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ID PMID Title PublicationDate abstract
19357858 [Vasculopathy in Sjögren's syndrome]. 2009 Jun Sjögren's syndrome is a systemic autoimmune disease with a predominant involvement of exocrine glands leading to sicca symptoms. Extraglandular involvement occurs in about 40% of patients with skin, musculoskeletal, neurological and organ manifestations. Systemic vasculitic manifestations of Sjögren's syndrome can be assumed in approximately 5%-10% of patients. Leukocytoclastic or cryoglobulinemic vasculitis represent classic vasculitic manifestations of Sjögren's syndrome. In the pathogenesis of vasculitis, B-cell-driven autoimmune processes play a major role by producing autoantibodies against the Ro/SS-A and La/SS-B antigens and cryoglobulins. In patients with Sjögren's syndrome, manifestation of vasculitis, non-Hodgkin's lymphoma and glomerulonephritis, as well as positive cryoglobulins and decreased levels of complement factors, are considered negative prognostic markers. Various immunosuppressive strategies, usually in co-medication with glucocorticoids, are used for the treatment of vasculitis in Sjögren's syndrome. For refractory and severe manifestations, a B-cell-targeted therapy with Rituximab should be also considered.
19786990 Clinical approaches to early inflammatory arthritis. 2009 Nov Several advances have been made in the understanding of the pathogenesis, as well as in the clinical evaluation and treatment, of early inflammatory arthritis. The presence of anti-citrullinated protein antibodies (ACPAs) has emerged as a major new biomarker for use in clinical practice. The presence of ACPAs can be used to divide patients with early arthritis into subsets that are phenotypically similar but have varying pathogenetic and prognostic features. Although the detection of ACPAs is a major development in the diagnosis and prognosis of rheumatoid arthritis (RA), prediction of the outcome of arthritis at the individual level can still be much improved. For patients diagnosed with RA, and who have active polyarthritis, treatment is not dependent on the assessment of prognostic factors, as these patients are best treated with combination therapy; over 40% of these patients achieve remission with such treatment. In patients who present with oligoarthritis, however, management should be based on the assessment of prognostic factors. The success of early treatment of inflammatory arthritis and the recognition of a measurable preclinical phase of RA offer hope that treating the disease before it becomes clinically active might be possible.
19196455 Complete heart block and severe aortic stenosis in a patient with rheumatoid arthtritis: a 2009 Feb 5 BACKGROUND: A 77-year-old male patient with a history of rheumatoid arthritis was admitted to our hospital for investigation of syncope and dyspnea on exertion class II according to NYHA class association. CASE PRESENTATION: The electrocardiogram revealed complete heart block whereas the echocardiogram showed severe aortic valve stenosis with a peak gradient = 80 mmHg. A permanent pacemaker was implanted in addition to aortic valve replacement. The coexistence of complete heart block and severe aortic stenosis with rheumatoid arthritis are presented. CONCLUSION: Further studies are necessary to assess whether a true association of the above conditions exist.
19727734 Bilateral low lobar atelectasis in a young woman with adult-onset Still's disease. 2010 Nov Adult-onset Still's disease (AOSD) is an uncommon inflammatory condition of unknown origin and pathogenesis. Pulmonary manifestations are rare and include pleuritis and transient radiological infiltrations. We report a case of a young woman with AOSD who developed unusual respiratory symptoms, with bilateral lower lobar atelectasis and restrictive syndrome and reviewed the literature on it. We illustrate the difficulties in diagnosis of atypical pulmonary defect with unusual radiological aspects and discuss causality relationship between lung abnormalities and Still's disease.
19935226 Lung disease related to collagen vascular disease. 2009 Nov Collagen vascular disease is one of the most common causes of chronic infiltrative lung disease. Patterns of lung injury from collagen vascular disease include nonspecific interstitial pneumonia (NSIP), usual interstitial pneumonia, organizing pneumonia, bronchiectasis, obliterative bronchiolitis, and pulmonary arterial hypertension. The prevalence of each entity varies according to the specific disease entity. NSIP and pulmonary hypertension are common in scleroderma, whereas usual interstitial pneumonia, bronchiectasis, and obliterative bronchiolitis are commonly found in rheumatoid arthritis. In systemic lupus erythematosus, pleural effusions and pulmonary hemorrhage are the salient features. In polymyositis, a combination of organizing pneumonia and NSIP is characteristic. Sjögren syndrome is characterized by bronchiectasis and lymphoid interstitial pneumonia, often associated with thin-walled cysts. Ankylosing spondylitis is associated with upper lobe fibrosis, and may be complicated by mycetoma.
