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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
25061425 Prevalence of falls in fibromyalgia patients. 2014 OBJECTIVE: To compare the risk of falls in fibromyalgia (FM) patients compared to rheumatoid arthritis (RA) patients and normal controls. METHODS: We studied 60 FM, 60 RA patients and 60 controls for fall frequency in one week, one month, six months and one year. Patients were submitted to body mass index determination and balance evaluation through the Berg scale. Data on disease impact and depression were collected in FM patients through the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Questionnaire. RESULTS: FM patients had a higher frequency of falls than RA patients and control individuals in one month (p<0.0001), in six months (p<0.0001) and in one year (p<0.0001). No relationship was found between falls and body mass index, pain or depression scores. Falls in 12 months were associated with higher FIQ values. CONCLUSION: FM patients fall more often than RA patients and control individuals.
24748859 Semantic Modeling for SNPs Associated with Ethnic Disparities in HapMap Samples. 2014 Mar Single-nucleotide polymorphisms (SNPs) have been emerging out of the efforts to research human diseases and ethnic disparities. A semantic network is needed for in-depth understanding of the impacts of SNPs, because phenotypes are modulated by complex networks, including biochemical and physiological pathways. We identified ethnicity-specific SNPs by eliminating overlapped SNPs from HapMap samples, and the ethnicity-specific SNPs were mapped to the UCSC RefGene lists. Ethnicity-specific genes were identified as follows: 22 genes in the USA (CEU) individuals, 25 genes in the Japanese (JPT) individuals, and 332 genes in the African (YRI) individuals. To analyze the biologically functional implications for ethnicity-specific SNPs, we focused on constructing a semantic network model. Entities for the network represented by "Gene," "Pathway," "Disease," "Chemical," "Drug," "ClinicalTrials," "SNP," and relationships between entity-entity were obtained through curation. Our semantic modeling for ethnicity-specific SNPs showed interesting results in the three categories, including three diseases ("AIDS-associated nephropathy," "Hypertension," and "Pelvic infection"), one drug ("Methylphenidate"), and five pathways ("Hemostasis," "Systemic lupus erythematosus," "Prostate cancer," "Hepatitis C virus," and "Rheumatoid arthritis"). We found ethnicity-specific genes using the semantic modeling, and the majority of our findings was consistent with the previous studies - that an understanding of genetic variability explained ethnicity-specific disparities.
24681935 [Methotrexate-related lymphomatoid granulomatosis successfully treated with discontinuatio 2014 Mar A 70-year-old woman with rheumatoid arthritis treated with methotrexate (MTX) complained of right arm weakness. On CT and MRI, tumors were found in the right frontal lobe, bilateral lungs, and left renal parenchyma. She was diagnosed as having lymphomatoid granulomatosis (LYG) grade 2 on thoracoscopic biopsy of the left lung. We discontinued MTX and treated a mass lesion in the right frontal lobe with stereotactic radiotherapy. As a result, the tumors showed a gradual reduction in size, and the patient achieved complete remission. LYG is a rare lymphoproliferative disorder, and has various clinical characteristics. We describe herein a patient with LYG grade 2 with cerebral, pulmonary, and renal lesions, who has maintained a complete remission for six months, to date, after treatment.
24450358 A case report of hearing loss post use of hydroxychloroquine in a HIV-infected patient. 2014 Jan 22 OBJECTIVE: A case with reversible symmetrical sensorineural hearing loss following hydroxychloroquine therapy is described. CASE SUMMARY: A 57-year-old, human immunodeficiency virus (HIV) positive man was referred to the HIV clinic of Imam Khomeini Hospital, Tehran with chief complaint of bilateral slowly progressive hearing loss starting from two months ago. The man had history of rheumatoid arthritis diagnosed from 3 months ago and was administered hydroxychloroquine 200 mg and prednisolone 5 mg twice daily. Audiometry test showed moderate to severe neuronal hearing loss and reduced speech recognition in both ears of the patient. With suspicion of hydroxychloroquine-induced hearing loss, this drug was discontinued. After 2 months of hydroxychloroquine discontinuation, his audiometry findings were improved. DISCUSSION: A few cases of hydroxychloroquine-induced hearing loss have been reported. All of the cases were non-HIV positive individuals. Irreversible hearing loss was developed following long-term therapy with hydroxychloroquine. The present case was a HIV-positive man who developed hearing loss following short course (one month) hydroxychloroquine therapy and his problem was resolved following discontinuation of hydroxychloroquine and continuation of prednisolone. CONCLUSIONS: Hydroxychloroquine-induced hearing loss may reversibly occur following short term therapy in HIV patients.
