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ID PMID Title PublicationDate abstract
7221397 Chronic sarcoid arthritis. 1981 Feb 1 Sarcoidosis can involve almost any organ or tissue. The outcome may be clinical recovery with radiographic evidence of residua, impairment of function of organs involved, or a continued chronic course. This report is a patient who presented with chronic sarcoid arthritis without evidence of active disease in other organs, 20 years after sarcoidosis had been diagnosed. The clinical picture superficially resembled rheumatoid disease with keratoconjunctivitis sicca and basal lung fibrosis.
6201437 Facb rosette-forming cells in mice: studies on their functional significance. 1984 May Lymphocytes bearing receptors for the Facb fragment of IgG have been shown previously to be elevated in the peripheral blood of patients with rheumatoid arthritis. The generation of these cells and their possible functional role in immune regulation have been investigated in mice. Facb rosette-forming (Facb-R+) lymphocytes were found to be elevated in the spleens of mice mounting a secondary plaque-forming cell (PFC) response to sheep erythrocytes but not during the primary response. Splenic Facb-R+ lymphocytes were also elevated when a cross-reacting antigen (goat erythrocytes) was used for the secondary immunization but not when a non-cross-reacting antigen (chicken erythrocytes) was used. Both primary and secondary immunization with bacterial lipopolysaccharide resulted in elevation of splenic Facb-R+ lymphocytes. Administration of antigen-specific Facb fragment in conjunction with antigen (calf erythrocytes) produced a suppression of the secondary PFC response. However, F(ab')2 fragments produced no such effect. This suppressive effect was shown to be antigen-specific since administration of Facb fragment of anti-calf erythrocyte IgG had no suppressive effect on the secondary PFC response to sheep erythrocytes. No change in splenic Facb-R+ lymphocytes was observed during delayed hypersensitivity responses to either sheep erythrocytes or the contact-sensitizing agent oxazolone. These results indicate that Facb-R+ lymphocytes are generated during secondary humoral responses but not cell-mediated immune responses, and suggest that these cells may exert a suppressive influence on antibody production. These findings are discussed in relation to the occurrence of these cells in patients with rheumatoid arthritis.
3874215 Neonatal lupus erythematosus, multiple thromboses, and monoarthritis in a family with Ro a 1985 Jun We describe a family afflicted with striking clinical and serologic autoimmune features. The mother and maternal uncle of a patient with neonatal lupus had rheumatic disease manifestations. All three had Ro antibodies (SS-A) in their sera, as well as La antibody (SS-B). The 17-year-old mother developed postpartum inflammatory monoarthritis of the right knee and had a positive lupus band test. The uncle at the age of 26 developed a fulminant disease most consistent with systemic lupus erythematosus (SLE); initial manifestations were myocardial infarction, deep vein thrombosis, and the nephrotic syndrome. Although it is known that mothers of neonatal lupus infants can develop SLE postpartum, the development of severe disease in the maternal uncle suggests the relevance of identifying seropositive relatives of individuals with neonatal lupus.
4002308 Factors that influence lymphocyte yields in lymphocytapheresis. 1985 May The recent use of lymphocytapheresis to treat immune-mediated diseases such as rheumatoid arthritis prompted a study of factors that influence the cell composition of lymphocytapheresis concentrates. Following single cytapheresis procedures, using protocols recommended by manufacturers, lymphocyte yields were significantly higher with the model 2997 (IBM) and CS-3000 (Fenwal) cell separators as compared to the model 30 (Haemonetics) separator (9.8 +/- 1.1 and 7.1 +/- 1.2 X 10(9) lymphocytes, respectively, versus 4.6 +/- 1.1 X 10(9); p less than 0.01). The lymphocyte concentrate obtained with the CS-3000 separator contained the smallest number of monocytes (0.6 +/- 0.4 X 10(9) versus 1.4 +/- 1.6 and 1 +/- 0.3 X 10(9) for the model 2997 and 30 cell separators, respectively). Platelet contamination of the lymphocyte concentrate was highest with the CS-3000 (6.5 +/- 2.4 X 10(11], and erythrocyte contamination was highest when the model 30 was used (21 +/- 3.0%). Studies using the model 2997 indicated that lymphocyte yields were significantly influenced by donor pre-apheresis absolute lymphocyte counts, and for this cell separator by specific operating variables, such as channel centrifugation speed and positioning of the red cell interface during lymphocyte collection. Maximal yields were obtained when the channel centrifugation speed was 800 to 1000 rpm (equivalent to 100-150 X g) and the red cell interface was adjusted to yield a cell concentrate with a hematocrit less than 4 percent. These results suggest that it will be necessary to standardize lymphocytapheresis collection protocols in future studies to assess the role of lymphocytapheresis in the management of immune-mediated diseases such as rheumatoid arthritis.