27320280 Arthritis: exercise plans to improve your life Arthritis: exercise plans to improve your l 2010 Mar 1 IT IS a challenge to explain simply the different forms of arthritis. Most of the time this book does this, although it sometimes fails to outline the differences in treatment options between osteoarthritis (OA) and rheumatoid arthritis (RA).
21691392 Effect of high-intensity statin treatment in rheumatoid arthritis: a case with possible co 2009 Rheumatoid arthritis (RA) is complicated by high mortality from cardiovascular disease. Statins have been shown to reduce cardiovascular disease events by approximately 30% and to induce coronary atheroma regression. There is no such documentation in patients with RA. This report describes a 49-year-old patient with RA who developed coronary atherosclerosis and rheumatoid valve disease. She underwent coronary artery bypass graft operation with two bypasses and a biological aortic valve replacement. Simultaneously, she was started on atorvastatin 80 mg, and low-density lipoprotein cholesterol reached 1.79 mmol/l and high-density lipoprotein cholesterol reached 1.59 mmol/l. One year after the heart surgery, she developed rheumatoid disease of the mitral valve. Coronary angiography revealed no signs of filling defect in her native coronary arteries. This case indicates that high-dose statin treatment may induce coronary atheroma regression in RA patients and that the rheumatoid valve disease process is not modulated by statins.
19639039 Epstein-Barr Virus (EBV) Prevalence and the Risk of Reactivation in Patients with Inflamma 2009 Jul 13 OBJECTIVE: Anti-TNF agents (etanercept, infliximab and adalimumab) are widely used in inflammatory conditions, such as rheumatoid arthritis; however, they are not without side effects, potentially including lymphoma. We compared Epstein-Barr virus (EBV) levels in patients with inflammatory arthritis taking biologic agents and controls matched for disease, age, gender and disease duration who were biologic naïve. Secondly, we determined the risk of reactivation of EBV in patients taking biologics. METHODS: One hundred and twenty-two patients were recruited and blood samples were collected. Immunoglobulin G (IgG) antibody to EBV was analysed using enzyme-linked immunosorbent assay. EBV DNA was analysed using polymerase chain reaction (PCR) on all positive IgG samples. Quantitative measures of viral DNA were made and expressed as copies/reaction volume. Reactivation was defined as the presence of viral DNA in the plasma and PCR activity was evaluated between 6 and 18 months after anti-TNF therapy. RESULTS: IgG for EBV was detected in 98% of controls and 90% of cases. Viral reactivation related to EBV was not observed in this study. There was one patient who tested positive for EBV using PCR, but upon confirmatory testing, this sample was actually negative. No samples were positive on PCR at the follow-up time points. CONCLUSION: There was a high rate of EBV IgG in the cases and controls in this study. Given the small sample size and timeframe for this study, treatment with anti-TNF agents does not seem to lead to EBV reactivation, and thus, this is likely not a mechanism for the development of lymphoma in patients taking biologics.
20349235 Monoarticular septic arthritis in a patient with juvenile rheumatoid arthritis under etane 2012 May A 7-year-old girl with polyarticular type juvenile rheumatoid arthritis (JRA) presented with acute onset of right hip pain with limited range of motion and fever within the past two days. She had received etanercept for more than one year. Percutaneous arthrocentesis was performed and showed a white blood cell count of 84150/μL in the synovial fluid, although the culture showed negative results. The fever and right hip pain completely resolved after antibiotic treatment. Herein, we report the first case of septic monoarthritis of JRA under etanercept treatment.
21686534 Fatal pulmonary Mycobacterium xenopi in a patient with rheumatoid arthritis receiving etan 2009 In this case study, a 71 year old man with emphysema and severe rheumatoid arthritis, previously treated with a TNFα receptor antagonist, presented with progressive dyspnoea and weight loss. Thoracic imaging revealed extensive destruction of the left lung and this was associated with positive Mycobacterium xenopi cultures from respiratory samples. Anti-mycobacterial chemoptherapy was poorly tolerated and the patient subsequently died from respiratory failure and generalised wasting.