24371773 Large granular lymphocytic leukemia associated with Lambert-Eaton Myasthenic Syndrome: A c 2013 Large granular lymphocytic (LGL) leukemia is an uncommon clonal lymphoproliferative disorder. Lambert-Eaton Myasthenic Syndrome (LEMS) is a rare neuromuscular autoimmune disease caused by pathogenic autoantibodies targeting the voltage-gated calcium channels (VGCC) on the presynaptic nerve terminal. We here describe the case of a 77-year old patient with LGL leukemia, associated with a seropositive and symptomatic LEMS and a seronegative rheumatoid arthritis. LGL leukemia treatment clearly improved LEMS symptoms, and led to anti-VGCC antibodies value decrease. To our knowledge, this is the first ever described association between LGL leukemia and LEMS.
24368941 Composite Indices Using 3 or 4 Components of the Core Data Set Have Similar Predictive Abi 2013 Background. Understanding how disease-assessment indices perform in rheumatoid arthritis (RA) clinical trials can inform their use in routine practice. The study objective was to assess the capacity of combinations of RA Core Data Set measures to distinguish rituximab from control treatment. Methods. Post hoc analysis of two randomised clinical trials was used. Composite Efficacy Indices were derived by combining three or four RA Core Data Set measures from three possible sources: physician, patient, and laboratory. Results. All 105 Composite Efficacy Indices evaluated significantly distinguished rituximab from control treatment (P < 10(-7)). Generally, indices containing measures from three different sources had a greater capacity to distinguish rituximab from control treatment than indices containing three measures from one source. Composite Efficacy Indices performed as well as validated indices such as DAS28, RAPID3, and CDAI. Conclusions. All indices composed of three or four RA Core Data Set measures have a similar capacity to detect treatment differences. These results suggest that the precise measurement used is less important than whether any measurement is performed, although selection should be consistent for each patient. Therefore, the choice of assessment tool should not be limited to a prescribed list and should instead be left to the clinician's discretion.
24231601 Helpful or harmful? Potential effects of exercise on select inflammatory conditions. 2013 Nov Inflammation has been characterized as a double-edged sword, requiring a balance between health as maintained by regular exercise and activities that would exacerbate inflammatory diseases. The influence of exercise on inflammation is complex and has been widely studied in both healthy patient populations as well as populations of patients with many inflammatory and/or autoimmune rheumatic diseases. Inflammatory markers can be affected by the type of exercise and muscle contraction, as well as the intensity, duration, and consistency of the exercise sessions. Because of these potentially important effects, many members of the general public, as well as some clinicians, believe that exercise could exacerbate symptoms and accelerate the progression of such conditions. The effects of different types of exercise have been studied among patients with inflammatory conditions such as ankylosing spondylitis, systemic lupus erythematosus, rheumatoid arthritis, osteoarthritis, fibromyalgia, and idiopathic inflammatory myopathies, as well as congestive heart failure, type 2 diabetes mellitus, and metabolic syndrome, which are considered low-grade systemic inflammatory diseases. This review will help exercise professionals and clinicians understand the effects of exercise on inflammatory markers, as well as offer effective treatment options and recommendations for patients exercising with rheumatic or inflammatory conditions.
