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1

Ankylosing Spondylitis  

Microsoft Academic Search

\\u000a Ankylosing spondylitis (AS) is a chronic inflammatory disease of the sacroiliac joints and spine that may be associated with\\u000a a variety of extraspinal lesions involving the eye, bowel, and heart. AS usually begins in young adulthood. The natural history\\u000a of AS involves progressive stiffening of the spine, with ankylosis (fusion of some or all spinal joints) occurring after some\\u000a years

DÉSIRÉE VAN DER HEIJDE

2

Ankylosing spondylitis and inflammatory bowel disease. II. Prevalence of peripheral arthritis, sacroiliitis, and ankylosing spondylitis in patients suffering from inflammatory bowel disease  

Microsoft Academic Search

To establish the prevalence of peripheral arthritis, radiographic sacroiliitis, and ankylosing spondylitis in patients with inflammatory bowel disease, 58 consecutive patients suffering from ulcerative colitis (UC) and 51 with Crohn's disease (CD) underwent a detailed rheumatological examination. In addition, all patients were screened for the presence of the antigen HLA B27. Peripheral arthritis was found in 14 (8 UC, 6

B J Dekker-Saeys; S G Meuwissen; E M Van Den Berg-Loonen; W H De Haas; D Agenant; G N Tytgat

1978-01-01

3

Surgery in the Treatment of Rheumatoid Arthritis and Ankylosing Spondylitis  

PubMed Central

The pain, deformities and disabilities resulting from rheumatoid arthritis and ankylosing spondylitis must be treated by a team composed of physician, physical medicine expert, orthopćdic surgeon, and, in certain cases, deep X-ray therapist working simultaneously. The principle of “rest” in order to relieve pain has to be combined with methods designed to preserve and restore function. The multiple joint deformities in these cases may necessitate a long programme of reconstructive or functional treatment, which entails whole-hearted co-operation on the part of the patient in intensive post-operative exercise regime. Procedures advocated for the upper limb include excision of the acromion process together with the subacromial bursa to allow free movement between the central tendon of the deltoid and the tendinous shoulder cuff: arthrodesis of the shoulder in cases where there is more severe joint destruction: in certain cases of elbow-joint arthritis, excision of the radial head and sub-total synovectomy may preserve joint function and avoid or delay the necessity for arthroplasty which can be carried out in two ways: (a) similar to the formal joint excision, or (b) re-shaping the lower end of the humerus and upper end of the ulna lining these surfaces with fascia. The former method is preferable in cases of rheumatoid arthritis. To overcome wrist-joint deformity and restore pronation and supination excision of the lower end of the ulna together with radiocarpal fusion in position for optimum function is advocated. Finger and toe joints may be corrected by resection of the bone ends and capsulectomy. In the lower limbs bilateral involvement of the hip-joint is best treated by vitallium mould arthroplasty which may be carried out in four ways: (1) Routine arthroplasty; (2) Modified Whitman procedure; (3) Modified Colonna operation; and (4) The proximal shaft or intertrochanteric arthroplasty. It is essential in these operations to have knowledge of the operative technique, the use of special hip gouges and reamers, and detailed post-operative supervision. For dorsal kyphosis of the spine, spinal osteotomy at the lumbar level provides excellent correction but is an operation demanding care and skill in its execution. The author's remarks are based on experience gained when working with Dr. M. N. Smith-Petersen at the Massachusetts General Hospital, Boston, U.S.A. PMID:18914877

Law, W. Alexander

1948-01-01

4

Atopic disorders in ankylosing spondylitis and rheumatoid arthritis  

PubMed Central

Background: The prevalence of atopic disorders in ankylosing spondylitis (AS) is unknown. AS and rheumatoid arthritis (RA) exhibit divergent T helper (Th) cell cytokine patterns. Objective: To test the hypothesis that Th2 polarised atopic disorders may be decreased in Th1 polarised RA but increased in AS, which is characterised by an impaired Th1 cytokine pattern, by assessing the prevalence of atopic disorders in AS and RA. Methods: 2008 subjects (380 patients with AS, 728 patients with RA, 900 controls) from Berlin, Germany, were considered in this cross sectional study. A questionnaire incorporating questions from the European Community Respiratory Health Service (ECRHS) and the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was mailed to all subjects. Disease severity was assessed by the modified Health Assessment Questionnaire (mHAQ). Results: 1271 (63.3%) people responded to the questionnaire. The prevalence of any atopic disorder was 24.6% (61/248) in patients with AS, 20.7% (111/536) in controls, and 13.1% (64/487) in patients with RA (p=0.0009 for AS v RA; p=0.001 for controls v RA). Hay fever was reported by 40/248 (16.1%) patients with AS, 82/536 (15.3%) controls, and 42/487 (8.6%) patients with RA (p=0.002 for AS v RA; p=0.001 for controls v RA). Atopic dermatitis was reported by 19/248 (7.7%) patients with AS, 26/536 (4.9%) controls, and 14/487 (2.9%) patients with RA (p=0.003 for AS v RA), and asthma by 18/248 (7.3%) patients with AS, 35/536 (6.5%) controls, and 21/487 (4.3%) patients with RA. The differences were related neither to age nor to drugs. Disease severity was less in atopic patients with RA who had the atopic disorder before the onset of RA (median mHAQ 0.75) than in patients in whom RA preceded the atopic disorder (median mHAQ 1.75; p=0.027). Conclusions: Atopic disorders are decreased in RA but only slightly and non-significantly increased in AS. This may imply that atopy confers some protection from RA but only little if any susceptibility to AS. It may further indicate that the cytokine deviation towards an impaired Th1 pattern in AS is less strong than the cytokine deviation towards Th1 in RA, a finding which may affect future therapeutic approaches. PMID:12379517

