Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 3718568 | Methotrexate therapy in juvenile rheumatoid arthritis: a retrospective study. | 1986 Jun | Nineteen selected patients with severe, mostly systemic onset, juvenile rheumatoid arthritis were treated with methotrexate (MTX) for an average of 10.5 months. Twelve patients showed statistically significant improvement, as measured by the number of affected, swollen, tender, and functionally impaired joints, and by decreases in erythrocyte sedimentation rate and C-reactive protein and an increase in hemoglobin level. Systemic manifestations improved in 6 of 8 patients. In 10 children receiving corticosteroids, the dosage was reduced. Seven patients did not respond to MTX therapy. Six of them showed an unchanged disease course, and 1 had a relapse after 4 months of MTX treatments. Probable side effects included gastrointestinal symptoms, elevated liver enzymes, and herpes zoster infection. MTX treatment should be considered for children with life-threatening or severe disabling arthritis that is unresponsive to other therapy. | |
| 2059234 | Development of a disability measurement tool for juvenile rheumatoid arthritis. The Juveni | 1991 Jul | Two questionnaires were developed for measuring disability due to juvenile rheumatoid arthritis (JRA), one based on patient reports and one on parent reports. These questionnaires were termed the Juvenile Arthritis Functional Assessment Report for Children (JAFAR-C) and for Parents (JAFAR-P). The questionnaires were administered to 72 JRA patients ages 7-18 years and to their parents. Respondents rated the patient's recent ability to perform 23 activities. Patient reports and parent reports were found to correlate highly with each other and with an objective assessment performed by therapists. Questionnaire scores did not correlate significantly with the age of the patient. The JAFAR appears to be a convenient, reliable, and valid measure of disability in patients with JRA. | |
| 1881719 | Randomized, double-blind trial of deflazacort versus prednisone in juvenile chronic (or rh | 1991 Sep | Thirty-four children with juvenile chronic (rheumatoid) arthritis were recruited to a randomized, double-blind study of deflazacort (an oxazolone derivative of prednisone) vs prednisone. All had been receiving glucocorticoid therapy for at least 1 year and required at least 5 mg/d of prednisolone (usually as 10 mg every 2 days). Thirty-one children completed the study. Bone density trends were measured in the spine by dual photon absorptiometry and in the forearm by single photon quantitative computed tomography at 3-monthly intervals. Trends (velocities) in bone and soft tissue growth were calculated. In the spine, bone growth correlated well with indices of soft tissue growth, but covariance analysis showed a significant advantage (P less than .007) of deflazacort when spinal bone mineral growth was compared to body surface area and weight. In part this was due to a temporary interruption in weight by children receiving deflazacort, whose gain in height was comparable with that of the prednisone group. Some children in both groups improved clinically and showed catch-up growth; in these children relative spinal bone mineral growth velocities were about twice those observed for height and weight. It is concluded that during the first year of deflazacort, their spinal bone mineral content at a level that was appropriate for their height and weight. Further observations are required to establish whether this advantage can be maintained subsequently. The anti-inflammatory effects of the two glucocorticoids appeared similar. | |
| 2797280 | [Bacterial joint infections: a retrospective study for the source of the infection]. | 1989 Aug 26 | Bacterial arthritis causes rapid damage of the affected joint. Knowledge of the source of the infection that leads to septic arthritis is necessary to judge possible preventive measurements. In this study we tried to detect the source of the infection in 77 episodes of bacterial arthritis in 73 patients admitted in the period 1976-1986. The source of infection was: a joint operation in 21, the skin in 15, the respiratory tract in 7, the genital tract in 8, others in 5, and unknown in 21. A skin infection was the source in patients suffering from rheumatoid arthritis. To our surprise in none of our cases was non-sterile surgery the cause of infection. Our results suggest that since perioperative joint infection is frequent, prevention of such infection may be meaningful. Skin infections are often the source of infection in rheumatoid arthritis, preventive measures are to be considered. Our results do not allow a judgment on the possible preventive measures for the other sources of infection detected or undetected. Administration of antibiotics during non-sterile surgery is not supported by the results of this study. | |