25336834 Hemodynamic stroke: A rare pitfall in cranio cervical junction surgery. 2014 Jul Surgical C1C2-stabilization may be complicated by arterial-arterial embolism or arterial injury. Another potential complication is hemodynamic stroke. The latter might be induced in patients with poor posterior fossa collateralization (risk factor 1) when the vertebral artery (VA) is compressed during reduction (risk factor 2). We report a clinical case where this rare situation occurred: A 72-year old patient was undergoing C1C2-stabilization for subluxation due to rheumatoid arthritis. Preoperative computed tomography angiography (CTA) had shown poor collaterals in the posterior fossa. Furthermore, intraoperative Doppler ultrasound (US) detected unilateral VA occlusion during reduction. It appeared to be a high-risk situation for hemodynamic stroke. Surgical inspection of the VA found osteofibrous compressing elements. Arterial decompression was performed resulting in the normal flow as detected by US. Subsequently, C1C2-stabilization could be realized. The clinical and radiological outcome was very favorable. In C1C2-stabilization precise analysis of preoperative CTA and intraoperative US are important to detect risk factors of hemodynamic stroke. Using these data may prevent this rare, but potentially life-threatening complication.
24585557 Beyond tumor necrosis factor inhibition: the expanding pipeline of biologic therapies for 2014 Jun Patients with rheumatoid arthritis and other immune-mediated inflammatory diseases are at higher risk for infectious morbidity and mortality, partially due to the therapies used to treat these conditions. Both prednisone and targeted biologic therapies such as tumor necrosis factor antagonists have been implicated to various degrees, although in some cases firm data are lacking with regard to certain types of infections. To date, there is a paucity of information regarding the infectious risks associated with the newer biologic agents. As new biologic agents become available for use, their potential infectious risks will challenge infectious disease clinicians who must work to prevent, diagnose, and treat infections in this setting. This article reviews our current understanding of infectious risk in the setting of targeted therapies and provides an update of the immune system targets and potential infectious sequelae of both current and emerging biologic therapies.
24062777 Epstein-Barr virus in systemic autoimmune diseases. 2013 Systemic autoimmune diseases (SADs) are a group of connective tissue diseases with diverse, yet overlapping, symptoms and autoantibody development. The etiology behind SADs is not fully elucidated, but a number of genetic and environmental factors are known to influence the incidence of SADs. Recent findings link dysregulation of Epstein-Barr virus (EBV) with SAD development. EBV causes a persistent infection with a tight latency programme in memory B-cells, which enables evasion of the immune defence. A number of immune escape mechanisms and immune-modulating proteins have been described for EBV. These immune modulating functions make EBV a good candidate for initiation of autoimmune diseases and exacerbation of disease progression. This review focuses on systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and Sjögren's syndrome (SS) and sum up the existing data linking EBV with these diseases including elevated titres of EBV antibodies, reduced T-cell defence against EBV, and elevated EBV viral load. Together, these data suggest that uncontrolled EBV infection can develop diverse autoreactivities in genetic susceptible individuals with different manifestations depending on the genetic background and the site of reactivation.
24023037 Reduction in bradykinin generation during leukocytapheresis using novel cellsorba(TM) CS-1 2014 Apr We evaluated the bradykinin generation level during leukocytapheresis (LCAP) using novel Cellsorba(TM) CS-180S, which has sodium pyrosulfite and sodium carbonate as a filling solution. Subjects of this study were 14 rheumatoid arthritis patients. Regardless of the type of anticoagulant used, bradykinin levels were lower with the novel CS-180S than with the conventional CS-180S (28.7 ± 53.3 vs. 8.0 ± 2.7 as the mean ± standard deviation). When anticoagulants other than nafamostat mesilate were used with the conventional CS-180S, bradykinin levels increased at the column outlet compared with the column inlet, and adverse effects of bradykinin were seen in several cases. In contrast, bradykinin levels remained low and no bradykinin-associated adverse events were observed with the novel CS-180S. We recommend using the novel column instead of the conventional column in the treatment of LCAP.
