Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1458708 | Disease activity in rheumatoid arthritis: preliminary report of the Consensus Study Group | 1992 Sep | The most suitable measures to assess the disease activity of rheumatoid arthritis patients treated with slow-acting anti-rheumatic drugs were considered in a prospective study. This was organised across Europe in 12 specialised centres and 282 patients were studied. The patients were all considered to be in need of therapy with a slow-acting anti-rheumatic drug and were studied at the initiation of therapy, and after 3 and 6 months of treatment. There were 215 patients who remained on treatment for 6 months. The most useful measures to assess disease activity were: the number of swollen joints, the number of tender joints, pain, the patients' assessment of response, and ESR. These should form a minimum data set when assessing the activity of rheumatoid arthritis. Some measures such as grip strength, hemoglobin, and the C-reactive protein level showed too much variation between centres and will require considerable standardisation before they can be used across Europe. There were problems in collecting functional data and further work is needed to develop a functional questionnaire available in all European languages with culturally suitable questions. | |
| 8506692 | [Degenerative diseases of the joints and spine]. | 1993 | A survey is given of the different kinds of osteoarthritis, how the diagnosis should be established, how the clinical examination should be performed; how information for the case history should be found out, and which supplementary findings (radiological laboratory) should be gathered. The therapeutic possibilities are discussed. | |
| 7918722 | Appraisal of and coping with arthritis-related problems in household activities, leisure a | 1994 Mar | PURPOSE: We examined whether or not there are systematic differences in how people appraise different types of illness-related problems and in how they cope with these problems. METHODS: Two hundred thirty-five adults with recently diagnosed rheumatoid arthritis completed a mailed questionnaire followed by a telephone interview. A series of stress appraisal and coping variables were assessed in relation to three areas: household activities, leisure activities, and pain management. RESULTS: Pain differed significantly from household and leisure activities with regard to several appraisal and coping variables. Participants reported the least control over problems with pain, while attaching the most importance to pain control. Leisure activities also stood out as unique on several variables. Participants perceived greater ability and were more satisfied with their ability in relation to leisure activities. CONCLUSION: These findings show that, at least early in the disease, appraisal and coping strategies differ across the areas of household activities, leisure activities, and pain management. | |
| 7863273 | Temporomandibular joint involvement in rheumatoid arthritis. Relationship with disease act | 1995 | Involvement of temporomandibular joint (TMJ) in rheumatoid arthritis (RA) patients is described, but the incidence varies greatly. In this study our aim was to determine the frequency and character of TMJ involvement in RA patients asymptomatic for this joint, to investigate the relationship with disease activity, and to evaluate the early diagnostic value of imaging techniques. Twenty patients were included in this study, ten were evaluated with computed tomography (CT) and ten with magnetic resonance imaging (MRI). Among the 20 patients 45% had TMJ involvement detected by imaging techniques. The most frequent pathological signs were osteophyte formation, erosion of the mandibular condyle and decreased joint space (40%). Age, duration of disease, number of swollen joints. CRP and RF levels were found to be correlated with TMJ involvement. It is concluded that TMJ involvement may be detected even in asymptomatic patients with RA and there is a positive correlation between the severity of disease and involvement of TMJ. | |
| 1491388 | Digital subtraction radiography for the assessment of bone changes in rheumatoid arthritis | 1992 Nov | A digital subtraction radiography (DSR) method was developed to assess changes of bony erosions in the hands of patients with rheumatoid arthritis (RA). The method initially was validated in vitro using simulated lesions in cadaver hands. The sensitivity, specificity and accuracy in detecting simulated lesions were 84.6, 100, and 92.3%, respectively. This technique was then pilot tested clinically using 17 patients with RA and 5 controls with no arthritis. All subjects received the nonsteroidal antiinflammatory drug, flurbiprofen, during the 6-month study period. No progressive changes in bone were observed in the control group; however, 18% of the target joints studied in the group with RA showed significant erosive changes (positive or negative) which correlated with the clinical assessment. The results indicate that DSR may be useful in detecting small changes in erosions on hand/wrist radiographs of patients with RA. | |
