Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
1369857 [Surgical treatment of metacarpo-phalangeal joints in patients with rheumatoid arthritis]. 1990 The results of surgical treatment of 195 metacarpo-phalangeal joints in 132 rheumatoid patients were evaluated. The indications for each of three operative methods were presented with clinical assessment and Larsen, Dahle, Eek scale of radiological changes taken into consideration. The results of 137 synovectomies, 32 joint replacements and 24 arthroplasties in 88% were rated as good and fair. The advantages of early synovectomy as well as joint replacement in advanced arthritis were underlined.
1990399 Rheumatoid arthritis. New developments in treatment. 1991 Feb 1 If a patient with active rheumatoid arthritis does not obtain significant relief from nonsteroidal anti-inflammatory drugs, prompt institution of disease-modifying antirheumatic drugs (DMARDs) is recommended. If one agent fails, another may be tried. At present, hydroxychloroquine (Plaquenil) sulfate is one of the most widely used and best tolerated. Careful follow-up is essential with all DMARDs, however, because toxic effects may be severe and sometimes unpredictable.
3134896 Elevated soluble interleukin-2 receptor levels in the sera and synovial fluids of patients 1988 Jul In a previous study, we used an enzyme-linked immunosorbent assay to measure soluble human interleukin-2 receptors (IL-2R), and found that when activated lymphocytes produce cell-associated IL-2R, they also release a soluble form of IL-2R into culture supernatants in vitro. Soluble IL-2R have also been detected circulating in vivo at low levels in the serum of healthy individuals, and at abnormal levels in a variety of diseases, particularly those where immune dysfunction is thought to play an important role. We therefore evaluated serum IL-2R levels in 77 patients with rheumatoid arthritis (RA), and compared them with levels in 46 age-matched healthy controls. Nineteen additional RA patients with concurrently obtained sera and synovial fluid (SF) samples were compared with 14 patients with osteoarthritis of the knee or hip. The serum IL-2R levels were significantly elevated in RA patients, compared with the control groups (P less than 0.0001). Serum IL-2R levels in the RA patients did not correlate with disease activity as determined by a variety of clinical and laboratory parameters. RA SF IL-2R levels were significantly higher than corresponding RA serum IL-2R levels (P = 0.0001). No such difference was noted in the osteoarthritis group, where serum and SF IL-2R levels were comparable with serum levels in healthy controls. These findings support the hypothesis that in vivo lymphocyte activation plays an important role in RA; moreover, soluble IL-2R measurement in serum and SF may be a very useful way to identify patients at risk for, or manifesting, a chronic immune-mediated inflammatory arthropathy.
2218267 [Remission of rheumatoid arthritis--myth or reality?]. 1990 Apr Proceeding from a long-term observation of 956 patients with RA (rheumatoid arthritis) the authors discuss the problem of its remission. Spontaneous remissions of the disease are possible but in most of the cases remission comes as a result of therapy. Lengthy remission (from one to five years) was attained in 14 per cent of the patients, steady remission (not more than five years) in 8 per cent of the patients. The following types of remission are distinguished: spontaneous remission, genuine remission changing the nature of RA course, therapy-induced remission, sham remission no modifying the nature of the process. Different types of remission have been analysed. Importance of correct evaluation of remission in prognosticating the course of RA and the choice of the most effective treatment plan has been analysed.
3690136 Cholesterol crystals in shoulder synovial fluid. 1987 Dec Samples of 1945 synovial fluids have been examined from patients with a wide variety of joint disorders. Typical cholesterol crystals were seen in only 14 of these samples, all from the shoulders of six patients with severe rheumatoid arthritis and persistent shoulder effusions.
