Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 7906428 | Adverse interaction between intramuscular methylprednisolone and sulphasalazine in patient | 1994 | A defective hypothalamic-pituitary-adrenal axis has been associated with susceptibility to arthritis in rats and with rheumatoid arthritis in humans. The effect of corticosteroid supplementation in early RA has not been tested previously. We undertook a double-blind placebo-controlled study of sulphasalazine plus either corticosteroid or placebo. No early benefit was demonstrated as 7 of 11 of the corticosteroid supplemented group had withdrawn by 1 year. The addition of corticosteroids to sulphasalazine in patients with early disease did not appear to offer any benefit. | |
| 1417106 | Palmar rheumatoid nodulosis associated with local pressure. | 1992 Aug | Rheumatoid nodulosis is a term used to describe adult patients with rheumatoid arthritis with little or no clinical joint inflammation who have numerous subcutaneous nodules indistinguishable from those of patients with active rheumatoid arthritis. This paper reports the case of a woman with quiescent rheumatoid arthritis who developed palmar nodulosis three weeks after the strenuous activity of painting her apartment. This case illustrates the direct association between the appearance of nodulosis and physical pressure despite inactive disease. | |
| 8607891 | Gender, paid work, and symptoms of emotional distress in rheumatoid arthritis patients. | 1996 Mar | OBJECTIVE: To evaluate the relative contribution of gender-related work conditions, gender-related socialization practices, and disease characteristics to the explanation of emotional distress in men and women with rheumatoid arthritis (RA). METHODS: Three hundred sixty-nine RA patients who were employed outside the home were recruited from a national randomized sample of rheumatology practices. Data on paid work and disease characteristics were obtained by telephone interview. Emotional distress was measured by the Center for Epidemiological Studies Depression (CES-D) scale. Hierarchical ordinary least-squares regression was used to assess the relationship of sex, class, work characteristics, and disease characteristics to both the CES-D summary scale and the CES-D factor structure. RESULTS: Differences in emotional distress were explained best by functional ability and pain and secondarily by the characteristics of paid work, with no independent effect for sex. Distress increased with decreasing functional ability, increasing pain, and exposure to such work characteristics as low autonomy, low income, and high demands. No sex differences in any of the CES-D subscales remained after controlling for disease and work variables. CONCLUSION: Among employed RA patients with high levels of functional disability and exposure to stressful work characteristics, men and women are at equal risk of experiencing emotional distress. | |
| 8053640 | Histomorphometry of periarticular bone in rheumatoid arthritis. | 1994 | Periarticular osteoporosis is a common feature of rheumatoid arthritis. However, the cellular basis and the aetiology of periarticular bone loss have not been established. We studied periarticular bone samples obtained from metatarsal resections (n = 18) and total knee arthroplasties (n = 9) by histomorphometry. Autopsy material (n = 10) and patients with osteoarthrosis (n = 11) served as controls. Histomorphometrically, there was reduced trabecular bone volume and increased resorption surfaces in rheumatoid arthritis patients in most of the measured areas. The indices of bone turnover were most markedly increased in the vicinity of inflammatory cells and rheumatoid granulation tissue. Trabecular bone volume and the degree of inflammation as measured by the erythrocyte sedimentation rate (ESR) had a negative correlation. In addition, an elevated ESR was associated with increased osteoid parameters in periarticular bone. We conclude that periarticular bone loss in rheumatoid arthritis is due to increased bone resorption. Local inflammatory mediators might account for the increased bone turnover. | |
| 7728401 | The prevalence of rheumatoid arthritis in affluent and poor urban communities of Pakistan. | 1995 Mar | Using previously applied methods a survey of joint symptoms was undertaken among 4232 adults, evenly distributed between affluent and poor areas of Karachi, Pakistan. Only six cases of definite rheumatoid arthritis (RA) (1958 ARA criteria) were identified in the 245 persons who complained of joint problems of at least 4 weeks duration. The prevalence was 0.9 [confidence interval (CI) 0.21-3.61] and 1.98 (CI 0.55-5.1) per thousand in the poor and affluent districts, respectively. These were substantially less than prevalence rates reported in the West but were similar to figures derived from other developing countries. There was no obvious impact of current living standards on the findings. The relative paucity of older female subjects in both the affluent and poor communities may account at least in part for the low rates observed. The infrequency of rheumatoid nodules in Southern Asians with RA illustrates the difficulty of applying existing diagnostic criteria to this community. | |