| 1491386 | Nitrogen mustard as induction therapy for rheumatoid arthritis: clinical and immunologic e | 1992 Nov | We treated 5 patients diagnosed with rheumatoid arthritis (RA) with nitrogen mustard (HN2) and monitored clinical and immunologic variables. HN2, 0.3 mg/kg ideal body weight was given over 7 days. Disease activity and immune function were monitored during and after treatment. Duration of morning stiffness (p = 0.0044), joint count (p = 0.0140), and assessment of pain (p = 0.0264) and function (p = 0.0057) improved by Day 6. T lymphocytes (p = 0.0060), especially T memory cells (CD4CD29; p = 0.0017) fell dramatically. HN2 is effective for rapidly gaining control of active RA. This effect is T cell specific. | |
| 8475348 | [Modern rheumatism surgery: prospects, hazards, results]. | 1993 Mar 30 | The conservative management of rheumatoid arthritis (RA) the value of which is a symptomatic or at best a pathogenetic one, has failed to achieve a decisive breakthrough in the past 25 years. By contrast the orthopedic-surgical management of RA has proved able to rehabilitate patients who would otherwise gradually lose their independence. The close cooperation between rheumatologists and orthopedists in specific rheumatoid arthritis centers and the recruitment of specially trained therapeutic teams have boosted the recent progress in this field. However, the main responsibility for the patient continues to lie with the rheumatologist. Operative procedures are only considered when despite a well-conducted conservative treatment signs of progressive articular destruction appear; they do not interrupt the conservative management, but are a completion of it. The art of the rheumatology-surgeon reveals itself in his ability to set up a clear-cut therapeutic plan with priorities. In particularly complex cases the indication will require a team discussion, which includes the occupational therapist who has previously assessed the patient's handicap in the performance of ADL and will be centered around the patient, whose motivation is of crucial importance to the success of our efforts. Throughout the many years of active practice and by performing thousands of operations--preventive (e. g. synovectomies) as well as reconstructive ones (e. g. arthroplasties)--we have gained a vast experience in different operative procedures, which we have come to divide into three categories. Whenever possible we start with an operation regarded as particularly promising, thus overcoming the patient's understandably reserved attitude towards surgery.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 8734144 | [Prognostic factors in early inflammatory arthritis]. | 1996 | Rheumatoid arthritis (RA) and spondylarthropathies are the most frequent chronic inflammatory arthritides. RA is a potentially severe disease which causes a functional handicap in nearly half the patients 10 years after the first clinical symptoms. However RA is a heterogenous disorder characterized by wide variations in clinical manifestations, disease course and response to therapy. No prognosis factor has been identified and universally accepted and validated. Markers of prognosis would be highly appreciated by clinicians who could then more closely adapt their management decisions to the disease potential. Clinical and biological data collected to date have provided a limited amount of information. Nevertheless, ESR, CRP and rheumatoid factor titer appeared to be the most powerful available indicators of prognosis at the early stage of the disease. Recent progress in molecular biology strongly suggests that genetic markers (HLA-DRB1 alleles) could be correlated with disease severity and it would appear possible to distinguish immunogenetically homogeneous subpopulations of patients with RA. Serum concentrations of specific cartilage and bone molecules reflecting tissue turnover could correlate to rate of joint destruction. Finally a combination of the most pertinent markers could determine a "score of severity" of the disease. In spondylarthropathies, limited information is available at present. The variables which were usually correlated with disease severity are: onset before 16 years of age, hip arthritis, ESR, limitation of lumbar spine, sausage-like finger or toe, oligoarthritis, poor efficacy of nonsteroidal antiinflammatory drugs and rapid evolution during the first 2 years. Genetic factors could also have prognosis value that should be clarified. | |
