Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The spondyloarthropathies of childhood present a diagnostic and therapeutic challenge. It is important to differentiate this group of arthritides from JRA because the nature and frequency of extra-articular complications are quite different, as is the prognosis and the therapeutic approach. JAS is the prototype of the spondyloarthropathies and probably accounts for greater than 75 per cent of all children with diseases included in this category. Unlike adult-onset ankylosing spondylitis, axial skeleton disease (sacroiliac, lumbar spine) is infrequent at onset of JAS and may not develop for months or years after the onset of arthritis in peripheral joints (particularly those of the lower extremity). Enthesitis, the inflammation of the insertion of tendon, capsule, ligament, or fascia to bone, is an important clinical diagnostic feature of this group of diseases. Extra-articular disease, such as rash in psoriatic arthritis, erythema nodosum, weight loss of abdominal pain (in the arthropathies of inflammatory bowel disease), urethritis, conjunctivitis, or Reiter's syndrome help to differentiate these spondyloarthropathies from JAS. Laboratory studies are of little assistance in differentiating JRA from the spondyloarthropathies except that in the latter group, RF is absent and HLA-B27 is frequently present. The high frequency of ANA in JRA contrasts with its corresponding low frequency in JAS. The long-term follow-up of chronic arthritis in childhood has demonstrated the variable and evolving nature of these conditions, and stresses the importance of continually questioning the accuracy of the diagnosis.
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PMID:Spondyloarthropathies of childhood. 376 52

A newly synthesized agent, disodium 4-chloro-2,2'-iminodibenzoate (CCA; Lobenzarit disodium), which prevents the development of autoimmune disease in B/W mice, and inhibits adjuvant arthritis in rats, was investigated to clarify its mode of action in B/W mice. CCA protected against the age-related decline of the suppressor T cell activity which played an important role in the regulation of both humoral and cell-mediated immunity. CCA also decreased the production of naturally occurring thymocytotoxic autoantibody (NTA) preferentially cytotoxic against the thymocytes and suppressor T cells, and inhibited both the antibody production to double-stranded DNA and the appearance of ANA in B/W mice.
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PMID:The effect of CCA (Lobenzarit disodium) on the suppressor T cell function and the production of autoantibodies in New Zealand black and New Zealand white F1 mice. 622 13

The presence of low molecular weight (LMW) IgM was found in 45% of patients with systemic lupus erythematosus (SLE). Complete chart analysis of clinical and laboratory variables was done on 39 patients with negative LMW IgM (Group 1) and on 40 patients with positive LMW IgM (Group 2). There were statistically significant differences between the 2 groups related to age at onset, hemoglobin concentration, IgM levels, and levels of anti-dsDNA. There were 12 known deaths among the 40 patients in the positive group (30.0%) and only 4 known deaths among the 39 patients in the negative group (10.26%), p less than 0.1. There were no significant intergroup differences of race, sex, mucocutaneous manifestations, arthritis, positive ANA, positive serologic test for syphilis by rapid plasma reagent, Coombs' positive anemia, thrombocytopenia, serositis, incidence of renal and central nervous system involvement. Our study shows that LMW IgM occurred in about half of the patients with SLE. Patients with positive LMW IgM compared to those without it had greater mortality at an earlier age.
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PMID:Clinical significance of low molecular weight IgM in patients with systemic lupus erythematosus. 633 43

Standardization of the indirect immunofluorescence antinuclear antibody (IF-ANA) test can be improved for a given substrate with use of reference ANA sera, uniform assay conditions, and standardization of optical systems. To accomplish this, reference sera from the Arthritis Foundation with defined antibody specificities for nDNA, SS-B, RNP, Sm, nucleoli, and "speckled pattern" were reacted with commonly used IF-ANA substrates, mouse kidney sections, KB and HEp-2 tissue culture cells. Reagents and assay conditions used were those provided with the substrates in commercially available IF-ANA kits. A microscope slide with graded intensities of fluorescent beads was used to standardize microscope fluorescence intensity readings. The authors' fluorescence pattern and intensity results should be directly comparable to results obtained in other laboratories for the six antibodies for which reference sera are available. Although no defined sera are widely available for SS-A, Scl-70, PM-1, and centromere antibodies, the ability of each substrate to detect these antinuclear antibodies as well as mitochondrial, smooth muscle, ribosomal and microsomal antibodies also was tested. HEp-2 cells and KB cells were found to be superior to mouse kidney sections for detection of SS-A, Scl-70, PM-1 and centromere antinuclear antibodies. Mouse kidney sections were superior for screening of sera for the absence of ANA as well as for detection of smooth muscle and liver-kidney microsomal antibodies. Other antibodies were detected with equal sensitivity with all substrates and each of the three ANA kits used in the study performed satisfactorily. Use of reference sera as well as optical standardization is recommended for IF-ANA testing.
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PMID:Standardization of the immunofluorescence test for autoantibody to nuclear antigens (ANA): use of reference sera of defined antibody specificity. 637 71