| 1409699 | Anti-tumor necrosis factor ameliorates joint disease in murine collagen-induced arthritis. | 1992 Oct 15 | There is considerable evidence implicating tumor necrosis factor alpha (TNF-alpha) in the pathogenesis of rheumatoid arthritis. This evidence is based not only on the universal presence of TNF-alpha in arthritic joints accompanied by the upregulation of TNF-alpha receptors but also on the effects of neutralizing TNF-alpha in joint cell cultures. Thus, neutralization of TNF-alpha in vitro results in inhibition of the production of interleukin 1, which like TNF-alpha, is believed to contribute to joint inflammation and erosion. To determine the validity of this concept in vivo, the effect of administering TNF-neutralizing antibodies to mice with collagen-induced arthritis has been studied. This disease model was chosen because of its many immunological and pathological similarities to human rheumatoid arthritis. TN3-19.12, a hamster IgG1 monoclonal antibody to murine TNF-alpha/beta, was injected i.p. into mice either before the onset of arthritis or after the establishment of clinical disease. Anti-TNF administered prior to disease onset significantly reduced paw swelling and histological severity of arthritis without reducing the incidence of arthritis or the level of circulating anti-type II collagen IgG. More relevant to human disease was the capacity of the antibody to reduce the clinical score, paw swelling, and the histological severity of disease even when injected after the onset of clinical arthritis. These results have implications for possible modes of therapy of human arthritis. | |
| 7795266 | Cross-sectional assessment and subgroup comparison of functional disability in patients wi | 1995 Feb | A cross-sectional study was undertaken on 222 patients with rheumatoid arthritis (RA) within a Swedish health-care district. An exploratory analysis of functional status, according to a Swedish version of the Health Assessment Questionnaire (HAQ), was carried out in order to explore the extent and pattern of functional disability in an unselected group of individuals with RA. The mean score of functional disability according to HAQ increased with more clinical manifest disease. There were no significant differences between the mean score in men and women. Most functional disability was related to hand-grip function and the ability to take care of personal hygiene. Increased functional disability was significantly associated with increasing age and disease duration. There was no significant relation between functional status and housing condition and educational level. A strong correlation was found between pain and functional disability. Multiple regression analysis was performed and predictive functional scores were tabulated based upon sex, age at onset and duration of RA disease. | |
| 8040437 | Bronchiolitis obliterans associated with rheumatoid arthritis: findings on HRCT and dynami | 1994 Jul | OBJECTIVE: To show the CT findings of bronchiolitis obliterans (BO) associated with rheumatoid arthritis. MATERIALS AND METHODS: We used high-resolution CT (HRCT) and dynamic expiratory cine CT to evaluate two patients with rheumatoid arthritis and a clinical diagnosis of BO. Both had pulmonary function tests to correlate with the radiographic findings. RESULTS: High-resolution CT showed bronchiectasis and mosaic perfusion in both patients. Expiratory CT showed multiple scattered areas of air trapping consistent with small airway obstruction. Imaging findings correlated with pulmonary function tests, which showed severe airway obstruction and inhomogeneous lung ventilation. CONCLUSION: Pulmonary HRCT and dynamic expiratory CT are useful in verifying the clinical diagnosis of BO in patients with rheumatoid arthritis, particularly those too unstable to undergo open lung biopsy. | |
| 8674144 | Spondylarthropathies: from gut to target organs. | 1996 Feb | Recent studies strongly support the concept that gut and joint inflammation are closely related. Progress also has been made in identifying individual mechanisms that contribute to the pathogenesis of joint disease in IBD and in undifferentiated SpAs. However, the interrelationship of these mechanisms that result in chronic disease manifestations at a site distant from the initiating event remain to be elucidated. The local absence of homing molecule receptors in the gut wall combined with an expression of these receptors in target organs can be responsible for the transformation of the synovial membrane and/or the enthesis into an aberrant tertiary lymphoid organ of the gut. | |
| 8646440 | A randomized clinical trial of in-patient multidisciplinary treatment versus routine out-p | 1996 May | The aim of the present study was to compare the effects of in-patient multidisciplinary treatment with standard out-patient care in patients with active rheumatoid arthritis (RA). Eighty patients with active RA were randomized to receive 11 days of in-patient multidisciplinary treatment followed by standard out-patient care (n = 39), or to standard out-patient care only (n = 41). Patients were assessed at baseline, and after 2, 4, 12 and 52 weeks. In the in-patients, the improvement in variables of disease activity (weeks 2 and 4) and emotional status (weeks 4 and 12) was greater when compared with the out-patients (P < 0.05). The improvement in laboratory and functional measures did not differ between the groups. In the in-patient group, the percentage of patients responding to the American College of Rheumatology criteria for improvement was significantly greater at any time point during follow-up than in the out-patient group. A short period of in-patient multidisciplinary treatment for active RA has a direct beneficial effect on disease activity and emotional status with the favourable effect on disease activity remaining after 52 weeks. | |
