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)

Three patients with fractures at or near the pubic symphysis presented with groin pain simulating hip fracture or arthritis. A 71-year-old osteoarthritic woman was treated with a nonsteroidal antiinflammatory drug (NSAID) and exercises for right-sided sciatic pain after a minor fall, but developed left groin pain and tenderness over the pubic symphysis after two days of exercise. She had an impacted fracture of the left pubic symphysis which responded to use of a cane. The second patient was a 90-year-old woman with rheumatoid arthritis (on steroids) who complained of right hip pain after a series of falls in her home. Initially treated with Buck traction for a presumed hip fracture, she was later treated with heat and exercises after negative hip x-rays were obtained. Retrospective analysis of pelvic films and bone scan revealed a right pubic symphysis fracture. The third patient was an 83-year-old rheumatoid arthritic woman with inability to walk secondary to left groin pain. Pubic tomograms revealed disruption of the superior aspect, and bone scan showed increased uptake of the left pubic bone. She was treated with moist heat, rest, and NSAID. Twenty-four cases of os pubis fractures without major trauma or symphysis disruption have been reported. All patients had osteoporosis, and six had rheumatoid arthritis. Our three cases are presented to increase awareness of pubic symphysis fractures as a cause for groin pain, especially in patients with osteoporosis and rheumatoid arthritis.
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PMID:Groin and hip pain due to fractures at or near the pubic symphysis. 277 89

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

A 71 year old patient with seropositive rheumatoid arthritis developed rapidly progressive pneumonitis with bilateral pulmonary infiltrations and severe hypoxemia. At this time the patient was treated with cyclosporin A, indomethacin, chlorthalidone, amitriptyline and chlordiazepoxide. After these medicaments were discontinued and prednisone therapy was initiated a rapid remission of the pneumopathy was observed. It is probable that the reversible pneumopathy was induced by the treatment with cyclosporin A. Among the other medicaments which were stopped at the same time as cyclosporin A no comparable side effects are known.
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PMID:[Pneumonia in cyclosporin A-treated chronic polyarthritis (a case report)]. 375 51

A 71-year-old Caucasian woman with rheumatoid arthritis, who had been treated with gold salts for 19 months, developed a significant proteinuria associated with nephrotic syndrome and renal impairment. Her renal biopsy revealed the unusual simultaneous occurrence of gold nephropathy and renal amyloidosis and she was treated by gold withdrawal, methylprednisolone pulses and azathioprine, with a good remission of symptoms. We describe the case and discuss the possible cause(s) of similar renal involvement and the results obtained with the combined therapy of steroids and cytotoxic drugs.
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PMID:Gold nephropathy and renal amyloidosis in a patient with rheumatoid arthritis. 401 16

A 71-year-old man with rheumatoid arthritis complained of pain and swelling in the left calf. X-ray examination of the calf disclosed radiolucencies suggestive of soft tissue gas; however, subsequent investigation revealed no evidence of infection and an arthrogram showed a dissected popliteal cyst in the area of the gas. Gas-like radiolucencies in a popliteal cyst are an unusual finding which has not been previously reported.
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PMID:Gas-like radiolucencies in a popliteal cyst. 666 68

A 71-year-old woman with rheumatoid arthritis suffered a spontaneous anterior subluxation of the fourth lumbar vertebra with compression of the cauda equina. The patient was operated upon with a decompressive lumbar laminectomy and a stabilizing posterior interbody fusion of L4 and L5. Histological examination of the unstable L4-L5 motor segment showed that the apophyseal and discovertebral joints had been destroyed by rheumatoid granulation tissue.
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PMID:Rheumatoid arthritis of the lumbar spine leading to anterior vertebral subluxation and compression of the cauda equina. 745 37

