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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The laboratory diagnostics essentially contributed to the pathogenetic clarification of rheumatological problems and gives multifarious support to the rheumatologist in differential and activity diagnostics and thus also decisively contributes to early diagnostics and therapy. When the acute-phase-reactions serve for the differentiation of inflammatory-rheumatic diseases and degenerative diseases and for the establishment of the degree of activity, so the ASR further the diagnostic ascertainment of a rheumatic fever, the agglutination tests for proving the rheumatoid factor further the differential diagnosis of the rheumatoid arthritis, the LE-phenomenon and the ANF further the differential diagnosis of the LEV, the proof of cardiac auto-antibodies essentially furthers the diagnostics of carditis, the increase of uric acid the early recognition of gout, the synovial diagnostics at length became necessary for the clarification of clinically unclear mon- or oligoarthritides and the determination of the local activity for the observation and judgment of the course. Notwithstanding the primate of the clinic without an effective laboratory diagnostics a modern rheumatology can no more be performed nowadays.
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PMID:[Laboratory diagnosis in rheumatology]. 32 50

A case of rheumatoid nodulosis and the difficulties encountered in its diagnosis are presented. A positive rheumatoid factor, biopsy proved involvement of the synovium and bone at the second metacarpophalangeal joint, and regression of nodules and mild arthritic symptoms with gold therapy, supported the diagnosis of a rheumatoid disease variant. The relationship of the disease to rheumatoid arthritis, gout, and xanthomatosis is discussed.
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PMID:Rheumatoid nodulosis: another cuase of juxtarticular nodules. 92 91

The authors confirm the great rarity of joint complications in patients with Kahler's disease. Among the records of 1953 cases the following complications were the only one found: 2 cases of proved articular amylosis, 2 cases of probable articular amylosis, 3 cases of possible articular amylosis, 20 cases of arthropathy that were impossible to classify, 27 cases of compression of the median nerve in the carpan canal, 6 cases of gouty arthritis, and 3 cases of septic arthritis. The data on symptoms obtained in the course of this enquiry are in conformity with the data in the literature. Articular amylosis often takes on the appearance of a polyarthritic syndrome of progressive installation and extension, involving in particular the hands and the wrists, but sometimes involving in a symmetrical bilateral manner the elbows, the shoulders, and the knees. The affected joints are swollen, stiff, and painful. Local signs of inflammation are, however, often absent. The deformations characteristic of rheumatoid arthritis do not develop. The joints do not show radiological signs for most of the time. In addition, it is not possible to detect the rheumatoid factor in the serum. The arthropathies can also assume an oligo-articular topography. Articular discharges are very frequent: they are usually of a mechanical nature. Whatever the clinical appearance, an exact diagnosis can be established only by means of anatomo-pathological examination of the synovial membrane or of certain para-articular amyloid nodules. Myelomas complicated by amyloid articular deposits are often light chain, with only little increase in the erythrocyte sedimentation rate, discrete hyperproteinaemia, moderate medullary plasmocytosis, and rare or limited radiological lesions. The carpal canal syndrome is either isolated or included within the framework of a polyarthropathy. Compression of the median nerve is due to amyloid infiltration into the synovial sheath of the tendons of the finger flexors, proof of which is not always easy. Gout is rare despite the frequency of hyperuricacidaemia caused by renal insufficiency. Septic arthritis is often caused by renal insufficiency. Septic arthritis is often caused by pneumococci to which those with a myeloma appear particularly suceptible.
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PMID:[Articular complications of Kahler's disease. Results of a survey of 1953 cases of plasmocytic myelomas]. 112 74

Interleukin 6 (IL-6), a multifunctional cytokine particularly active in regulation of the acute phase response, governs the terminal maturation of B lymphocytes and participates in early activation of T cells. IL-6 levels of synovial fluids of 153 patients with different arthritides were measured by a simple sandwich enzyme immunoassay. Highest IL-6 concentrations were detected in patients with rheumatoid arthritis (RA), particularly in those characterized by very active general symptoms and severe joint pain. High IL-6 levels were detected in patients with juvenile RA with polyarticular onset of disease and in gout. Corresponding to the suggested in vivo relevance of IL-6, dose correlation of IL-6 levels with the synovial IgM rheumatoid factor accumulation was demonstrated. The rate of the correlation between synovial IL-6 level and concentration of serum C-reactive protein in RA was inversely proportional to the dose of steroid treatment in patients with RA.
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PMID:Interleukin 6 levels in synovial fluids of patients with different arthritides: correlation with local IgM rheumatoid factor and systemic acute phase protein production. 837 Dec 34

With the sandwich binding protein assay utilizing hyaluronic acid binding protein, we measured serum concentration of hyaluronic acid in 458 healthy persons, 71 patients with rheumatoid arthritis (RA) and 51 patients with various rheumatic diseases such as osteoarthritis (OA), progressive systemic sclerosis (PSS), systemic lupus erythematosus (SLE) and gout. The mean concentration +/- standard deviation (SD) of healthy persons whose age ranged 2 to 92 years old was 38.5 +/- 35.7ng/ml, and those with over 50 years old had apparently higher concentrations (51.9 +/- 40.5ng/ml) than those with below 50 of age (20.6 +/- 14.8ng/ml). When the upper limit of normal range was set up at 130 ng/ml, abnormal percentages were 62.0% (44/71) in RA, 0% (0/18) in OA, 6.3% (1/16) in PSS, 18.2% (2/11) in SLE and 0% (0/6) in gout. Patients who apparently had arthritis but not RA revealed normal or near to the upper limit in serum hyaluronic acid compared to RA patients having the mean +/- SD of 351.4 +/- 463.7ng/ml. When patients with RA were classified into stage I to IV with X ray of bone destruction, patients with more advanced X ray stage showed significantly higher serum concentrations of hyaluronic acid. Similarly, patients with lower activity of daily living revealed significantly higher serum concentrations of hyaluronic acid. In addition, serum hyaluronic acid level did correlate to concentration of serum CRP and sialic acid. Lansbury's index, strength of grip, joint score and erythrocyte sedimentation rate, but did not to duration of morning stiffness and titer of rheumatoid factor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Serum concentration of hyaluronic acid in healthy populations and patients with rheumatoid arthritis--relationship to clinical disease activity of RA]. 194 54

In this study, 26 patients with rheumatoid arthritis (RA), 10 with gout, 8 with scleroderma and 10 healthy volunteers were included. Antibodies to native and denatured human collagen types I, II and III were measured by an enzyme linked immunosorbent assay (ELISA). The frequencies of antibodies to native collagen type II were 19% in the sera of 26 patients with RA. These antibodies were also cross-reacted with collagen types I and III and generally, their activities to collagen in synovial fluids were higher than that in the serum. Only one in 8 patients with scleroderma showed high serum antibodies to these collagens. However, levels of collagen antibodies in patients with RA were not correlated with levels of rheumatoid factor, IgG, IgM and IgA. There was no different in the interleukin (IL)-1 production by synovial cells stimulated by collagens from patients with either RA or gout. The correlation between anti-collagen antibodies and HLA-DR4 antigen was poor, though the presence of DR4 was common in patients with RA. These evidences suggest that collagen antibodies were important to joint pathology only in some of the patients with RA. Thus, collagen autoimmunity warrants further investigation.
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PMID:Collagen autoimmunity to rheumatoid arthritis. 209 4

Laboratory tests are sometimes combined into "panels," presumably to facilitate a swift and accurate diagnosis. "Rheumatic panels" were available from 16 of 17 members of the American Clinical Laboratory Association. Panels included an average of five tests (range three to 11). Panel prices ranged from $25 to $189. The three tests most common in the available panels were those for rheumatoid factor, antinuclear antibody, and uric acid level. A panel combining these three tests would have a positive predictive value of only 34.6% in identifying rheumatoid arthritis, systemic lupus erythematosus, or gout in a population with joint pain, in which the combined prevalence of these diseases is estimated to be 10%. Therefore, 65.4% of persons with a "positive" test would not have one of these three rheumatic diseases. Lack of independence between diseases and second tests (for example, positive antinuclear antibodies in rheumatoid arthritis) increases misclassification errors. A careful history and physical examination along with serial ordering of a few selected tests appear optimal to establish a clinical diagnosis of a rheumatic disease.
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PMID:How useful are combinations of blood tests in "rheumatic panels" in diagnosis of rheumatic diseases? 326 32