Sera from 104 children with JA with different onset-types of disease were evaluated for 19S IgM RF by the LFT , hidden 19S IgM RF by the hemolytic assay, ANA by HEp-2 cell substrate, and levels of IC by the C1qSPA . Their relationship to active disease was determined. Classical 19S IgM RF were detected by the LFT in only seven patients. All were late-onset polyarticular females. Hidden 19S IgM RF were detected by the hemolytic assay in the separated IgM-containing fraction in 55 patients of all onset-types. Clinical activity correlated with the presence of hidden 19S IgM RF in 82% of cases. ANA, using the HEp-2 cell substrate, were found in 61 patients, the majority showing a speckled, immunofluorescent pattern. ANA were noted in all RF positive patients and in nine of 10 patients with iridocyclitis. IC were found in 39 patients, and correlation with clinical activity occurred in 54% of cases. A search for positive associations among the four parameters showed no statistically significant correlations except for the concordance of ANA positivity in all seven RF positive patients. The presence of hidden RF correlated more closely with disease activity (P less than 0.001) than did that of ANA or IC. The significance of these data and previous studies remains to be determined. We have demonstrated that in the average JA population 7% have 19S IgM RF and about 60% have hidden RF, ANA, or elevated levels of IC. The present findings of 98 of 104 patients with at least one of the abnormal immunoproteins , the association of ANA in patients with iridocyclitis or with RF positivity, of hidden RF with disease activity, and the presence of 19S IgM RF in isolated IC suggest a possible immunologic etiology for JA.
Semin Arthritis Rheum 1984 May
PMID:Autoantibodies in juvenile arthritis. 661 Feb 17

Anti-histone antibodies were measured in a group of patients with drug-induced lupus erythematosus and in asymptomatic patients with drug-induced antinuclear antibodies (DANA). Anti-histone antibodies were found in the majority of drug-induced lupus patients. DANA patients had lower titers of ANA and no detectable anti-histone activity. Longitudinal studies of the drug-induced lupus patients showed a gradual fall in the ANA and anti-histone titers. Our data suggest that the immune response in the drug-induced lupus patients is similar to but more intense than that seen in the DANA patients. Possible factors altering the immune response in these 2 groups are discussed.
Arthritis Rheum 1981 Jul
PMID:Histone reactivity of drug-induced antinuclear antibodies. A comparison of symptomatic and asymptomatic patients. 697 43

We evaluated 96 patients (50 males, 46 females) with juvenile chronic arthritis (JCA) for various prognostic factors in an adult rheumatology clinic. Although the onset of JCA occurred before the age of 15 in all cases, the majority had a juvenile or late onset of disease. The mean duration of disease was 14 years. Twenty-eight % had a monoarticular onset, 26% a pauciarticular, 28% a polyarticular and 14% a spondylarthropathic onset. HLA-B27 was positive in 52% of the cases, 35 males and 12 females, and HLA-DW4 was present in 10%; 11.5% were ANA positive and 4% were found rheumatoid factor positive (latex greater than 1/128). Patients were classified in functional classes, using a slight modification of Steinbrocker's criteria. Patients who underwent major orthopaedic surgery of the hip or knee were classified in functional class IV, although they actually showed better function. Twenty-seven % had a functional class I, 45% class II and 24% class III-IV at the latest evaluation. In the group with poor prognosis (functional class III and IV) there were significantly more cases with a persistently high erythrocyte sedimentation rate; polyarticular involvement at onset and at the time of their last evaluation; and a family history of rheumatic diseases. There were significantly more females in the poor prognosis group. The presence of HLA-B27 and an ANA positive test were not significantly different in the functional class groups. HLA-B27 did not predict the development of typical ankylosing spondylitis but was associated with pauciarticular peripheral arthritis with or without mild spondylitis.
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PMID:Prognostic factors in juvenile chronic arthritis. 698 66

