Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical features of ankylosing spondylitis (AS) were compared in 63 HLA-B 27 positive (+) and 15 B27 negative (-) individuals with this disease. There were no differences in age at onset, functional class, degree of deformity, pain, severity of X-ray changes, or frequency of peripheral joint involvement or of reconstructive orthopedic surgery. These data demonstrated that skeletal manifestations of AS were essentially the same in B27(+) and (-) patients, and provide no evidence for the speculation that AS in B27(-) patients is milder or is a different disease from that occurring in B27(+) patients. On the other hand, acute anterior uveitis was found to be significantly more common in B27(+) patients, a fact suggesting that the "uveitis of AS" may in fact be an independent condition occurring in B27(+) individuals, rather than a manifestation of AS per se.
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PMID:Comparison of clinical features in HLA-B27 positive and negative patients with ankylosing spondylitis. 55 64

Recent developments in genetic tissue typing have altered concepts of ankylosing spondylitis (AS) or variants of this spondylitic arthritis. It is now apparent that AS is separate and distinct from rheumatoid arthritis; and the term "rheumatoid" should be avoided except as it applies to the latter, usually characterized by rheumatoid factor or nodules and symmetrical arthritis of peripheral joints. Classical definitions of AS require X-ray evidence of sacroiliitis and/or restriction of chest expansion. Recent studies suggest that many patients, especially women, may have symptoms of AS without typical roentgenographic or clinical findings. Use of the HL-A B27 genetic test is useful for identifying AS patients. Radioisotope bone or joint scanning techniques further augment present diagnostic capabilities. Atypical AS may be a very common form of morbidity among patients with back pain in the United States. Since patients have a tendency to form osseous reankylosis after total hip replacement, it is especially important for orthopedic surgeons to identify incipient AS and related disorders. Inappropriate treatment or procedures may be avoided by use of these newer clinical tools in the evaluation of patients with chronic back or skeletal pain.
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PMID:Ankylosing spondylitis and its variants. A review of recent developments for orthopedic surgeons. 60 74

A study comparing 12 patients with ankylosing spondylitis (AS) to 25 with osteitis condensans ilii (OCI), referred to a rheumatic disease center, was carried out to determine whether OCI represents a varient of AS in women. In the group with OCI, chronic lumbodorsal pain was present in 9, 36%, a 'fibrositis' syndrome in 6, 24%, and 16, 64% had recurrent episodes of polyarthralgia. A definite arthritis with effusion developed in 10 patients, 40%. No patient with OCI had iritis or colitis, whereas 4 patients with AS had iritis and four had colitis. Radiographs of the spine showed no evidence of spondylitis in the OCI group. Of the 25 patients with OCI, only 2, 8% were HLA B27 positive compared with 11 of 12 patients with AS, 92%. These results suggest that OCI is not a variant of AS in women.
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PMID:Comparison of osteitis condensans ilii and ankylosing spondylitis in female patients: clinical, radiological and HLA typing characteristics. 67 May 38

Thirty-nine Caucasian women with definite or probable ankylosing spondylitis were tissue typed and the radiographic and clinical features were correlated with the presence of B27 (formerly W27). This investigation showed that the same strong positive correlation observed in men obtains in women between B27 and unequivocal radiographic changes. As such changes develop slowly in women, clinical and laboratory features were identified which were sufficiently characteristic to enable the diagnosis to be reached in advance of decreased spinal mobility. Immobility pain and stiffness and bilateral sacroiliac pain are the most characteristic features, but additional support is provided by the presence of any of the following: onset by age 30, a raised sedimentation rate, peripheral joint involvement, circumthoracic pain, family history, and iritis.
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PMID:Clinical diagnosis of ankylosing spondylitis in women and relation to presence of HLA-B27. 98 7

In order to establish how many children with seronegative spondyloarthropathy (SpA) starting with peripheral arthritis and/or enthesitis will develop ankylosing spondylitis (AS), 13 consecutive Caucasian pediatric patients, (11 with the seronegative enthesopathy and arthropathy (SEA) syndrome and 2 with isolated B27 associated peripheral arthritis or enthesitis at entry), were followed prospectively with no loss for more than 5 years. Sacroiliac joint plain films obtained at the last visit were mixed with those of 14 control subjects and read blindly. The course of SpA was self-limiting in 6 patients and recurrent in the other 7. Six patients had episodes of inflammatory cervical and/or lumbar pain during followup. However, none showed any limitation of spinal movement in the asymptomatic periods. Only one patient (9.1%) of 11 with the SEA syndrome showed bilateral sacroiliitis and met New York criteria for AS after 5 years of disease. Our results suggest that the proportion of Caucasian children with the SEA syndrome developing AS is much lower than the 75% found in a similar study on Mexican children. Lack of evaluation of all patients after 5 years, the reading of pelvic plain films without reducing observer error, and the male predominance in the Mexican study, probably in addition to ethnic or environmental factors, may account for differences.
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PMID:Low frequency of axial involvement in Caucasian pediatric patients with seronegative enthesopathy and arthropathy syndrome after 5 years of disease. 157 64