| 7732492 | [Histomorphometric study of osteoporosis in rheumatoid arthritis]. | 1995 Feb | A histomorphometric study of osteoporosis in rheumatoid arthritis was performed on thirty-eight specimens from the proximal tibial metaphysis, which were obtained during total knee arthroplasty. Fourteen specimens from the proximal tibial metaphysis of osteoarthritis patients were also histomorphometrically studied, and the osteoporosis in rheumatoid arthritis was compared with it in osteoarthritis. In nine rheumatoid arthritis patients, specimens from the iliac bone were obtained, and the difference between the generalized osteoporosis and the juxta-articular osteoporosis was evaluated. The proximal tibial metaphysis in rheumatoid arthritis was usually represented by a fairly low bone area and by thin mean trabecular thickness. No correlations were seen between histomorphometric parameters and the age at operation, the age of onset and the duration of disease. However, in patients of long duration (over 20 years), the bone area was very low and mean trabecular thickness was thin. In one parameter (scalloped surface) which shows bone resorption, there was a high correlation between generalized osteoporosis and juxta-articular osteoporosis in rheumatoid arthritis. There was no significant difference between rheumatoid arthritis and osteoarthritis in bone area and mean trabecular thickness. However, the scalloped surface of rheumatoid arthritis was significantly higher than it of osteoarthritis. | |
| 8833050 | History of combination therapy of rheumatoid arthritis. | 1996 Mar | Faced with continued active rheumatoid arthritis (RA) despite conventional treatments, clinicians have added and combined whatever drugs were available to them, attempting to increase the benefits and minimize the adverse effects of treatment. First, combined antimalarial and gold salts therapy was favorably compared with antimalarial therapy in a large series of patients reported in 1963, but was cautioned against in 1966 because of concern about increasing toxicity. This concern discouraged subsequent publication of clinical experiences with combination therapies until 1982, when major benefits were reported in 17 patients treated with cyclophosphamide, azathioprine, and hydroxychloroquine. This report opened the door to numerous abstracts and publications during the 1980s, describing anecdotal series and poorly controlled clinical trials with various combinations of disease modifying antirheumatic drugs (DMARD), mostly with favorable results. During the past 5 or 6 years, a few, large, well controlled, randomized, double blind clinical trials with a balanced design have been published, but conclusive evidence of benefit from combinations of DMARD was lacking. Recent abstracts have suggested that triple therapy with methotrexate (MTX), hydroxychloroquine, and sulfasalazine produces additive benefits, and that the addition of cyclosporine, in patients who are poorly controlled by MTX, is more effective than continuing MTX alone. Only a few of the many possible permutations and combinations of drugs and doses have been evaluated, and confirmatory studies have not been done. Combination therapy of RA is only now starting to evolve, with most major milestones yet to be achieved. | |
| 8983573 | [Pleural effusion as initial presentation of rheumatoid arthritis. Cytological diagnosis]. | 1996 Oct | A 24-year-old woman with an unremarkable history presented with a large right-sided pleural effusion. Analysis of the pleural fluid showed a sterile exudate with a low sugar level. Complementary analyses were unable to pinpoint the etiology. The effusion was drained and the patient was released with no specific diagnosis. Nine months later the effusion recurred and the initial laboratory analyses were the same. Pleural fluid cytology revealed the presence of an amorphous necrotic background and non-small cells with multiple nuclei, two signs that constitute part of the pathognomonic triad of rheumatoid pleural effusions, the third characteristic benign fusiform histocytes. The biochemical characteristics of the pleural fluid thus suggested rheumatoid pleural effusion, and cytology confirmed the diagnosis. Corticoid therapy effected spectacular recovery, but when the dose was reduced, rheumatoid symptoms presented in the joints. Rheumatoid arthritis should be considered as a possible explanation for unexplained pleural effusion. Cytology must be used for diagnosis. | |
| 8777854 | Facioscapulohumeral dystrophy with myositis associated with rheumatoid arthritis. | 1996 Mar | We report a case of facioscapulohumeral dystrophy with myositis, rheumatoid arthritis and serologic findings suggestive of autoimmune disease. To our present knowledge this is the first time this association has been observed. | |
| 1458790 | Rheumatoid nodulosis: a puzzling variant of rheumatoid arthritis. | 1992 Sep | Four patients with rheumatoid nodulosis are here described, together with a review of cases reported to date in the literature. This particular variant of rheumatoid arthritis (RA) is characterized by the presence of subcutaneous rheumatoid nodules, scanty or absent systemic manifestations and a clinically benign course. Joint involvement appears more commonly as palindromic rheumatism, although patients with arthralgia episodes alone and others with chronic polyarthritis have been described. Seldom reported up to now, a consideration of this entity may help to avoid diagnostic pitfalls and the use of aggressive therapy. | |