23991330 Pneumocystis jiroveci pneumonia in patients with non-Hodgkin's lymphoma after Rituximab-co 2013 Aug Rituximab, a monoclonal antibody against CD20+ antigen specific B cell, has been increasingly used in the treatment of non-Hodgkin's lymphoma and some other autoimmune diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis. It is noted that Rituximab could enhanced the efficacy of CHOP-based chemotherapy. Meanwhile it could increase the opportunity of lung infection. Pneumocystis jiroveci pneumonia (PCP), a rare opportunistic infection that was not reported in the large-scale clinical trials of Rituximab, was found recently in patients with non-Hodgkin's lymphoma treated with remedy containing Rituximab. We herein report two cases of PCP in lymphoma patients after Rituximab-containing chemotherapy. Both patients were successfully treated, with trimethoprim-sulfamethoxazole (TMP-SMX) in one case and Caspofungin alone in the other. We also reviewed the literature and concluded that PCP is an infrequent but potentially life-threatening infection in patients with non-Hodgkin's lymphoma subjected to Rituximab-containing regimen. Therefore, adequate prophylaxis, timely diagnosis and treatment are necessary.
23237056 Chronic leg ulcers in adult patients with rheumatological diseases - a 7-year retrospectiv 2014 Dec Chronic leg ulcers in patients with rheumatological diseases can cause significant morbidity. We performed a retrospective case review to describe the epidemiology, clinical features and outcome of chronic leg ulcers in this group of patients. Twenty-nine patients with underlying rheumatological conditions, such as, rheumatoid arthritis (15 patients), systemic lupus erythematosus (8 patients), overlap syndromes (3 patients), systemic sclerosis (1 patient) and ankylosing spondylitis (1 patient) were included. The ulcers were mostly located around the ankle (55·2%) and calves (37·9%). The predominant aetiology of the ulcers, in decreasing order of frequency, was venous disease, multifactorial, vasculitis or vasculopathy, infective, pyoderma gangrenosum, ischaemic microangiopathy and iatrogenic. Treatment modalities included aggressive wound bed preparation, compression therapy (17 patients), changes in immunosuppressive therapy (15 patients), hyperbaric oxygen therapy (4 patients) and cellular skin grafting (2 patients). Management of chronic leg ulcers in rheumatological patients is challenging and the importance of careful clinicopathological correlation and treatment of the underlying cause cannot be overemphasised.
23116307 Advances in clinical study of curcumin. 2013 Curcumin has been estimated as a potential agent for many diseases and attracted great attention owing to its various pharmacological activities, including anti-cancer, and anti-inflammatory. Now curcumin is being applied to a number of patients with breast cancer, rheumatoid arthritis, Alzheimer's disease, colorectal cancer, psoriatic, etc. Several clinical trials have stated that curcumin is safe enough and effective. The objective of this article was to summarize the clinical studies of curcumin, and give a reference for future studies.
25378852 Granulomatosis with polyangitis with mononeuritis multiplex-immunosuppressives playing a d 2014 Oct A 52-year-old female was diagnosed with rheumatoid arthritis and was on methotrexate and prednisolone. She developed fever, cough, hemoptysis, and cavitary lesion on chest skiagram. She was put on antitubercular therapy without any improvement, meanwhile she developed painful right foot drop. Clinicoradiology and C-ANCA study confirmed the diagnosis of granulomatosis with polyangitis (GPA). She was started on cyclophosphamide, corticosteroid, and co-trimoxazole. While her treatment was being continued she showed significant improvement of pulmonary manifestations. About 1 year later, there was reappearance of fever, cough, and radiological opacity with oropharyngeal candidiasis. She became very ill with disseminated intravascular coagulation (DIC)-like features. Immunological markers were negative but bronchoalveolar lavage fluid study showed growth of Aspergillus spp. The patient was promptly put on intravenous voriconazole but unfortunately she succumbed to her illness.
25354676 Myasthenia gravis and risks for comorbidity. 2015 Jan Myasthenia gravis (MG) is an autoimmune disorder leading to skeletal muscle weakness and fatigability. MG subgroups are defined according to pathogenetic autoantibody (against acetylcholine receptor, muscle-specific tyrosine kinase or lipoprotein receptor-related protein 4), thymus pathology and clinical manifestations. MG patients have an increased risk for concordant autoimmune disease, in particular with early onset MG. Most common comorbidities are thyroid disease, systemic lupus erythematosus and rheumatoid arthritis. Cardiomyositis and subclinical heart dysfunction have been described in patients with thymoma MG and late onset MG but represent no major threat. A thymic lymphoepithelioma implies an increased risk for another cancer. Autoimmune MG represents no distinct cancer risk factor, although lymphomas and a few other cancer types have been reported with slightly increased frequency. Severe MG-related muscle weakness means a risk for respiratory failure and respiratory tract infection. Drug MG treatment can lead to side-effects. Thymectomy is regarded as a safe procedure both short and long term. Non-MG-related comorbidity represents a diagnostic and therapeutic challenge, especially in elderly patients. Diagnostic accuracy and optimal follow-up is necessary to identify and treat all types of coexisting disease in MG.