With reference to a new case of acne conglobata-associated rheumatic disease in a thirteen-year-old boy, we recall the characteristics of the main joint and/or bone manifestations that may occur during severe flares of acne conglobata, but also acne fulminans or pustulosis of the palms and soles. Joint manifestations mainly involve the large proximal joints of the limbs and consist in pain rather than in signs of inflammation. Although recurrences may develop, joint disease responds to treatment of the acne combined with a non-steroidal antiinflammatory drug. Bone involvement consists in true rheumatic osteitis with hyperostosis responsible for densification and thickening of bone, mainly in the anterior chest wall and spine. The pathogenesis and nosologic place of these bone and joint manifestations remain controversial: they do not seem to represent true reactive arthritis and, although the B27 antigen is usually lacking, they have been likened to the group of spondylarthropathies, especially in those cases with sacroiliac involvement and enthesopathy . Oddly enough, they are reminiscent of some of the side effects of etretinate, an agent prescribed in these severe forms of acne. After a national survey carried out in 1986, the acronym SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) was suggested to designate the range of skin, bone and joint manifestations observed.
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PMID:[Rheumatism and acne conglobata . Apropos of a new case, in a 13-year-old boy]. 214 87

A Phase I clinical trial of the immunogenicity and safety of a vaccine against the C-terminal region of the beta subunit of human chorionic gonadotropin (hCG-B) demonstrated a dose-related immune response. The antigen was a synthetic peptide of the C 109-145 region of hCG-B, conjugated to diphtheria toxoid, and administered in a water-soluble synthetic adjuvant in a saline-oil emulsion. This vaccine had been previously tested for toxicity in laboratory animals and for immunogenicity, safety and contraceptive effectiveness in baboons. 30 previously sterilized women were given 2 injections 6 weeks apart, ranging from 50 to 1000 mcg of the antigen. Each woman tested free of HLA B27 antigen and reacted negative to the diphtheria toxoid skin test. Based on calculated contraceptive antibody binding level of 0.52 nmol/l, all subjects mounted an effective antibody response for at least 6 months. 2 subjects in the group given 1000 mcg who were followed for 9 and 10 months maintained this level of antibody. 12 women showed an anamnestic response to diphtheria toxoid, while 8 did not. The only adverse reactions were mild, transient pain at the injection site. Several women who received unstable adjuvant experienced more severe myalgia. Menstrual changes appeared in 5 subjects: early menopause in 1, spotting in 3 and menorrhagia in 1 woman. Only transient positive findings were seen in some sera screened for autoantibodies. This preliminary trial indicates that anti-hCG vaccine is a hopeful reversible contraceptive.
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PMID:Phase I clinical trial of a World Health Organisation birth control vaccine. 245 66

An aviator with prolonged right sided low back pain is described. The diagnostic workup is presented leading to diagnosis of HLA B27 positive reactive sacroiliitis. Trial of sulfasalazine lead to resolution of his pain. The spondylarthropathies are briefly reviewed. Implications on his aeromedical status are discussed.
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PMID:HLA B27 positive helicopter pilot with reactive arthritis responsive to sulfasalazine. 290 Jun 30

The prevalence of complaints of thoracic pain or stiffness in the past 6 months was assessed by examination, HLA typing and sacroiliac radiographs in 420 relatives of 275 B27+ probands with ankylosing spondylitis (AS). AS or sacroiliitis was found in 15 of 420 relatives (3.6%). The gender of the proband did not influence the probability of AS or sacroiliitis among the relatives. In the absence of sacroiliitis, B27+ relatives had chest pain more often (31 of 208, or 14.9%) than B27- relatives (13 of 197, or 6.6%) (p less than 0.01). Chest pain assessed by questionnaire was associated with pain on pressure at the costosternal junctions. The concept of AS as a combination of radiographic sacroiliitis plus clinical signs or symptoms may be too narrow.
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PMID:Chest pain without radiographic sacroiliitis in relatives of patients with ankylosing spondylitis. 326 53

From a retrospective analysis (1980-1984) we found 32 cases of chronic Reiter's syndrome with spinal involvement on the radiographs (as sacroiliitis, parasyndesmophytes, and rarely syndesmophytes). In these 32 case histories spinal pain was a rather frequent symptom, often beginning with the onset of the disease, whereas severe functional spinal impairment was seldom found. Joints were only mildly affected, organic symptoms were found chiefly in clinical history, but were often incomplete. Trigger infections were known in 40%, and 87% of the patients were HLA B27 positive. These 32 patients with mainly spinal symptoms represent 75% of all cases (n = 43) suffering from chronic Reiter's syndrome within the period of observation. Previous observations as well as our experience point to the fact that the chronic course of disease in Reiter's syndrome mainly affects the spinal structure with comparatively mild clinical symptoms.
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PMID:[Spinal involvement in chronic Reiter's syndrome]. 377 63


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