Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
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| 8343181 | Rheumatoid arthritis and mortality. A longitudinal study in Pima Indians. | 1993 Aug | OBJECTIVE: To determine the effect of rheumatoid arthritis (RA) on mortality rates. METHODS: Longitudinal analyses of data from a cohort of Pima Indians from the Gila River Indian Community in Arizona, who were followed up during the period February 1965 through December 1989. RESULTS: Among 2,979 study subjects aged > or = 25 years, there were 858 deaths, 79 of which occurred in subjects with RA (36 men, 43 women). Age- and sex-adjusted mortality rates were slightly higher in subjects with RA than in those without (mortality rate ratio 1.28, 95% confidence interval [95% CI] 1.01-1.62). Among those with RA, mortality rates were higher in older subjects (mortality rate ratio 1.51 per 10-year increase in age, 95% CI 1.22-1.88), in male subjects (mortality rate ratio 2.23, 95% CI 1.44-3.45, adjusted for age), and in subjects with proteinuria (mortality rate ratio 1.88, 95% CI 1.02-3.46, adjusted for age and sex). Mortality rate ratios for these risk factors were similar in subjects without RA. In addition, among subjects with RA, rheumatoid factor (RF) positivity was predictive of death (mortality rate ratio 1.94, 95% CI 1.10-3.43), and the excess mortality was found primarily among subjects who were seropositive. The death rate from cardiovascular disease (mortality rate ratio 1.77, 95% CI 1.10-2.84) and from liver cirrhosis or other alcohol-related disease (mortality rate ratio 2.52, 95% CI 1.06-6.01) was increased in persons with RA. CONCLUSION: The results of this population-based study suggest that although the risk of mortality in subjects with RA is significantly higher than in those without RA, the risk ratio is in the lower range of that described previously in studies of clinic-based cohorts. RF positivity as a predictor of early death among subjects with RA indicates that the immunologic processes in seropositive RA may contribute to the events that eventually lead to early death. | |
| 1417118 | Effect of disease severity on rheumatoid arthritis concordance in same sexed siblings. | 1992 Aug | To assess the factors in a proband with rheumatoid arthritis (RA) that might predict the occurrence of the disease in siblings, 240 same sexed sibships (190 female, 50 male) in which the proband had classical or definite RA were clinically and immunologically documented. Sibship concordance rates were consistently higher for features of severe disease in the proband, reaching statistical significance for a clinical score of disease severity (the SS index). This trend for increasing disease severity to be associated with increasing sibship concordance rates could not be accounted for by age or disease duration of the proband. These results suggest that siblings of probands with severe RA are at greater risk of developing RA than those of probands with mild disease. | |
| 1581367 | Effect of the arthritis health professional on compliance with use of resting hand splints | 1992 Mar | This study examined the effects of an occupational therapist's approach during the initial splinting session on the subsequent use of resting hand splints by patients with rheumatoid arthritis. Forty subjects were randomly assigned either to a standard treatment (control) group or to a compliance-enhancement (experimental) group, for whom the use of learning principles, sharing of expectations, use of a positive affective tone and behaviors by the therapist, and the assumption of responsibility by the patient were emphasized. During the 28-day period after splinting, patients in the experimental and control groups wore their splints an average of 23.3 and 18.1 days, respectively (p = 0.056). Nine subjects in the experimental group, but only four in the control group used their splints every day (p = 0.035). Knowledge of splint use correlated with actual use, regardless of the group assignment (p = 0.035). Change in the amount of wrist and hand pain was not significant in either group; however, the experimental group experienced a decrease in the duration of morning stiffness (p = 0.013). This intervention provides health professionals with a pragmatic and effective method to enhance compliance. | |