Thirty-four cases of SLE treated during the past seven years (1974-1981) in Taipei Municipal Jen-Ai Hospital are reported and analyzed. Diagnosis of SLE was based on ARA preliminary criteria and Hahn's preliminary criteria. There were 32 females (94.2%) and 2 males (5.8%). The mean age at diagnosis was 28.5 years (range 14-51). Clinical manifestations were as follows: facial erythema 24 cases (70.6%), Raynaud's phenomenon 4 cases (11.4%), oral or nasopharyngeal ulceration 7 cases (20.6%), arthritis without deformity 22 cases (64.7%), proteinuria 21 cases (61.8%), pleural or pericardial effusions 13 cases (38.2%), psychosis or convulsions 9 cases (26.5%), hematological abnormalities 25 cases (73.5%). Laboratory findings were as follows: positive ANA test 33/34 (97.0%), hypocomplementemia 10/13 (76.9%), direct Coombs' test 4/18 (22.2%), indirect Coombs' test 1/13 (7.6%), LE cell 19/34 (55.9%), RA Latex 7/17 (41.7%), polyclonal gammopathy 15/17 (88.2%), anemia 25/34 (73.5%), leukopenia 12/34 (35.3%), thrombocytopenia 10/34 (29.4%). Three cases were complicated by herpes zoster, one by hyperthyroidism, and one by autoimmune thyroiditis. Ten cases died, including 4 renal failure, 2 heart failure, 2 cases of committed suicide and 1 case of CNS involvement.
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PMID:[Clinical experience in systemic lupus erythematosus (author's transl)]. 709 84

Sixty children who were considered to have juvenile psoriatic arthritis were analyzed retrospectively; the mean length of follow-up was 10.8 years. There was a female predominance of 3:2. The mean age at onset for both the psoriasis and the arthritis was between 8 and 9 years. A family history of psoriasis was present in almost half, and was a valuable clue in diagnosing the 26 of 60 who presented with arthritis first. The majority had a monarticular presentation, usually of the knee. Additional joints usually became involved sporadically in an asymmetric pattern, in both upper and lower limbs, so that 87% ultimately had polyarticular disease. This course is unlike the usual one of childhood arthritis. Although 40% were asymptomatic at follow-up, six patients required bilateral hip replacement, four within the first five years following the onset of arthritis. Sixteen patients received slow-acting drugs, usually gold; eight of these had had a polyarticular onset and seven a positive test for ANA.
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PMID:Juvenile psoriatic arthritis--an analysis of 60 cases. 719 70

The sera of 138 patients with juvenile chronic arthritis (JCA) were tested in ELISA with the five individual histones, 34 histone peptides covering the full length of the four core histones, and two peptides corresponding to the N- and C-terminal domains of H1. The occurrence of IgG antibodies was examined regarding the different subsets of JCA (pauciarticular, polyarticular, and systemic onset) and regarding clinical features (chronic anterior uveitis, CAU) and other serological features (antinuclear antibodies, ANA). Seventy-two percent of the 138 sera reacted with at least 1 histone peptide. The peptides 204-218 of H1, 1-25 of H2B, and 111-130 of H3 were recognized by 22-28% of JCA sera, and 42% of JCA sera reacted with one or both peptides 1-25 of H2B and 111-130 of H3. The frequency of occurrence of anti-histone antibodies (AHA) regarding the type of histone fraction (H1, H2A, H2B, H3 and H4) or the regions of histones was not significantly different in the three subsets of JCA. No obvious association was found between IgG antibodies to histone peptides and uveitis. In the subset of pauciarticular JCA, 13/31 patients (41.9%) with CAU against 14/41 patients (34.1%) without CAU possessed IgG antibodies reacting with peptides of the C-terminal domain 83-135 of H3. This difference is not statistically significant. Finally, the presence of antibodies to histones and histone peptides cannot completely explain ANA reactivity found in patients' sera. Although antibodies to histone peptides occur frequently in the serum of children with JCA, the antibody profiles seem to be highly individual and do not correlate with disease subtype or activity. Identification of AHA present not only in the circulation but also in tissue deposits may provide better insight into the identification of pathogenic antibodies.
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PMID:Mapping of B-cell epitopes recognized by antibodies to histones in subsets of juvenile chronic arthritis. 754 36


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