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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The course of rheumatoid arthritis was analyzed in 50 newly-diagnosed adults followed prospectively for an average of over five years. Eighteen patients had no swelling and no erosion (outcome 1), 22 patients had swelling without erosion (outcome 2) and 10 patients had erosion (outcome 3). Computer-assisted data screening and multivariate analytic technics were employed to derive a simple index from entry data which correlated closely with the patients' subsequent articular course. The index included six entry items: positive rhematoid factor; two or more swollen upper extremity joints on examination (2 points each); history of Raynaud's-like symptoms; malaise or weakness at the onset of arthritis; white race and female sex (1 point each). This index was 80 per cent accurate over-all in classifying patients into the three mutually exclusive articular outcome categories. Zero to 2 points on entry predicted no swelling, 3 to 5 points swelling without erosion and 6 to 8 points the development of bony erosion. Although results must be qualified to this patient population in the early stages of disease, the analytic approaches developed promise to assist with a broad range of clinical research and medical care delivery problems.
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PMID:Prognosis in rheumatoid arthritis. A longitudinal study of newly diagnosed younger adult patients. 43 43

Murine monoclonal antibody (Mab) therapy in patients with rheumatoid arthritis (RA) produces an antimouse immunoglobulin response by the recipient. We studied a chimeric (human/mouse) CD7 Mab, in a dose ranging tolerability study in 10 patients with RA. Modest improvements in disease activity occurred with frequent acute adverse effects of malaise, fever and nausea. After treatment, peripheral blood T lymphocyte numbers fell by 50% and CD7 expression fell by 97% for less than 7 days. Our study demonstrates chimeric Mab function in vivo and illustrates the influence of antibody isotype and patient characteristics on adverse effects.
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PMID:Chimeric CD7 monoclonal antibody therapy in rheumatoid arthritis. 127 68

The patient was a 64-year-old female who had been treated by a local doctor for rheumatoid arthritis and hypertension for 10 years. Malaise and edema developed since July, 1990, and as proteinuria and renal dysfunction were noted, the patient was admitted to our hospital on November 2. On admission, BUN was 33mg/dl, creatinine was 2.5mg/dl, and proteinuria was about 3g/day. Renal biopsy was performed after admission. Light microscopy revealed nodular lobulation of glomeruli and occlusion of loops. Dylon staining was negative. Immunofluorescent study showed granular deposition of IgG, IgM, C3, C4, Clq in the glomerular basement membrane and mesangial area. Electron microscopy showed a large amount of electron dense deposits in the subendothelium and mesangial area and dense aggregation of tubular structure in the deposit, part of which exhibited a profile of fingerprint deposit. The tubular structures were classified into three major types, which were 120, 100, and 50nm in diameter. From these findings, a diagnosis of immunotactoid glomerulopathy was made. After renal biopsy, plasmapheresis and prednisolone were administered, and the patient has been managed conservatively to date.
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PMID:[A case of rheumatoid arthritis with immunotactoid glomerulopathy]. 148 14

Cryptogenic organizing pneumonitis is a clinical and pathologic syndrome characterized by a "pneumonia-like" illness with excessive proliferation of granulation tissue within small airways and alveolar ducts associated with chronic inflammation in the surrounding alveoli. The duration of illness prior to lung biopsy is short, usually less than 2 months, and it is markedly different from that of IPF. Interestingly, unlike in IPF where the patient has difficulty remembering the exact onset of symptoms, patients with COP are frequently very specific about the timing of their disease onset. This is because the disease onset is recent and is often dramatic with the development of a severe flulike illness, ie, cough, fever, malaise, fatigue, and weight loss. Inspiratory crackles are frequently present on chest examination. Pulmonary function is usually impaired with a restrictive defect being most common. Gas exchange abnormalities are extremely common with a reduction in Dco and resting hypoxemia being almost universal findings. The roentgenographic manifestations are quite distinctive with a pattern of bilateral, diffuse but inhomogeneous, ground-glass or alveolar opacities being present in the majority of the cases. Bronchoalveolar lavage findings are nonspecific but usually reveal a lymphocytosis. The response to corticosteroid treatment is quite favorable and death from progressive disease is uncommon in COP, especially if treatment is instituted early in the course of the disease. In our experience, the cases with the worse prognosis are those associated with another disease process, in particular, connective tissue disorders like rheumatoid arthritis. In fact, these patients are prone to develop a rapidly progressive form of BOOP with a clinical course similar to the "Hamman-Rich syndrome." Recurrences are relatively frequent, consequently, withdrawal of treatment should be done with extreme caution. Corticosteroids have been the conventional initial treatment of COP, although to our knowledge, there are no controlled clinical trials to support it use. Antibiotics are not effective in treating this syndrome. Thus, based solely on our experience and that of others, we believe that high-dose corticosteroid therapy should be used to treat COP, usually initiated with 1 to 1.5 mg/kg/day (using ideal body weight) not to exceed 100 mg/day. Prednisone is given as a single oral dose in the morning. We recommended maintaining this dose for 4 to 8 weeks. If the patient's condition is stable or improved, the prednisone dosage is gradually tapered to 0.5 to 1 mg/kg/day (using ideal body weight) for the ensuing 4 to 6 weeks.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Cryptogenic organizing pneumonitis. The North American experience. 162 12