A 71-year-old woman with psoriasis-associated rheumatoid arthritis had for 15 months been treated with methotrexate (5 mg/week orally). Four weeks before admission she had developed dyspnoea and cough. On admission her axillary temperature was 38.2 degrees C, the white cell count was normal. Erythrocyte sedimentation rate (50/90 mm), lactate dehydrogenase activity (449 U/l) and the creatinine level (1.33 mg/dl) were all elevated. Blood gas analysis revealed partial respiratory impairment (pO2 52 mm Hg), and the chest X-ray demonstrated bilateral interstitial-alveolar changes. Despite antibiotics the temperature continued to rise, and on the 11th day a blood eosinophilia of 4% was noted. The bronchial mucosa was normal on bronchoscopy, and transbronchial biopsy showed only minor interstitial fibrosis, occasional macrophages and lymphocytes. Cultures of the lavage-fluid were negative. As methotrexate pneumonitis was suspected the drug was discontinued and prednisolone administered (50 mg daily for 3 days, gradually reducing over 7 days). The symptoms quickly improved, and blood gas analysis and the X-rays became normal. The patient was discharged symptom-free after 30 days.
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PMID:[Severe pneumonitis as a complication of low-dose methotrexate therapy in psoriasis-associated polyarthritis]. 773 58

A 71-year-old male patient with rheumatoid arthritis was scheduled for posterior fusion of the cervical spine. He showed limited cervical movement and atrophic mandible. Tracheal intubation was difficult in his last anesthetic management for the same surgery. This time, we planned a special procedure for predicted difficult tracheal intubation. After induction of general anesthesia, a size-4 laryngeal mask airway was inserted. Next, a flexible fiberscope sheathed with a 6.0-mm-ID cuffed endotracheal tube was inserted through a laryngeal mask airway into the trachea, and the fiberscope was withdrawn. Then, an endotracheal tube changer was inserted through the endotracheal tube. The laryngeal mask airway and the endotracheal tube were withdrawn simultaneously leaving the tube changer. Finally, a 7.5-mm-ID armored endotracheal tube was inserted through the tube changer. The procedure applied in this case is a safe and reliable intubating method in patients with difficult tracheal intubation.
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PMID:[Intubation of a patient with rheumatoid arthritis with a 7.5-mm-ID armored endotracheal tube using a laryngeal mask airway]. 945 92

A 71-year old man who had had severe rheumatoid arthritis for many years involving all the joints suddenly developed stridor caused by immobilisation of both the vocal cords. Arthritis of the cricoarytenoid joints of the larynx was suspected, and the patient was successfully treated with prednisolone.
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PMID:[Stridor caused by laryngeal rheumatoid arthritis]. 1040 82

Early erroneous diagnosis of rheumatic disease is common in subjects with arthropathy due to hereditary hemochromatosis. A 71-year-old male with chronic obstructive pulmonary disease and monoclonal gammopathy underwent hip replacement and was referred to our Department because of altered liver function tests. Test results were negative for hepatitis B surface antigen and hepatitis C virus, and positive for rheumatoid factor. A diagnosis of rheumatoid arthritis had been made on the basis of compatible joint involvement and laboratory data and steroid treatment prescribed. Since his serum ferritin was 3249 ng/mL, genetic testing for hereditary hemochromatosis was carried out and revealed homozygosity for Cys282Tyr mutation in the HFE gene. Liver biopsy disclosed cirrhosis compatible with hemochromatosis. Following a review of the patients' radiographs, the diagnosis of hemochromatosis arthropathy was made. Phlebotomies and family screening for hereditary hemochromatosis were done. The most logical explanation for the positive rheumatoid factor result in this subject are his age and the presence of two chronic diseases involving long-standing antigenic stimulation and monoclonal gammopathy of uncertain significance. It is important to distinguish rheumatoid arthritis from hemochromatosis arthropathy for several reasons: patients with hereditary hemochromatosis do not require corticosteroid treatment; in case of erroneous diagnosis of rheumatoid arthritis, phlebotomy is not started early, and familial genetic counseling is not considered. In male subjects with positive rheumatoid factor and joint and liver disease, hereditary hemochromatosis should be considered. More liberal use of genetic testing is justified in such cases.
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PMID:Hereditary hemochromatosis masquerading as rheumatoid arthritis. 1168 50


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