Rudwaleit, M; Andermann, B; Alten, R; Sorensen, H; Listing, J; Zink, A; Sieper, J; Braun, J

2002-01-01

5

Disease flare of ankylosing spondylitis presenting as reactive arthritis with seropositivity: a case report  

PubMed Central

Introduction Concurrent rheumatoid factor seropositivity is occasionally detected in ankylosing spondylitis and often causes confusion in clinical routine. Overlap between various seronegative arthritides is a known but uncommon association. Differentiation of spondyloarthropathy from rheumatoid arthritis is important, since the natural history, complications, treatments and prognosis of the two diseases differ significantly. Case presentation Here, we report the case of a 47-year-old Sri Lankan man who had a long history of intermittent joint pains worsening following a recent episode of self-resolving non-bloody diarrhea. Subsequently, he developed a skin rash suggestive of keratoderma blenorrhagica and circinate balanitis. He had classical radiological evidence of ankylosing spondylosis (previously undiagnosed) associated with human leukocyte antigen B27 antigen, but was positive for rheumatoid factor. Conclusions A disease flare of ankylosing spondylitis prompted by a minor diarrheal illness showing well documented features of reactive arthritis is remarkable. The prognostic implications of seropositivity in spondyloarthritis are discussed. PMID:22333429

2012-01-01

6

Effectiveness of adalimumab in treating patients with ankylosing spondylitis associated with enthesitis and peripheral arthritis  

PubMed Central

Introduction The purpose of this study was to investigate the effectiveness of adalimumab in enthesitis and peripheral arthritis in patients with ankylosing spondylitis (AS). Methods Adults with active AS (Bath ankylosing spondylitis disease activity index [BASDAI] ? 4) received adalimumab 40 mg every other week with standard antirheumatic therapies in a 12-week, open-label study. Effectiveness in enthesitis was assessed using the Maastricht ankylosing spondylitis enthesitis score (MASES, 0-13) and by examining the plantar fascia in patients with enthesitis (? 1 inflamed enthesis) at baseline; effectiveness in peripheral arthritis was evaluated using tender and swollen joint counts (TJC, 0-46; SJC, 0-44) in patients with peripheral arthritis (? 1 swollen joint) at baseline. Overall effectiveness measures included Assessment of SpondyloArthritis International Society 20% response (ASAS20). Results Of 1,250 patients enrolled, 686 had enthesitis and 281 had peripheral arthritis. In 667 patients with MASES ? 1 at baseline, the median MASES was reduced from 5 at baseline to 1 at week 12. At week 12, inflammation of the plantar fascia ceased in 122 of 173 patients with inflammation at baseline. The median TJC in 281 patients with SJC ? 1 at baseline was reduced from 5 at baseline to 1 at week 12; the median SJC improved from 2 to 0. ASAS20 responses were achieved by 70.5% of 457 patients with no enthesitis and no arthritis; 71.0% of 512 patients with only enthesitis; 68.0% of 107 patients with only arthritis; and 66.7% of 174 patients with both. Conclusions Treatment with adalimumab improved enthesitis and peripheral arthritis in patients with active AS. Trial registration ClinicalTrials.gov NCT00478660. PMID:20230622

2010-01-01

7

Recommendations of the French Society for Rheumatology regarding TNF? antagonist therapy in patients with ankylosing spondylitis or psoriatic arthritis: 2007 update  

Microsoft Academic Search

ObjectiveTo update French Society for Rheumatology guidelines regarding the use of tumor necrosis factor ? (TNF?) antagonists for treating patients with ankylosing spondylitis (AS) or psoriatic arthritis (PsA).

Thao Pham; Bruno Fautrel; Emmanuelle Dernis; Philippe Goupille; Francis Guillemin; Xavier Le Loët; Philippe Ravaud; Pascal Claudepierre; Corinne Miceli-Richard; Michel de Bandt; Maxime Breban; Jean-Francis Maillefert; Charles Masson; Alain Saraux; Thierry Schaeverbeke; Daniel Wendling; Xavier Mariette; Bernard Combe

2007-01-01

8

Thalidomide in ankylosing spondylitis.  

PubMed

Despite potential side effects dominated by teratogenicity and peripheral neuropathy, thalidomide has recently been used to treat severe ankylosing spondylitis (AS). Over 50 patients have been treated across several 6-12 month open studies. Altogether 68% of the patients improved and the drop-out rate was 19%. Inhibition of NF-kappaB and/or TNFalpha is a putative mechanism for thalidomide efficacy in AS. PMID:12463469

Huang, F; Wei, J C C; Breban, M

2002-01-01

9

Drug survival rates of tumor necrosis factor inhibitors in patients with rheumatoid arthritis and ankylosing spondylitis.  

PubMed

We investigated the compliance of Korean patients using tumor necrosis factor (TNF) inhibitors to treat rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and identified potential predictors associated with treatment discontinuation. The study population comprised 114 RA and 310 AS patients treated with TNF inhibitors at a single tertiary center for at least 1 yr from December 2002 to November 2011. Of the 114 RA patients, 64 (56.1%) discontinued their first TNF inhibitors with a mean duration of 18.1 months. By contrast, 65 of 310 patients (21.0%) with AS discontinued their first TNF inhibitors, with a mean duration of 84 months. Although the survival rate did not differ among the three TNF inhibitors in the AS patients, the etanercept group had a lower discontinuation rate than the infliximab group in the RA patients. In addition, RA patients who received corticosteroids in combination with TNF inhibitors were more likely to discontinue their TNF inhibitors. The independent predictors of drug discontinuation in AS patients were male gender and complete ankylosis on radiographs of the sacroiliac joint. Our results provide further evidence that real-life treatment outcomes of RA and AS patients may be different from those observed in randomized clinical trials. PMID:25246737

Kang, Ji-Hyoun; Park, Dong-Jin; Lee, Jeong-Won; Lee, Kyung-Eun; Wen, Lihui; Kim, Tae-Jong; Park, Yong-Wook; Lee, Shin-Seok

2014-09-01

10

The immunopathogenesis of ankylosing spondylitis.  