A patient with severe rheumatoid arthritis treated with prednisone had a painless soft tissue nodule develop on the dorsal aspect of the ring finger. She denied any history of hand trauma, animal exposure, or systemic symptoms such as fever or malaise. Fungal cultures performed on an aseptically obtained aspirate of this lesion demonstrated dark, olive-black creamy colonies on Sabouraud's agar. Slide cultures made from mold colonies produced slender conidial forms with annellations and spine-like conidiophores, features characteristic of Exophiala spinifera. The lesion was surgically excised, and the patient was successfully treated with a course of oral itraconazole. This nodular lesion has not recurred at the time of this writing. Exophiala species are difficult to differentiate, and E. spinifera may be confused with Exophiala jeanselmei. A literature review will consider Exophiala species and clinical manifestations produced by these dematiaceous fungi.
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PMID:Subcutaneous phaeohyphomycosis of the finger caused by Exophiala spinifera. 265 27

To test the hypothesis that there are significant differences in the radiographic appearance of rheumatoid arthritis between men and women, the authors blindly evaluated bilateral hand and wrist radiographs in 32 men with definite rheumatoid arthritis and 32 age- and disease duration-matched women (mean age, 56.4 years; mean disease duration, 10.5 years). Radiographically, disease distribution and severity were identical in these matched groups. Superimposed osteoarthritis was frequent in both groups and related to age. Ill-defined bone proliferation was present in 13 of 64 hands in both groups. Cystic changes and well-defined erosions were present in 12 of 64 male hands and six of 64 female hands, but this difference was not statistically significant. In women, presence of cysts and bone proliferation was related to disease duration, whereas men exhibited these atypical features independent of disease duration. There was no statistically significant difference in the frequencies of typical and atypical features of rheumatoid arthritis between the two sexes, and the authors postulate that previously reported differences relate to patient selection and lack of adequate matching.
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PMID:Rheumatoid arthritis: similarity of radiographic abnormalities in men and women. 336 42

Septic arthritis is associated with a definite morbidity which may be related to a delay in diagnosis and hence treatment. The cases of three patients with rheumatoid arthritis and chronic chest disease where the joint sepsis was not the predominant feature are presented. The responsible organism was Streptococcus pneumoniae which had spread after recent chest infections. Minimal joint symptoms or general malaise in association with an unexplained rise in erythrocyte sedimentation rate in these circumstances warrant a search for joint sepsis.
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PMID:Pneumococcal septic arthritis in rheumatoid arthritis. 363 70

A partially purified extract of an ant venom from the South American tree ant Pseudomyrmex sp. was tested in a double-blind, controlled study of patients with rheumatoid arthritis. Venom treated patients demonstrated an improvement in global efficacy and a decrease in the number of tender/painful joints and swollen joints. Swollen joint index improved in 60% of venom treated patients. Other parameters did not demonstrate significant change. Reduction of joint swelling was followed by symptomatic improvement that was sometimes delayed by weeks. Reactions were limited to erythema at the injection site (all patients), local pruritus (two-thirds of the patients), and fever with malaise (one-third of the patients). Further study of this venom in rheumatoid arthritis appears warranted in view of its apparent favorable efficacy-to-toxicity ratio.
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PMID:The effects of a partially purified fraction of an ant venom in rheumatoid arthritis. 636 51

Human adjuvant disease is an immunologically mediated disorder manifested by arthritis, arthralgias, skin lesions, malaise, pyrexia, and weight loss. Clinically, it often resembles rheumatoid arthritis and Reiter's syndrome. While scattered cases of adjuvant disease have been reported following injections with silicone fluid of unknown purity, paraffin, and petroleum jelly, no cases of adjuvant disease following silicone gel implant mammaplasty have been reported. We present such a case, discuss the pertinent biology of silicone, and review the literature describing adjuvant disease.
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PMID:Silicone-induced human adjuvant disease? 684 84

Leukocytoclastic vasculitis (L.V.) is a polymorphous inflammatory dermatosis, characterized clinically by palpable purpura of the lower legs and, histologically by fibrinoid change in the small dermal vessels as well a polymorphonuclear infiltrate and nuclear dust. Fifty one cases (33 females and 18 males) of histologically confirmed L.V., seen at the Dermatologic Clinic, University Hospital of Coimbra, are reviewed. The most common type of skin lesions found were palpable purpura (80%), erythematous papules, vesicles and bullae (45%). Systemic manifestations occurred in 32 patients (63%), predominantly fever (33%), arthralgias (27%), malaise (18%) and gastro-intestinal pain (10%). The most frequent laboratory abnormality was a high E.S.R. found in 80% of the patients tested. Possible causative agents could be identified in 37 patients (73%) and included drugs in 12 patients (24%), drugs and infections in 16 (31%) and infection in 3 (6%). Three patients had malignancies and 2 had rheumatoid arthritis. The course of the disorder was acute in 25 cases (49%), recurrent in 14 (27%) and chronic in 10 (20%). The majority of patients (61%) were treated with systemic corticosteroids.
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PMID:[Leukocytoclastic vasculitis. Review of 51 cases]. 774 5


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