Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 2823368 | Rheumatoid arthritis in Greece. Manifestations in different age groups. | 1987 | A high frequency of anti-Ro (SSA) circulating antibodies and lack of HLA-DR4 association described recently in Greek rheumatoid arthritis (RA) patients, prompted us to study their clinical and laboratory picture and compare it with that described in the literature. One hundred and ninety seven patients with definite or classical RA were divided into three groups A, B, and C with age at disease onset below 39, between 40 and 59, and above 60 years respectively. Disease duration below 5 and above 5 years resulted in further division of each group into subgroups 1 and 2. With few exceptions, there were no significant differences between the groups in terms of maximal articular index, lymphadenopathy, splenomegaly, hepatomegaly, frequency of rheumatoid nodules and lowest hematocrit, highest erythrocyte sedimentation rate, and C-reactive protein values. The presence of rheumatoid factor, antinuclear antibodies, cryoglobulins, and elevated levels of globulins, C3 and C4 in patients' sera were not significantly different among the groups. A statistically significant radiologic deterioration was observed with disease duration, common in all groups. Diffuse interstitial lung disease was the most common pulmonary abnormality noted. There were no differences between the groups. Penicillamine toxicity was independent of age and disease duration. This study suggests that the clinical picture of RA in Greece is similar to that in other populations and that there are no significant differences in general among its age groups. | |
| 2717158 | Rheumatoid arthritis of the temporomandibular joint: radiologic evaluation based on standa | 1989 May | A radiologic scoring system that uses tomography and panoramic radiography to evaluate severity of rheumatoid arthritis in the temporomandibular joint of adults is presented. The scoring system is based on six verbally described grades illustrated by standard reference films. The interobserver agreement was significantly higher for the grading with reference films than for that without reference films. Intraobserver performance was similar for grading with and without reference films. The grading system with reference films is recommended in epidemiologic studies of rheumatoid arthritis localized to the temporomandibular joint or other studies in which multiple observers are involved. | |
| 3316362 | Surgical considerations in hallux abducto valgus with rheumatoid arthritis. | 1987 Sep | The rheumatoid arthritis patient often suffers with forefoot complaints. The most frequently seen pedal deformities are hallux abducto valgus and metatarsus primus adductus. Various surgical procedures have been developed to treat these disabling problems. Arthroplasty has been successfully utilized to relieve pain, but often leaves an unpleasant cosmetic result due to shortening and possible return of the deformity. Arthrodesis and implant arthroplasty are alternatives, but introduce other risks and complications for the patient and surgeon. | |
| 3304039 | Cricoarytenoid arthritis: a cause of laryngeal obstruction. | 1987 Aug | Cricoarytenoid arthritis, principally as a result of long-standing rheumatoid arthritis, is a disorder that may present to the emergency physician with a number of symptoms and signs referable to the larynx. The presentation of this disorder as acute laryngeal obstruction and collapse is uncommon. It is important to recognize early cricoarytenoid joint involvement and not mistakenly diagnose mild cases as asthma or psychoneurosis. The use of steroids in mild cases has been beneficial at times, but progressive airway obstruction and fatalities have occurred during their administration. | |
| 1970764 | Care of the person with rheumatoid arthritis. | 1990 Apr | The therapeutic choices in rheumatoid arthritis have expanded greatly in the past decade and continue to do so. We are unable to predict which drugs will be best for an individual patient, but the vast majority of patients do respond to therapy, and the destructive consequences of rheumatoid arthritis can be modified or prevented. An over-reliance on pharmacology to the exclusion of such things as occupational therapy, counseling, and exercise therapy, however, will hamper us in achieving our ultimate goal of a creative, functional person who has achieved some freedom from disease. | |