| 7633794 | Prognostic factors in rheumatoid arthritis. Comparative study of two subsets of patients a | 1995 Jun | Clinical and biological profiles at the onset of the disease, obtained retrospectively, and human leucocyte antigen typing were studied in 47 rheumatoid arthritis (RA) patients with severe articular damage (group 1) and in 47 patients with limited radiological abnormalities (group 2). The two groups were matched according to disease duration (mean: 8.1 yr). Systemic manifestations were more frequent in group 1. Erythrocyte sedimentation rate (ESR), platelet counts, C-reactive protein (CRP), rheumatoid factor and IgG titres were higher and haemoglobin level lower in group 1. HLA class II genotyping demonstrated that 95.7% of patients in group 1 were Dw4, Dw14 or DR1 as compared to 55.3% in group 2 and 37.1% in normal controls. Two RA-linked DRB1 genes were detected in 34.1% of patients in group 1, vs 8.5% in group 2 and 7.9% in controls. Multiple logistic regression analysis demonstrated that ESR, CRP and genetic markers were the most relevant independent variables and when combined could indicate the outcome in early RA. These data confirmed that different RA subtypes with different prognoses could be associated with particular clinical, biological and genetic profiles. Moreover, some of these factors could serve as predictive markers for outcome at the onset of RA. | |
| 7494771 | The use of rheumatoid factors in clinical practice. | 1995 Nov | Rheumatoid factor is a commonly requested test in the investigation of joint problems. Although the test has been found to be both sensitive and specific for rheumatoid arthritis in patients attending Rheumatology Clinics, when the test is applied to general hospital or community populations it performs poorly. Thus the setting in which rheumatoid factor tests are requested and awareness of the test's limitations are critical for appropriate use and interpretation of results. We studied 295 consecutive requests for testing at four centres. The majority were performed for the investigation of joint problems but only 6% of these were positive, suggesting unselective requesting. Half of the results were used to make diagnoses and influence management. However, significant numbers of clinicians felt that the test result had either excluded or confirmed a diagnosis of rheumatoid arthritis suggesting that results were being over-interpreted and that clinical decisions made on this basis may have been inappropriate. We conclude that in this setting rheumatoid factor testing is of limited value and generates misleading information. | |
| 8714796 | Clinical use of cyclosporin in rheumatoid arthritis. | 1995 | Rheumatoid arthritis is a chronic immune-mediated disease characterised by an inflammatory synovitis and extra-articular manifestations. There is an expanding body of evidence to indicate that the activation of T lymphocytes is central in the initiation and perpetuation of this disease. Cyclosporin is an immunomodulator and a highly specific inhibitor of T-lymphocyte function, and has demonstrated disease-modifying properties in clinical studies in patients with rheumatoid arthritis. A concern with the use of cyclosporin has been the development of dose-dependent adverse effects, in particular renal dysfunction. Cyclosporin is lipophilic by nature and the conventional oral formulation (Sandimmun) was subject to incomplete and highly variable absorption, resulting in substantial inter- and intrasubject variations in peak concentrations and systemic bioavailability. A microemulsion-based formulation of cyclosporin (Neoral) has recently been developed, and possesses more predictable and improved absorption with a consequent increased peak concentration and systemic bioavailability. The improved predictability of absorption, and hence blood concentrations, facilitates the ability to 'tailor' therapy to an individual patient, which, in theory, could translate into an improved efficacy and safety profile. | |
| 7985038 | Posterior interosseous nerve entrapment in rheumatoid arthritis. | 1994 Aug | Posterior interosseous nerve (PIN) entrapment is a rare complication of rheumatoid arthritis (RA) which, together with extensor tendon rupture and metacarpophangeal joint dislocation, should be considered in the differential diagnosis of inability to extend the fingers. The inability to extend the thumb in PIN entrapment is a useful distinguishing clue on physical examination, and nerve conduction studies confirm the diagnosis. Elbow joint swelling and compression of the PIN at the arcade of Frohse are the main reasons for PIN entrapment in RA. Intraarticular steroid injections and surgical intervention resolve symptoms of PIN entrapment in RA. In our case, the addition of methotrexate, which induces a rapid antiinflammatory effect, resulted in resolution of weakness with complete recovery in the extensor muscles of the fingers. | |
| 7833872 | [Rheumatoid arthritis and recurrent rheumatism associated with sclerosing cholangitis]. | 1994 Jun | The authors report two cases presenting to a rheumatologist, one with palindromic rheumatism and previously undiagnosed ulcerative colitis, and one with rheumatoid arthritis. Both were subsequently found to have early sclerosing cholangitis with some response treatment. | |
