Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003862 (arthralgia)
 7,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A computer analysis was made of the data from a prospective study of the clinical course of systemic lupus erythematosus (SLE) in 234 patients followed for an average of 46 months. All fulfilled four ARA criteria for the diagnosis of SLE. Sixteen of the 234 patients were aged 51 or older. They were compared with the 218 younger SLE patients to determine the influence of age on the signs and symptoms of the disease, the organ systems involved, the laboratory data, amount and duration of corticosteroid or azathioprine therapy, and the prognosis. The older group showed more discoid lupus, photosensitivity and pulmonary fibrosis than did the younger group, but a similar incidence of malar rash, alopecia, arthritis, arthralgia, myalgia and serositis, and a lower incidence of oral ulcers, Raynaud's phenomenon, cutaneous vasculitis, neuropsychiatric manifestations, leukopenia, hypocomplementemia and profus proteinuria. The older patients needed a lower dosage of corticosteroids, and a shorter course of azathioprine therapy. These findings suggest a milder form of SLE with better response to therapy in the older group.
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PMID:Systemic lupus erythematosus in the older age group: computer analysis. 76 67

At the 51st American Rheumatism Association meeting, a new ARA criteria for rheumatoid arthritis (RA) was proposed. According to this criteria, both the sensitivity and the specificity have improved to 93% and 90%, respectively. We investigated the adequacy of this criteria by applying this to Japanese patients with RA and control subjects with rheumatic diseases, other than RA. By using new criteria the sensitivity was decreased from 89.6% to 85.3% and the specificity was increased from 82.7% to 92.8%. The factors for the decreased sensitivity of the new criteria were 1) morning stiffness which became more than 1 hour, 2) the number of swelling joints increased from one to three and 3) radiologic changes, which were restricted to the hand only. On the other hand, the factors for increased specificity were (1) morning stiffness, (2) deletion of criterion of joint pain and (3) joint swelling. According to the classification tree method, the sensitivity and the specificity were 96.3% and 90.0% respectively in this study. Continued nationwide study on this new criteria, whether this is applicable and useful to classify Japanese patients with RA is necessary.
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PMID:[Clinical evaluation and application of new ARA criteria for rheumatoid arthritis]. 158 34

Between November 1984 and July 1988 a total of 8044 randomly selected German residents of the city of Hannover/FRG, aged 25 to 74, have been screened for rheumatic complaints by means of a postal questionnaire. An average 87% of the probands contacted returned completed questionnaires. Respondents with a "positive" questionnaire, i.e. suggestive of the existence of an inflammatory joint disease were invited for a rheumatological examination at the Hannover Medical School. 72% participated. 45 of a total of 1291 participants were identified as suffering from active or inactive, mostly rheumatoid arthritis. This yields a minimum prevalence of 0.56% (+/- 0.19%). The true prevalence is estimated to be 0.91% (99%-confidence interval 0.64-1.18). In 1985 and 1986 103 German RA sufferers aged 25 to 74, all citizens of Hannover, were referred to our outpatient rheumatology clinic for a first consultation. A comparison between the two groups revealed a higher disease activity in terms of "objective" criteria (joint swellings, ESR, rheumatoid factor) in the group of the referred patients as opposed to RA suffers from the community. Both groups were comparable in respect to "subjective" symptoms (morning stiffness, joint pain, pain intensity), functional capacity and degree of erosive joint lesions. The rheumatological outpatient clinic at the Hannover Medical School, providing the only specialized service in the region, actually covers less than 20% of all RA sufferers within the municipal area of Hannover and less than 50% of those with a "classical" RA according to the ARA-criteria.
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PMID:Activity and severity of rheumatoid arthritis in Hannover/FRG and in one regional referral center. 259 38

The overwhelming majority of patients with PSS present with combinations of Raynaud's phenomenon, sclerodactyly, polyarthralgias, or swelling of an extremity. However, the clinical presentation of PSS may be atypical; 14% of patients in the present series initially sought medical attention for symptoms other than Raynaud's phenomenon, tight skin, or joint pain. In the present series, only 31% of patients fulfilled the ARA criteria for PSS at the time of initial medical evaluation. Most patients manifested advanced disease by the time the criteria were fulfilled. The ARA criteria for the classification of PSS appear to have limited value with regard to making the diagnosis in an individual patient. Rapidly progressive PSS occurred in 17.6% of patients in this series and represents a particularly fulminant form of the disease whose course may not be predictable on clinical grounds at the time of initial medical evaluation or diagnosis. Patients destined to develop renal or cardiorespiratory failure usually do so in the first 3 years of disease. Close observation of PSS patients during the first 12 to 18 months may serve to identify those individuals who will undergo an accelerated disease course. Prognosis for patients with rapidly progressive PSS is poor and is associated with significantly higher mortality compared with patients with a more protracted disease course. Future therapeutic trials in PSS should be designed with the recognition that a subgroup of patients with this disorder will have a rapidly progressive disease course.
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PMID:Progressive systemic sclerosis: mode of presentation, rapidly progressive disease course, and mortality based on an analysis of 91 patients. 318 42

Four patients presented with the nephrotic syndrome. The histological appearances on renal biopsy were in three characteristic and in one suggestive of lupus nephritis. These patients did not initially have other clinical features of SLE, but three had a positive ANA and one a raised DNA titre. Remission occurred in two patients, in one spontaneously and in another following corticosteroid therapy, but two developed renal failure. During follow-up all developed elevated DNA binding levels and arthralgia or lymphopenia. The ARA classification criteria for lupus were only fulfilled at this late stage.
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PMID:Lupus-like nephritis heralding the definitive manifestation of systemic lupus erythematosus. 387 72

