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PMID	Title	PublicationDate	abstract
6859063	Relation of menstrual cycle phase to symptoms of rheumatoid arthritis.	1983 Jun	Since progesterone and estrogen have been shown to exhibit anti-inflammatory/anti-arthritic activity, women with rheumatoid arthritis might be expected to have a reduction of some symptoms of rheumatoid arthritis during the postovulatory phase of the menstrual cycle when the plasma concentrations of these hormones increase. Daily examination of symptoms during 69 menstrual cycles in 14 patients with rheumatoid arthritis revealed that rheumatoid arthritis was significantly reduced during the postovulatory phase of the menstrual cycle. This reduction was clinically and statistically significant. The data presented in this report indicate that some of the "spontaneous" fluctuations in rheumatoid arthritis symptoms may be the result of changes in plasma concentrations of estrogen and progesterone.
7230161	IgE rheumatoid factor in a case of rheumatoid arthritis with pleuritis.	1981 Mar	IgE rheumatoid factor (RF) was detected in sera from 4 out of approximately 100 rheumatoid patients using a solid phase enzyme-linked immunosorbent assay. All 4 patients had extraarticular lesions. A quantitative analysis revealed that over 60% of total IgE in the serum and pleural fluid from a rheumatoid patient with pleuritis had RF activity. The changes in the level of serum IgE RF in our case paralleled the disease activity. This study suggests that IgE RF may play some role in the pathogenesis of certain extraarticular features of RA.
6751242	Time of day of prednisolone administration in rheumatoid arthritis.	1982 Oct	Twelve patients with rheumatoid arthritis took low dosage prednisolone, mean 5.6 mg daily, at either 0800 h, 1300 h or 2300 h in a double-blind within-patient controlled trial. Each patient was studied on each of the 3 regimens to assess control of symptoms and side effects and also to examine circadian rhythms in signs and symptoms. For several days during each drug regimen patients collected urine at each micturition and self-assessed their signs and symptoms. Circadian rhythms of finger joint swelling and of grip strength were determined, and were similar on all regimens, with morning peaks of symptoms and signs. Subjective and objective assessments showed no differences in effectiveness between the 3 times of administration of prednisolone. Urinary excretion patterns were similar to those observed in untreated people. The quantity and circadian pattern of 11-hydroxycorticosteroids excreted were similar to those in healthy patients, providing no evidence of adrenal cortical suppression at the dose levels studied, even when this dose was taken in the evening. A single morning dose of prednisolone appears in many patients to be as effective as a single evening dose or divided doses. It is therefore reasonable to initiate therapy with a morning-only regimen, because adrenopituitary suppression should be minimised.
4064593	Rapidly progressive glomerulonephritis with glomerular crescent formation in rheumatoid ar	1985 Sep	Systemic vasculitis is a well-known complication of rheumatoid arthritis (RA). Rapidly progressive glomerulonephritis is commonly associated with vasculitis syndromes but rarely found in RA. This report describes two RA patients with complicating systemic vasculitis who developed rapidly progressive glomerulonephritis with glomerular crescent formation. One recovered after treatment with corticosteroids and cytostatic drugs and the other died of severe systemic vasculitis despite similar therapy.
147420	Association of the B-cell alloantigen DRw4 with rheumatoid arthritis.	1978 Apr 20	Previous testing of patients with rheumatoid arthritis showed that one HLA-D type, Dw4, occurred more frequently than in normal controls. B-cell alloantigens closely related to HLA-D can now be identified by a simple serologic procedure. Using this test, I studied 80 white patients with erosive, rheumatoid-factor-positive rheumatoid arthritis. The B-cell alloantigen HLA-DRw4 occurred in 70 per cent of 54 patients, as compared to 28 per cent of the 68 normal controls (P less than 10(-5)). Both groups were also tested for the HLA-A, B and C antigens and for HLA-D. HLA-Dw4 occurred in 54 per cent of the patients and 16 per cent of the controls (P less than 10(-5)). Small differences observed in several of the HLA-A and B antigens were not statistically significant. The results indicate that rheumatoid arthritis in whites is associated with genes of the HLA-D region and that immunogenetic factors linked to HLA have a role in its pathogenesis.
718274	SOluble and insoluble immune complex-platelet interactions in rheumatoid inflammation.	1978 Oct	The interactions of soluble and insoluble immunoglobulin G (IgG) complexes with macromolecular rheumatoid factor (RF) and platelets were examined in an in vitro system permitting observation of platelet activities which may contribute to rheumatoid inflammation. Studies of the aggregation phenomenon by the nephalometric technique and by selective sedimentation of 51Cr-labelled platelets revealed no aggregation by platelets exposed to heat aggregated IgG (HAIgG) complexes or their RF precipitates in a plasma test system. Release of serotonin was demonstrated by the increasing radioactivity of platelet supernates to 45 min by 14C-serotonin labelled platelets exposed to insoluble IgG heat aggregates. Significantly less release was shown with saline, native IgG, and soluble IgG complexes. When RF was added to soluble HAIgG complexes, the resulting precipitate caused significantly higher release than controls. No concomitant release of the lysosomal enzyme beta-glucuronidase was detected. Thus, although soluble complexes do not cause significant release of biologically active amines, conversion of soluble complexes to insoluble immune precipitates by RF is associated with this activity which is independent of platelet aggregation and/or lyosomal enzyme release in our test system. Release of biologically active amines from platelets exposed to insoluble complexes may be important in the initiation and propagation of inflammation in rheumatoid arthritis.
