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)

Juvenile rheumatoid arthritis (JRA) is best defined as the condition of chronic synovitis in children. Such chronic childhood arthritis probably includes several distinct disease processes. Recognizable subgroups are systemic-onset disease (20%), rheumatoid factor-negative polyarthritis (25%), rheumatoid factor-positive polyarthritis (5%), pauciarthritis associated with antinuclear antibodies and chronic iridocyclitis (30%-35%), and pauciarthritis associated with sacroiliitis and HLA-B27 (10%-15%). Rheumatoid factor-positive polyarthritis appears to be the childhood equivalent of classic adult rheumatoid arthritis; the pauciarthritis associated with HLA B27 appears to be closely related to the spondyloarthropic diseases. Although there are no diagnostic laboratory tests, various subgroups differ in immunogenetic findings as well as in clinical appearance and prognosis. A wide variety of conditions (infectious diseases, childhood malignancies, genetic and congenital conditions, and noninflammatory musculoskeletal lesions) can mimic JRA and must be considered in the differential diagnosis. The outlook for most children with JRA is good; fewer than 20% have progressive destructive disease (generally those with rheumatoid factor-positive or systemic-onset disease). Therapy rests on the conservative use of antirheumatic drugs, active physical therapy programs, maintenance of activities, and attention to the psychosocial development of the whole child. Orthopedic surgery can be helpful, particularly in the rehabilitation of children who have suffered severe joint destruction or deformity. Combined orthodontic and oral surgery therapy can restore function and appearance for young people with the micrognathia of temporomandibular joint involvement.
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PMID:Chronic arthritis in children. Juvenile rheumatoid arthritis. 660 49

This paper will provide an overview of the case-control study including the definition, types of study design, advantages and disadvantages, potential types and sources of bias, selection of controls, statistical measures of association, and criteria for suggesting inferences about causation. Measures of association for HLA-B27 and ankylosing spondylitis (AS) and HLA-DR4 and rheumatoid arthritis (RA) are calculated from previously published data. Case-control studies are useful for identifying etiologic associations in uncommon diseases.
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PMID:Case-control studies. 660 52

The frequency of radiographic signs of sacroiliac joint involvement (greater than or equal to 2 and greater than or equal to 3 according to the New York criteria) was significantly higher in 28 HLA-B27 positive patients with classical seropositive rheumatoid arthritis (RA), than in 28 B27 negative RA controls. The B27 positive RA patients had more subcutaneous nodules (p less than 0.01), worse functional class (p less than 0.05), and higher levels of erythrocyte sedimentation rate (ESR) (p less than 0.05) and haptoglobin (p less than 0.05). Sacroiliitis, independent of HLA-B27, was associated with higher levels of ESR (p less than 0.05), and with a higher frequency of positive ANA test (p less than 0.05). It is neither related to the functional class nor to the duration of the disease.
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PMID:HLA-B27 and involvement of sacroiliac joints in rheumatoid arthritis. 660 94

Fifty-one North Indian patients with ankylosing spondylitis (AS) are described with mean age of onset 21.2 years and male to female ratio of 16:1. AS began with peripheral arthritis in 47%, low back pain in 41%, acute anterior uveitis in 10%, and heel pain in 2% of the patients. 76% of 51 patients had one of the extra-axial features of AS: peripheral arthritis (61%), heel pain (24%), anterior uveitis (22%), urethritis (12%), kidney disease (10%), mucosal ulcerations (6%), aortic incompetence (4%), and apical pulmonary fibrosis (4%). A majority (71%) of the patients with peripheral arthritis had mono- or oligoarthritis affecting mainly the lower limb joints. Two patients had coexistent rheumatoid arthritis also. HLA-B27 antigen was detected in 48 (94%) of 51 patients compared with 7 (6%) of 118 controls (relative risk 254; Fisher's exact p = 3.49(-29]. On comparing patients with juvenile onset AS and patients with adult onset disease we found peripheral arthritis to be more frequent at the beginning and during the course of disease in the former.
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PMID:Ankylosing spondylitis in North India: a clinical and immunogenetic study. 661 Nov 38

Patients with clinical features of rheumatoid arthritis (RA) but negative rheumatoid factor (RF) present a diagnostic challenge. The seronegative spondyloarthropathy (SNSA) syndromes, previously believed to be "rheumatoid arthritis variants," eg, Reiter's syndrome and psoriatic arthritis, are now considered to be genetically separate from RA and have been shown to be closely associated with HLA-B27. This syndromic discrimination has raised question as to the validity of RF negative RA (ie, seronegative RA). Demographic, clinical, and roentgenologic features of seronegative RA and SNSA are compared. Also, more common diagnoses that may stimulate seronegative RA are outlined according to onset age of arthritis. Recent concepts of RF positivity and HLA-DR4 correlations are reviewed. Multiple unknown factors contribute to the currently recognized syndrome of RA. Its diagnosis continues to rest on an aggregate of host, clinical, immunologic, and radiologic features.
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PMID:Seronegative rheumatoid arthritis. Fact or fiction? 663 37