| 3363964 | Sternoclavicular bacterial arthritis. | 1988 Mar | Bacterial infection of the sternoclavicular joint is an unusual event, with cases being reported in those with diabetes mellitus, in intravenous drug abusers, and in patients afflicted with rheumatoid arthritis. A case of this unique infection occurred in a person not known to be at risk for septic arthritis. Our report shows the difficulty in diagnosing this disorder. | |
| 2612120 | Palindromic rheumatism in Israel--a disease entity? A survey of 34 patients. | 1989 Dec | Over a period of 10 years 34 patients were diagnosed as suffering from palindromic rheumatism. Eighty-one percent of the patients were of North African origin. This is significantly higher (p = 0.01) than the age-adjusted origin of the general population in the region. Attacks were usually monoarthritic or oligoarthritic in nature. The joint most often involved was the knee. Prophylactic therapy with colchicine was ineffective. Gold salts brought about partial remission in three of six patients. Despite a relatively long average follow-up period of 9.3 years and the finding of a positive rheumatoid factor in 12% of the patients, not one of the patients developed rheumatoid arthritis. In 50% of the patients we detected an unexplained elevation in serum globulins and immunoglobulins. The possible association between this syndrome and Familial Mediterranean Fever is discussed. | |
| 3494455 | Immunity to soluble retinal antigen in patients with uveitis accompanying juvenile rheumat | 1987 Mar | Studies of immunity to bovine soluble retinal antigen (antigen S) were carried out using serum and peripheral blood lymphocytes from children with juvenile rheumatoid arthritis and chronic anterior uveitis (JRA-uveitis), children with JRA alone, children with nonrheumatic diseases, and controls who had no ocular or rheumatic disease. Enzyme-linked immunosorbent assay and the lymphocyte transformation assay were used to determine immunity. Antibody to antigen S was present significantly more frequently in children with JRA-uveitis than in children with JRA alone, children with nonrheumatic disorders, or controls. These latter groups did not differ in positivity for this antibody. Lymphocyte transformation occurred more frequently in children with JRA-uveitis than in children with JRA alone or controls. Children with JRA alone and controls had similar frequencies of lymphocyte transformation positivity. Enzyme-linked immunosorbent assay positivity and lymphocyte transformation positivity tended to occur in different children. Children with JRA-uveitis who had HLA-B35 had the highest frequency of antibody to antigen S. Immunity to antigen S may be the result of ocular damage by mechanisms other than a pathogenic mechanism per se. | |
| 2979820 | Rheumatoid factor diversity. | 1988 Jan | Rheumatoid factors, antibodies directed against the Fc portion of IgG, exhibit considerable isotypic and idiotypic diversity. Differential expression of IgM and IgA rheumatoid factors suggests that isotype-specific regulatory pathways are operative in man. The physical characteristics of IgA rheumatoid factor in rheumatoid arthritis have also been investigated. Although the polymeric form of IgA rheumatoid factor generally predominates in sera and synovial fluids of rheumatoid arthritis patients, wide variations in the ratio of monomeric to polymeric IgA rheumatoid factor are observed. Both forms are elaborated by synovial plasma cells. That differences in the proportions of monomeric and polymeric IgA RF present in sera may be of pathogenetic significance is suggested by evidence that complexes of polymeric IgA rheumatoid factor and IgG are potent inducers of lysosomal release by RMN whereas monomeric IgA rheumatoid factor-IgG complexes are essentially inactive in this regard. The idiotypic diversity of rheumatoid factors has also been under intensive investigation. A monoclonal antibody designated 6B6.6 recognizes a Vk-associated idiotype present on approximately one-third of IgMk rheumatoid factor paraproteins, but only a small fraction of polyclonal IgM 6B6.6-defined idiotype is distinct from previously described rheumatoid factor cross-reactive idiotypes. Taken together, these studies underline the extensive diversity of rheumatoid factors present in various conditions. Application of molecular genetic approaches to the study of rheumatoid factors should provide explanations for the molecular basis of this diversity and serve to clarify the relationship among rheumatoid factors expressed in both physiologic and pathologic states. | |