2259840 The effect of gold treatment on monocyte interleukin-1 production in rheumatoid arthritis. 1990 Monocyte interleukin-1 (IL-1) production in vitro was studied in 49 patients with rheumatoid arthritis (RA) and 31 controls. Twenty-six of the RA patients were studied prospectively for up to 12 months after beginning chrysotherapy. About half of the patients (group 1) exhibited pretreatment levels of monocyte IL-1 secretion (as measured by bioassay or B-IL-1) significantly higher than that of the controls. Immunoreactive IL-1 (IR-IL-1) levels, however, were similar to controls. Clinical improvement in this group of patients was modest and transient but could be associated with a fall in the level of IL-1 (B-IL-1 and IR-IL-1) secretion. Other RA patients (group 2) appeared to have normal or reduced pretreatment levels of IL-1 secretion. Chrysotherapy resulted in significant clinical improvement within 3 months, and this was associated with an increase in IL-1 (both B-IL-1 and IR-IL-1) secretion by the patients' blood monocytes to normal or supranormal levels. Thus these two groups of RA patients (which differed only in the average duration of disease) had different prognoses in relation to chrysotherapy and the effect of chrysotherapy-induced remission on monocyte IL-1 secretion was opposite. These results suggest that monocyte IL-1 production in vitro reflects changes secondary to the anti-rheumatic effects of chrysotherapy.
2600940 Bone remodeling and osteophyte formation after remission of rheumatoid arthritis. 1989 Nov Bone remodeling and osteophyte formation rarely take place in active rheumatoid arthritis (RA). To determine if disease inactivation leads to their occurrence, we studied 38 patients with RA whose disease had gone into drug induced remission. We looked for osteophytes at the metacarpophalangeal (MCP) joints in roentgenograms taken before and after remission, and correlated their presence to that of osteoarthritis of the distal interphalangeal (DIP) joints. There were 21 patients with RA who had a median of 3 (range 1-8) osteophytes in their "remission" films which were rarely present in their "activity" films (p less than 0.0001). The osteophytes were frequently symmetrical and most often located (41%) at the third MCP joint. In addition, we observed a peculiar remodeling of the styloid process in 13 patients, 9 of whom had developed MCP joint osteophytes. There were no other detectable differences between patients who had MCP joint osteophytes and those who did not. Presence of osteoarthritis at the DIP joints did not correlate with development of osteophytes. We were able to classify the MCP osteophytes into 3 types on the basis of their shape: hook-like that were most frequently bilateral and situated on the radial aspect of the metacarpal side of the joint, beak-like that were most often found at the ulnar aspect of the phalangeal side, and nipple-like which occurred equally on either sites. These differences in distribution indicate that they are not stages of the same process. Our findings indicate that paraarticular bone remodeling occurs upon remission of RA, even in joints where osteoarthritis is unusual. Its shape and location may depend on both their site and the mechanism of joint damage.
2765002 Pristane-induced arthritis. The immunologic and genetic features of an experimental murine 1989 Aug Pristane was injected intraperitoneally into mice of several strains, inducing an inflammatory seropositive arthritis in susceptible strains. The evolving histologic features included synovial hyperplasia, periostitis, and progressive marginal erosions. Multiple serologic immune abnormalities, including rheumatoid factor and anticollagen antibodies, also developed. Genetic analysis indicated that the major histocompatibility complex (H-2), C5 hemolytic complement (Hc), Newcastle disease virus-induced interferon (IF-1), and athymic (nu/nu) loci were involved in regulating susceptibility to pristane-induce arthritis. This experimental murine disease may provide a novel model of rheumatoid arthritis.
1682225 [Sulfasalazine in rheumatoid arthritis]. 1991 May 15 Sulfasalazine (SLZ) is now a second-line treatment in rheumatoid arthritis (RA), as well as in psoriatic arthritis and ankylosing spondylitis. 54 patients with active RA were treated with enteric coated SLZ (2 g daily) in a 24-week open study. Clinical and laboratory parameters of disease activity were monitored initially and thereafter at 2-week intervals for the first 2 months, and then at 4-week intervals until the end of the 24-week study. There was significant clinical improvement at the end, as shown by scores for joint pain (Ritchie), grip strength and morning stiffness (p less than 0.0001, less than 0.0001 and less than 0.01, respectively, by paired t test). Clinical improvement was accompanied by significant decrease in erythrocyte sedimentation rate and increase in hemoglobin (p less than 0.002 and less than 0.016, respectively). There was improvement in some cases as early as 3 weeks after starting therapy. The drop-out rate was significant: 19/54 (35%), most (13) due to side-effects, mainly gastrointestinal; none of the side-effects were serious. Our results, similar to those of other studies, indicate that despite the high rate of side effects, SLZ is an effective, second-line drug for RA.
2023194 Longterm cyclosporine therapy in rheumatoid arthritis. 1991 Jan Sixteen patients who had shown a good clinical response to cyclosporine therapy during a randomized 6-month double blind study comparing cyclosporine with D-penicillamine in active rheumatoid arthritis, had an opportunity to participate in an open study with cyclosporine. The initial daily dose of cyclosporine was 5 mg/kg. Before the planned maximal duration of 18 months, there were 6 premature discontinuations, 2 because of inefficacy, 2 because of side effects, and 2 for other reasons. During the study there was an improvement in all clinical variables. Even under the strict conditions of our trial there was an irreversible loss of about 15% of renal function. Suggestions are given to minimize the chance of nephrotoxicity.
3606680 Magnetic resonance imaging in the evaluation of patients with rheumatoid arthritis and sub 1987 Jun We used magnetic resonance imaging (MRI) to examine 21 patients with rheumatoid arthritis and vertebral subluxations of the cervical spine, in whom neurologic symptoms and signs indicated spinal cord compression. Based on neurologic signs, the patients were assigned to 1 of 3 classes: class I, no objective signs of cervical myelopathy (9 patients); class II, only 1 objective sign of cervical myelopathy (4 patients); or class III, 2 or more objective signs of cervical myelopathy (8 patients). Atlantoaxial subluxation (20 patients) and subluxations below C2 (6 patients) were detected equally well by MRI and radiography. MRI revealed physical distortion of the spinal cord in all class III patients with compressive myelopathy. This distortion was found less frequently in class II and class I patients (3 patients), and the difference was statistically significant (P less than 0.005, class III versus class I and class II). No correlation was found between the vertebral dislocation (measured in millimeters) on plain radiographs and the presence of cord distortion on MRI. Myelography in class III patients showed that passage of contrast medium was blocked at the same level as the cord distortion seen on MRI. These findings suggest that MRI can serve as a useful, noninvasive procedure in the diagnosis and management of rheumatoid arthritis patients in whom compressive cervical myelopathy is suspected.
3763219 [The shoulder joint in chronic polyarthritis]. 1986 Aug In patients with rheumatoid arthritis, shoulder problems are very common. In the present study, 96 of 105 patients, i.e., 91%, reported shoulder problems. Thirty-one percent of the patients had such severe shoulder disability that they considered it to be their main rheumatic problem. With increasing duration of the rheumatic shoulder disease, there are progressive destructive changes and a decrease in the range of motion and functional capacity even with conservative treatment, indicating that intervention with surgical procedures may be warranted. In the early effusive stages of rheumatic shoulder disease, radiological synovectomy with beta-emitting radionuclides may be indicated. In proliferative synovitis, surgical synovectomy gives good pain relief and increased shoulder mobility and function. In shoulders with more advanced painful shoulder arthropathy, shoulder replacement is gaining in popularity. However, it is mandatory that candidates must be selected very carefully for shoulder replacement and in patients with severe fibrotic capsulitis, muscular atrophy or mutilation with severe loss of bone, the results after shoulder replacement surgery are often less successful.
3213271 [Basic therapy of chronic inflammatory joint diseases with D-penicillamine and disorders o 1988 In the past, D-penicillamine has been thought to cause wound healing disturbances due to its influence on connective tissue. A series of 217 operations in 150 patients with rheumatoid arthritis on D-penicillamine treatment were performed and compared with controls (106 operations in 86 patients with rheumatoid arthritis). It was shown that disturbances of wound healing were less in patients on D-penicillamine therapy (12.4%) than in patients who did not receive D-penicillamine (18.9%). A perioperative withdrawal of D-penicillamine therefore does not seem justified.
2421531 Characteristic and specific histological findings in rheumatoid pleurisy. 1986 Jan The histological findings in rheumatoid pleuritis (RP), as seen in thoracoscopical biopsies, are found to be: A slightly inflamed stroma with a wave-like surface due to vessel-containing flattened papillae. The surface is covered by layers of pseudostratified epithelioid cells and scattered multinucleated giant cells, layers that easily detach as membranes, leaving the stroma surface "naked". These findings, in combination with the absence of mesothelial cell covering, are viewed as characteristic and specific, as based on a blind review of 17 pleural biopsies from RP patients and 14 biopsies from a control group.
3941873 Cricoarytenoiditis: CT assessment in rheumatoid arthritis. 1986 Feb The cricoarytenoid (CA) joint is a true diarthrodial joint that can be affected by rheumatoid disease. Its strategic location in the airway anatomy makes its evaluation of clinical importance. Direct fiberoptic laryngoscopy (DFL) and high-resolution computerized tomography (HRCT) were used to assess the larynx in 32 rheumatoid patients. Abnormalities were seen in 75% of patients at endoscopic examination. HRCT studies showed abnormalities in 72%. Erosion-luxation of the CA joint and surrounding soft-tissue swelling can be demonstrated on HRCT scans. A radiologic grading of the rheumatoid larynx is proposed, stressing that accurate evaluation of the larynx should be part of the diagnostic evaluation of every rheumatoid arthritic patient, given the high frequency of occurrence of rheumatoid laryngitis.
2925711 Arthrodesis of the cervical spine in rheumatoid arthritis. 1989 Mar Forty-one patients who had rheumatoid arthritis were treated with a cervical arthrodesis and were followed for a minimum of twenty-three months. Twenty patients had had an isolated atlanto-axial subluxation; five, isolated cranial settling; and four, subaxial subluxation alone. Twenty patients had an atlanto-axial arthrodesis; sixteen, an occipitocervical arthrodesis; and five, a posterior arthrodesis of the subaxial spine. In addition, two patients had a transoral odontoidectomy and one, an anterior cervical vertebrectomy. At the latest follow-up, thirty-six (88 per cent) of the patients had osseous union, two had fibrous union but were stable, and three had a non-union. All of the problems with union occurred in the patients who had had an isolated atlanto-axial arthrodesis. Clinically, twenty-seven (66 per cent) of the patients had improved, fourteen were unchanged, and none were worse. The preoperative neurological status remained the same postoperatively in thirty patients (73 per cent) and it improved in eleven (27 per cent). Twenty-one of the twenty-three patients who had had marked pain preoperatively had little or no pain at the latest follow-up. Complications included a transient hemiparesis in one patient, a superficial wound infection in two, displacement of an anterior graft in one, a broken wire in three, and erosion of methylmethacrylate into the outer part of the occipital cortex in one. Four patients died, but not as a result of the operation.(ABSTRACT TRUNCATED AT 250 WORDS)
1856816 Rheumatoid iliopsoas bursitis presenting as unilateral femoral nerve palsy. 1991 Mar A 65-year-old woman with rheumatoid arthritis (RA) developed symptomatic compression of the femoral nerve secondary to an iliopsoas bursitis. Her adjacent hip joint was not severely affected by arthritis. This entity should be included among the entrapment neuropathies complicating RA.
2888802 Collagenous colitis and rheumatoid arthritis with response to sulfasalazine. A case report 1987 Aug Collagenous colitis has been associated with rheumatoid arthritis in only a few cases. We describe a 76-year-old man with chronic rheumatoid arthritis whose diarrhea and abdominal pain came from collagenous colitis. He had a good clinical response to sulfasalazine. We review the clinical and histopathological features of collagenous colitis, together with the different therapeutic approaches.
2595346 Backward tilting of the posterior atlantal arch in rheumatoid arthritis. 1989 In a retrospective survey of 450 patients with rheumatoid arthritis on whom cervical spine radiography was performed, one patient was found with a backward tilting of the posterior arch of the atlas. With preserved relations anteriorly, the posterior arch was rotated downward in front of the spinous process of the axis, encroaching on the space of the spinal canal.
1925396 [Levels of IgA rheumatoid factors in seropositive rheumatoid polyarthritis. Absence of cor 1991 Jul Rheumatoid factors of the IgA isotype directed to human IgG Fc fragment were assayed, using an Elisa test, in the serum of 30 patients with seropositive rheumatoid arthritis and in the synovial fluid of 9 of them. A high incidence was found in the serum (90%) and synovial fluids (77%). Clinical, radiological and biological parameters of each patients were recorded at the time of the assay, and two years later. There was no statistically significant association between IgA rheumatoid factors levels and other parameters, nor with a pejorative evolution. However, a significant negative correlation was observed between IgA rheumatoid factors levels and the duration of the disease, suggesting that IgA rheumatoid factors are predominantly produced at the earliest stages of rheumatoid arthritis.