E-print Network

??The Spondyloarthritides (SpA) are a group of genetically and pathophysiologically related diseases. Ankylosing spondylitis (AS), the prototypic SpA family member, is a systemic inflammatory disease… (more)

Wright, Pamela Burnby

2013-01-01

11

Serum adipokines and adipose tissue distribution in rheumatoid arthritis and ankylosing spondylitis. A comparative study.  

PubMed

Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal, and particularly intra-abdominal or visceral adiposity is closely linked to cardiovascular events. Thus, in this study, we aimed to evaluate the body composition of patients with RA or AS compared to healthy controls (HC), with a special emphasis on the visceral region. In parallel, we measured adipose products or adipokines, namely leptin, adiponectin and its high molecular weight (HMW) isoform, resistin, and ghrelin, a gastric peptide that plays a role in energetic balance. The homeostasis model assessment for insulin resistance (HOMA-IR) and atherogenic index were used to evaluate cardiovascular risk. One hundred and twelve subjects were enrolled (30 patients with RA, 31 with AS, and 51 HC). Body composition was measured using dual-energy X-ray absorptiometry to determine total fat mass and lean mass, adiposity, fat in the android and gynoid regions, and visceral fat. Patients and HC did not differ in terms of body mass index. On the contrary, adiposity was increased in RA (p?=?0.01) while visceral fat was also increased, but only in women (p?=?0.01). Patients with AS tended to have lower total fat mass (p?=?0.07) and higher lean mass compared to HC (p?=?0.07). Leptin and leptin/fat mass were decreased in male patients with AS (p?

Toussirot, Eric; Grandclément, Emilie; Gaugler, Béatrice; Michel, Fabrice; Wendling, Daniel; Saas, Philippe; Dumoulin, Gilles

2013-01-01

12

Serum Adipokines and Adipose Tissue Distribution in Rheumatoid Arthritis and Ankylosing Spondylitis. A Comparative Study  

PubMed Central

Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal, and particularly intra-abdominal or visceral adiposity is closely linked to cardiovascular events. Thus, in this study, we aimed to evaluate the body composition of patients with RA or AS compared to healthy controls (HC), with a special emphasis on the visceral region. In parallel, we measured adipose products or adipokines, namely leptin, adiponectin and its high molecular weight (HMW) isoform, resistin, and ghrelin, a gastric peptide that plays a role in energetic balance. The homeostasis model assessment for insulin resistance (HOMA-IR) and atherogenic index were used to evaluate cardiovascular risk. One hundred and twelve subjects were enrolled (30 patients with RA, 31 with AS, and 51 HC). Body composition was measured using dual-energy X-ray absorptiometry to determine total fat mass and lean mass, adiposity, fat in the android and gynoid regions, and visceral fat. Patients and HC did not differ in terms of body mass index. On the contrary, adiposity was increased in RA (p?=?0.01) while visceral fat was also increased, but only in women (p?=?0.01). Patients with AS tended to have lower total fat mass (p?=?0.07) and higher lean mass compared to HC (p?=?0.07). Leptin and leptin/fat mass were decreased in male patients with AS (p?

Toussirot, Eric; Grandclement, Emilie; Gaugler, Beatrice; Michel, Fabrice; Wendling, Daniel; Saas, Philippe; Dumoulin, Gilles

2013-01-01

13

Fibromyalgia in women with ankylosing spondylitis  

Microsoft Academic Search

Fibromyalgia (FM), pre-dominantly found in women, may accompany other pre-existing rheumatic diseases. The association between\\u000a FM and ankylosing spondylitis (AS) is uncertain. We evaluated FM in women with AS. Eighteen women with AS were compared with\\u000a 18 men with AS (controls) for age, duration of symptoms, time to diagnosis, degree of sacroiliac involvement, history of peripheral\\u000a arthritis, patient global assessment,

Valerie Aloush; Jacob N. Ablin; Tatiana Reitblat; Dan Caspi; Ori Elkayam

2007-01-01

14

Therapeutic advances in ankylosing spondylitis.  

PubMed

Ankylosing spondylitis (AS) is a systemic inflammatory rheumatic disease involving spinal and sacroiliac joints. This condition is responsible for back pain, stiffness, but also loss of functional capacity with socio-economic consequences. The management of AS includes patient education, rest, a programme of regular physical exercise, together with the use of NSAIDs. Second-line treatments are required in cases of severe or refractory AS, however only sulfasalazine has proven to benefit AS patients with peripheral arthritis. In spite of this management, the disease may not be adequately controlled, mainly for patients with refractory axial disease, enthesopathy or extra-articular features. Thus, new innovative treatments are needed for AS. It is likely that the new NSAIDs or COX-2 specific inhibitors will certainly take the place of the conventional NSAIDs, with regard to their superior tolerability. Methotrexate is a therapeutic option for AS treatment, but its usefulness in this disease remains to be established in adequate controlled studies. Finally, the TNF-alpha targeting drugs, namely thalidomide and the anti-TNF-alpha mAb, infliximab, have given promising results in the treatment of severe and/or refractory AS patients, however further controlled studies are required. In addition, the long-term use (efficacy and tolerability) of these two agents deserves attention. PMID:11116278

Toussirot, E; Wendling, D

2001-01-01

15

Arthropathy, ankylosing spondylitis, and clubbing of fingers in ulcerative colitis  