| 1817067 | Impaired mandibular growth and micrognathic development in children with juvenile rheumato | 1991 Dec | The present report is a longitudinal study of the craniofacial growth, based on lateral cephalographs of a group of 26 patients with juvenile rheumatoid arthritis (JRA), and a matched English control group. In the 26 matched pairs, the mean age at baseline was 8.4 years and at 6-year follow-up 14.7 years, female/male ratio was 3.3/1, and all patients had temporomandibular joint (TMJ) abnormalities. The study revealed obvious growth disturbances in the facial skeleton in the children with JRA. Compared with the controls, the patients showed a smaller mandible with an altered morphology and position. The mandible became more retruded by rotating posteriorly, around a centre in the molar region, and was characterized by appositional growth in the gonion area, vertical growth in the anterior part and proclination of the lower incisors. During the observation period the growth disturbances became more pronounced, reflecting the progressive nature of the abnormal development. Based on these findings, a future aspect of research in this field could be TMJ surgery and orthognathic surgery in an early stage, trying to avoid this unfavourable facial development. | |
| 2428704 | [Review. The status of plasmapheresis and apheresis]. | 1986 | The paper surveys the technical and clinical development of plasmaexchange therapy. Until today there is no agreement on a unique treatment protocol, the variation ranges from 3-4 treatments in multiple sclerosis to biweekly chronic treatment in hypercholesterolaemia. An exchange volume of 1-1.5 of the plasma volume is recommended. Despite occasional complications, mostly due to replacement fluid, the method is regarded as safe. The first clinical application dates back to 1952, when Adams reported on the treatment of hyperviscosity syndrome. With rheumatoid arthritis plasmaexchange therapy of immunological mediated diseases started in 1963. In the following years a lot of enthusiastic case reports caused a general therapeutic optimism which was to be corrected by controlled trials. There is no proven benefit of plasmapheresis in rheumatoid arthritis and rapid glomerulonephritis for instance. For lymphoplasmapheresis in rheumatoid arthritis and for plasmapheresis in multiple sclerosis and renal graft rejection the results are contradictive. The paper discusses the different indications for apheresis therapy including hematologic disorders to be treated with plasmapheresis or cytapheresis. | |
| 3260954 | Rheumatic disease in the Nuu-Chah-Nulth native Indians of the Pacific Northwest. | 1988 Apr | The Nuu-Chah-Nulth are a tribe of 2,300 Pacific Northwest native Indians. A retrospective study has identified 157 requiring referral to rheumatologists over 15 years. Rheumatoid arthritis (RA) was found in 23, systemic lupus erythematosus (SLE) in 8, sacroiliitis 5, and Reiter's syndrome 1. Overlap syndromes with combinations of RA, SLE, scleroderma and polymyositis were seen in 9. Other rheumatic disorders included osteoarthritis 10, soft tissue rheumatism 14, and musculoskeletal complaints of known etiology (trauma, infection, neoplasm) 12. The remaining 75 patients suffered from periodic weather dependent joint swelling (52) or polyarthralgia (23) which were sometimes accompanied by features of systemic connective tissue disease. These findings are compared with rheumatic disease in other North American Indians. | |
| 2545000 | [Infantile JRA and ACTH therapy]. | 1989 Feb | Systemic juvenile rheumatoid arthritis is characterized by chronic arthritis and associated with extra-articular features. Although JRA may present at any age throughout childhood, the onset of symptoms during the first year of life is relatively uncommon. The diagnosis of infantile JRA is difficult because of poor complaints. We had a 7-month-old female, first onset at 6 months of age for daily "spiking" fever and skin rash, subsequently developed signs of systemic rheumatoid arthritis. Although aspirin or other nonsteroidal anti-inflammatory agents were used for the therapy, no significant effect was obtained. Prednisone was administered to control arthritis and serious systemic features, however no satisfactory effect was shown. In this patient a single morning alternate-day shot of ACTH-Z (4 units) was employed, and this regimen showed significant effect to control her clinical symptoms. It may be necessary to add a small dose of ACTH-Z for control in some cases of infantile JRA patient compared to adult cases. | |