20018009 Data for Genetic Analysis Workshop 16 Problem 1, association analysis of rheumatoid arthri 2009 Dec 15 For Genetic Analysis Workshop 16 Problem 1, we provided data for genome-wide association analysis of rheumatoid arthritis. Single-nucleotide polymorphism (SNP) genotype data were provided for 868 cases and 1194 controls that had been assayed using an Illumina 550 k platform. In addition, phenotypic data were provided from genotyping DRB1 alleles, which were classified according to the rheumatoid arthritis shared epitope, levels of anti-cyclic citrullinated peptide, and levels of rheumatoid factor IgM. Several questions could be addressed using the data, including analysis of genetic associations using single SNPs or haplotypes, as well as gene-gene and genetic analysis of SNPs for qualitative and quantitative factors.
21794693 [Evaluation through imaging of early rheumatoid arthritis]. 2010 Mar Radiography is the most widely utilized imaging modality for measuring joint damage in early rheumatoid arthritis. Conventional radiography is, however, insensitive for showing bone erosions and is totally unsuitable for assessing synovial inflammation. The recognition of these limitations has led to intense interest in ultrasonography and magnetic resonance imaging for assessing synovitis and bone erosions. Magnetic resonance imaging allows detection of bone marrow edema, which is considered to be a very early marker of inflammation as well as a "forerunner" of erosions.
20054693 Longitudinal growth attainments of Indian boys with juvenile rheumatoid arthritis. 2011 May The objective is to study the pattern of distance and velocity growth in terms of weight and height in adolescent boys with Juvenile Rheumatoid Arthritis (JRA). This study was conducted on children diagnosed to have JRA (Cassidy and Petty in Juvenile Rheumatoid Arthritis, WB Saunders Co., Philadelphia, 2005) at the Pediatric Rheumatology and Immunology Clinic of Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh. A total of 203 observations made on 70 boys with JRA, between 9 and 17 years of age, comprised the sample for this prospective mixed-longitudinal growth study. Each subject was measured for body weight and standing height using standardized anthropometric techniques (Eveleth and Tanner in Worldwide variation in human growth, Cambridge University Press, New York, 1990) at half yearly age intervals. All anthropometric measurements were carried out in the Growth Laboratory of Advanced Pediatrics Centre. Boys with polyarticular and systemic onset types of JRA in general measured lighter than their pauciarticular counterparts throughout the period of study. Height attainments in boys with polyarticular and systemic onset JRA measured shorter than their pauciarticular counterparts till 15 years and 12 years, respectively, where-after they became comparable to boys with pauciarticular JRA. As compared to normal Indian (Bhalla and Kumar in Int J Anthropol 18:113-125, 2003; Aggarwal et al. in Indian Pediatr 29:1203-1282, 1992) and American (Ogden et al. in Pediatrics 109:45-60, 2002) counterparts boys representing all categories of JRA remained lighter and shorter. Onset of Peak Height Velocity (PHV) in boys with polyarticular JRA (i.e. 12.5 years) was delayed by 1 year as compared to boys with pauciarticular JRA (i.e. 11.5 years). Attainment of Peak Weight Velocity (PWV) in boys with polyarticular JRA (i.e. 13.5 years) was also delayed by 1 year when compared to those with pauciarticular type (i.e. 12.5 years). In conclusion, weight and height growth attainments in Indian adolescent boys afflicted with different categories of JRA in general remained impaired as compared to their normal counterparts. However, the magnitude of growth deficit experienced by them appears to be a disease severity related phenomenon. This is the first study of its kind from a developing country.
20017999 Genome-wide gene-based analysis of rheumatoid arthritis-associated interaction with PTPN22 2009 Dec 15 The genes PTPN22 and HLA-DRB1 have been found by a number of studies to confer an increased risk for rheumatoid arthritis (RA), which indicates that both genes play an important role in RA etiology. It is believed that they not only have strong association with RA individually, but also interact with other related genes that have not been found to have predisposing RA mutations. In this paper, we conduct genome-wide searches for RA-associated gene-gene interactions that involve PTPN22 or HLA-DRB1 using the Genetic Analysis Workshop 16 Problem 1 data from the North American Rheumatoid Arthritis Consortium. MGC13017, HSPCAL3, MIA, PTPNS1L, and IGLVI-70, which showed association with RA in previous studies, have been confirmed in our analysis.
19270830 A case of adult-onset Still's disease complicated with diffuse alveolar hemorrhage. 2009 Feb Adult-onset Still's disease (AOSD) is an inflammatory disease that presents with a variety of clinical symptoms. Pulmonary involvement is well-known in AOSD and is seen in up to 53% of AOSD cases, with the most common pulmonary diseases being pleural effusion and transient pulmonary infiltrates. We present the first case of chronic AOSD complicated with diffuse alveolar hemorrhage during the acute flare of the disease.