PubMed Central

In a retrospective study of 399 patients with ulcerative colitis, 27 patients had colitic arthritis, 17 had ankylosing spondylitis, and 20 had clubbing of the fingers. Colitic arthritis and ankylosing spondylitis were not related to severity, extent of involvement, or duration of colitis. A significant association between colitic arthropathy and other complications of ulcerative colitis, such as pseudopolyposis, perianal disease, eye lesions, skin eruptions, aphthous ulceration, and liver disease has been demonstrated. The outcome of the first referred attack of colitis in the presence of colitic arthritis and ankylosing spondylitis remained uninfluenced. Clubbing of fingers was related to severity, extent of involvement, and length of the history of colitis. A significant association between clubbing of the fingers and carcinoma of the colon, pseudopolyposis, toxic dilatation, and arthropathy has been shown. The frequency of surgical intervention in patients with clubbing was higher but the overall mortality was not significantly different from the patients without clubbing. PMID:5473606

Jalan, K. N.; Prescott, R. J.; Walker, R. J.; Sircus, W.; McManus, J. P. A.; Card, W. I.

1970-01-01

16

The treatment of ankylosing spondylitis.  

PubMed

Ankylosing spondylitis is an inflammatory disorder affecting the axial skeleton and periphery. Symptoms can often be debilitating. Current therapy for the disease include physical therapy, non-steroidal anti-inflammatory drugs (NSAIDS, anti-rheumatic disease modifying drugs (DMARDS), and the newly developed biologic agents targeting tumor necrosis factor alpha (TNF-alpha). This paper will provide a comprehensive review of these treatments which focusing on evidence based medicine for the daily clinical practice of rheumatology. PMID:12624705

Scalapino, K J; Davis, J C

2003-02-01

17

Nervous System Involvement in Ankylosing Spondylitis  

Microsoft Academic Search

In a review of 45 patients with ankylosing spondylitis 10 had neurological symptoms and signs and three of them had two separate neuropathological disorders. The neurological profiles fell into five main categories—multiple sclerosis, the cauda equina syndrome, focal epilepsy, vertebrobasilar insufficiency, and peripheral nerve lesions. An association between ankylosing spondylitis and multiple sclerosis is suggested, possibly due to an immunological

D. J. Thomas; M. J. Kendall; A. G. W. Whitfield

1974-01-01

18

Associations between walking time, quadriceps muscle strength and cardiovascular capacity in patients with rheumatoid arthritis and ankylosing spondylitis.  

PubMed

The aim of this study was to examine whether there are any associations between walking time, quadriceps muscle strength and cardiovascular capacity in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Thirty-one patients with RA and 26 patients with AS belonging to Steinbrocker's functional class I-II were examined. Cardiovascular capacity was calculated from the expired air during a bicycle test and quadriceps muscle strength by the peak torque from an isokinetic dynamometer test. Walking time was the time it took to walk a distance of 160 m on a flat floor and to climb up and down a staircase. In patients with RA, flat floor walking and stair climbing times correlated inversely with quadriceps muscle strength and cardiovascular capacity. Similar results were seen in patients with AS, although the association between cardiovascular capacity and stair-climbing time was not statistically significant. Multiple regression analysis was performed for all patients with quadriceps muscle strength and cardiovascular capacity applied as independent variables in two separate models. Cardiovascular capacity explained 32% and quadriceps muscle strength 21% of the variance in flat floor walking time. Quadriceps muscle strength, together with diagnosis and age, explained 38% of the variance in stair-climbing time, and cardiovascular capacity together with age and pain explained 36% of the variance. In conclusion, in spite of cardiovascular capacity and quadriceps muscle strength being associated with walking times, the findings suggest that they play only a modest role in explaining rapid walking on flat floor and in stairs. PMID:15293089

Mengshoel, Anne Marit; Jokstad, Kari; Bjerkhoel, Frithjof

2004-08-01

19

Advances in managing ankylosing spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory disease with prominent involvement of the spine and sacroiliac joints which frequently leads to significant spine deformity and disability. The development of effective therapies for AS, particularly with anti-tumor necrosis factor agents, has resulted in improved symptoms and functions for many patients, and clinical research increasingly suggests that effective therapy can also prevent destruction in the spine and other structures. Recent focus of disease classification in AS has emphasized that many individuals with features of inflammatory back pain but no visible changes on plain x-rays have active inflammatory disease when imaged with magnetic resonance imaging (MRI). Recent studies indicate that individuals with “non-radiographic” spondylitis can also respond to anti-inflammatory therapies. Several new agents are also showing promise for treatment of AS. These developments represent a significant advance in the management of this debilitating condition. PMID:25343035

Chen, Patty P.

2014-01-01

20

Cardiovascular manifestations of ankylosing spondylitis  

Microsoft Academic Search

Summary  In a retrospective study, 40 patients with ankylosing spondylitis were assessed for extraspinal manifestations. Cardiovascular\\u000a complications were found in 17 patients (42.5%)?5(12.5%) had aortic insufficiency, 3 (7.5%) had atrioventricular block and\\u000a 5 (12.5%) had bundle branch block. Wolff-Parkinson-White syndrome was diagnosed in one case and short PR syndrome in another.\\u000a Cardiovascular complications were more common in patients with longer disease

S. Sukenik; A. Pras; D. Buskila; A. Katz; Y. Snir; J. Horowitz

1987-01-01

21

Drug Retention Rates and Treatment Discontinuation among Anti-TNF-? Agents in Psoriatic Arthritis and Ankylosing Spondylitis in Clinical Practice  