2931844 [Effect of the method of extracorporeal heparin precipitation of plasma proteins (selectiv 1985 A study was made of the effect of selective plasmapheresis (SPP) on the concentration of circulating immune complexes (CIC). The method is based on precipitation at 4 degrees C of plasma fibronectin and associated macromolecular complexes by means of heparin. Sterile plasma of the patient is separated from the precipitate, frozen and kept at -20 degrees C till the next plasmapheresis during which it is returned to the patient instead of the donor's one. All 15 patients examined were exposed to 6 SPP with an interval made every 2 to 5 days. Six patients were diagnosed to have rheumatoid arthritis, 2 systemic lupus erythematosus, 3 hemorrhagic microthrombovasculitis, and 4 multiple sclerosis. The concentration of CIC was measured by precipitation with 3.5% polyethylene glycol before and after SPP, in some cases between sessions. All the patients with rheumatoid arthritis and systemic lupus erythematosus and 2 out of the 3 patients with hemorrhagic vasculitis showed an elevated content of CIC (greater than 0.150 Units OD). The CIC content appeared normal in all the patients with multiple sclerosis. After SPP 4 patients manifested a reduction in the CIC concentration, whereas in 6 it returned to normal. Such a time course correlated with the improvement of other clinical and laboratory findings. It was established that after the first session of SPP the CIC content sharply declined followed by a gradual increment and exceeded the initial values toward the beginning of the second session. After the second SPP the patients manifested the same tendencies. The CIC content reached a maximum by the third SPP and then fell from session to session.(ABSTRACT TRUNCATED AT 250 WORDS)
4014267 Two-dimensional echocardiographic detection of preclinical aortic root abnormalities in rh 1985 Jun Two-dimensional echocardiographic findings of subaortic fibrous ridging, aortic leaflet thickening, and aortic root dilatation and thickening are described in a group of 36 patients with rheumatoid variant diseases. The group consisted of 25 patients with ankylosing spondylitis, nine patients with Reiter's syndrome, and two patients with inflammatory bowel disease and spondylitis. No patient had clinical or laboratory evidence of aortic regurgitation or heart block. Subaortic fibrous ridging or marked leaflet thickening was noted in 11 of 36 patients; in contrast, no such changes were found in an age-matched control group of 29 men. The subgroup of patients with subaortic fibrous ridging or leaflet thickening (11 patients) had significantly longer disease duration (28.1 versus 17.7 years) and higher incidence of aortic root echo-density (82 versus 36 percent) than the remaining patients. It is concluded that a significant portion of patients with ankylosing spondylitis or Reiter's syndrome have echocardiographic evidence of aortic root involvement prior to the clinical onset of aortic regurgitation.
6302858 [Articular manifestations in leprosy]. 1983 Feb 3 Articular manifestations occur in approximately 1% of cases of leprosy, sometimes at onset. They consist in a highly inflammatory polyarthritis, fairly similar to that seen in rheumatoid polyarthritis. They often herald a reactive leprous exacerbation and are dependent upon immunologic disturbances in brittle leprosy (mainly lepromatous). Joint pain should be differentiated from neurologic pain resulting from peripheral neuropathy which is often concomitant. Leprosy should be considered among the causes of polyarthritis, especially in immigrants, but also in residents who have travelled to areas where leprosy is endemic.
