Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 7880120 | Radiolabelled lymphocyte migration in rheumatoid synovitis. | 1995 Jan | OBJECTIVES: To study the ability of technetium-99m hexamethyl propylene amineoxime (HMPAO) labelled lymphocyte scintigraphy to quantify synovial inflammation, and to analyse the kinetics of lymphocyte retention in the joints of patients with rheumatoid arthritis (RA). METHODS: After isolation of the lymphocytes, the cells were radiolabelled in vitro with 250 MBq 99mTc-HMPAO. The scans were performed 30 minutes, three hours and 20 hours after injection. RESULTS: An increase of the scintigram signal obtained at 20 hours was associated with a high joint swelling and joint pain score (F test = 3.07, p < 0.002), but not with the radiological score. A positive joint scintigram was predictive of active synovitis. Although the scintigram variation over time did not reach statistical significance, the kinetics of the scintigram signal tended to differ according to the disease duration: in early RA, active arthritis could be clearly imaged as early as 30 minutes, increased at three hours and the signal intensity persisted at 20 hours. In contrast, in long standing disease, the affected joints were imaged at 30 minutes, persisted unchanged at three hours, and the scintigram score decreased significantly at 20 hours. CONCLUSIONS: The study shows that 99mTc-HMPAO joint scintigraphy may be used to detect and to localise active rheumatoid arthritis. | |
| 1560610 | [Cushing's syndrome found during long-term glucocorticoid treatment of rheumatoid arthriti | 1992 Jan | A 69-year-old female patient had been treated with glucocorticoid for eight years because of rheumatoid arthritis. She showed characteristic Cushingoid features such as central obesity, moon face, and fragility of skin and vessels. She was disabled because of spinal compression fracture and muscle weakness. The blood pressure was 186/100 mmHg and the laboratory tests revealed serum K: 2.8 mEq/l, WBC: 15, 510/mm3, total cholesterol: 310 mg/dl. These suggested that she had iatrogenic Cushing's syndrome. After discontinuation of glucocorticoid, however, the serum cortisol level remained high. This fact prompted us to conduct further examinations for Cushing's syndrome. Oral dexamethasone administration did not suppress the plasma cortisol level and a left adrenal adenoma was found on abdominal CT scan. Because of the presence of bleeding diathesis, operation for adenoma was contraindicated. Though we tried to treat her with metyrapone, trilostane or opeprim (OP'-DDD), we had to abandon specific treatment because of severe side effects such as acute adrenal dysfunction and gastrointestinal problems. Decrease in the endogenous cortisol level after metyrapone treatment caused exacerbation of symptoms of rheumatoid arthritis. This is a peculiar case in which the long-term administration of glucocorticoid for rheumatoid arthritis might have concealed Cushing's syndrome, and conversely the increased intrinsic adrenal steroid hormone might have suppressed the activity of the rheumatoid arthritis. | |
| 8239763 | Presence of foam cells containing oxidised low density lipoprotein in the synovial membran | 1993 Sep | OBJECTIVE: Increased concentrations of lipid peroxidation products have been described in the serum and synovial fluid from patients with rheumatoid arthritis. A large proportion of the unsaturated lipids in human extracellular fluids is a component of low density lipoprotein (LDL). The oxidative modification of LDL, and its subsequent uptake by macrophages, has been implicated in the pathogenesis of atherosclerosis, but not of rheumatoid arthritis. This study aimed to assess whether oxidatively modified LDL was present in the rheumatoid synovium. METHODS: A polyclonal antiserum raised in rabbits against oxidised LDL (o-LDL) was used to perform an immunohistochemical study of a series of synovial biopsy specimens from patients with rheumatoid arthritis. RESULTS: Collections of positively stained macrophages, arranged in a linear fashion and with the morphological characteristics of foam cells--that is, 'fatty streaks', were identified around blood vessels within the intimal connective tissue. In addition, scattered, positively stained foam cells were present in association with deposits of fibrin. These staining patterns were absent from control synovial membranes (traumatic knee injuries). CONCLUSIONS: The findings in all rheumatoid patients studied suggest that atherosclerosis and rheumatoid arthritis have analogous pathogenetic features. | |
| 8610138 | On the belief that arthritis pain is related to the weather. | 1996 Apr 2 | There is a widespread and strongly held belief that arthritis pain is influenced by the weather; however, scientific studies have found no consistent association. We hypothesize that this belief results, in part at least, from people's tendency to perceive patterns where none exist. We studied patients (n = 18) for more than I year and found no statistically significant associations between their arthritis pain and the weather conditions implicated by each individual. We also found that college students (n = 97) tend to perceive correlations between uncorrelated random sequences. This departure of people's intuitive notion of association from the statistical concept of association, we suggest, contributes to the belief that arthritis pain is influenced by the weather. | |