PubMed Central

Objective. The study aim was to determine treatment persistence rates and to identify causes of discontinuation in psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients in clinical practice. Methods. Patients treated with adalimumab (ADA), etanercept (ETA), or infliximab (INF) were retrospectively included. Treatment persistence rates were analyzed by means of a stepwise logistic regression. Differences between therapy duration were assessed by means of an analysis of variance model (ANOVA), while a chi-square test was used to evaluate relationships between therapies and causes of treatment discontinuation and the administration of concomitant disease-modifying antirheumatic drugs (DMARDs) among therapies and types of disease considering completed courses of therapy versus courses that were discontinued. Results. 268 patients received a total of 353 anti-TNF treatment courses (97 ADA, 180 ETA, and 76 INF). Comparison among therapies showed significant difference regarding the treatment persistence rates due to the contrast between ETA and INF (P = 0.0062). We observed that 84.7% of patients were still responding after 6 months of follow-up. Comparison among diseases showed that there were significant differences between PsA and AS (P = 0.0073) and PsA and PsA with predominant axial involvement (P = 0.0467) in terms of duration of the therapy, while there were no significant differences with regard to the persistence rate. Conclusions. In this cohort, anti-TNF-? therapy was associated with high drug persistence rates. As in rheumatoid arthritis, switching to another anti-TNF-? agent can be an effective option when, during the treatment of AS or PsA, therapy is suspended because of inefficacy or an adverse event. Combination therapy with DMARDs was associated with a better persistence rate. PMID:25110401

Fabbroni, Marta; Costa, Luisa; Pagano, Veronica Anna; Frediani, Bruno; Manganelli, Stefania; Galeazzi, Mauro

2014-01-01

22

Coexistence of Ankylosing Spondylitis and Löfgren's Syndrome.  

PubMed

A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren's syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient's subjective and laboratory assessments. PMID:24741443

Kobak, Senol; Sever, Fidan; Sivrikoz, Oya; Karaarslan, Ahmet

2014-01-01

23

Ankylosing Spondylitis: Diet and Nutrition  

MedlinePLUS

Diet & Nutrition: Quick Links Overview of Diet & Spondylitis >>> Medication & Diet >>> Dietary Supplements >>> Changing Your Diet >>> The London AS / Low Starch Diet >>> Back To The About Spondylitis Main Page >>> DIET & ...

24

Breakthroughs in genetic studies of ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS), the prototypic seronegative arthropathy, is known to be highly heritable, with >90% of the risk of developing the disease determined genetically. As with most common heritable diseases, progress in identifying the genes involved using family-based or candidate gene approaches has been slow. The recent development of the genome-wide association study approach has revolutionized genetic studies of such

M. A. Brown

2008-01-01

25

[Anti-TNF alfa therapy in ankylosing spondylitis].  

PubMed

Ankylosing spondylitis (AS) is an inflammatory chronic disease that affects young males and in more than 90% of cases is associated with HLA B27 antigen. Therapeutic options for those patients with spondyloarthropathies have been limited during the last decades. Infliximab and etanercept are both approved for the treatment of patients with active disease that does not respond to conventional therapies. Anti-TNF therapy is very effective in AS, and eventually can be more effective than in rheumatoid arthritis. In 2003 Assessments in Ankylosing Spondylitis Group (ASAS) published international recommendations about the use of these agents in AS, which can be used as guidance in taking decisions and elaborating guidelines. To define their utilization it is necessary more studies about efficacy, toxicity and about ways of use. PMID:17187716

Cravo, Ana Rita; Tavares, Viviana; Da Silva, José Canas

2006-01-01

26

The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people  

PubMed Central

Background The health-related quality of life (HRQL) is an important indicator of the burden of musculoskeletal disease. The Medical Outcome Study Short-Term 36 (SF-36) is the most used tool that evaluates HRQL as a subjective perception about psychological and physical limitations due to an underlying illness. The purpose of this study was to compare the HRQL scores among patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) and a selected sample of health people and determine their relationship with measures of clinical condition. Methods 799 patients (469 with RA, 164 with AS, 65 with axial PsA and 101 with peripheral PsA) accepted the invitation to participate. 1579 healthy controls were used for the comparison. We calculated scores for the eight SF-36 subscales, the Physical Component Summary (PCS) score, and the Mental Component Summary (MCS) score, according to published algorithms. Disease-related characteristics included disease duration, comorbidity, a measure for disease activity and for radiographic damage. The presence of comorbidity was ascertained through patient's self-reports by the Self-Administered Comorbidity Questionnaire (SCQ). Comparison were performed with respect to sex and age, and s-scores were calculated for comparison with the norm. Multivariate analyses were used to assess the relationship between HRQL and radiographic damage, disease activity, and socio-demographic data. Results The four inflammatory rheumatic diseases (IRD), compared to controls, significantly impaired all eight health concepts of the SF-36 (p < 0.0001) in both component PCS and MCS scores (p < 0.0001). Overall, the dimensions typically affected were physical functioning, limitations due to physical function, and bodily pain. The disease with the worst HRQL for those dimensions was RA. The multivariate analyses revealed that the physical component was influenced by a high disease activity and comorbidity. The severity of psoriatic lesions was associated with poor mental functioning in patients with PsA. Conclusion Chronic IRD have a clearly detrimental effect on the HRQL in both sex and in age groups, and physical domain is more impaired than mental and social ones. PMID:19296831

Salaffi, Fausto; Carotti, Marina; Gasparini, Stefania; Intorcia, Michele; Grassi, Walter

2009-01-01

27

Clinical characteristics of patients with ankylosing spondylitis in India.  