| 8625610 | The epidemiology of hip osteoarthritis and rheumatoid arthritis in the Orient. | 1996 Feb | The prevalence of hip osteoarthritis and rheumatoid arthritis has been found to be lower in Chinese, Japanese, and other Asian populations than in whites. The low prevalence of osteoarthritis hip in the Chinese and Japanese populations cannot be explained by the rarity of hip dysplasia, which is as prevalent in those two populations as in whites. As in other populations, rheumatoid arthritis in the Chinese is associated with the shared epitope of the third hypervariable region of the DR gene. However, the low prevalence of rheumatoid arthritis in the Chinese cannot be accounted for entirely by genetic factors. | |
| 7510724 | Lymph node hyalinisation in rheumatoid arthritis and systemic sclerosis. | 1994 Feb | AIMS: To review the histological features of lymph nodes excised from seven patients with rheumatoid arthritis and one with systemic sclerosis. METHODS: Lymph nodes excised from seven patients with rheumatoid arthritis and one patient with systemic sclerosis over a 10 year period were examined using the stains haematoxylin and eosin, periodic acid Schiff (PAS), Masson-trichrome, and Congo red for amyloid. RESULTS: Of the seven nodes examined from the cases of rheumatoid arthritis, three showed definite reactive follicular hyperplasia with a prominence of plasma cells in the interfollicular areas, two showed subtotal replacement of the node by numerous sarcoid like granulomata, and one contained a large central area of necrosis with a surrounding palisade of histiocytes. In all six cases, focal areas of PAS positive eosinophilic hyaline material were present, which did not stain with Congo red. In some cases this hyaline material was focally calcified. In the seventh patient with rheumatoid arthritis the excised lymph node was almost totally replaced by similar PAS positive hyaline material which showed extensive areas of calcification. The lymph node removed from the patient with systemic sclerosis similarly showed almost total replacement by PAS positive hyaline material. CONCLUSION: In all cases the nodes contained PAS positive extracellular hyaline material to a greater or lesser degree. The lymph nodes from two of the patients with rheumatoid arthritis contained numerous sarcoid like granulomata, further indicating a possible association between sarcoidosis and rheumatoid arthritis. Pathologists and clinicians should include rheumatoid arthritis and systemic sclerosis in their differential diagnosis of lymph node hyalinisation of unknown aetiology. | |
| 8266028 | Natural killer cell cytotoxicity and alpha-interferon in early rheumatoid arthritis. | 1993 | Natural killer (NK) cell number, cytotoxicity, and serum alpha-interferon (alpha-IFN) was measured in a group of early synovitis patients and compared to that of established rheumatoid arthritis patients and normal controls. No significant differences in NK cell number or serum alpha-IFN were found. NK cell cytotoxicity (NKCC) in the early synovitis group was significantly (p < 0.05) reduced compared to that of the normal controls and not significantly different from the established rheumatoid controls. There was a trend for those early synovitis patients with a good outcome to have higher NKCC. Low NKCC is evident very early in the course of rheumatoid arthritis and is thus unlikely to be secondary to chronic inflammation. There is no relationship between NKCC and alpha-IFN levels and the cause of the reduced NKCC is unknown. Alpha-IFN levels are not raised early in the course of RA. | |
| 8938867 | Are somatosensory evoked potential recording and magnetic resonance imaging useful for eva | 1996 Oct | The objective of this study was to determine whether early somatosensory evoked potential recording and/or magnetic resonance imaging are helpful for evaluating and monitoring the risk of neurologic compromise in rheumatoid arthritis patients. Thirty-seven patients with definite rheumatoid arthritis were studied, including 18 with atlantoaxial subluxation. A physical examination, roentgenograms of the cervical spine, early somatosensory evoked potential recording at all four limbs and magnetic resonance imaging of the cervical spine were done in each case. Alterations in somatosensory evoked potentials and magnetic resonance imaging evidence of compression of the medulla oblongata or spinal cord were found in similar proportions of patients with and without atlantoaxial subluxation. These results support the view that physical findings and changes on plain films of the cervical spine are the most reliable data for evaluating and monitoring the risk of neurologic damage in patients with atlantoaxial subluxation. Somatosensory evoked potential studies and magnetic resonance imaging should be reserved for those cases in which physical and roentgenographic data cannot be collected in a satisfactory manner and for patients who are included in study protocols that require accurate evaluation of lesions. | |