6368185 Non-steroidal anti-inflammatory drugs. Current status and rational therapeutic use. 1984 Mar Aspirin (acetylsalicylic acid), the first of the NSAIDs (introduced in 1899), was initially never referred to as an anti-inflammatory agent. It was the advent of cortisone in 1949 that demonstrated dramatically that corticosteroids had anti-inflammatory properties and the term 'non-steroidal anti-inflammatory drug' was first used when phenylbutazone was introduced 3 years later. Since then, the NSAIDs have proliferated. There is to date no good evidence that they halt progression of rheumatoid disease, but by easing pain and diminishing swelling they make life much easier in osteoarthrosis, rheumatoid arthritis and many other types of arthritis, and are the drugs of first choice in acute gout. Their mode (or modes) of action are obscure and though inhibition of cyclo-oxygenase (prostaglandin synthetase) is clearly important, other mechanisms are also involved. The assessment of the anti-inflammatory action of these agents has received considerable attention in clinical trials because, whatever their action may be in experimental animal models, their action in inflamed joints in human patients must be ascertained, since there may be little parallel between the two. Different experimental animal models give different results with various agents and often bear little relation to their therapeutic action in man. No attempt has been made here to review in depth all the NSAIDs that have appeared since 1952. All have anti-inflammatory and analgesic activity and all can cause gastrointestinal side effects, though effectiveness and toxicity vary from drug to drug and patient to patient, there being very great interpatient variability. Non-reactors, patients who apparently fail to respond to certain agents, need further study, for it seems that these subjects may metabolise these agents differently from others. Considerable ingenuity has been shown not only in evolving new NSAIDs but in finding new ways of administering them. The number and variety of NSAIDs in their various forms varies greatly from country to country, depending largely on the regulatory bodies of those countries. In the meantime, the search for a better, less toxic compound continues with the hope that one may be found which has a deeper and more basic action on the underlying disease process.
6332327 Ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis, and arthritis of inflammat 1984 Jun These diseases are classified together as the seronegative spondyloarthritides. They are characterized by an association with the cell surface antigen HLA-B27, sacroilitis and spondylitis, inflammatory peripheral arthritis, enthesopathy (abnormalities in ligamentous attachments), and the absence of rheumatoid factor. Extra-articular complications are common. The diseases are usually treated with nonsteroidal anti-inflammatory drugs and physical therapy.
3973184 Eosinophils in the cellular infiltrate of granuloma annulare. 1985 Feb Eosinophils have been described in the infiltrates of granuloma annulare, but their frequency, distribution and extent are not well documented. We found eosinophils in 18/45 (40%) cases of granuloma annulare, without significant variation relating to histologic sub-pattern. Eosinophils were seen in over half the cases of deep granuloma annulare and in over one-third of the cases of superficial granuloma annulare. This study demonstrates the lack of specificity of eosinophils in differentiating superficial granuloma annulare from deep granuloma annulare, granuloma annulare from necrobiosis lipoidica, and granuloma annulare from occasional clinical simulants which histologically show eosinophils, such as arthropod bite reactions.
629649 [Biopsy of the mucosa of the lower lip for purposes of diagnosing Sjögren's syndrome]. 1978 Thirty biopsies of the lower lip mucosa from patients with clinical and subclinical manifestations of Sjögren syndrome were studied. The results indicate characteristic morphological changes in small salivary glands. The dynamics of these changes consists in progressive lymphoid infiltration of the gland tissue and includes 4 stages: I--weak lymphoid infiltration, II--focal lymphoid infiltration, III--focal-extensive lymphoid infiltration, IV--diffuse lymphoid infiltration, that is, lymphomatosis. In parallel with the progressive lymphoid infiltration there occur sclerosis of the stroma, atrophy and loss of parenchyma of the salivary glands in which the chemical composition of the secrete is changes as confirmed by tests done for mucus. The results obtained and data from literature permit a conclusion that Sjögren syndrome is a generalized autoimmune disease underlain by the disturbance of immunological homeostasis.