| 2233432 | Leg ulcers in rheumatoid arthritis. | 1990 Nov 19 | A retrospective study over an eight-year period of 33 episodes of leg ulceration in 26 patients with rheumatoid arthritis requiring inpatient management is reported. the aetiology of the ulcers was found to be multifactorial. The most common factors were venous insufficiency (45.5%), trauma or pressure (45.5%) and arterial insufficiency (36.4%). Vasculitis (18.2%) and Felty's syndrome (12.1%) were less frequent causes, and pyoderma gangrenosum was rare. Most patients had seropositive erosive disease with high rheumatoid factor titres and significant functional impairment; over half were on maintenance corticosteroids. Colonisation of the ulcers by organisms, predominantly Staphylococcus aureus, was common (69.7%). Skin grafting was required in 63.3%, but the rate of complete take was only 42.9% despite multiple attempts. Hospitalisation was prolonged (mean 47.9 days) and the recurrence rate requiring further hospitalisation was 26.9%. The diagnosis of vasculitis and the limited role of biopsy in establishing its presence are discussed. | |
| 2192057 | 50 years of antirheumatic therapy: the prognosis of rheumatoid arthritis. | 1990 May | The longterm prognosis of rheumatoid arthritis (RA) is bad. All markers of outcome--mortality, functional ability, cumulative pain, economic costs, and adverse reactions to therapy--are unfavorably altered in this illness. But considerable evidence exists that pharmacologic and nonpharmacologic interventions can alter the course of RA by decreasing work and functional disability, and improving the quality of life of those with RA. Therapy alters the slope of RA decrement, permanently or intermittently. Such changes, however, are difficult to measure in short-term cross-sectional studies, and the effect of treatment may be underestimated. | |
| 2335586 | Rheumatoid neutrophilic dermatitis. | 1990 May | Three cases of rheumatoid neutrophilic dermatitis, a specific entity that occurs in association with rheumatoid arthritis, are presented. Clinically, the condition presents as papules and nodules on the dorsal aspect of the fingers, the extensor aspect of the forearms, and the thighs. Like some other neutrophilic dermatitides, it is characterized histologically by a dense, diffuse infiltrate of neutrophils throughout the dermis. The cause of this neutrophilic infiltrate is not known. | |
| 2663418 | New perspectives of secondary and tertiary therapy for rheumatoid arthritis. | 1989 May | Rheumatoid arthritis continues to be recognised as a disorder with a variable prognosis, but recent studies have emphasised its potential for shortening life span. Epidemiological, genetic, and natural history studies have helped to identify patients who are at risk for the development of more aggressive disease earlier in their clinical course, and rheumatologists are willing to be more aggressive in their treatment now as their armamentarium expands. Earlier separation of drugs into anti-inflammatory and immunomodulatory agents becomes irrelevant as these concepts change and drugs fulfil both definitions. Sequences of therapy continue to be dictated by the potential of toxicity and generally follow rather than precede disease progression. The addition of several new agents to the algorithms of therapy against rheumatoid arthritis raises questions about their effects and place in therapeutic regimens, especially as concerns auranofin, sulphasalazine, methotrexate and cyclosporin. Combination therapy is currently at the end of the drug line, but the therapeutic horizon beckons with the potential of biological agents aimed at the restoration of immune balance. | |
| 3673534 | Forefoot amputation in rheumatoid arthritis. | 1987 Aug | Five patients with long-standing rheumatoid arthritis underwent transmetatarsal amputation. Operative indications were severe pain on walking, marked deformity of the forefoot, and no effect of conservative treatment. After a median follow-up time of 7 (1-12) years, 4 patients had no pain, all patients could wear normal shoes, and the gait was significantly improved without imbalance. | |
| 2928990 | Rheumatoid arthritis with extensive lung lesions. | 1989 Jan | A man of 74 who had had seropositive rheumatoid arthritis for 10 years presented with dyspnoea and reticular striation in both lung fields. At necropsy two years later there was pulmonary fibrosis with multiple rheumatoid nodules and non-specific granulomas. | |
| 2197838 | The pathognomonic cytologic picture of rheumatoid pleuritis. The 1989 Maurice Goldblatt Cy | 1990 Jul | Patients with rheumatoid arthritis of any degree of severity or duration may develop necrotizing granulomatous pleuritis, a morphologic replica of the inflammatory reaction characteristic of rheumatoid synovitis and rheumatoid nodules. The ensuing pleural effusion may show a unique cytologic picture consisting of slender, elongated multinucleated macrophages, round giant multinucleated macrophages and necrotic background material. A review of 24 such cases from our laboratory as well as the relevant literature clearly demonstrated that not only is this cytologic picture unique, but that it is pathognomonic of rheumatoid disease, even in patients who have not yet developed arthritis. | |