| 1366142 | [The effect of 6 months of treatment with Tauredon on clinical indicators in rheumatoid ar | 1992 | The objective of this research has been to evaluate the efficacy of Tauredon (the aqueous solution of Na-thiomalate) on the development of some clinical parameters in patients with rheumatoid arthritis. The group being tested comprised 8 men and 35 women, their average age being 50, the average duration of their illness being 9.5 years. As regards the anatomic development stage of illness, the majority of patients belonged to stage 2 (62.8%), with no patients belonging to stage 4. During the continuous six-month application of Tauredon, the following parameters have been observed: the Ritchie index, the PIP extent of the fist joints and the morning stiffness span of the small fist joints. The evaluation of the six-month treatment with Tauredon has proved its positive effect on all clinical parameters, shown in the lower value of the Ritchie index, the lower PIP extent of the fist joints as well as the shorter morning stiffness span. Further, the Tauredon effect has been seen in suppressing the inflammatory activities and in restituting the joint functions in patients with rheumatoid arthritis. | |
| 8517038 | [Energy expenditure at rest in patients with active rheumatoid arthritis and malnutrition] | 1993 Jan | Malnutrition is found significantly more often in patients with rheumatoid arthritis than in the normal population. One of the contributing causes may be the elevated energy expenditure at rest found in the stage of increased activity of the disease. The aim of the present work was to evaluate the association between the activity of the disease, the presence of signs of malnutrition and the energy expenditure at rest. In 26 patients with rheumatoid arthritis stage I-IV, mean age 62.2 +/- 11.0 years the basic parameters describing the activity of the disease were assessed (sedimentation rate, C-reactive protein (CRP), the articular index according to Thompson) and the nutritional status (body mass index, total serum protein and albumin, the skinfold above the triceps, the circumference of the muscles of the arm). In all patients indirect calorimetry at rest on fasting was applied. The assessed value of the energy expenditure at rest (REE) was expressed as % BMR calculated according to the formula of Harris-Benedict. In the group of patients with a higher activity of the disease (CRP positive, n = 14) REE was significantly higher as compared with the other patients (109.4 +/- 13.3% vs. 98.7 +/- 9.3%, p < 0.05). In patients who suffered from obvious depletion of visceral protein (albumin less than 30 milligrams, n = 5) REE was significantly higher than in the remainder (117.8 +/- 13.8% vs. 101.3 +/- 10.4%, p < 0.05). In the whole group there was a less close, though statistically significant correlation between CRP and REE (correlation coefficient 0.463, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 8493486 | Ultrastructural causes of rupture of hand tendons in patients with rheumatoid arthritis. A | 1993 | To identify the cause of rupture of hand tendons in patients with rheumatoid arthritis, we studied the underlying ultrastructural changes of the collagenous fibril systems. Samples of the flexor digitorum superficialis (n = 12) and the extensor digitorum communis (n = 20) were taken during tenosynovectomy. Tendons dissected at necropsy (n = 30) served as controls. Specimens were analysed by transmission and scanning electron microscopy. Interfibrillar dysplastic fibrils, "Luse bodies", and intracellular collagen were found in rheumatoid tissues. The diameters of collagen fibrils were significantly reduced compared with the control group (p < 0.01). The duration of the disease usually correlated well with the ultrastructural collagenous lesions. To provide optimum conditions for restoration of rheumatoid hand tendons, early synovectomy in rheumatoid patients seems warranted from the ultrastructural point of view. The alterations in collagen may explain the inadequate function of the hand tendons in patients with rheumatoid arthritis. | |