| 8929785 | D-penicillamine-induced myositis in rheumatoid arthritis. | 1996 Jan | D-penicillamine, an agent still used in the treatment of rheumatoid arthritis (RA) may produce inflammatory myopathy or myositis. Some reported cases are documented with muscle biopsy. We report a 34-year old female, receiving the drug for more than 4 years, who consulted us with recently developed proximal muscle pain and weakness. EMG-findings were typical for inflammatory muscle disease; muscle enzymes remained normal. D-penicillamine was stopped and she was started on prednisolone with rapid improvement. The EMG-findings, with follow-up within three months, proved to be a good diagnostic tool, in the absence of laboratory muscle enzymes abnormalities. | |
| 7597808 | [Clinical aspects of arthrosis]. | 1995 | Symptoms, physical, laboratory, and x-ray findings in osteoarthrosis are reviewed, special emphasis is drawn to the different clinical forms as compensated, activated, decompensated osteoarthrosis. A sample of 2,494 patients with degenerative joint disease or functional disorders as e.g. myalgia were studied with respect to symptoms and physical findings. As previously described in other studies it turned out, that osteoarthrosis of the knee specially in women is correlated with high body weight; furthermore it could be shown that foot deformities--hallux valgus and pes planus in gonarthrosis, hallux valgus and hammer-toe in polyarthrosis of the finger joints--are significantly more frequent in some degenerative joint diseases. | |
| 7774088 | Purine enzymes in rheumatoid arthritis. A clue to the prediction of the response to azathi | 1995 Jan | Azathioprine (AZA), a purine analog, is an effective agent in the treatment of rheumatoid arthritis (RA), but variability of response and sometimes life-threatening side effects limit its use (1). The metabolism of AZA parallels the endogenous purine pathways. In this paper we review some general aspects of purine and thiopurine metabolism, their relation with various disease states and current knowledge of the influence of purine enzymes on the effects of AZA treatment. We suggest that intracellular purine enzyme activities determine the response to AZA treatment in patients with RA, and that a role for purine enzyme activities in the ethiopathogenesis of RA should be considered. | |
| 7738960 | Tophus-like cholesterol nodules in 2 patients with rheumatoid disease. | 1995 Feb | We describe 2 patients, both with rheumatoid disease, with tophus-like nodules that contained cholesterol crystals. A tophus-like cholesterol nodule had developed in a tendon sheath of the left little finger of one. The other presented with multiple tophus-like nodules on his left elbow and both forefeet. We discuss the etiology and pathogenesis of crystalline deposits of cholesterol. Nodules at sites of local pressure in patients with rheumatoid arthritis may be deposits of cholesterol crystals. | |
| 8996471 | Bone loss in rheumatoid arthritis. Influence of disease activity, duration of the disease, | 1996 | Axial and appendicular bone mass were studied in 95 patients with rheumatoid arthritis. The aims were to quantify bone mineral density (BMD) and to evaluate the importance of disease activity, duration of disease, functional capacity, and corticosteroid treatment for bone loss in patients with rheumatoid arthritis. The BMD in the lumbar spine (BMDSPINE) did not differ from age-matched healthy controls, but distal forearm BMD (BMDARM) and metacarpal BMD (BMDMCB) were significantly lower in the patients (p < 0.01 and p < 0.001, respectively). Neither BMDSPINE nor BMDMCB were related to the disease activity at the time of investigation. By contrast, BMDARM was decreased in patients with active disease. BMD in any of the three measured locations was not directly correlated to duration of the disease. However, the bone mass in the appendicular skeleton was already decreased within the first two years after the start of the disease. The overall functional capacity in terms of physical activity increased BMD in the axial skeleton. The local functional capacity in terms of grip strength was positively related to BMD in the appendicular skeleton. Patients with severe functional impairment had the lowest BMDARM. The decreased BMD in patients with rheumatoid arthritis seems primarily to be caused by an impaired physical activity which may be related to disease activity. Corticosteroids did not decrease BMD in neither the axial nor the appendicular skeleton. The antiinflammatory effect of steroids lead to clinical improvement, which may counteract the expected negative effect of these drugs on bone in rheumatoid arthritis. | |
| 7645366 | [Palindromic rheumatism--progression to erosive rheumatoid arthritis--presentation of 3 ye | 1995 | The 3-year course of treatment of a 35-year old male patient presenting with recurrent afebrile episodes of acute mono- or polyarthritis, periarthritis and at times paraarthritis of the left ankle and knee joint as well as the PIP and MCP joints of the hands is presented. The episodes lasted from a few hours up to several days, leaving no residual changes in the joints. After initial observation and treatment, palindromic rheumatism was diagnosed. During the second year of treatment, seroconversion from the rheumatoid factor negative to the rheumatoid factor positive arthritis form was established. In the third year of treatment, erosions of cartilage and bone in the left knee joint were confirmed radiologically. On the basis of the clinical picture, laboratory findings and radiologic changes in the joints, the diagnosis of erosive seropositive rheumatoid arthritis was made. The author stresses that the diagnosis "palindromic rheumatism" could be established sooner and more often, particularly if, regarding the typical clinical course and history, the possibility of this disease were taken into consideration at all. | |
| 8324942 | CAMPATH-1H in inflammatory arthritis. | 1993 Mar | CAMPATH-1H is a humanised mAb directed against lymphocytes. This mAb has been used to treat patients with rheumatoid arthritis. Clinical improvement with reduction in the Ritchie index and joint score has lasted for up to 8 months in some patients. A profound and prolonged lymphopaenia is induced by the mAb, with CD4+ numbers remaining suppressed for up to one year. | |
| 7575696 | Prediction of progression of radiologic damage in newly diagnosed rheumatoid arthritis. | 1995 Oct | OBJECTIVE: To investigate the extent to which early radiologic damage is predicted by joint inflammation in patients with newly diagnosed rheumatoid arthritis (RA). METHODS: Regression analysis was performed on 1-year progression of total radiologic damage for baseline characteristics and cumulative disease activity measures, and the effects of continued joint inflammation on the progression of damage in separate joint groups were investigated. RESULTS: Odds ratios for progression of total damage were 12 for the presence of rheumatoid factor, 5 for the presence of damage at baseline, and 2 for cumulative joint inflammation. A positive association between continued joint inflammation and progression of damage was found to be statistically significant for most joint groups. CONCLUSION: Progression of radiologic damage in patients with newly diagnosed RA is independently associated with the presence of rheumatoid factor and damage at baseline and with cumulative joint inflammation. | |
| 8961377 | Evaluation of interleukin-6 in rheumatoid arthritis as an activity criterion. | 1996 | This study evaluated interleukin-6 levels as an activity criterion in rheumatoid arthritis (RA) and compared if with other activity criteria. We evaluated 35 patients with active RA, 31 with inactive RA, and 25 patients with osteoarthritis, in addition to 28 healthy individuals. Serum interleukin-6 levels were higher in active RA patients than in those with inactive RA, or osteoarthritis and healthy individuals (P < 0.001). Serum interleukin-6 levels of patients with active RA were positively correlated with the erythrocyte sedimentation rate, C-reactive protein, and alpha 2-globulin levels (P < 0.001), but there was a negative correlation with serum albumin levels (P < 0.05). We conclude that interleukin-6 can be responsible for both the most systemic manifestations of RA and for its local manifestations. | |
| 8016587 | Low energy laser therapy in rheumatoid arthritis. | 1994 | Low energy laser (LEL) is a widely used treatment for a variety of musculoskeletal disorders although convincing documentation of the effect is missing. We have examined the LEL effect on Rheumatoid Arthritis (RA) in a double blind placebo controlled study. Twenty-two patients completed the study (10 receiving LEL treatment) according to the protocol. A significant effect on pain score was found due to LEL treatment, but when data were corrected for disease variation the effect disappeared. No effect of LEL could be demonstrated on the other assessed variables: grip strength, morning stiffness, flexibility, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). In conclusion, we did not find that LEL had any clinically relevant effects on RA. | |
| 8973867 | Standardising joint assessment in rheumatoid arthritis. | 1996 Nov | Evaluating joint involvement in rheumatoid arthritis in a key clinical assessment. We investigated the extent of variation in measurement of joint swelling and tenderness and evaluated the impact of training to standardise methods. Eight observers (medical and nursing staff) examined eight rheumatoid patients for joint swelling and tenderness before and after training in clinical methods. The EULAR handbook for joint evaluation was used for training and assessments were based on the 28 joint count. There was extensive variability in both numbers of swollen and tender joints. Coefficients of variation for articular indices recorded by the 8 observers in individual patients were often high (up to a maximum of 204%), indicating considerable differences between observers. Training had an impact on the assessment of the numbers of swollen joints which increased by a mean of 32% (P < 0.05) and the number of tender joints which increased by 41% (p < 0.01). Training had only a limited impact on the variation among observers in determining the number of swollen and number of tender joints. After training, the mean coefficients of variation were still 59% for swollen joints and 65% for tender joints. These results highlight the extent of variation in clinical assessment of rheumatoid arthritis and show the advantages of training. It leads to increased sensitivity of measurement. Standardisation appears essential for clinical studies. | |
