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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of all the signs of Whipple's disease, the joint manifestations are among the most constant and the earliest to indicate the enteropathy, appearing long before the digestive and general signs. Essentially they consist of painful, peripheral joint manifestations: either simple arthralgia, or true arthritis differing in the degree of pain, the degree of the clinical signs accompanying the pain, the mode of evolution, and the number and the grouping of the joints affected, thus occurring in numerous clinical forms of which the two principal ones are subacute oligoarthritis with a tendency to migrate and chronic polyarthritis that gives rise to few definitive deformations. The radiographic appearance is usually normal. There is nothing specific about the laboratory aspects of the inflammatory syndrome. Synovial histology may in some cases clarify the diagnosis by demonstration of histiocytes with positive PAS granulations. The axial joint manifestations, which are always associated with the preceding ones, are infrequent and practically limited to unilateral or bilateral sacro-iliac lesions, with little or no clinical expression, that are discovered by standard radiology. Jejunal biopsy can be the key to early diagnosis. The pathogenesis remains obscure. The treatment is the same as for Whipple's disease, long-term antibiotic therapy.
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PMID:[Joint manifestations of Whipple's disease]. 6 80

We report two cases of a syndrome related to the bowel bypass surgical procedure. This syndrome consists of a flu-like illness, with temperatures from 38.3 to 39.4 degrees C (101 to 103 degrees F), chills, malaise, and inflammatory papules and pustules, 2 to 4 mm in diameter, on the extremities and upper part of the trunk. The illness lasts two to six days, and then recurs in one to six weeks. During some episodes, myalgia and polyarthralgia occur; between episodes, joints are normal. In both patients, extensive evaluations had been made to determine the cause of the persistent illness before this distinctive syndrome, related to the bowel bypass surgical procedure, was recognized. These two cases are also illustrative of the two therapeutic approaches that may be of value: administration of antibiotics, esecially metronidazole, or reconstitution of the normal bowel anatomy. The relationship of this syndrome to the arthritis associated with bowel bypass and to bypass enteropathy is discussed.
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PMID:Bowel bypass syndrome. 45 91

Amyloidosis is a rare but serious complication of inflammatory bowel disease (IBD), especially Crohn's disease (CD). It occurred in 15 of our 1709 patients with CD (0.9%) (706 with ileocolitis, 310 with colitis, and 693 with enteritis), but in only 1 of our 1341 patients with ulcerative colitis (UC) (0.07%), admitted to The Mount Sinai Hospital between 1960 and 1985. Eleven of the patients with CD who had amyloidosis had ileocolitis, 2 colitis, and 2 ileitis; these figures represent a frequency within each group of 1.6%, 0.6%, and 0.3%, respectively. Amyloidosis was thus associated 4.4 times more often with CD of the colon than with pure small bowel disease. We have added to this group of 15 patients the 5 cases of CD that were originally reported by Werther et al in 1960, plus another 4 (2 with UC and 2 with CD) who have been seen since 1985, making a total of 25 patients in this series, 22 with CD and 3 with UC. There was a striking male preponderance, 16 of 22, among patients with CD, although 2 of the 3 patients with UC were female. Amyloid disease was diagnosed at a mean age of 40 years, 15 years (range, 1-42) after the onset of CD. Six major forms of amyloidosis occurred: nephropathy, enteropathy, cardiomyopathy, hepatosplenomegaly, thyroid mass, and generalized amyloidosis. Renal disease with proteinurea and/or renal insufficiency occurred in 18 of the 22 patients with CD and in all 3 with UC. Nephropathy was by far the most common lethal manifestation of IBD-associated amyloidosis in this series. Nephrotic syndrome developed in 15 patients with CD and was accompanied by renal failure, the major contributor to mortality, in 10 of the 13 patients who died. Amyloidosis may be associated with suppurative or other extraintestinal manifestations of IBD. Fifteen of the 22 patients with CD who had amyloidosis also had suppurative complications of their bowel disease, although the other 7 had no recognizable suppuration. Extraintestinal manifestations were also common in this series, occurring in 12 of 22 patients with CD and in 2 of the 3 patients with UC; 6 of the 18 patients with nephrotic syndrome also had arthritis. However, there is no evidence that patients with IBD with amyloidosis have extraintestinal manifestations more frequently than do IBD patients without amyloidosis. Earlier reports of amyloid associated with IBD came from autopsy series. In recent years, biopsy has allowed diagnosis to be made during life.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Amyloidosis and inflammatory bowel disease. A 50-year experience with 25 patients. 152 2