PubMed

This study focuses on describing full spectrum of clinical, laboratory, and radiological characterization of ankylosing spondylitis (AS) patients in India. Data on 70 consecutive AS patients, seen at the rheumatology clinic in India, was prospectively obtained using investigator-administered questionnaires. Diagnosis was made according to the modified New York criteria. The core set of variables selected by Assessment in AS International society were obtained. The differences in clinical characteristics based on presence or absence of peripheral arthritis, gender, and juvenile (JOAS) vs. adult onset AS (AOAS) were evaluated. The male/female ratio was 5:1. The mean age of onset of symptoms and diagnosis were 23.6 and 32.5 years, respectively. Females had similar spinal indices and radiological damage as male counterpart. However, they had more common extra-articular manifestations and root joint involvement. The majority of patients consisted of AOAS (78.5%) and was clinically similar to JOAS. One or more peripheral joints were involved in 65.7% of patients, affecting predominantly the lower extremity (90.6%, knee 47.1%, and ankle 35.7%) in asymmetrical pattern (78%). Patients with peripheral arthritis had higher erythrocyte sedimentation rate, more frequent enthesitis, root joint, and whole spine involvement, suggesting more aggressive disease. Most common site of enthesitis was chondro-sternal junction (30%) and Achilles tendonitis (24.3%). The root joints frequently involved extra-axial joints. Uveitis was the most common extra-articular manifestation (25.7%). The predominant initial symptom was typical inflammatory low back pain (87.1%). Assessment in ankylosing spondylitis indices showed a moderately severe disease activity and damage with following values: mean Bath Ankylosing Spondylitis Disease Activity Index, 3.2 (+/-1.8); mean Bath Ankylosing Spondylitis Functional Index, 2.3 (+/-2.0); and mean Bath Ankylosing Spondylitis Metrology Index, 3.15 (+/-2.3). Majority of the patients had bilateral sacroiliitis (grades 2-4) on radiographs (87.1%). In conclusion, the features of AS in Indian patients were broadly similar to other part of world, with the exception of increased frequency of peripheral arthritis. PMID:19618098

Aggarwal, Rohit; Malaviya, Anand N

2009-10-01

28

Periodontal disease in patients with ankylosing spondylitis  

Microsoft Academic Search

Objective:Ankylosing spondylitis (AS) and periodontal disease (PD) are characterised by dysregulation of the host inflammatory response, resulting in soft and hard connective tissue destruction. AS has been related to other inflammatory diseases, however, there is a paucity of data on whether AS is associated with inflammatory PD.Methods:The association between AS and PD was examined in 48 patients with AS and

N Pischon; T Pischon; E Gülmez; J Kröger; P Purucker; B-M Kleber; H Landau; P-G Jost-Brinkmann; P Schlattmann; J Zernicke; G-R Burmester; J-P Bernimoulin; F Buttgereit; J Detert

2010-01-01

29

Treatment of ankylosing spondylitis: focus on etanercept  

PubMed Central

Ankylosing spondylitis is a chronic inflammatory condition which preferentially affects the axial skeleton, often beginning in the sacroiliac joints. The etiology of the pathologic lesions of this condition including enthesitis, erosive articular changes, osteitis, and fibrous ankylosis, as well as changes which occur in the eye, gastrointestinal tract, cardiovascular system, and lungs is unknown; however, there is a strong association with HLA-B27, which indicates altered immunity. One of the major mediators of the immune response is TNF-?, which functions as a pleiotrophic soluble messenger primarily from macrophages. TNF-? is principally involved with activation of both normal and transformed cells, including endothelium, synoviocytes, osteoclasts, chondrocytes, and fibroblasts. The cornerstone of medical management of ankylosing spondylitis includes intensive physical therapy and nonsteroidal anti-inflammatories for symptomatic relief. However, it is becoming increasingly recognized that TNF-? blockade has an important role in the reduction of spine and joint inflammation. This review discusses the data that supports use of etanercept in the treatment of ankylosing spondylitis. PMID:19707347

Frech, Tracy

2007-01-01

30

Searching for optimal rating scales in the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).  

PubMed

The comparison of the performance of the numerical rating scale (NRS) versus visual analog scale (VAS) in the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) showed that the 11-point NRS is psychometrically superior to the 10-cm VAS. This finding is in agreement with previous studies and the recommendation by the Assessment of SpondyloArthritis international Society. To illustrate the functioning of the response categories of both BASFI and BASDAI, we analyzed the rating scales (using the Rasch rating scale model) in patients with ankylosing spondylitis. Our results have shown that the 11 categories available in the 0-10 NRS version of both BASFI and BASDAI exceed the number of levels of a construct that participants can discriminate. This indicates the need for improving the metric quality of both rating scales by appropriately reducing the number of categories. PMID:24212675

Franchignoni, Franco; Salaffi, Fausto; Ciapetti, Alessandro; Giordano, Andrea

2014-02-01

31

Patellar Tendon Properties and Lower Limb Function in Rheumatoid Arthritis and Ankylosing Spondylitis versus Healthy Controls: A Cross-Sectional Study  

PubMed Central

Objective. Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) lead to inflammation in tendons and peritendinous tissues, but effects on biomechanical tendon function are unknown. This study investigated patellar tendon (PT) properties in stable, established RA and AS patients. Methods. We compared 18 RA patients (13 women, 59.0 ± 2.8 years, mean ± SEM) with 18 age- and sex-matched healthy controls (58.2 ± 3.2 years), and 12 AS patients (4 women, 52.9 ± 3.4 years) with 12 matched controls (54.5 ± 4.7 years). Assessments with electromyography, isokinetic dynamometry, and ultrasound included quadriceps muscle force and cross-sectional area (CSA), PT stiffness, and PT CSA. Additionally, measures of physical function and disease activity were performed. Results. PT stiffness and physical function were lower in RA and AS patients compared to healthy controls, without a significant difference in force production. PT CSA was significantly larger leading to reduction in Young's modulus (YM) in AS, but not in RA. Conclusion. The adverse changes in PT properties in RA and AS may contribute to their impaired physical function. AS, but not RA, leads to PT thickening without increasing PT stiffness, suggesting that PT thickening in AS is a disorganised repair process. Longitudinal studies need to investigate the time course of these changes and their response to exercise training. PMID:23844402

Matschke, Verena; Jones, Jeremy G.; Lemmey, Andrew B.; Maddison, Peter J.; Thom, Jeanette M.

