of JRA with poor response to traditional therapy including non-steroidal anti-inflammatory drugs and disease-modifying antirheumatic drugs. Two of the patients had polyarticular JRA and 1 had systemic JRA. Etanercept was administered at a dosage of 0.4 mg/kg (maximum 25 mg) subcutaneously twice a week. Clinical as well as inflammatory parameter improvement was noted after use of etanercept in all cases. The preliminary results of etanercept use in these 3 cases showed significant clinical benefit without obvious adverse effects.
16112982 Management of the upper extremity in juvenile rheumatoid arthritis. 2005 Jul Juvenile rheumatoid arthritis is a multifaceted disease. Average age of onset is 6 years, with peaks between 1 and 4 and between 9 and 14 years. Girls are affected more frequently than boys. Nonsteroidal anti-inflammatory drugs are the standard first line of therapy. Second-line therapy of antirheumatic drugs may be used early for progressive disease. Intra-articular corticosteroid injections should be considered to preserve joint mobility and muscle strength when medical treatment fails to control synovitis or when marked functional impairment exists. Historically, surgery has been a last resort, but in appropriate patients, it should be considered soon after failure of conservative management. However, when possible, reconstructive surgery should be delayed until completion of skeletal growth.
16906368 Cartilage destruction by matrix degradation products. 2006 The progressive destruction of articular cartilage is one of the hallmarks of osteoarthritis and rheumatoid arthritis. Cartilage degradation is attributed to different classes of catabolic factors, including proinflammatory cytokines, aggrecanases, matrix metalloproteinases, and nitric oxide. Recently, matrix degradation products generated by excessive proteolysis in arthritis have been found to mediate cartilage destruction. These proteolytic fragments activate chondrocytes and synovial fibroblasts via specific cell surface receptors that can stimulate catabolic intracellular signaling pathways, leading to the induction of such catalysts. This review describes the catabolic activities of matrix degradation products, especially fibronectin fragments, and discusses the pathologic implication in cartilage destruction in osteoarthritis and rheumatoid arthritis. Increased levels of these degradation products, found in diseased joints, may stimulate cartilage breakdown by mechanisms of the kind demonstrated in the review.
16268068 [Complex functional test in juvenile rheumatoid arthritis]. 2005 The Juvenile rheumatoid arthritis is a special form of rheumatoid arthritis which occurs in childhood and adolescence (before the age of sixteen). The disease primarily affects the joints, but can also cause heavy damages to organs and systems such as the heart, blood vessels, skin, epidermis, eyes, peripheral nerves etc. The disease occurs more often with girls. In the therapeutic sense, viewed from the physical medicine and rehabilitation aspect, lying in bed is needed during the acute phase of the disease, and when the inflammation ceases, normal body activities should be encouraged. Rehabilitation with standard methods of physical therapy includes enhancement of daily activities and quality of life, adaptation of patient to the new conditions and prevention of complications. At the Physical medicine and rehabilitation department of the Pediatric clinic CCU Sarajevo, during year 2001 and 2002, fourteen children were observed. All children were treated with kinezitherapy, after which everyday life activities were observed as well as the mobility. In these everyday life activities we were observing whether child can use spoon, fork and knife, whether or not a child can dress his/her upper or lower part of the body with or without buttoning, whether or not it can bathe without someone's help. While observing mobility we evaluated general mobility with changing the body's position from lying to sitting and also from sitting to standing position, climbing onto and getting of a bed, ascending and descending stairs, ability to crouch down or not. These methods are used to prevent inability or decrease it as much as possible. It is accomplished by preventing the forming of muscular atrophies, preventing the development of contractions of joints, as well as preventing the development of osteoporosis and bone destruction due to the inactivity. The imperative of a good rehabilitation is "active movement".
16625453 [Current status of wrist arthrodesis]. 2006 Mar AIM: In order to ascertain the value and future of wrist arthrodesis we assessed the results of 47 wrist arthrodeses performed at the Departments of Orthopaedic and Trauma Surgery of the University of Goettingen between 1980 and 1998. METHOD: In a retrospective analysis we examined the patients clinical and radiological records. Evaluating the results we used the score described by Lohmann and Buck-Gramcko in order to consider function, pain, strength and assessment of the patient him/herself. RESULTS: 93.6 % of all cases could be examined. We found a wrist arthrodesis in posttraumatic arthritis in 22 cases and in rheumatoid arthritis in 25 cases. Plate (n = 30) and Rush-Pin osteosynthesis (n = 17) were used as surgical procedures. In all patients we found a successfully stabilised wrist, although in 3 trauma cases a further surgical procedure was necessary. A better function of the wrist was reached in every patient. The majority of the patients had no pain and an acceptable strength. The results obtained showed good and excellent results in 86.4 % of the wrist arthrodesis for post-traumatic arthritis and in 90.9 % for rheumatoid arthritis. CONCLUSION: The increase in quality of life, especially in patients suffering from rheumatoid arthritis, shows the procedure of wrist arthrodesis to be a still worthwile surgery.