| 7551653 | Specificity of antiperinuclear factor for rheumatoid arthritis in rheumatoid factor-positi | 1995 Aug | Although antiperinuclear factor (APF) has the same specificity for rheumatoid arthritis (RA) as rheumatoid factor (RF), there is no evidence that this specificity is maintained in patients with positive RF-agglutination tests. Thus, we evaluated the specificity and usefulness of APF for RA diagnosis, regardless of RF titre. APF was tested (1:100 threshold) on 214 sera sent for RF evaluation over a 9-month period. These sera were previously determined to have latex or Rose-Waaler (RW) titres > or = 12 or 4 IU, respectively, but not necessarily above the threshold values of 100 and 32 IU. The APF test was performed blindly, and physicians were not advised of the results. In the patient population (119 RA and 95 non-RA) APF still demonstrated good specificity (0.82) for RA. As expected, APF proved useful for RA diagnosis in 28/33 (85%) RA cases with an RF level below 1:100 for latex and 1:32 for RW, thus reducing the number of 'seronegative' RA from 33/119 to 5/119. However, it also improved the serological positive predictive value for RA, even in cases when RW results were > or = 32 IU. Indeed, the positive predictive value for RA when both tests were positive was 0.94 (68/72), whereas concordant results (either positive or negative) for both APF and RW tests allowed correct classification (RA or non-RA) in 94% of cases. | |
| 8408150 | Rheumatoid arthritis of the cervical spine. A long-term analysis with predictors of paraly | 1993 Sep | We analyzed the cases of seventy-three patients who were managed over a twenty-year period for rheumatoid involvement of the cervical spine and were followed for a minimum of two years, with an average follow-up of seven years. A neurological deficit did not develop in thirty-one patients (Ranawat et al. Class I) and paralysis developed in the remaining forty-two patients: Class II in eleven and Class III in thirty-one. Of the forty-two patients in whom paralysis developed, thirty-five had operative stabilization. Seven patients were managed with a soft cervical collar because they refused or were medically unable to have the operation; all of the had an increase in the severity of the paralysis. The posterior atlanto-odontoid interval and the diameter of the subaxial sagittal canal measured on the cervical radiographs demonstrated statistically significant correlations with the presence and severity of paralysis. All of the patients who had a Class-III neurological deficit had a posterior atlanto-odontoid interval or diameter of the subaxial canal that was less than fourteen millimeters. In contrast, the anterior atlanto-odontoid interval, which has traditionally been reported, did not correlate with paralysis. The prognosis for neurological recovery following the operation was not affected by the duration of the paralysis but was influenced by the severity of the paralysis at the time of the operation. The most important predictor of the potential for neurological recovery after the operation was the preoperative posterior atlanto-odontoid interval. In patients who had paralysis due to atlanto-axial subluxation, no recovery occurred if the posterior atlanto-odontoid interval was less than ten millimeters, whereas recovery of at least one neurological class always occurred when the posterior atlanto-odontoid interval was at least ten millimeters. If basilar invagination was superimposed, clinically important neurological recovery occurred only when the posterior atlanto-odontoid interval was at least thirteen millimeters. All patients who had paralysis and a posterior atlanto-odontoid interval or diameter of the subaxial canal of fourteen millimeters had complete motor recovery after the operation. In this series, although only patients who had a neurological deficit were operated on, we observed the range of the posterior atlanto-odontoid interval that was associated with poor or no recovery after the operation, and we identified the safe range on the basis of the patients in whom paralysis did not develop.(ABSTRACT TRUNCATED AT 400 WORDS) | |
| 7926987 | [The wrist joint in chronic polyarthritis--a new classification based on the type of destr | 1994 Jul | Existing classifications of rheumatoid wrist involvement are based on the degree or stage of destruction of the wrist. We suggest to classify rheumatoid wrist involvement according to the type rather than the extent of destruction. In order to recognize the nature of wrist destruction at an early stage of the disease as well as in late stages, a continuous series of 63 patients with definitive rheumatoid arthritis for over 20 years and wrist involvement of more than ten years were analysed both clinically and radiologically. Based on radiological appearance of the late stage, three different types of wrist involvement can be recognized: Group I--Type I: rheumatoid arthritis--ankylosis Group II--Type II: rheumatoid arthritis--(secondary) osteoarthrosis Group III--Type III: rheumatoid arthritis--destabilization Spontaneous ankylosis is characteristic for patients with a juvenile onset of rheumatoid arthritis, however, it also occurs in patients with a later consent of the disease. Patients