2013-01-01

32

Imbalance between HAT and HDAC Activities in the PBMCs of Patients with Ankylosing Spondylitis or Rheumatoid Arthritis and Influence of HDAC Inhibitors on TNF Alpha Production  

PubMed Central

Objective Acetylation or deacetylation of histone proteins may modulate cytokine gene transcription such as TNF alpha (TNF). We evaluated the balance between histone deacetytlase (HDAC) and histone acetyltransferase (HAT) in patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) compared to healthy controls (HC) and determined the influence of HDAC inhibitors (trichostatin A -TSA- or Sirtinol -Sirt-) on these enzymatic activities and on the PBMC production of TNF. Methods 52 patients with RA, 21 with AS and 38 HC were evaluated. HAT and HDAC activities were measured on nuclear extracts from PBMC using colorimetric assays. Enzymatic activities were determined prior to and after ex vivo treatment of PBMC by TSA or Sirt. TNF levels were evaluated in PBMC culture supernatants in the absence or presence of TSA or Sirt. Results HAT and HDAC activities were significantly reduced in AS, while these activities reached similar levels in RA and HC. Ex vivo treatment of PBMC by HDACi tended to decrease HDAC expression in HC, but Sirt significantly reduced HAT in RA. TNF production by PBMC was significantly down-regulated by Sirt in HC and AS patients. Conclusion HAT and HDAC were disturbed in AS while no major changes were found in RA. HDACi may modulate HDAC and HAT PBMC expression, especially Sirt in RA. Sirtinol was able to down regulate TNF production by PBMC in HC and AS. An imbalance between HAT and HDAC activities might provide the rationale for the development of HDACi in the therapeutic approach to inflammatory rheumatic diseases. PMID:24039666

Toussirot, Eric; Abbas, Wasim; Khan, Kashif Aziz; Tissot, Marion; Jeudy, Alicia; Baud, Lucile; Bertolini, Ewa; Wendling, Daniel; Herbein, Georges

2013-01-01

33

Treatment of ankylosing spondylitis with disease modifying antirheumatic drugs.  

PubMed

Ankylosing spondylitis (AS) is a common (prevalence 0.2-0.9%) chronic inflammatory disease that mainly affects young males and is characterised by inflammatory back pain with sacroiliitis and often arthritis of the peripheral joints. The disease can lead to deformities of the vertebral column, joints and extra-spinal structures, e.g. the eye (uveitis). Non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy seem to improve the long-term outcome of AS. However, the effect of disease modifying antirheumatic drugs (DMARDs) is less impressive compared with other rheumatic diseases, such as rheumatoid arthritis (RA). In placebo controlled trials, sulfasalazine showed some improvement of disease activity, especially in spondyloarthropathy patients with peripheral arthritis. Altogether the number of therapeutic options for AS is limited and other drugs, such as leflunomide or thalidomide, should be explored further in placebo-controlled trials. PMID:12463451

van der Horst-Bruinsma, I E; Clegg, D O; Dijkmans, B A C

2002-01-01

34

Divergent perceptions in health-related quality of life between family members and patients with rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis.  

PubMed

The aim of this study was to assess whether family members perceive health-related quality of life (HRQoL) of family members with rheumatic illnesses differently from the perceptions of these patients themselves. Cross-sectional study of consecutive patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) attending two outpatient rheumatic clinics. HRQoL was assessed using the Spanish version of the World Health Organization Disability Assessment Scale (WHODAS-II) questionnaire; the "proxy" version is available for relatives. All patients and one proxy per patient separately answered the questionnaire at the clinic. Differences were determined by coefficients of determination (r (2)), Z scores, and meaningful differences of 30 %. Two hundred and ninety-one patients (111 SLE, 100 RA, and 80 AS) and their respective proxies were included. The mean age was 35 ± 13 years in SLE, 49.5 ± 14 years in RA, and 40 ± 14 years in AS patients. Divergent perceptions between patients and their proxies were found in 57 % of the SLE group, in 69 % of the RA group, and in 47 % of the AS group as per WHODAS-II global score. Stronger disagreement occurred for all the three groups in domains representing cognition and interaction with other people: around 60 % in the SLE group, 80 % in the RA group, and 40 % in the AS group. A substantial proportion of family members perceived the HRQoL of rheumatic family members differently from the perception of the patients themselves, most of the time biased toward underestimation, suggesting problems in the dynamics of efficient communication and social support. PMID:24859395

Ramos-Remus, Cesar; Castillo-Ortiz, José Dionisio; Sandoval-Castro, Carlos; Paez-Agraz, Francisco; Sanchez-Ortiz, Adriana; Aceves-Avila, Francisco Javier

2014-12-01

35

The classification and diagnostic criteria of ankylosing spondylitis.  