| 2181722 | [Clinical manifestations of primary Sjogren's syndrome]. | 1990 Feb 28 | The article reviews the symptoms and signs of primary Sjögren's syndrome. It describes the clinical and laboratory investigations of such patients, and briefly discusses the occurrence of malignancy in Sjögren's syndrome. | |
| 3052034 | Diagnosis of Sjögren's syndrome in children. | 1988 Nov | We treated four children with clinical symptoms and laboratory findings suggestive of Sjögren's syndrome (SS). We also review the findings in 23 children with the diagnosis of SS whose cases were reported in the literature. We propose that the following criteria for the diagnosis of SS, which are mostly used in adults, should also be applied to children: (1) keratoconjunctivitis evidenced by a Schirmer test and a quantitative rose bengal test; (2) xerostomia shown by a decreased basal and stimulated salivary flow; (3) lymphocytic infiltration in a minor salivary gland biopsy specimen with at least two foci per 4 mm2; (4) laboratory evidence of a systemic autoimmune disorder on the basis of a rheumatoid factor of 1/160 or greater, antinuclear antibody of 1/160 or greater, or extractable nuclear antigen antibodies. Only close observation and long-term follow-up of these patients will allow a better insight in the natural history of SS in children. Those children who do not fulfill these diagnostic criteria also need close and prolonged follow-up study: one of the possibilities is that their conditions will ultimately evolve toward definite SS. | |
| 2710699 | The Charnley total hip arthroplasty in juvenile rheumatoid arthritis patients. | 1989 Mar | A follow up of 27 consecutive total hip arthroplasties in 16 patients with juvenile rheumatoid arthritis was performed. The mean age at surgery was 18 years, and the average follow-up period was 64 months. No serious early complications were recorded, but three deep infections developed from 6 to 18 months after the arthroplasty, all requiring revision. The clinical results were good at follow up, as 20 hips were free of pain and 7 had only slight pain. Most of the patients had improved their walking ability and the range of motion in the hip as well. A poor correlation was, however, shown between the clinical and the roentgenographical results, as there was one femoral implant that was definitely loose and four more hips that had components which were probably loose. The frequency of infections might have been reduced by using antibiotic prophylaxis during surgery in all the cases; the frequency of aseptic loosening might also have been reduced by improved cementing techniques. Because of high loosening rate without clinical symptoms, it is recommended to follow the patients roentgenographically to make revision surgery possible while the bone stock still is sufficient. | |
| 2064906 | The epidemiology of rheumatic diseases. | 1991 Apr | This review concentrates on certain areas of current interest in the major rheumatic diseases. In rheumatoid arthritis, there is some epidemiologic evidence that the disease is diminishing in incidence and severity. The possible protective effect on rheumatoid arthritis of the oral contraceptive pill has also attracted attention. There is some evidence that it may act by modifying the disease process. Parity may also be a protective factor in rheumatoid arthritis. Recent twin studies have suggested that the monozygotic concordance rate may be lower than previously believed, suggesting that genetic factors may only account for 20% of the disease. In osteoarthritis, new clinical criteria for the hand, knee, and hip have appeared that require further testing. The finding of a specific mutation of one amino acid of a procollagen II gene in family members with premature osteoarthritis has aroused considerable interest. There has been recent debate on the risk of developing ankylosing spondylitis in the population with HLA B27, although most believe this to be less than 7%. Scleroderma is a rare disease that may be increasing in incidence. One study has suggested the clustering of cases around airports. In the majority of countries, osteoporotic fractures appear to have increased at all ages over the last 30 years, although methods of screening using questionnaires or single bone density measurements are unlikely to be useful as widespread public health measures. The question of estrogen use is increasingly being dominated by the large cardiovascular benefit. | |