in group II (type II) demonstrate a tendency to develop secondary arthrosis. Articular surface cartilage loss progresses at a rate which remains in relative equilibrium with processes typical of arthrosis, stabilizing the carpal architecture. In group III (type III), all wrists develop an unstable radiocarpal joint as evidenced by ulnar and palmar subluxation of the carpus relative to the radius and progressive loss of carpal height. When early surgical treatment is considered, it is crucial to recognize patients with type III wrist destruction. For these patients, an osseous stabilizing procedure is essential for long-term stabilization of the wrist. It is important that any evidence of progressive loss of carpal height or of ulnar radiocarpal translocation not be ignored.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 7554563 | Construct validation of the ACR 1991 revised criteria for global functional status in rheu | 1995 May | In order to assess the construct and discriminatory validity of the 1991 ACR functional status criteria for rheumatoid arthritis (RA), a cross-sectional analysis of 62 consecutive patients with RA (according to the American Rheumatism Association 1987 revised criteria) who were attending the outpatient clinic of rheumatology, University Hospital Zürich, was carried out. A moderate-to-strong association of the ACR criteria with pain (r = 0.54), the tender (r = 0.54) and swollen joint count (r = 0.31), grip strength (r = -0.49), C-reactive protein (r = 0.35), the HAQ disability index (r = 0.76), self-perceived global health (r = 0.58), and the Larsen radiological score (r = 0.32) was found. The mean scores of most disease parameters and all 8 domains of the health assessment questionnaire were significantly different between, and increased regularly across, the 4 classes. We conclude that the ACR 1991 functional status criteria for RA are a valid measure of the consequences of impairment and discriminate well the physical functional status. | |
| 1633356 | Development of rheumatoid arthritis after chronic hepatitis caused by hepatitis C virus in | 1992 Apr | We describe a patient with rheumatoid arthritis (RA) who had preceding evidence of post-transfusion, non-A, non-B hepatitis. The patient showed positive serological tests for anti-hepatitis C virus (HCV) antibody. The manifestations of RA, including progressive polyarthritis and positive serum rheumatoid factors, emerged after the ameriolation of hepatitis and persisted for more than 3 years, indicating that the polyarthritis in this patient was not the prodrome of the hepatitis. This patient had HLA-DR4 and HLA-Bw54 which are found to be strongly associated with RA in Japan. It is therefore suggested that HCV may trigger the development of RA especially in genetically susceptible individuals. | |
| 1390969 | Effect of active hand exercise and wax bath treatment in rheumatoid arthritis patients. | 1992 Jun | The effect of active hand exercise and warm wax treatment was evaluated in 52 rheumatoid arthritis patients randomized into four groups: (1) both exercise and wax bath, (2) exercise only, (3) wax bath only, and (4) controls. Treatment was given three times a week for 4 weeks. Deficits in flexion and extension in digits II-V bilaterally, grip function, grip strength, pain, and stiffness were measured before and after the treatment period. The control group was measured at corresponding times. Wax bath treatment followed by active hand exercise resulted in significant improvements of range of motion (ROM) and grip function. Active hand exercise alone reduced stiffness and pain with nonresisted motion and increased ROM. Wax bath alone had no significant effect. | |
| 1588731 | [Histamine receptors in arthritis]. | 1992 Mar | Histamine H1 and H2 receptors in lymphocytes, bone marrow mononuclear cells, synovial fibroblasts and chondrocytes were measured by binding assay and pharmacological study. Histamine suppressed IgG production through H1 and H2 receptors and cytotoxic activity through H2 receptor in lymphocyte. Histamine increased the production of hyaluronic acid in synovial fibroblast through H1 and H2 receptors. In the production of keratan sulfate in the chondrocyte, histamine increased through H1 receptor and decreased through H2 receptor. In arthritis, the functions of H2 receptor in the lymphocyte, bone marrow mononuclear cell and synovial fibroblast were decreased, and the function of H1 receptor in the chondrocyte was decreased. On the other hand, histamine content was reported to increase in synovial fluid with RA. Our data indicate histamine had suppressive effects on IgG production and cytotoxic activity, but the functions of histamine receptors, especially H2 receptor, were decreased in RA. The beneficial effects of histamine in RA synovial fluid might therefore be decreased by hypofunction of the H2 receptor. These data suggest that abnormalities in histamine receptors in arthritis could be involved in perpetuating the inflammatory process in RA. | |