Abnormal exposure to bacterial or dietary antigen across a diseased bowel wall may result in extraintestinal clinical complaints. Persistence of this antigen for years at these extraintestinal sites does occur, resulting in chronic and sometimes autoreactive disease. Treating the bowel disease can "cure" the extraintestinal complaints, but identifying the etiology of the original bowel disorder remains a problem, especially with the inflammatory bowel diseases. In 1992, nonsteroidal anti-inflammatory drugs remain essential in the treatment of various rheumatologic complaints. Although these drugs do work, they also produce gastrointestinal disease that may be far more extensive than was formerly appreciated. This risk is obviously a problem, and those who demand a change in our therapeutic approach to arthritis probably have the right idea.
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PMID:Gastrointestinal disorders in rheumatic diseases. 154 65

Psoriatic arthritis and the enteropathic arthropathies are included among the seronegative spondyloarthropathies. The concept of psoriatic arthritis as a specific entity continues to be challenged by some investigators, while others report on additional findings in this condition, such as temporomandibular joint disease. The etiopathogenesis of the condition continues to be investigated by the exploration of genetic and immunologic factors. Treatment options include dietary manipulations. The prevalence of arthritis among patients with bowel disease seems to be increasing, while the presence of gut lesions among patients with spondyloarthropathy is noted to be associated with disease activity.
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PMID:Gastrointestinal-related arthritis and psoriatic arthritis. 191 Oct 52

Spondyloarthropathies represent an important problem within the field of chronic childhood arthropathies. Nosology and differential diagnosis are yet unclear. It is important to distinguish spondyloarthropathies from JCA because biological aspects of affected patients, clinical findings, extraarticular manifestations and prognosis are very different. Ankylosing spondyloarthritis is the prototype of spondyloarthropathies: at the beginning, axial involvement is rare; it may develop during the following years or it may not occur. Enthesopathy is an important finding of spondyloarthropathies. Diseases with joint involvement, HLA B27 related, as ankylosing spondyloarthritis, psoriatic arthritis. Reiter's syndrome or arthritis associated with chronic bowel disease, enter the chapter of spondyloarthropathies. Children with familial history of spondyloarthropathies showing enthesopathy, "sausage fingers" and with the presence of HLA B27, may be classified in the group of spondyloarthropathies. Children with a chronic arthritis with pauciarticular onset, B27 positive, without any sign and finding spondyloarthropathies, should be classified as JCA from the beginning. A follow up of children affected with chronic arthritis is fundamental for a more correct classification of the disease.
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PMID:[Arthropathies related to HLA-B27]. 209 77

Fifteen patients with severe scleroderma bowel disease began receiving home central venous hyperalimentation (HCVH) between 1979 and 1987. The major reasons for instituting HCVH were intestinal pseudo-obstruction, malabsorption, and malnutrition. Eleven patients had an improved quality of life. Serious complications encountered over these 15,700 catheter-use days were 2 episodes of septicemia and 2 episodes of superior vena cava obstruction. Seven patients died, but none directly from their gastrointestinal disease or from the HCVH.
Arthritis Rheum 1989 Feb
PMID:Home central venous hyperalimentation in fifteen patients with severe scleroderma bowel disease. 249 54