| 1591382 | Paraproteins in rheumatoid arthritis and related disorders. | 1992 | There is evidence that the prevalence of monoclonal parparoteinaemia is slightly increased in patients with rheumatoid arthritis. The possibility that this may be a marker of the development of later malignancy in such patients is explored. Mortality rates in rheumatoid arthritis are increased although the development of lymphoreticular malignancy contributes only a small percentage of this increase. However, it does seem likely that patients with longstanding severe rheumatoid arthritis are more at risk of developing myeloma or lymphoma if they have a monoclonal paraprotein band in their serum. IgA paraprotein seems to carry a higher risk than IgG whilst other factors such as urinary free light chains and the presence of secondary Sjögren's syndrome are of less prognostic significance. Similarly a monoclonal paraprotein may identify patients with primary Sjögren's syndrome who have a particular risk of later lymphoma whilst this risk does not appear to extend to patients with systemic lupus erythematosus. Patients with an overlap syndrome do not appear to be at greater risk than those with "pure disease". The association of other rheumatological disease and paraproteinaemia is briefly discussed. | |
| 8373121 | Bronchiolitis obliterans and rheumatoid arthritis. Report of a case in a Chinese patient o | 1993 May | Rheumatoid arthritis is the commonest connective tissue disease associated with bronchiolitis obliterans, a clinico-pathologic entity of bronchiolar inflammation and fibrosis reflecting injury to the small airways, and presenting with symptoms and signs of small airways obstruction. It may arise de novo or as a complication of therapy due to d-penicillamine, when a distinct histologic picture of bronchiolar constriction without intraluminal inflammatory polyps appeared to be predominant in most reported cases. This condition is associated with a high morbidity and mortality, and apart from cessation of d-penicillamine, there are no standard recommendations for treatment. Response to various immunosuppressive agents, including corticosteroid, azathioprine, and cyclophosphamide, had been variable and unsatisfactory. We report a case of bronchiolitis obliterans in a Chinese female treated with d-Penicillamine for rheumatoid arthritis with the first documented response to corticosteroid alone, and review the literature on this subject. | |
| 1567284 | [Blood coagulation, fibrinolysis and various values of Lansbury's activity index in rheuma | 1992 Feb | To clarify pathophysiological significance of blood coagulation and fibrinolysis in rheumatoid arthritis (RA) patients with various values of Lansbury's activity index, we analysed by means of the urokinase activated platelet rich plasma thromboelastography. In RA patients, coagulation time (k) and reaction time (r)+k were shorter, maximal amplitude (ma) was larger and lysis time (LT) was longer comparing with those in healthy control. Especially LT and ma showed marked differences between RA patients and control subjects. The mild RA patients whose Lansbury's activity indexes were 0-19% had significant differences from healthy control subjects, in order of LT less than ma less than r+less than k, the probability values were smaller. Significant coefficients of positive correlations with Lansbury's activity index were higher in order of LT greater than LT/k greater than ma x LT. These findings suggested that RA patients had fibrin formation, which had close relations with maximal amplitude (ma) and lysis time (LT) which had positive correlation with Lansbury's activity index. | |
| 8336302 | Clinical staging and gadolinium-DTPA enhanced images of the wrist in rheumatoid arthritis. | 1993 May | The usefulness of gadolinium (Gd)-DTPA enhanced magnetic resonance imaging (MRI) of the wrist joint for predicting articular destruction was investigated in 49 patients with rheumatoid arthritis (RA). On T1 weighted images with Gd-DTPA enhancement, the synovium showed a localized or diffuse pattern of enhancement. Many patients classed as stage II or higher by plain radiography had diffuse enhancement on MRI, while all except one stage I patient had relatively confined localized enhancement. Our study showed that MRI of the carpus could detect soft tissue changes in patients with RA earlier than anything revealed by radiography, and suggested that contrast MRI may be useful for predicting articular destruction. | |
| 8844484 | Rheumatoid arthritis associated with ulcerative colitis. | 1996 Aug | This report describes a 58-year-old man with rheumatoid arthritis (RA) and interstitial pneumonia who suffered from low-grade fever, abdominal pain, and bloody diarrhea 16 months after the diagnosis of RA. Ulcerative colitis (UC) was diagnosed, based on endoscopic and histological findings. RA associated with UC is rare and the underlying mechanism is unknown. We discuss here whether vasculitis and HLA class may play some role in the association of RA with UC. |