| 9456634 | In vitro synthesis of prostaglandin E2 by synovial tissue after helium-neon laser radiatio | 1996 Aug | This paper reports the effect of helium-neon laser radiation (power of 5 mW and 632.8 nm wave length) on the synthesis of PGE2 in vitro in synovial tissue of biopsy samples of knee joints in patients with chronic rheumatoid arthritis stages II or III. Twelve patients were studied. Each patient received 15 applications of He-Ne laser. Eleven points for He-Ne laser applications were selected in one of the affected knees. The energy density used was 8 J/cm2 per application point. The He-Ne laser therapy reduced the synthesis of PGE2. The analysis of the data revealed a statistically significant difference between the levels of the synthesis of PGE2 before treatment (17.69 +/- 2.65 ng mg-1 of dry tissue h-1) and after treatment (13.85 +/- 2.73 ng mg-1 of dry tissue h-1), with p < 0.01 comparing mean values. This was also accompanied by relief of pain (91.6%), and a favorable subjective report from the patient. We conclude that PGE2 is a quantifiable parameter that could explain what causes pain relief in patients with rheumatoid arthritis that are treated with He-Ne laser. | |
| 8085083 | [Cryoglobulins in rheumatoid arthritis: exhaustive detection, immunochemical findings and | 1994 Feb | Cryoglobulins were measured in 29 patients (24 female, age 53.8 +/- 9.8 years) with rheumatoid arthritis (70% active). The cryoprecipitate was isolated, characterized and quantified. Cryoglobulinemia, always polyclonal or type III, was found in 83% of patients. The most frequent immunochemical isotypes found were IgG and A. Acrocyanosis was found in 50% and Raynaud phenomenon in 32% of patients with cryoglobulinemia. It is concluded that exhaustive detection of cryoglobulinemia in rheumatoid arthritis demonstrated a higher frequency than previously reported an is important for understanding pathogenesis of the disease. | |
| 8060764 | Vasculitis in rheumatoid arthritis. | 1994 May | The inflammatory process characteristic of rheumatoid arthritis is typically targeted to the synovial membrane. In a subset of patients, rheumatoid disease is complicated by an inflammatory destruction of blood vessels, rheumatoid vasculitis. Rheumatoid vasculitis has been understood to be the result of severe disease extending beyond the joint, possibly caused by immune complex deposition. In an alternative pathogenetic model, it is hypothesized that rheumatoid vasculitis represents a distinct dimension of rheumatoid disease. This model implies that rheumatoid arthritis patients can be separated into two groups: individuals with synovial disease and individuals with synovial plus extra-articular disease. The model is supported by immunogenetic analysis describing an accumulation of vasculitis patients with rheumatoid arthritis among HLA-DRB1*0401 homozygotes. The clinical experience that different types of extra-articular diseases cluster in some patients and the lack of correlation between the activity of synovial and extra-articular disease provide further support for this model. | |
| 1587884 | Leg oedema due to a rheumatoid cyst in the pelvis. | 1992 May | We describe a case in which chronic oedema of a leg was due to pressure on the external iliac vein from an intrapelvic rheumatoid cyst. Ultrasound and CT scanning gave the clues to diagnosis. | |
| 8688245 | Painful ankle region in rheumatoid arthritis. Analysis of soft-tissue changes with ultraso | 1996 Jul | PURPOSE: To establish the diagnostic usefulness of ultrasonography (US) and MR imaging in patients with rheumatoid arthritis (RA) suffering from prolonged pain in the ankle region, where plain radiography did not demonstrate any changes. MATERIAL AND METHODS: Seventeen patients were studied with 0.1 T MR imaging and with high-frequency US. Talocrural and subtalar joints (including talonavicular joints), and medial, lateral, and extensor tendons and their synovial sheaths were examined by MR and US. RESULTS: Abnormal findings were found by MR imaging and US in altogether 76% of the patients, by MR alone in 53%, and by US alone in 59%. In 41% of the patients, lesions were demonstrated only by one method. Talocrural and subtalar joints were the most often affected sites (41% each), followed by the peroneus tendon (23%). In the joints, the abnormal findings were interpreted as synovitis; in the tendon areas, mostly as tenosynovitis. MR and US were highly significantly concordant (p < 0.0001), but correlation with clinical features was poor. CONCLUSION: In patients with pain in the ankle region, US and MR imaging can contribute to the diagnosis and localization of the abnormality when the plain radiography is normal. Easily available and inexpensive US can be recommended as the first imaging method after plain radiography. Some divergence seems to exist between US and MR, and in complicated cases both methods are recommended. |