| 3330694 | The epidemiology of rheumatoid disease: past and present. | 1986 Jun | The epidemiology of rheumatoid arthritis is poorly defined. We know neither how long rheumatoid arthritis has been a major disease, nor whether its incidence is decreasing. If it is decreasing, is this because of the contraceptive pill or some other variable? We do know that the disease occurs worldwide and that there may be increased prevalence among urban living individuals, compared to their rural counterparts. To some extent the disease 'runs in families', but heritibility is low. Concordance among monozygotic twins is only 32 per cent. Women develop the disease more frequently than men. The prognosis for black males is said to be better than for white females. Whether seronegative 'rheumatoid arthritis' should be considered part of the same disease process is unknown. An agreed definition for rheumatoid arthritis is essential before meaningful genetic and immunogenetic data can be developed. However, it is unclear whether the term rheumatoid arthritis should only be given to those individuals with seropositive erosive disease or whether we should include a self-limiting process of poorly characterized change that is sometimes seen, for example, in the first degree relatives of index cases with disease. The ARA criteria for rheumatoid arthritis are unhelpful since 'possible' and 'probable' rheumatoid arthritis patients almost certainly do not have rheumatoid disease. Moreover, the majority of patients with 'definite' rheumatoid arthritis are seronegative. These subjects may be differentiated from seropositive patients on epidemiological, familial, clinical, immunogenetic, and perhaps radiological grounds. The consensus view is that the DR4 allotype occurs more frequently in severe seropositive disease than in severe seronegative 'rheumatoid arthritis'.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 3488715 | Rheumatoid factor tests in the diagnosis and prediction of rheumatoid arthritis. | 1986 Aug | Four assays of rheumatoid factor (RF) have been measured on serum from 213 individuals from 13 families containing at least two sufferers from classical or definite rheumatoid arthritis (RA). Families were not uniformly RF positive or negative, and there was no evidence that non-RA RF positivity was inherited. Four individuals developed definite RA over a two year period, showing that the family members were at increased risk of RA. IgG RF and latex RF assays predicted the RA in the four cases. An association of RF positivity in RA with DR4 was observed, but this may be related to disease severity. | |
| 3267826 | Experiences in the psychotherapy of rheumatoid arthritis. | 1988 | According to the relevant literature, psychological factors may play an important role in the onset and clinical course of rheumatoid arthritis. This is the first study reported in which the treatment of rheumatoid arthritis is based on such factors. Twenty-seven arthritics were treated psychotherapeutically and a close connection was seen between the course of the psychotherapy and the development of the somatic disease. | |
| 2380514 | Wrist arthrodesis for treatment of rheumatoid arthritis. | 1990 Jul | Eighty-seven wrist fusions using the technique of Millender and Nalebuff were reviewed in 79 patients with rheumatoid arthritis. Follow-up averaged 6 years and 97% of all patients had an excellent or good result. Pain was absent or mild in all patients after operation, and 95% of this patient population had improved hand function after wrist fusion. Wrist position averaged neutral in the lateral plane and 6 degrees ulnar deviation. Time to clinical fusion averaged 10.8 weeks. Complications were present in 23% of all cases, with half of these a result of symptomatic hardware. Carpal tunnel syndrome was seen after operation in five patients, all of whom had significant palmar carpal dislocation before surgery. A neutral position of the wrist with slight ulnar deviation is very functional and cosmetically acceptable for the patient with rheumatoid arthritis, even in bilateral fusions. Wrist arthrodesis for the patient with rheumatoid arthritis is a dependable procedure with a high degree of success and patient satisfaction. | |