A case of definite ankylosing spondylitis (AS), classical rheumatoid arthritis (RA) and membranous nephropathy is presented. Concurrent presence of the HLA-B27 and HLA-DR4 antigens was demonstrated. The association of AS and RA as well as RA and membranous nephropathy are discussed and the literature reviewed.
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PMID:Coexistence of HLA-B27 ankylosing spondylitis and DR4 seropositive nodular rheumatoid arthritis in patient with membranous nephropathy. 697 78

A diagnosis of Reiter's syndrome was made in 12 males and 13 females based on an asymmetrical oligoarthritis with lower extremity predominance and at least 1 characteristic extraarticular manifestation. The pattern of disease was similar in both sexes; females had more extensive upper extremity joint involvement and ocular inflammation; males had more nonbacterial urethritis. Eighty-two % of males and 62% of females were HLA-B27 positive. We suggest that Reiter's syndrome has not been diagnosed in more females in the past because of an historical bias, a reliance on the complete classical triad, and confusion with seronegative rheumatoid arthritis.
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PMID:Reiter's syndrome: a male and female disease. 709 84

A painful heel syndrome (plantar fasciitis and/or Achilles tendinitis) was found in 33 among 150 patients suffering from a seronegative spondarthritis. The clinical and radiological manifestations of this syndrome were similar in the nosological entities included in the seronegative spondarthritis group. HLA-B27 antigen was found in 91% of the patients, radiological sacroliitis in 64% and an asymmetric peripheral arthritis in all cases. By contrast, Achilles tendinitis was not encountered in 220 cases of rheumatoid arthritis; plantar fasciitis was exceptional in the same cases.
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PMID:Plantar fasciitis and Achilles tendinitis among 150 cases of seronegative spondarthritis. 720 86

Despite many reports on the association between ankylosing spondylitis and HLA-B27, most studies have failed to find a significant relationship between HLA-A or B antigen and rheumatoid arthritis. Stastny, however, showed a significantly high frequency of HLA-Dw4 in rheumatoid arthritis in 1976. The study of HLA antigens in Japanese patients with rheumatoid arthritis are thought to be significant in view of the pathogenesis of disease. Eighty-eight Japanese patients with "definite" or " classical" rheumatoid arthritis according to the ARA criteria and 104 normal individuals were typed for serologically detectable HLA-A, B, C, and D antigens. Though small discrepancies were observed in several of the HLA-A, B, and C, antigens, they were not definitely significant. The frequency of HLA-DR4 increased to 70.5% in patients compared to 46.1% in the control (i.e. normal) group (p less than 0.001). However, the frequency increased to 80.6% in male patients (p less than 0.0005). Of interest was the significantly high frequency of HLA-DR4 in males, compared to the low frequency of HLA-DR2 (p less than 0.02). Rheumatoid patients were subdivided into different groups according to the year of onset, the presence of the the rheumatoid factor or rheumatoid nodules, the functional grade and treatment. There were no significant differences in the frequency of HLA-DR4 among subgroups. The results indicate that rheumatoid arthritis, especially in males, is associated with genes of the HLA-D region and that immunogenetic factors linked to HLA have an important role in its pathogenesis.
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PMID:[[HLA in rheumatoid arthritis (author's transl)]. 728 33

This study was performed in order to probe the possible pathogenesis of Klebsiella pneumoniae (KP) in ankylosing spondylitis (AS). 34 anti-KP antibody positive serum samples, including 26 patients with AS, 5 patients with rheumatoid arthritis (RA) and 2 healthy individuals, were selected to detect anti-subtypical KP antibodies by using an immunoblotting technique. The results showed that the number of antigenic bands to KP on nitrocellulose membrane was higher in AS patients than in RA patients and healthy individuals. Patients with AS had common antibodies response to KP components weight 64,600 (80.7%), 48,200 (61.5%) and 36,000 (65.4%), patients with RA and healthy individuals had anti-36,000 (75%) and anti-30,000 (50%) antibodies. Human anti-HLA-B27 serum and rabbit antisera against KP-derived synthetic peptide containing the hexapeptide sequence shared by HLA-B27 were able to cross react with 64,600 and 48,200 KP components. Our findings suggest that KP might play a role in the pathogenesis of AS by molecular mimicry between it and HLA-B27.
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PMID:[Serum anti-subtypical Klebsiella pneumoniae antibodies in ankylosing spondylitis]. 764 43


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