608621	Functional disability in the rheumatoid hand.	1977 Oct	The investigation of sixty-one rheumatoid patients relates their hand function to measured hand deformity. Certain deformities are related to a reduction in function; others are not. The dominant hand, used more frequently, deteriorates more quickly than the non-dominant. The benefit on hand function of synovectomy is limited in duration and should be accompanied by some procedure to defer or correct deformity. Study of the metacarphophalangeal joints by radiography and at operation shows that degeneration starts where the metacarpal head first loses articulation with the base of the phalanx, and spreads out from there across the metacarpal head as deformity increases.
6795350	A study of the response of the leukopenia of rheumatoid arthritis to gold salt therapy.	1981 Jul	Five patients with leukopenia and rheumatoid arthritis were treated with sodium aurothiomalate. An improvement in peripheral white blood count, neutrophil count and articular index was noted in all patients.
6496022	Specific risks of anesthesia in patients with osteoarticular disease.	1984 Jun	Anesthesia in patients with either treated or untreated osteoarticular disorders poses a number of specific problems. The authors deal with risks resulting from mechanical deformities produced by these disorders, by the involvement of a large number of functional systems, by changes in the immune status of such patients and by alterations in the reactions of arthritic patients resulting from prior or concurrent treatments. The authors emphasise the crucial points which require evaluation and observation before and during anesthesia.
83137	The clinical and pathogenetic significance of rheumatoid factors.	1978	Rheumatoid factors are immunoglobulins with antibody specificity for antigenic sites on the Fc part of the heavy chain of IgG. The heterogeneity of RF in terms of antigenic specificity and class of immunoglobulin is indicative of the complexity of the provoking immune response. There is little doubt that in many patients rheumatoid factors are autoantibodies which form part of immune complexes, and that complexes containing IgG rheumatoid factor appear to be of pathogenetic importance. Although IgM rheumatoid factors are not specific for RA, their detection aids in the diagnosis and categorisation of rheumatoid arthritis. On the other hand, IgG rheumatoid factors occur in a variety of rheumatic diseases and are of little diagnostic value.
6926808	Prognosis of functional capacity and work capacity in rheumatoid arthritis.	1982 Jun	In the study functional capacity and work capacity were investigated in a series of 405 hospital patients suffering from rheumatoid arthritis. One-third of the patients had had the disease for 5 years, one-third for 10 years and one-third for 15 years. The functional capacity index presented by Lee et al. (1973) was used. Half of the patients in the 5 and 10-year groups and one-third of those in the 15-year group had good functional capacity. One-fourth in the 5 and 10-year groups and one-third of those in the 15-year group had poor functional capacity. Sixty per cent of the 5-year group, 50 per cent of the 10-year group and 33 per cent of the 15-year group were able to work. The prognosis of functional capacity and work capacity was better for young persons than for older ones. No differences were found between the prognoses for men and women. High ESR, a positive blood rheumatoid factor and joint erosion seemed to be linked with an unfavourable prognosis of functional capacity. Light work was favoured for the prognosis of functional capacity and work capacity and extensive general education and vocational training for work capacity. The results indicate that starting vocational rehabilitation at an early stage of the disease could improve the prognosis of functional capacity and work capacity.
7346966	Thoracic intervertebral discitis in rheumatoid arthritis due to costovertebral joint invol	1981	Discitis (with intervertebral disc destruction), found pathologically in the thoracic region of 8 out of 114 rheumatoid patients, is shown to derive and spread from primary rheumatoid involvement of the costovertebral joints. Erosion and destruction of bone may occur, followed by healing, visible radiologically as disc narrowing and posterolateral bony sclerosis and sometimes with ankylosis. There are few clinical symptoms, since most of these patients have limited locomotor function.
7066033	Immunomodulating effect of human placenta-eluted gamma globulins in rheumatoid arthritis.	1982 Jan	Patients who had active and severe rheumatoid arthritis (RA) were treated with human placenta-eluted gamma globulins (PEGG) composed of purified IgG eluted from trophoblastic cells. A control group of RA patients received retroplacental gamma globulins with no clinical effects. Seven of eleven treatments with PEGG showed good (4 patients) or very good (3 patients) clinical results. All patients had immunologic modifications demonstrated by a significant increase in active E-rosette-forming cells and mitogen responsiveness. The precise mechanism of immunomodulating effect of PEGG should be further investigated.