6236759 Eosinophil cationic protein in inflammatory synovial effusions as evidence of eosinophil i 1984 Aug Eosinophils are seldom noted in inflammatory synovial fluids but are reported to infiltrate the synovial tissue in inflammatory arthritides. To elucidate a possible role for eosinophils in inflammatory joint reactions the concentrations of eosinophil cationic protein (ECP)--a specific granule protein from eosinophils--were measured by radioimmunoassay in 90 synovial fluids from patients with various inflammatory arthritides (rheumatoid arthritis, reactive and crystal arthritides, Reiter's disease and psoriatic arthropathy). In the same specimens lactoferrin was measured as an indicator of neutrophil-involved inflammation. In comparison with the normal circulating levels of ECP and lactoferrin the measured synovial fluid concentrations of both proteins were considerably raised in all patient groups with inflammatory joint diseases in contrast to patients with non-inflammatory arthritides. There was a striking positive correlation between the ECP and lactoferrin synovial fluid concentrations. These data indicate that eosinophil activation is prominent in inflammatory joint reactions and is linked to the activation of neutrophils. The regulation of degranulation or secretion by eosinophils is unknown. Our in-vitro studies showed that peripheral blood isolated neutrophils as well as eosinophils degranulated when exposed to IgG complexes. However, eosinophil degranulation was modest compared with neutrophil degranulation. These data suggest that neutrophil phagocytosis of, for example, immune complexes may be one major mechanism in neutrophil degranulation but that other factors determine the appearance of eosinophil products in inflammatory synovial effusions. The possible modulatory or harmful role of eosinophils in inflammatory joint disease can at present only be speculated on.
6375915 A combined immunohistological and histochemical analysis of lymphocyte and macrophage subp 1984 May The histochemical demonstration of acid phosphatase (ACP) and adenosine triphosphatase (ATP) has been combined with standard immunofluorescence techniques, using a panel of monoclonal and conventional antibodies, to examine lymphocyte and macrophage subsets and their microanatomical relationships within the subcutaneous rheumatoid nodule (RN). This analysis reveals that the RN is composed largely of strongly HLA-DR+, ATP- macrophages which contain lysosomal enzymes (ACP) in large amounts. The lymphocytic infiltrate which is sparse and poorly organized is comprised almost entirely of thymus derived lymphocytes (T cells) with a normal proportion of helper/inducer (OKT4+) and suppressor/cytotoxic (OKT8+) cells. These observations are in contrast to the findings in the rheumatoid synovial membrane of a prevalence of interdigitating type, HLA-DR+ cells and the predominance of helper (OKT4+) type T cells.
851093 Ultrastructure of lymphoid interstitial pneumonia: virus-like particles in bronchiolar epi 1977 Apr Ultrastructural studies of an open lung biopsy of a patient who had lymphoid interstitial pneumonia, Sjögren's syndrome, and a highly elevated level of immunoglobulin M in the serum disclosed the presence in bronchiolar epithelium of numerous round electron-dense particles 70-120 nm in diameter. These were closely reminiscent of the oncogenic type-A viral particles associated with tumors of laboratory and wild mice. In the inflammatory infiltrate the morphology of some small lymphocytes was suggestive of germinative activity, although no germinal centers were found. Plasma cells, which were numerous in the vicinity of the bronchiolar epithelium, contained varying amounts of electron-dense material, probably immunoglobulin, which was also deposited in the irregulary thickened epithelial basal lamina. The observations support the theory that viral infection may be the stimulus to the immunologic abnormalities observed in patients with lymphoid interstitial pneumonia and Sjögren's syndrome.