The great variety of rheumatoid arthritis is well known. By means of exemplary cases subgroups are described, which show more homogeneity in relation to onset and course than rheumatoid arthritis as defined by the ARA-criteria. As a result of treatment clinical signs of inflammation as joint pain and swelling and laboratory findings as ESR and Hb may improve, but there is no change in radiological progression. There are correlations between clinical and laboratory measurements but not to radiological findings. It is considered that inflammation and joint destruction may result from independent pathomechanisms. The conclusion is that the pathognomonic process of rheumatoid arthritis, i.e. destruction, shown by radiological progression, is not influenced by treatment and is reflecting the natural course of the disease.
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PMID:[Course of chronic polyarthritis]. 398 32

We report a case of systemic lupus erythematosus (SLE) and recurrent infections associated with isolated Clq deficiency. A 17-year-old girl from Saudi Arabia was hospitalized with seizures, fever, arthralgia, hair loss, oral ulceration and skin rash. Clinical and laboratory findings fulfilled the ARA preliminary criteria for the classification of SLE. Nonlesional skin contained immunoglobulins and C3 at the dermal-epidermal junction. She did not have antibodies to DNA or low C3 or C4. Total serum hemolytic complement activity was absent due to a total selective absence of Clq. There was no circulating inhibitor of Clq activity. The published experience of isolated selective complete Clq deficiency associated with clinical disease is reviewed.
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PMID:Selective complete Clq deficiency associated with systemic lupus erythematosus. 641 87

Three cases are presented, in two of which the CNS lesions revealed the presence of systemic lupus erythematosus (SLE). The diagnosis of SLE was certain according to the criteria of the ARA, and it was further confirmed by results of renal needle puncture biopsy. Case 1: A 16-year-old adolescent developed choreic movements followed, one month later, by psychotic symptoms suggesting a mixed hebephrenic-catatonic schizophrenic affection. Cutaneous lesions and signs of renal insufficiency 3 months later established that these disorders were related to SLE. A favourable outcome was observed rapidly for the systemic signs, recovery from neuropsychic symptoms being obtained after 3 months only but then in a few days. This course suggests the diagnosis of a "functional psychosis" of lupus origin. Case 2: A 24-year-old woman developed left hemiparesis followed by febrile coma. The slowly favourable course of the disease led to the appearance of a progressive dementia, with numerous epileptic seizures. Although tests for antinuclear antibodies were negative and the ESR was normal, several minor biological anomalies were suggestive of a systemic disease and the diagnosis of SLE was finally established. Corticotherapy produced only slight transient improvement. This progression towards dementia with progressive cerebral atrophy is most probably related to cerebral lupus lesions, the initial coma in the absence of any other apparent cause possibly being the first sign. Case 3: A 47-year-old woman developed simultaneously or separately episodes of arthralgia and uveitis of unknown origin over a 12-year period, and attacks of regressive multilocular neurological deficiency over a 15-year period.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Central nervous system involvement in systemic lupus erythematosus]. 671 10

The authors report the case of a 22-year-old Guatemalan in whom lupus was diagnosed 8 months after a second pregnancy. The diagnosis of lupus met the criteria of the ARA: Raynaud's syndrome, alopecia, arthralgia, thrombophlebitis, facial erythema, antinuclear factor at 1/100, Farr at 75 p. 100 and immunofluorescent demonstration of IgM binding in healthy skin. Two months after the beginning of the lupus, there was onset of insulin-resistant ketosic diabetes without overweight. The serum insulin was 1.140 mu U/ml. Acanthosis nigricans was noted and confirmed by a biopsy. Insulin-resistance can be attributed to anti-membrane receptor antibodies titrating at 1/200 (R. Khan). The short-term progress of the disease was favorable on corticosteroid treatment. Insulin could be stopped, but high insulin serum levels persisted. This case meets criteria for type B as defined by Flier, Khan and Roth, and is the first European case of lupus with a complete presentation. Short-term progress was favorable, and there is no evidence to affirm that there will be a tardive progression towards hypoglycemia which is, however, possible due to the persistence of elevated serum insulin levels.
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PMID:[Lupus, insulin-resistant diabetes and acanthosis nigricans (author's transl)]. 723 1

The widespread use of alpha-interferon (IFN-alpha) therapy in different diseases draws attention to its side effects, such as autoimmune-related diseases, especially thyroid autoimmune dysfunctions. Data about hepatitis and nonhematologic neoplasia are available, while data about hematologic malignancies are fragmentary. We studied the incidence of autoimmune-related disturbances and thyroid dysfunctions in 54 consecutive patients suffering from hematologic malignancies, treated with recombinant human IFN-alpha for a mean time of 15.9 +/- 8.9 months. Our results minimize the incidence of autoimmune dysfunctions in hematologic malignancies as side effects of IFN-alpha therapy. We registered the appearance of autoantibodies in only 3 females (5% of total): 2 patients (1 affected with essential thrombocythemia and one with multiple myeloma) presented antithyroglobulin antibodies with no clinical symptoms; 1 patient, affected with essential thrombocythemia, developed antinuclear antibodies with arthralgia and myalgia. ARA criteria for systemic lupus erythematosus were not fulfilled but the therapy had to be interrupted. No patient developed thyroid dysfunction. In patients with hematologic malignancies, the dosage and the duration of IFN-alpha treatment do not seem to influence the appearance of autoantibodies, while female sex appears to be a risk factor.
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PMID:Autoimmune thyroid dysfunctions in hematologic malignancies treated with alpha-interferon. 772 47


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