15852248 Differentiating the efficacy of the tumor necrosis factor inhibitors. 2005 Apr The tumor necrosis factor inhibitors are a diverse group of biologic agents. Although there are no studies that directly compare these agents, data from noncomparative trials suggest that all 3 agents have therapeutic activity in rheumatoid arthritis. Etanercept and infliximab have also demonstrated beneficial activity in other inflammatory arthritides (ie, psoriatic arthritis and ankylosing spondylitis [both agents] and juvenile rheumatoid arthritis [etanercept only]) and inflammatory diseases (ie, psoriasis and uveitis). Their effects in granulomatous diseases are more variable, with only infliximab demonstrating clear efficacy in the treatment of Crohn's disease, sarcoidosis, and Wegener's granulomatosis. The purpose of this brief review is to summarize current efficacy data and explore possible explanations for observed clinical differences.
16932698 The management of Sjögren's syndrome. 2006 May Sjögren's syndrome is a chronic autoimmune disorder, characterized by lymphocytic infiltration and malfunction of the exocrine glands, resulting in dry mouth and eyes. The syndrome can present either alone (primary Sjögren's syndrome) or in the context of an underlying connective tissue disease (secondary Sjögren's syndrome). Systemic features, resulting from cutaneous, respiratory, renal, hepatic, neurologic, and vascular involvement, often occur. Two types of primary Sjögren's syndrome are currently recognized: a benign disease that affects quality of life, and a systemic syndrome associated with increased morbidity and mortality owing to a high risk of malignant transformation, and that requires close follow-up. Ocular involvement, manifested as keratoconjunctivitis sicca, is managed with local and systemic stimulators of tear secretion and supportive surgical procedures. Treatment of oral manifestations includes intense oral hygiene, prevention and treatment of oral infections, use of saliva substitutes, and local and systematic stimulation of salivary secretion. Cholinergic agents, such as pilocarpine and cevimeline, are helpful in patients with residual salivary function, and ciclosporin ocular drops seem to be of some benefit. Systemic immunosuppressives are reserved for treatment of severe extraglandular manifestations of Sjögren's syndrome. Anti-B-cell therapy is a new potential therapy for the glandular and extraglandular manifestations, such as glomerulonephritis or vasculitis, in addition to the management of lymphoma associated with Sjögren's syndrome. Induction of oral tolerance and gene-transfer modalities were recently attempted in animal models, with promising results.
16469087 Adult-onset Still's disease with prurigo pigmentosa-like skin eruption. 2006 Jan A 34-year-old woman with adult-onset Still's disease (AOSD) developed prurigo pigmentosa-like lesions on her chest and upper back in addition to the typical rash of AOSD. A biopsy specimen taken from the upper back showed characteristic features of prurigo pigmentosa. The eruption and fever subsided immediately after the administration of 40 mg/day prednisolone, but arthralgia persisted even after intravenous pulse methylprednisolone therapy in combination with immunosuppressive drugs. Various atypical skin rashes, including prurigo pigmentosa-like lesions, have been reported in association with AOSD. Therefore, one should carefully follow the clinical course of a patient in order not to overlook these atypical cutaneous manifestations of AOSD.
15857467 Adult-onset Still's disease with atypical cutaneous features. 2005 May INTRODUCTION: The diagnosis of adult-onset Still's disease (AOSD) can be very difficult. There are no specific tests and reliance is usually placed on a symptom complex and the well described typical rash seen in most patients. In recent years, however, other cutaneous manifestations of AOSD have been reported but these are not so well known. OBSERVATIONS: We report a patient with urticaria and fixed plaques and review the other 'atypical' cutaneous findings associated with AOSD. CONCLUSIONS: The diagnosis of AOSD can be made in the absence of the typical Still's rash but in the presence of other atypical cutaneous features.
17041997 Static orthoses in the prevention of hand dysfunction in rheumatoid arthritis: a review of 2005 Static orthoses are recommended for individuals who have early rheumatoid arthritis (Scottish Intercollegiate Guidelines Network, 2002; College of Occupational Therapists, 2003). These orthoses aim to rest and immobilize weakened joint structures and decrease local inflammation (Janssen et al., 1990; Nicholas et al., 1982); correctly position joints (Nordenskiöld, 1990; Ouellette, 1991); minimize joint contractures (McClure et al., 1994); increase joint stability (Kjeken et al., 1995); relieve pain (Feinberg, 1992; Callinan and Mathiowetz, 1996; Kjeken et al., 1995) and improve function (Janssen et al., 1990; Pagnotta et al., 1998; Nordenskiöld, 1990). Wrist and hand orthoses have been routinely prescribed for individuals with rheumatoid arthritis (RA) for the last 30 years with limited evidence that they are effective in achieving their purported aims. This article reviews the possible deterioration in hand structure that can occur in RA and discusses the theoretical basis for the application of static orthoses in RA. The evidence for the effectiveness of four commonly used static orthoses is then examined.
23674987 Metacarpal Index Estimated by Digital X-ray Radiogrammetry as a Tool for Differentiating R 2006 Sep To investigate Metacarpal Index (MCI) and Bone Mineral Density (BMD) estimated by Digital X-ray Radiogrammetry (DXR) with respect to its ability to quantify severity-dependent variations of bone mineralisation in patients with early rheumatoid arthritis compared to Dual Energy X-ray Absorptiometry (DXA), 122 patients underwent a prospective analysis of BMD and MCI by DXR, whereas both DXR-parameters were estimated from plain radiographs of the non-dominant hand. In comparison DXA measured BMD on total femur and lumbar spine (L2-L4). Additionally Steinbrocker Stage was assessed to differentiate the severity of rheumatoid arthritis (RA). Disease activity of RA was estimated by C-reactive Protein (CRP; in mg/l), Erythrocyte Sedimentation Rate (ESR in mm/1st hour) and by the disease activity score with 28-joint count (DAS 28). In consequence, The DXR-parameters, in particular DXR-MCI, revealed significant associations to age, Body Mass Index, CRP, DAS 28 and Steinbrocker graduation; no significant associations could be verified between DXA-parameters and all characteristics of disease activity and severity of RA. The highest correlation was found between DXR-MCI and DXR-BMD with R=0.89 (independent from severity of RA). In all patients DXR-MCI significantly decreased (-14.3%) from 0.42 ± 0.09 (stage 1) to 0.36 ± 0.07 (stage 2) dependent on severity of RA. The comparable relative reduction of DXR-BMD was -11.1%. The group of patients with minor disease activity (DAS 28>5.1) showed a significant flattened reduction (-11.4%) for DXR-MCI from 0.44 ± 0.08 (stage 1) to 0.39 ± 0.08 (stage 2). For accentuated disease activity (DAS 28>5.1) the DXR-MCI revealed a pronounced reduction (-23.1 %). No significant declines were observed for DXA-BMD of the lumbar spine and total femur in all patients as well as dependent on disease activity. CONCLUSION: DXR can exactly quantify cortical thinning of the metacarpal bones and can identify cortical demineralisation in patients suffering from early rheumatoid arthritis surpassing DXA-measurements at axial bone sites. In this context DXR-MCI seems to be the most sensitive parameter for differentiation of patients with minor or accentuated disease activity following severity-dependent cortical bone loss.
15977874 Orbital pseudotumor in a child with juvenile rheumatoid arthritis. 2005 May We report a child with persistent fevers, arthritis, and parvoviral infection who subsequently developed unilateral orbital pseudotumor, lytic bone lesions, bilateral anterior uveitis, band keratopathy, and migratory polyarthritis. Our working diagnosis was systemic-onset juvenile rheumatoid arthritis, although pseudotumor of the orbit and lytic bone lesions are not found in this disease.
21919249 Rheumatoid Arthritis Medicines: A Guide for Adults . 2005 This guide can help you work with your doctor or nurse to find a medicine for rheumatoid arthritis (RA). It is a lifelong condition. RA causes inflammation (swelling, redness, and pain) that can damage the joints. No treatment can cure RA. But the drugs in this guide can slow down the disease and help you feel better. This guide is based on a government-funded review of research about RA medicines. Besides helping you learn about what happens with RA, this guide explains the benefits, risks, and costs of RA drugs.
20528534 Economic burden of rheumatoid arthritis in France. 2006 Feb In France, few economic assessments on the cost of rheumatoid arthritis have been undertaken. Descriptive cost studies were available with different methodological approaches (prospective vs retrospective, economic and/or medical assessment, analytical economic assessment of the cost vs tariff per diagnosis-related group for calculation of hospital costs, based on inpatient and/or outpatient records, focused on diagnosis and/or treatment, and based on real vs theoretical practice) at different times, especially compared with the daily availability of biotherapy or the phase of change of the French Health System financing. Direct medical costs were primarily described. Medicoeconomic assessment should be continued when the disease prognosis is altered by the administration of a new but expensive therapy (i.e. biotherapy) and focused on direct and indirect costs. The ESPOIR and the VERA cohort studies of recent arthritis patients, recently initiated in France, will be useful database contributors. In parallel with the hospitalizations for rheumatoid arthritis extracted from the French national hospital database, a national register is required to follow the administration of biotherapy. As the French Health System is currently changing, some methodological approaches of economic assessment were proposed. Further studies need to be conducted according to guidelines for economic evaluation to allow relevant economic data at country level and for international comparison.