7063804 Cobalamin-binding proteins in serum and saliva from patients with Sjögren's syndrome. 1982 Cobalamin-binding proteins in saliva and in serum were determined in 28 patients with primary Sjögren's syndrome (primary SS), 8 patients with secondary SS and 20 matched healthy controls. The unsaturated transcobalamin II level in serum was significantly increased in patients with secondary SS. The unsaturated cobalamin binding capacity in saliva was increased in patients with primary SS. Considerable interindividual variations were found between patients and in the control group. The local production of cobalamin-binding proteins in SS was sufficient to achieve concentrations in saliva comparable to the control group. The cobalamin-binding capacity in saliva was significantly correlated to the albumin concentration in both primary and secondary SS patients, suggesting a defect in the aqueous phase.
311650 Dermatitis herpetiformis and Sjögren's syndrome. 1979 Feb Two patients are described with dermatitis herpetiformis and Sjögren's syndrome. The increased incidence of autoantibodies in dermatitis herpetiformis would suggest that this association is significant. Antinuclear antibodies commonly occur in dermatitis herpetiformis (Seah et al,, 1971) yet are rarely associated with autoimmune disease in these patients (Moncada, 1974). This report records two patients with dermatitis herpetiformis and Sjögren's syndrome.
3002396 Peripheral inflammatory vascular disease in Sjögren's syndrome. Association with nervous 1985 Dec Two histopathologic types of inflammatory vascular disease (IVD) occur in Sjögren's syndrome (SS): mononuclear IVD (MIVD) and neutrophilic IVD (NIVD). We describe 50 SS patients with IVD (30 with NIVD and 20 with MIVD). Thirty-three (66%) of the SS patients with biopsy-documented IVD had nervous system disease unattributable to other causes. Nineteen patients (58%) had involvement of both the central and peripheral nervous systems, while 9 had peripheral and 5 had central nervous system dysfunction alone. Patients with both histopathologic types of IVD were at risk for the development of nervous system abnormalities (57% of NIVD patients and 80% of MIVD patients). Indirect evidence is presented which suggests that IVD may play a role in the immunopathogenesis of nervous system disease, at least in a subset of SS patients.
4057191 D-penicillamine in Felty's syndrome. 1985 Aug We report our experience with 8 patients with Felty's syndrome who were treated with D-penicillamine for a mean of one year. Six of the 8 patients experienced improvement in their neutropenia. Cutaneous ulcers healed in 4 of 6, while recurrent infections cleared in 3 of 5 patients. The drug was withdrawn in 6 patients--lack of response in one, thrombocytopenia in one, urticaria in one, rash in one, and granulocytopenia in 2. One of the latter 2 patients developed pancytopenia and died. Although D-penicillamine is effective in treatment of Felty's syndrome, its side effects can be serious and potentially lethal. Its use should be limited to patients who have failed other treatments.
4001887 Lewis blood type frequency in patients with primary Sjögren's syndrome. A prospective stu 1985 Seventy-five patients in two randomly selected groups (N = 40 plus 35) with primary Sjögren's syndrome were tested for Lewis, A1A2BO, secretor, MNSs, P, Duffy, Kell, Lutheran and rhesus blood group antigens. The results were compared with the frequencies in a control group and in the general population. The Lewis blood group frequency differed (p less than 0.05) from that of the general population, due mainly to an increased Le(a-b-) frequency. Similar immuno-haematological findings have not been reported earlier in patients with rheumatological diseases. If confirmed by other centres, the results may be of importance for our understanding of the immunological mechanisms of chronic inflammatory connective tissue diseases.
1191353 Spontaneous remission of Felty's syndrome. 1975 Sep The clinical course of a patient with Felty's syndrome is described. This patient was unusual because during a 3-year period of splenomegaly and leukopenia she did not develop repeated infections, leg ulcers, or other complications of Felty's syndrome. Then a spontaneous remission began. During the subsequent 6 years, neither symptoms nor signs of Felty's syndrome have recurred.