Serum IgG antibodies to native and denatured human type II collagen (Col II) were measured using an enzyme linked immunosorbent assay (ELISA). One hundred and thirty one patients with various forms of arthritis such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PSA). Reiter's Syndrome (RS), osteoarthritis (OA), and gout, 60 with autoimmune connective tissue disease, and 37 with the chronic inflammatory conditions--graft versus host disease and leprosy--were studied. With the exception of RS, PSA, OA, and gout, significant levels of Col II antibodies were detected in each disease group. Blocking studies with types I and II collagen on selected serum samples confirmed the specificity to native Col II, though some cross reactivity was apparent with denatured collagen. The patients with RA who were Col II antibody positive tended to fall into stage III of disease progression. There was, however, no correlation with rheumatoid factor, erythrocyte sedimentation rate, or disease duration and this, together with the finding that Col II antibodies are present in a wide array of diseases, makes their role in the pathogenesis of RA questionable. They may arise as a secondary disease perpetuating mechanism in some patients, or in turn may be an epiphenomenon secondary to generalised disturbed immunoregulation or B cell hyperreactivity, or both, that characterises these clinical conditions.
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PMID:Autoantibodies to type II collagen: occurrence in rheumatoid arthritis, other arthritides, autoimmune connective tissue diseases, and chronic inflammatory syndromes. 336 30

Gout and classical rheumatoid arthritis rarely coexist. We report a patient with strong evidence for both these diseases. Possible reasons for the negative correlation between these diseases are summarised. One hypothesis suggests inhibition of surface activity of monosodium urate crystals (MSU) by binding of rheumatoid factor (RF). This was studied with a purified monoclonal rheumatoid factor (mRF) with specificity for IgG. The mRF bound preferentially to MSU coated with IgG in contrast with the IgM control. Inhibition of the neutrophil chemiluminescence (CL) response to IgG-coated MSU was observed at concentrations of mRF that had no effect on the CL response to uncoated crystals. Neutrophil activation was not altered by coating crystals with an IgM control at the same concentration. These data suggest that RF may bind to antigenic determinants on exposed Fc of adsorbed IgG and block the interaction of crystal-bound IgG with Fc receptors. Although crystal coating by RF may modify the expression of gouty arthritis, it is unlikely to be the sole explanation for the dissociation between gout and RA.
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PMID:Studies on the interaction of rheumatoid factor with monosodium urate crystals and case report of coexistent tophaceous gout and rheumatoid arthritis. 401

Piroxicam is a chemically unique, long-acting, potent antiinflammatory/analgesic agent now available for the treatment of arthritis and other inflammatory diseases in over 80 countries around the world. The literature of the last 2 years on preclinical and clinical results with piroxicam has been reviewed. Recent laboratory experiments have given insights into additional actions of piroxicam which may play a role in its broad spectrum of antiinflammatory activity. In various animal models, piroxicam inhibits cell migration into an inflamed site. In vitro, piroxicam inhibits both superoxide anion production and lysosomal enzyme release from human neutrophils and also inhibits IgM-rheumatoid factor production by human lymphocytes. The safety and excellent toleration of piroxicam in animals has been reconfirmed. Extensive clinical trials in over 66,000 patients have demonstrated the high efficacy and excellent toleration of piroxicam in rheumatoid arthritis, osteoarthritis, gout, various musculoskeletal disorders and pain of varied etiology. Patient preference and compliance has consistently been higher for patients on piroxicam therapy. A single 20 mg, daily oral dose produces 24 hour control of symptoms. Piroxicam has been shown to be a useful addition to the physicians armamentarium.
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PMID:Piroxicam--a literature review of new results from laboratory and clinical studies. 634 66


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