518139	Hypercalcaemia in rheumatoid arthritis: investigation of its causes and implications.	1979 Oct	When correction was made for hypoalbuminaemia, 23 of 50 ambulant patients with definite or classical rheumatoid arthritis were found to have hypercalcaemia. When these 23 patients were studied 6 months later, 7 had hypercalcaemia as defined by the correction factor for a low serum albumin level, and 6 of these patients had raised serum ionised calcium concentrations. Biochemical studies in the 23 patients indicated evidence of hyperparathyroidism, namely, hypophosphataemia, increased serum alkaline phosphatase, hyperchloraemia, and reduced tubular reabsorption of calcium. However, serum immunoreactive parathyroid hormone concentrations were normal. Only one patient had an abnormally low serum 25-hydroxy-vitamin D result: this patient had a high level of urinary D-glucaric acid and was receiving phenobarbitone for treatment of epilepsy. The biochemical features suggestive of parathyroid overactivity were particularly found in patients with raised serum calcium levels. The cause of hypercalcaemia in rheumatoid arthritis remains to be explained.
441625	Long-term studies on therapy and tolerance of ketoprofen.	1979	The therapeutic value of non-steroid anti-inflammatory agents for therapy of rheumatoid arthritis is discussed and a long-term study is described which was carried out for up to 12 monts on tolerance of ketoprofen compared with indomethacin. Objective laboratory data were used as criteria for possible influence on organ function. No abnormalities in renal and liver function were observed.
596946	Ankle joint synoviography in rheumatoid arthritis.	1977 Dec	Twenty-six ankles of 23 patients with seropositive or negative arthritis and 24 ankles of 12 cadavers as a control group were studied by contrast synoviography. The main features in the patients were capsule enlargement, hypertrophic synovitis, and connections to tendon sheaths and to the posterior subtalar joint. None of the controls showed capsule distension or irregular outline of the joint cavity, but connections to tendon sheaths and/or to the posterior subtalar joint were present. Other features such as tibiofibular recess, early lymphatic filling, and joint destruction were seen.
7125715	Obliterative bronchiolitis in rheumatoid arthritis.	1982 Oct	Two patients with rheumatoid arthritis who developed obliterative bronchiolitis are described. Both patients had received penicillamine. The first patient died in respiratory failure 4 months after the onset of her breathlessness and the diagnosis was confirmed at post-mortem. The second patient was diagnosed with appropriate lung function tests and has been started on azathioprine. Although she is still disabled by breathlessness 12 months after presentation, her condition has stabilised.
6614847	Surgical treatment of the cervical spine in rheumatoid arthritis.	1983 Apr	Rheumatoid arthritis can affect any of the synovial joints in the vertebral column. However, the cervical spine, which is the most commonly involved, is the region where segmental instability can lead to neurological sequelae. Severe pain may also be a feature demanding relief. The natural history of the disease as it affects the cervical spine must be a yardstick of management, because quite severe subluxation can occur without neurological embarrassment, whilst a small segmental shift may have profound neurological implications. It is with this knowledge that surgical fusion is offered to a few selected patients. Our own cases are derived from the Medical Research Council Rheumatism Unit at Taplow and the paper will also include experience of Juvenile Chronic Arthritis and ankylosing Spondylitis.
6742902	Thrombokinetics in patients with rheumatoid arthritis treated with D-penicillamine.	1984 Jun	The mechanism of D-penicillamine induced thrombocytopenia in rheumatoid arthritis was investigated by measuring platelet life-span and platelet production rate in 2 groups of rheumatoid arthritis patients treated with 250-750 mg/day D-penicillamine, 14 with a normal platelet count and 9 with thrombocytopenia (platelet count 50-130 X 10(9)/1). Age matched control patients not treated with D-penicillamine included 14 with rheumatoid arthritis and 9 with osteoarthritis. The platelet life-span was normal, but platelet production rate was significantly reduced in the thrombocytopenic patients, suggesting that D-penicillamine causes thrombocytopenia through bone marrow suppression.
476269	Pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) and various acute phase reactants	1979 Jun	Pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) concentrations have been measured in matched sera and synovial fluid samples obtained from 36 patients with rheumatoid arthritis and 10 patients with osteoarthritis. Levels of alpha 2-PAG in serum and synovial fluid were significantly higher in rheumatoid arthritis than in osteoarthritis. Calculation of the synovial fluid/serum ratios for alpha 2-PAG gave results which are explicable only if this protein were being synthesised locally. In a longitudinal study of 15 patients with rheumatoid arthritis, concentrations of alpha 2-PAG did not reflect disease activity, unlike those of the classical acute phase reactants, C-reactive protein and caeruloplasmin.