In this chapter we have outlined the seronegative spondarthritides associated with bowel disease, excluding those discussed in separate chapters. Although, traditionally, Crohn's disease and ulcerative colitis have been dealt with separately in any discussion of seronegative arthritides, they have been discussed together here for the following reasons. Despite being pathologically distinct they show remarkable similarity in extraintestinal manifestations including any associated arthritis. Any observed differences in prevalence rates of arthritis may be secondary to the relative difficulty in diagnosing Crohn's disease, and most of the important prevalence studies were done before the more sophisticated techniques to investigate the bowel became available. This may in part explain the dramatic increase in the world-wide incidence of Crohn's disease seen in the last 30 years, particularly through the 1970s, but which has fallen off recently (Miller et al, 1974). It would seem that the body has a limited means of expressing disease processes. The final common pathway of a number of quite distinct disease entities is the concept of the seronegative spondarthritides. Exactly how the microbiological, immunogenetic and molecular factors interact to produce a particular disease end-point is currently not clearly defined, but with the increasingly sophisticated means to investigate the body at a cellular level the explanations may soon be at hand. Further controlled family studies are also needed to define the genetic relationships more precisely. We may then be able to piece the jigsaw puzzle together.
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PMID:Seronegative arthritis and the bowel. 267 Feb 56

Asymmetric affection of the major lower limb joints is a characteristic feature of the joint syndrome in yersiniosis-associated arthritis. The sacroiliac articulations are frequently (47% cases) involved. In addition, yersiniosis-associated arthritis concurs with the signs and symptoms of systemic disease--gastroenterocolitis, myocardiopathy and myocarditis, erythema nodosum, hepatitis, urethritis, conjunctivitis, myositis and myalgia, enteropathy; changes in the CNS typical for the astheno-neurotic syndrome are frequently present. Comparison of the immunological assay data in complicated and uncomplicated yersiniosis shows equally high levels of IgG and CIC. High anti-DNA antibody titres are more frequently found in the serum of uncomplicated yersiniosis patients. ELISA quantitation of specific IgA, IgM, and IgG class antibodies in yersiniosis-associated arthritis patients demonstrated persistence of all the three antibody classes or of IgA-IgG combination in cases with most severe of the joint syndrome. In the presence of cardiac disease, patients were found to have high titres of antibodies reactive with the cardiac interstitial tissue, while in authentically diagnosed myocarditis cases with the sarcolemma. The investigation findings strongly suggest a high degree of involvement of immune and autoimmune processes in the pathogenesis of arthritides secondary to Yersinia infection.
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PMID:[Clinico-immunologic characteristics of complicated and uncomplicated yersiniosis]. 277 63

A random sample of 170 patients (88 men) with chronic inflammatory bowel disease (75 ulcerative colitis) were first interviewed in 1978 about their employment status, problems at work, and influence of surgery. Surgery had been carried out on 120 and 53 had an ileostomy. After six years 144 (92%) of the 156 survivors replied to a follow up postal questionnaire. Of the initial sample, 122 (72%) were working and there were only three (1%) registered unemployed. After six years a similar proportion were working and only seven (5%) were unemployed. Continuity of employment was good with 57% in the same job. Changes in work because of health had been made by 72 patients mainly caused by bowel disease. After surgery 10% completely changed and 22% modified their work while a few had to retrain or retire. Panproctocolectomy and ileostomy resulted in more changes and longer time off work after surgery than colectomy and ileorectal anastomosis, with 35% and 17% respectively off work after one year. Problems at work, in particular general malaise and arthritis were experienced by 34 (28%) patients. Fewer problems were experienced by patients with a stoma who also had less sickness absence than those without a stoma. Colleagues and employers were usually supportive although some patients encountered discrimination especially those with a stoma or working in the food industry. Few patients had been counselled on their work. In general employment prospects and time off work were good and employers should be encouraged to take an optimistic and supportive role. Doctors should consider that convalescence after surgery may be longer than they perceive and must provide better counselling for patients.
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PMID:Employment problems and prospects for patients with inflammatory bowel disease. 319 97


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