| 1768683 | [Heart alterations in chronic polyarthritis]. | 1991 | Described in this paper are pathomorphological alterations to the heart postmortem recorded from 100 deceased with rheumatoid arthritis. Vasculitis of subepicardial or intramural rami of coronary arteries was recorded from twelve cases and had caused multiple myocardial necrosis in ten of these. These developments had led to progressive cardiac insufficiency which actually then was the direct cause of death. Formal pathogenesis of vasculitis-related multifocal myocardial necrosis in concomitance with rheumatoid arthritis had never been described in the literature before, although such reference would have been justified for the clinical consequences for which it deserves to be emphasised as a nosological entity in its own right. Isolated rheumatic nodes were detected in the myocardium of five of the decreased and could be attributed to rheumatic arteritis in two cases. Those myocardial rheumatic nodes, according to the author's view, represent the severest form of necrotising rheumatic vasculitis. Pathognomonic pericarditis was found in four cases (2 pericarditis nodularis and 2 pericarditis rheumatica). Pathognomonic nodular valvulitis was identified in another four cases. Systemic secondary amyloidoses were found to be present in 24 of the above 100 deceased with chronic polyarthritis. The heart was involved in 23 of these 24 cases (95.8%). | |
| 2600945 | Juvenile rheumatoid arthritis inflammatory eye disease. Parasitization of ocular leukocyte | 1989 Nov | Patients with juvenile rheumatoid arthritis (JRA) commonly develop serious eye disease, particularly chronic uveitis. Most chronic uveitis is idiopathic. Mollicute-like organisms (MLO) were recently reported to be a common cause of chronic uveitis. MLO are pathogenic intracellular cell wall deficient bacteria. No culture system exists for MLO. Disease diagnosis is based on detection using a transmission electron microscope. Uveitis producing MLO are detectable within parasitized intraocular leukocytes. They appear as intracytoskeletal 0.005-0.01 micron diameter filaments and undulating pleomorphic 0.01-1.0 micron tubulospherical bodies. This report describes MLO parasitized lesional leukocytes in the inflammatory eye disease of 5 patients with JRA. Our results indicate that MLO caused the uveitis of these patients. The significance of these findings and rifampin treatment of MLO disease are discussed. | |
| 2977987 | Spontaneous improvement of juvenile rheumatoid arthritis after T lymphocytosis with suppre | 1988 Dec | Spontaneous improvement of active juvenile rheumatoid arthritis (JRA) occurred after T lymphocytosis in an 8-year-old boy. He had prominent lymphocytosis, the count reaching 59,000/mm3, followed by spontaneous disappearance of fever, arthralgia, lymphadenopathy, hepatomegaly, and C-reactive protein. The serum immunoglobulin levels were gradually decreased. The surface marker analysis, using two color flow cytometry, showed that the lymphocytes were activated suppressor T lymphocytes, expressing CD3, CD8, HLA-DR, and CD8 plus CD11. When studied in vitro with pokeweed mitogen stimulation, the T lymphocytes significantly suppressed the immunoglobulin production by autologous B lymphocytes as compared with the T lymphocytes at remission (p less than 0.01). Based on the widely believed notion that depression of suppressor T lymphocyte functions is one of the important mechanisms underlying systemic JRA, the activated T lymphocytosis with the suppressor phenotype and suppressive function on the immunoglobulin production may have been related to the improvement of active JRA in the patient. | |
| 3517321 | Azathioprine versus placebo in patients with juvenile rheumatoid arthritis: a single cente | 1986 Feb | Thirty-two patients with juvenile rheumatoid arthritis (JRA) entered a comparative, double blind, parallel 16-week clinical trial of azathioprine versus placebo. After 8 weeks of therapy the changes in disease activity measurements indicated an improvement in the azathioprine group compared to the placebo group. At the end of the study, most of the disease activity measurements were changed in favour of the azathioprine group compared to the placebo group, but statistically significant differences between the groups were found for only 2 disease activity measurements. Therapy was stopped for 2 patients in the azathioprine group because of reversible leukopenia. Our results and the risk for severe adverse reactions indicate that azathioprine remains a third line drug for patients with JRA. |