| 8014927 | The correlation of indium-111 joint scans with clinical synovitis in rheumatoid arthritis. | 1993 Dec | OBJECTIVE: An inflammatory compartment radionuclide such as Indium-111 chloride (111InCl3) may offer advantages over bone seeking radionuclides in the assessment of active rheumatoid synovitis. As an iron analog, 111InCl3 binds iron complexing proteins including transferrin. Active rheumatoid synovitis is a transferrin receptor rich compartment, reflecting profound cellular activation and proliferation. We investigated 111InCl3 scanning for the detection of active rheumatoid arthritis (RA). METHODS: Nine patients satisfying ACR criteria for definite or probable RA were scanned twice at a 28-day interval. Patients were undergoing multiple medication changes with resultant fluctuating disease activity. Blinded readings were performed by an experienced nuclear medicine physician and correlated with simultaneous clinical examinations by a single rheumatologist. Sixteen assessed joint areas/patient and a total of 144 joint areas were available for analysis. RESULTS: Scintigraphy correlated with swollen and tender joint scores at both timepoints. Specificity was highest with stringent scoring. Sensitivity was lowest for small joints with lower 111InCl3 uptake relative to background. A receiver operator curve (ROC), generated to analyze the diagnostic value of varying 111InCl3 scan stringency, demonstrated utilization of the most accurate portion of the ROC curve by the reader. CONCLUSION: 111InCl3 joint scintigraphy correlates with clinically detectable rheumatoid synovitis, supporting the hypothesis that transferrin receptor levels reflect rheumatoid disease activity. | |
| 7789498 | Association of histologically proven rheumatoid arthritis with pulmonary sarcoidosis. | 1995 Mar | The association of rheumatoid arthritis proven by means of synovial biopsy with pulmonary sarcoidosis proven by means of bronchial biopsy, occurred in a 58 year old woman. Corticosteroid therapy resulted in complete resolution of sarcoidosis but only slight improvement of the rheumatoid arthritis, which was secondarily treated with methotrexate with a successful outcome. Only two similar cases have been reported with simultaneous histological proofs of both diseases. | |
| 8252319 | The mobility outcome for amputees with rheumatoid arthritis is poor. | 1993 Dec | This study examines the reasons for amputation of the lower limb in 11 patients with RA. The reasons for amputation were ischaemia due to peripheral vascular disease; rheumatoid vasculitis; or complications of knee arthroplasty. Delayed healing was common in patients on steroid therapy. The patients had difficulty donning and doffing their prostheses due to poor hand function and impaired agility. Walking training and rehabilitation were slow and tended to precipitate a generalized flare-up of disease activity. Rheumatoid nodules developed on pressure points between stump and socket. Despite these problems the majority of patients preferred to wear a prosthesis for help in transferring in and out of the wheelchair, to complete their appearance and for limited mobility. Most found using an electric powered indoor wheelchair helped maintain their independence. | |
| 1609240 | [Temporomandibular joint and rheumatoid polyarthritis. Correlations between clinical and t | 1992 Mar | Clinical and CT scan abnormalities of the temporomandibular joint in rheumatoid arthritis have been little studied in the literature. The temporomandibular joint was examined clinically and by CT scan in 26 patients with rheumatoid arthritis and 26 controls. In the rheumatoid arthritis group, 61.2% of patients had physical signs of temporomandibular disease as compared with 42.3% of the controls. 88.4% of rheumatoid arthritis had erosive or geodic lesions of the temporomandibular joint by CT scan as compared with 57.6% of the controls (p less than 0.05). The temporomandibular clinical score was not correlated with CT scan score in rheumatoid arthritis. CT scan score was correlated with the number of basic drugs used, rheumatoid factor levels and radiological scores of the hands and cervical spine. The authors feel that the only CT scan abnormalities specific to rheumatoid arthritis consist of erosive and geodic lesions of the mandibular condyle, that there is no correlation between clinical and CT scan abnormalities of the temporomandibular joint in rheumatoid arthritis and that the extent of destructive lesions of the temporomandibular joint by CT scan in rheumatoid arthritis is closely correlated with the severity of the disease. | |
| 8358983 | Intestinal absorption in patients with rheumatoid arthritis treated with methotrexate. | 1993 Jun | Twelve patients with rheumatoid arthritis treated for at least 12 months with methotrexate and 11 matched rheumatoid arthritis controls underwent a standard d-xylose absorption test. No patients had any pre-existing clinical of biochemical evidence of malabsorption. No significant difference was observed in the 1 hour plasma d-xylose estimation between methotrexate treated patients and controls. The 2 to 5 hour urinary excretion ratio, however, was significantly lower in the methotrexate-treated group compared with controls indicating a minor degree of malabsorption. Six of the methotrexate treated patients and 5 of the controls underwent endoscopic duodenal biopsy but neither group demonstrated any significant histological changes. In conclusion, methotrexate therapy in patients with rheumatoid arthritis produces mild intestinal malabsorption. |