19784886 [Myocarditis--the first symptom of adult Still's disease]. 2009 Aug Myocardial involvement during the course of adult Still's disease is very rare. We present a case of a 34-year-old man admitted with fever, tachycardia, weakness and chest discomfort. The electrocardiogram showed non-specific diffuse ST-T changes, troponin level was slightly elevated and echocardiography did not reveal any abnormalities. After ruling out other relevant diseases, the adult Still's disease was diagnosed.
21423883 Prognostic factors in arthroplasty in the rheumatoid shoulder. 2011 Feb Total shoulder arthroplasty is commonly considered a good option for treatment of the rheumatoid shoulder. However, when the rotator cuff and glenoid bone stock are not preserved, the clinical outcome of arthroplasty in the rheumatoid patients remains unclear. Aim of the study is to explore the prognostic value of multiple preoperative and peroperative variables in total shoulder arthroplasty and shoulder hemiarthroplasty in rheumatoid patients. Clinical Hospital for Special Surgery Shoulder score was determined at different time points over a mean period of 6.5 years in 66 rheumatoid patients with total shoulder arthroplasty and 75 rheumatoid patients with shoulder hemiarthroplasty. Moreover, radiographic analysis was performed to assess the progression of humeral head migration and glenoid loosening. Advanced age and erosions or cysts at the AC joint at time of surgery were associated with a lower postoperative Clinical Hospital for Special Surgery Shoulder score. In total shoulder arthroplasty, status of the rotator cuff and its repair at surgery were predictive of postoperative improvement. Progression of proximal migration during the period after surgery was associated with a lower clinical score over time. However, in hemiarthroplasty, no relation was observed between the progression of proximal or medial migration during follow-up and the clinical score over time. Status of the AC joint and age at the time of surgery should be taken into account when considering shoulder arthroplasty in rheumatoid patients. Total shoulder arthroplasty in combination with good cuff repair yields comparable clinical results as total shoulder arthroplasty when the cuff is intact.
19783075 [Adult-onset Still's disease with liver failure requiring liver transplantation]. 2009 Dec We present the case of a 23-year-old man with fever of unknown origin, who developed acute liver failure 2 months after symptom onset, requiring an urgent liver transplantation. The diagnosis of adult-onset Still's disease was established after the reappearance of symptoms after transplantation, and high doses of corticosteroids were used to control disease activity. Subsequently, given the impossibility of tapering the steroid dose, interleukin-1 receptor blocking treatment was started with satisfactory outcome. We also review the published literature.
20383508 Hemophagocytic syndrome in adult-onset Still's disease (AOSD): a must for biologics?--Case 2012 Oct A case of adult-onset Still's disease complicated by hemophagocytic lymphohistiocytosis is reported. Its management is being discussed on the background of the latest literature with special regard on the use of high-dose corticosteroids and immunosuppressive agents.
20369741 [Annular erythema as the skin manifestation of primary Sjögren's syndrome--case report]. 2010 Feb Annular erythema is a term used to identify skin lesions, in which the rash is erythema burgeoning peripherally and outgoing in the center. In this paper we present the case of 71-year old woman in whom diagnosis of possible causes of the development of annular erythema, led the team to identify primary Sjögren's syndrome (SS). Annular erythema was diagnosed on the basis of characteristic clinical picture and histopathological examination. Primary Sjögren's syndrome was diagnosed based on diagnostic criteria for primary SS and the exclusion of other autoimmune diseases. The patient in the study were the presence of characteristic subjective symptoms such as eye occurring for many years dry eyes and periodic feeling of sand in the eyes and dry mouth symptoms requiring frequent drinking of liquids to help swallow food. Changes within the eye was confirmed Schirmer's test, and the seizure of the salivary glands Saxon test. The serum showed the presence of autoantibodies Ro (SS-A) titer > 600 U/ml. The treatment recommended substitution of tears in order to protect the eye and the occasional use of preparations moisturizing mucous membrane of the nose and mouth. Due to the few reports of coexistence of annular erythema with primary Sjögren syndrome among Caucasians this case deserves special attention and calls for the implementation of diagnostic tests in each case, clinical suspicion of annular erythema in order to determine possible causes for its development.