25276300 Cardiac manifestations in systemic sclerosis. 2014 Sep 26 Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis (SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography (especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome.
24902526 Preliminary investigation: acupoint-skin conductance in stroke survivors. 2014 Dec It has been reported that patients with rheumatoid arthritis or asthma have skin conductance over the acupoints that is lower than that of their healthy counterparts; this has been regarded as indirect evidence of the existence of acupoints and the energy-based model of diseases. In order to investigate the potential application of acupoint-skin conductance measurement that may reflect pathology of ischemic stroke, the present study recruited 34 stroke survivors with hemiparesis, whose skin conductance of a hand acupoint and an adjacent non-acupoint and the finger temperature in both affected and unaffected hands were simultaneously measured; the data revealed that the skin conductance and finger temperature were statistically higher in the unaffected hand than that of the affected, and the skin conductance of the acupoint and the non-acupoint were comparable in the affected and unaffected hands respectively. We attribute the observed drop in the skin conductance to the diminished peripheral blood flow of the affected hand that is signified by relatively lower finger temperature. As such, it should be advisable when studying skin conductance over acupoints, monitoring the adjacent non-acupoint skin and local vascular circulation is essential.
24634591 Advanced glycation end products and diabetic complications. 2014 Feb During long standing hyperglycaemic state in diabetes mellitus, glucose forms covalent adducts with the plasma proteins through a non-enzymatic process known as glycation. Protein glycation and formation of advanced glycation end products (AGEs) play an important role in the pathogenesis of diabetic complications like retinopathy, nephropathy, neuropathy, cardiomyopathy along with some other diseases such as rheumatoid arthritis, osteoporosis and aging. Glycation of proteins interferes with their normal functions by disrupting molecular conformation, altering enzymatic activity, and interfering with receptor functioning. AGEs form intra- and extracellular cross linking not only with proteins, but with some other endogenous key molecules including lipids and nucleic acids to contribute in the development of diabetic complications. Recent studies suggest that AGEs interact with plasma membrane localized receptors for AGEs (RAGE) to alter intracellular signaling, gene expression, release of pro-inflammatory molecules and free radicals. The present review discusses the glycation of plasma proteins such as albumin, fibrinogen, globulins and collagen to form different types of AGEs. Furthermore, the role of AGEs in the pathogenesis of diabetic complications including retinopathy, cataract, neuropathy, nephropathy and cardiomyopathy is also discussed.
24413537 Nasal NSAIDs for Alzheimer's Disease. 2014 Aug Alzheimer's disease may result from low-grade inflammation of the brain, and the characteristic amyloid β may be a protective response. Epidemiological observation indicates that long-term oral administration of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to patients having rheumatoid arthritis results in reduced risk and delayed onset of Alzheimer's disease. However, oral ibuprofen, flurbiprofen, and other NSAIDs are not an effective treatment. The NSAIDs may work as an Alzheimer's preventive but not a treatment because the oral dose to the brain is too small, 1% to 2% of the total plasma concentration. The NSAID brain dose could be significantly increased by delivering the drug intranasally. Flurbiprofen would be preferable to ibuprofen because flurbiprofen has 12½ times the potency of ibuprofen. The smaller nasal dose of flurbiprofen than ibuprofen could significantly increase patient compliance. Alzheimer's disease starts in the entorhinal cortex, which is closely connected to the olfactory nerves, and spreads anatomically in a defined pattern. Therefore, a nasal NSAID would readily reach the region of the brain where it is most likely to be therapeutic.