PubMed

Ankylosing spondylitis is the prototype of immune-mediated inflammatory rheumatic diseases grouped under the term spondyloarthritis (SpA). An early diagnosis has now become increasingly important because effective therapies are available and anti-TNF drugs are even more effective if used in early stages of the disease. In ankylosing spondylitis, the 1984 modified New York criteria have been used widely in clinical studies and daily practice but are not applicable in early disease when the characteristic radiographic signs of sacroiliitis are not visible but active sacroiliitis is readily detectable by magnetic resonance imaging (MRI). Thus there has been a need for new classification or diagnostic criteria to identify inflammatory spondyloarthritis at early stage of the disease. This led to the concept of axial SpA to include the entire spectrum of patients with axial disease both, with and without radiographic damage. New classification criteria for the wider group of SpA have been proposed by ASAS (Assessment of Spondylo Arthritis International Society); and the patients are sub-grouped into (1) a predominantly axial disease, termed axial SpA including AS and non-radiographic axial SpA; (2) peripheral SpA. The clinical course and disease process of non-radiographic axial spondyloarthritis remains unclear. However the development of the SpA criteria by ASAS particularly for axial SpA, is an important step for early diagnosis and better management of these patients. PMID:24534717

Raychaudhuri, Siba P; Deodhar, Atul

2014-01-01

36

Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis  

PubMed Central

To date, anti-tumor necrosis factor alfa (anti-TNF-?) therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn’s disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept therapy in patients with ankylosing spondylitis. PMID:24101863

Senabre-Gallego, Jose Miguel; Santos-Ramirez, Carlos; Santos-Soler, Gregorio; Salas-Heredia, Esteban; Sanchez-Barrioluengo, Mabel; Barber, Xavier; Rosas, Jose

2013-01-01

37

[Ankylosing spondylitis--the current situation and new therapeutic options].  

PubMed

Ankylosing spondylitis (AS) is a chronic, immunologically mediated rheumatic disease whose progression largely depends on the extent of inflammatory activity. In contrast to rheumatoid arthritis (RA), therapeutic control of AS is very limited. Therapy of ankylosing spondylitis should not only control inflammatory processes, but also prevent structural damages and maintain the functions. Until recently, physiotherapy and non-steroidal antiphlogistics (NSA) therapy was a gold standard of AS treatment. NSA therapy alleviates inflammatory pain of spine in 60 to 80% of patients. According to the most recent findings, long-term administration of NSA can affect also X-ray progression. DMARD therapy, which is efficient in RA, has insignificant effect on axial form of AS. Sulfasalazine proved to be efficacious against peripheral form of AS; administration of MTX and leflunomide is not supported by controlled studies. Peripheral arthritis and enthesitis is usually treated by short-term application of corticoids. The fact remains that an important role in AS immunopathogenesis is played by TNF alpha whose increased levels were found in patients with AS in serum, synovial fluid and SI joints. Anti-TNF therapy with infliximab and etanercept proved to be highly efficacious in patients with AS resistant to conventional therapy. Infliximab and etanercept reduced the disease activity (50% improvement in more than half of patients), improved the function and slowed down the structural damage. MRI studies of anti-TNF therapy proved reduction of inflammatory activity in SI joints and spine. Other studies verified the efficacy of adalimumab in AS therapy and showed that adalimumab is a promising drug. Also, several randomized clinical studies proved efficacy of thalidomide whose administration, however, is limited by its severe adverse effects. Until now, the results of studies focused on pamidronate therapy appear to be rather controversial. Better understanding of AS pathogenesis led to implementation of new therapeutic procedures that significantly improve activity and functional condition of patients. PMID:16967616

Zlnay, D; Zlnay, M; Rovenský, J

2006-01-01

38

Drug-induced granulomatous interstitial nephritis in a patient with ankylosing spondylitis during therapy with adalimumab.  

PubMed

Tumor necrosis factor ? (TNF-?) inhibitors are used in the treatment of rheumatoid arthritis, psoriasis, psoriatic arthritis, Crohn disease, ankylosing spondylitis, and juvenile idiopathic arthritis. Use of TNF inhibitors is associated with the induction of autoimmunity (systemic lupus erythematosus, vasculitis, psoriasis, and sarcoidosis/sarcoid-like granulomas). We report a case of interstitial granulomatous nephritis in a patient with ankylosing spondylitis after 18 months of treatment with adalimumab. Previously reported cases of sarcoid-like reactions secondary to the use of TNF-? inhibitors involved the liver, lung, lymph nodes, central nervous system, and skin. Granulomatous nephritis after adalimumab treatment has not been described. Close observation of patients undergoing treatment with TNF inhibitors for evolving signs and symptoms of autoimmunity is required. Organ involvement is unpredictable, which makes correct diagnosis and management extremely challenging. PMID:20974510

Korsten, Peter; Sweiss, Nadera J; Nagorsnik, Ulf; Niewold, Timothy B; Gröne, Hermann-Josef; Gross, Oliver; Müller, Gerhard A

2010-12-01

39

Respiratory muscle performance as a possible determinant of exercise capacity in patients with ankylosing spondylitis  

Microsoft Academic Search

Reduction of exercise capacity in patients with ankylosing spondylitis is associated with skeletal muscle performance. The contribution of respiratory muscle performance is questionable. This pilot study was designed to investigate the relationship between respiratory muscle performance and exercise capacity in ankylosing spondylitis. Subjects were 12 patients with ankylosing spondylitis. Measurements of maximal respiratory pressures and inspiratory muscle endurance were performed

M. van der Esch; A. J. van't Hul; M. Heijmans; J. Dekker

2004-01-01

40

Serum copper and caeruloplasmin in ankylosing spondylitis, systemic sclerosis, and morphea  

Microsoft Academic Search

Jayson, M. I. V., Davis, P., Whicher, J. T., and Walters, G. (1976).Annals of the Rheumatic Diseases, 35, 443-445. Serum copper and caeruloplasmin in ankylosing spondylitis, systemic sclerosis, and morphea. Studies of serum copper and caeruloplasmin were performed in patients with ankylosing spondylitis, systemic sclerosis, and morphea. Mean levels of both were raised significantly in ankylosing spondylitis, with the greatest

M. I. V. Jayson; P. Davis; J. T. Whicher; G. