Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gold lung, a gold-induced pneumonitis, is considered to be caused by hypersensitivity reaction to gold. We performed lymphocyte stimulation test (LST) to determine the response to gold, using lymphocytes obtained by bronchoalveolar lavage (BAL) from a patient with gold lung. A 57-year-old man was admitted with progressive shortness of breath following a skin eruption. He had been receiving weekly sodium gold thiomalate (Shiosol) for rheumatoid arthritis, with a cumulative dose of 485 mg. Chest roentgenogram showed diffuse interstitial infiltrates. LST for the response to gold, using peripheral lymphocytes, was positive. T cell lymphocytosis was observed in BAL, and transbronchial lung biopsy showed lymphocytic alveolitis and granulation tissue in alveolar ducts. From these findings, we diagnosed gold lung. Prednisolone (PSL) was started with an initial dose of 30 mg/day and resulted in a rapid improvement. As the dose of PSL was tapered, the patient's condition deteriorated and he was treated with a maintenance dose of 10 mg PSL. The second BAL revealed persistent lymphocytosis, and LST using bronchoalveolar lymphocytes for response to gold was positive. LST using peripheral lymphocytes was also positive, but was weaker than that using bronchoalveolar lymphocytes. This is the first report in Japan of a positive LST for response to gold, using bronchoalveolar lymphocytes from a patient with gold lung. This case suggests that the presence of activated lymphocytes against gold in the lung is cumulative, and that cell-mediated hypersensitivity is related to gold lung.
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PMID:[A case of gold lung with positive lymphocyte stimulation test to gold, using bronchoalveolar lymphocytes]. 156 28

A prospective phase II trial was conducted to assess the feasibility, tolerance, and efficacy of a device designed for selective removal of rheumatoid factor from the plasma of rheumatoid arthritis patients. The device contained terpolymer hydrogel-coated plates with chemically attached, aggregated human immunoglobulin G, and it operated as an immunoaffinity column. Sixty-one patients aged 25 to 73 underwent weekly plasmapheresis treatments (the primary therapy phase). During the trial, patients continued current rheumatoid arthritis medications without dose adjustments. All patients received two to six treatments (primary therapy). Responding patients were eligible to continue apheresis treatment every 2 to 6 weeks (maintenance therapy). No serious, untoward side effects were noted in the course of this study; of 640 treatments, only 2 (in different patients) were aborted, one because of complaints of dizziness and angioedema and the other because of chest tightness and shortness of breath. Except for a significant (p less than 0.05) decrease in serum iron, no significant changes in complete blood count, serum electrolytes, renal and hepatic function tests, or serum C3 and C4 were noted. Although the trial was not designed to determine clinical efficacy, patients noted less morning stiffness, longer time to onset of fatigue, and improved global pain assessment (p less than 0.004); significant objective improvements were noted in joint pain, tenderness, swelling, and the number of affected joints (p less than 0.001). One-half of the treated patients had at least a 50 percent improvement in objective measures of antirheumatic activity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Selective in vivo removal of rheumatoid factor by an extracorporeal treatment device in rheumatoid arthritis patients. 199 91

A 71-year-old man with a long-standing history of rheumatoid arthritis required methotrexate treatment since 1986, with a total dose of 210 mg. In April 1987, before arthroplastic surgery, methotrexate was discontinued. Four weeks later a syndrome of fever, dry cough, shortness of breath, and diffuse air-space consolidations on the chest radiograph evolved. An antibiotic therapy had no beneficial effect, and a bronchoscopy yielded no pathogens. An open lung biopsy led to the diagnosis of methotrexate-induced pneumonitis. This is the first report of a case where methotrexate-induced pneumonitis developed several weeks after cessation of the treatment. Methotrexate can cause four types of pulmonary adverse reactions: pneumonitis, pulmonary edema, pulmonary fibrosis, and pleuritis. Possible pathogenetic mechanisms, symptoms, treatment, and prognosis are discussed.
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PMID:Methotrexate-induced pneumonitis: appearance four weeks after discontinuation of treatment. 280 69

In the free-living population, approximately 30% of men and 53% of women over the age of 55 years have peripheral joint complaint. Neck and low back complaints occur in 25% of men and 40% of women in the corresponding age group. One third of free-living elderly people suffer from rheumatism. About 25% have shortness of breath, and another 25% have hypertension. Diabetes ranks seventh among self-reported diseases. Approximately 40% of elderly people report a poor health condition, 20-50% cannot perform all activities of daily life, and about 30% are physically handicapped. An examination of problems seen by general practitioners reveals that overweight ranks first (prevalence, 20% of visits per year), osteoarthritis second (19% of visits per year), and hypertension third (17.5% of visits per year); diabetes, however, ranks thirteenth among problems seen during annual visits to the general practitioner. Only 20-50% of people suffering from osteoarthritis or entesopathies soft-tissue rheumatisms visit their general practitioners, while three quarter do so in the case of rheumatoid arthritis. For people older than 55 years of age, 40-60% of men, and 55-82% of women use drugs daily. Analgesics and antirheumatic drugs are used daily by 15% of women and 5% of men over 55 years old. In view of our aging population, it can be anticipated that soon after the year 2000, the percentage of elderly people will be doubled in most European countries reaching 25% of the total population, while 40% will be older than 55 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiologic considerations of the geriatric population. 326 92

A fibrosing pulmonary disease, which could not be further classified, was diagnosed in a 76-year-old woman who for 40 years had worked as a seamstress in the textile industry. For the last 16 years she had suffered from progressively increasing shortness of breath. She died three weeks after hospitalization during which she received intensive respiratory and circulatory supportive treatment. At post-mortem examination there was evidence of minimal asbestosis, of pulmonary manifestations of rheumatoid arthritis and of recurrent pulmonary thromboembolism, as well as of the consequences of two weeks of artificial ventilation during the terminal period. This constellation of histopathological findings was assessed in relation to the part played by her occupational disease. She had been previously awarded a pension as a recognized sufferer form asbestosis (50% reduction of earning power). The histopathological findings were not such--in view of the difficult diagnostic constellation while she was alive--as to contradict with a high degree of probability the finding that she had suffered from an occupational disease.
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PMID:[Asbestosis and the rheumatic lung. Medical insurance assessment of combined lung diseases]. 366 58

Valve replacement for aortic regurgitation in patient with rheumatoid arthritis was rare in Japan. We report a successful case in which aortic regurgitation necessitated aortic valve replacement. A 62-year-old woman was admitted for shortness of breath, chest pain and progressive edema. She had been treated for rheumatoid arthritis for more than ten years using steroids. The aortic valve was successfully replaced by a prosthetic mechanical valve. The histopathological examination of the excised aortic valve demonstrated rheumatic nodules in the right- and non-coronary cusp. It was supported that these changes caused shrinkage of cusp and resulted in aortic regurgitation. This patient was discharged on the 20th postoperative day. There was no evidence of detachment of the prosthetic valve.
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PMID:[Aortic valve replacement for rheumatoid aortic valve regurgitation]. 747 90

A 65-year-old female with severe aplastic anemia induced by gold salt, whose hematopoietic recovery was initiated by rhGM-CSF therapy, was reported. The patient has been given a total of 500 mg of gold-sodium thiomalate for treatment of her rheumatoid arthritis. Two months after the final administration of it, she was admitted to our hospital with complaints of palpitation and shortness of breath. The hemogulobin was 5.9 g/dl, the platelet count was 0.5 x 10(4)/microliter, and the leukocyte count was 800/microliters with 19% neutrophils. Her bone marrow showed aplasia, and both of Ham and sugar-water tests were positive. Three times of bolus-methylprednisolone treatment, with or without methenolone acetate, resulted in no definite improvement of peripheral pancytopenia and marrow aplasia. Subsequent subcutaneous rhGM-CSF, 300 micrograms daily for 28 days with oral prednisolone 5 mg and methenolone acetate 40 mg daily, initiated hematopoietic recovery of all three cell lineages in both peripheral blood and bone marrow. The same doses of prednisolone and methenolone acetate were continued after rhGM-CSF administration, and three months later peripheral cytopenia and positive Ham and sugar-water tests disappeared completely.
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PMID:[Initiation of hematopoietic recovery by recombinant human granulocyte-macrophage colony-stimulating factor in a case of severe aplastic anemia induced by gold salt]. 771 74

A 56-year-old woman was diagnosed as having rheumatoid arthritis in 1983. She was treated with D-penicillamine in addition to non-steroid anti-inflammatory drugs from April 1990. In August she noticed shortness of breath on exertion. Chest X-ray films showed bilateral interstitial shadows, and chest CT revealed bilateral multiple wedge-shaped shadows extending distally. Blood gas analysis showed severe hypoxemia and pulmonary function tests demonstrated decreased %VC, FEV1.0% and diffusion capacity. Open lung biopsy specimens revealed infiltration of inflammatory cells and fibrotic change in the walls of bronchioles. She was diagnosed as having obstructive bronchiolitis. Corticosteroid therapy and discontinuation of D-penicillamine therapy stopped the progression of her symptoms, and she was discharged on corticosteroid maintenance treatment and home oxygen therapy.
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PMID:[A case of rheumatoid arthritis with obstructive bronchiolitis appearing after D-penicillamine therapy]. 825 35

D-penicillamine-associated bronchiolitis obliterans (BO) is a rare but well-known pulmonary complication in patients with rheumatoid arthritis or progressive systemic sclerosis. It has been assumed that in most, if not all cases, BO is a complication of the underlying disease rather than a side-effect of treatment. We report the case of a 46 year old man with scleroderma localized to his lower legs (morphea), who received a daily dose of 750 mg D-penicillamine. During the treatment of 1 yr duration, he developed progressive shortness of breath due to a worsening obstructive ventilatory defect suggesting BO, which was confirmed by surgical lung biopsy (constrictive BO). Bronchial obstruction progressed over the next 5 yrs and did not respond to corticosteroids. The patient finally underwent a successful single left lung transplantation. The histological features of constrictive BO were confirmed in the explanted lung. This observation suggests that D-penicillamine may induce bronchiolitis obliterans in the absence of a systemic connective tissue disease.
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PMID:Bronchiolitis obliterans in a patient with localized scleroderma treated with D-penicillamine. 880 54

A 57-year-old woman was found to have rheumatoid arthritis (RA) in 1996. Treatment with different immunoregulatory agents, including actarit and bucillamine, produced no improvement. Therefore, combined therapy with methotrexate (MTX) (5 mg/week oral) and low-dose prednisolone (PSL) (5 mg/day) was started in April 1997. Sulindac and famotidine were also administered. In August 1997, she was admitted to our hospital because of palpitations and shortness of breath due to severe anemia. Results of laboratory studies were hemoglobin, 2.9 g/dl; reticulocyte count, 225/1000; and haptoglobin, less than 10 mg/dl. The direct and indirect Coombs'tests were positive. A diagnosis of autoimmune hemolytic anemia (AIHA) was made on the basis of the laboratory findings. Treatment with high-dose PSL (50 mg/day) was started, and the anemia improved. The hemoglobin level increased to 6.0 g/dl within the 1st week and to 12.6 g/dl 6 weeks later. We believe that the most likely explanation for this anemia was the low-dose MTX because the anemia appeared soon after treatment was started.
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PMID:[A case of rheumatoid arthritis associated with autoimmune hemolytic anemia due to weekly low-dose methotrexate therapy]. 1102 Nov 73


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