| 1914416 | Protrusio acetabuli in adult rheumatoid arthritis. | 1991 Jun | In a retrospective study of 100 patients with adult rheumatoid arthritis, 23/100 (23%) were found presenting protrusio acetabuli (PA). PA of the hips was present in 28/193 (14.5%). This complication was more frequent in females, with 19/23 cases (82%), and its presence and severity were associated with longer duration of disease. On analysing the probable relationship between PA and glucocorticoid intake, no statistically significant differences were found between patients who had received such drugs and those who had not. With the method employed and in a selected rheumatoid arthritis population, PA was found in high prevalence. | |
| 1757931 | "Pseudoseptic" arthritis complicating rheumatoid arthritis: a report of six cases. | 1991 Sep | Six cases of a severe, sterile, inflammatory arthritis mimicking septic arthritis occurred in 328 patients with rheumatoid arthritis (RA) over a 4-year period. Four patients were poorly controlled by or had recently discontinued a disease modifying antirheumatic drug. Five improved after receiving increased glucocorticoid therapy. Radiographs showed no accelerated joint destruction after a mean followup of 29.5 months (range 8-49). Recognition of "pseudoseptic" arthritis occurring in the course of RA permits appropriate therapy and avoids extended antibiotic treatment. | |
| 1984487 | Atlantoaxial stabilization in rheumatoid arthritis. | 1991 Jan | Atlantoaxial subluxation in patients with rheumatoid arthritis is common. Operative stabilization is clearly indicated when signs and symptoms of spinal cord compression occur. However, many recommend early operative fusion before evidence of appreciable neural compression occurs because 1) the myelopathy in these patients may be irreversible; 2) the overall prognosis is poor once symptoms of cord compression are present; and 3) the risk of sudden death associated with atlantoaxial subluxation is increased even in asymptomatic patients. The authors believe that rheumatoid arthritis patients in relatively good health without advanced multisystem disease and less than 65 years of age should be considered for operative stabilization if mobile atlantoaxial subluxation is greater than 6 mm. Seventeen patients with severe rheumatoid arthritis and atlantoaxial subluxation treated with a posterior arthrodesis are presented. A new method of fusion, devised by the senior author (V.K.H.S.), was utilized in all cases. Indications for operative therapy in these patients included evidence of spinal cord compression in 11 patients (65%) and mobile atlantoaxial subluxation greater than 6 mm but no signs or symptoms of cord compression in six patients (35%). Thirteen patients developed a stable osseous fusion, two patients a well-aligned fibrous union, one patient a malaligned fibrous union, and one patient died prior to evaluation of fusion stability. The details of the operative technique and management strategies are presented. Several technical advantages of this method of fusion make this approach particularly useful in patients with rheumatoid arthritis. Because of multisystem involvement of this disease, a high rate of osseous fusion is often difficult to achieve. | |
| 3178905 | The incidence of rheumatoid arthritis is predicted by rheumatoid factor titer in a longitu | 1988 Oct | Rheumatoid factor (RF) is often detected in subjects who do not have rheumatoid arthritis (RA). To determine if the presence of RF is predictive of the development of RA, 2,712 Pima Indians of Arizona, 20 years of age or older, initially without RA, have been observed for up to 19 years with biennial examinations. These included a medical history, physical examination of the joints, radiographs, and RF determination by sheep cell agglutination test. During the study period, 70 new cases of RA developed. When the population at risk was stratified by RF titer, with reclassification at subsequent examinations if the RF titer changed, the age- and sex-adjusted incidence of RA increased with higher titers of RF. The incidence of RA (in cases per 1,000 person-years) according to RF titer was 2.4 (RF titer less than 1:2); 6.7 (titer 1:2-1:16); 11.0 (titer 1:32-1:256); and 48.3 (titer greater than 1:256) (P less than 0.001). The same trend was also found within each age and sex group, and within groups defined by the number of American Rheumatism Association criteria present before the definite diagnosis. We conclude that the presence of RF, in subjects without RA, is a risk factor for the development of RA, and that this risk is related to the RF titer. It is also suggested that RF may represent a marker of the earliest phases of the pathogenetic process of RA, that may be detectable before the appearance of other features that permit a clinical diagnosis. |