| 8259719 | [Epidemiology of rheumatic complaints in Germany. Data on the prevalence and physical and | 1993 Sep | Because of their considerable socioeconomic costs rheumatic symptoms are a major concern in industrialized nations. Our study provides data on the prevalence of rheumatic symptoms in the general population and on their physical and psychosocial impact. We performed a survey of 1814 randomly selected non institutionalized persons, aged 40 to 69 years, living in the Federal Republic of Germany. The selected subjects were asked whether they had pain in one or more of the following sites: neck/back, joints of upper extremities, joints of lower extremities. Physical and psychosocial disability was assessed using a multidimensional questionnaire that included a German version of the Arthritis Impact Measurement Scales (AIMS) and validated instruments concerning psychosocial dimensions of health status. The prevalence of rheumatic symptoms increases between 40 and 59 years and decreases thereafter. Rheumatic symptoms are more frequent in women than in men. The predominant pain localization is the back. Individuals reporting pain in one region (back, upper and lower extremities) often feel pain in other areas as well and often suffer from additional symptoms such as weakness and sleep disturbance. We found significant disabilities in physical (mobility, activities of daily living, physical activities) and psychosocial (depression, anxiety, exhaustion, family problems) dimensions of health status in subjects reporting rheumatic symptoms. | |
| 8686466 | Bone loss of the radius in rheumatoid arthritis. Comparison between 34 patients and 40 con | 1996 Jun | We measured bone mineral density (BMD) in the radius by dual energy X-ray absorptiometry in 34 patients with rheumatoid arthritis (RA) and in 40 healthy controls. The BMD in RA patients in their fifties and sixties, but not in their forties and seventies, was significantly lower than that in the control subjects. The decrease in total radial BMD correlated with grip strength, RA activity and RA stage. The decrease in distal radial BMD correlated with RA activity, but not with grip strength. The levels of serum parathyroid hormone, alkaline phosphatase, and urinary hydroxyproline/creatinine were significantly higher in the patients. From these findings, we suggest that the bone loss in RA patients is affected by severity of inflammation, disuse, postmenopausal osteoporosis and secondary hyperparathyroidism. | |
| 8406687 | Functions of polymorphonuclear leukocytes in early rheumatoid arthritis. | 1993 Aug | We carried out a prospective study on clinical variables and functions of polymorphonuclear leukocytes (PMNs) of 20 patients with early rheumatoid arthritis (RA) and compared the results with the presence of erosions before treatment and at a one-year follow-up. Migration of PMNs determined by agarose and filter assays and respiratory burst of PMNs determined by luminol-enhanced chemiluminescence (CL) test were studied both before starting RA-modifying treatment and 6-12 (mean 7.3) months later. PMNs of the patients without erosions at one year, as compared to the patients with erosions, showed significantly depressed migration into filter and significantly depressed CL responses to N-formyl-methionyl-leucyl-phenylalanine, both before starting the treatment and at 7.3 months. Although causality remains uncertain, the results suggest that depressed functional capacity of PMNs is associated with low risk of joint destruction in early RA. | |
| 8074134 | Case report: recurrent pneumothorax in a patient with rheumatoid arthritis. | 1994 Sep | Rheumatoid arthritis is a multi-system disease. Pulmonary manifestations and complications include pleural disease, pulmonary infections, pneumonitis and interstitial pulmonary fibrosis, bronchogenic carcinoma, arteritis with pulmonary hypertension, obliterative bronchiolitis, bronchiectasis, and amyloidosis. Pulmonary rheumatoid nodules, including rheumatoid pneumoconiosis (Caplan's Syndrome), can result in spontaneous pneumothorax. In this article, the authors present a patient with rheumatoid arthritis and recurrent spontaneous pneumothorax. Through investigation, a bronchopleural fistula caused by a rheumatoid nodule was revealed. The authors also discuss the potential pitfalls caused by a lung nodule in a patient with rheumatoid arthritis, including the overlap with bronchogenic carcinoma and confusion with tuberculosis. | |
| 1613732 | Rheumatoid factors in the pathogenesis of rheumatoid arthritis. | 1992 Jan | Rheumatoid factors (RF) participate in the pathogenesis of rheumatoid arthritis by formation of immune complexes. IgM-RF form complement activating immune complexes with IgG-containing antigen-antibody complexes. IgG-RF form unique immune complexes without the presence of separate antigen molecules. The specificities of RF in rheumatoid arthritis have subtle differences from RF formed by B cell neoplasms. Immune deposits in rheumatoid articular cartilage have high potential for generating inflammation and contain RF. The immune deposits in articular cartilage need to be characterized further, and the mechanisms that initiate and perpetuate RF production in patients with rheumatoid arthritis should be elucidated. |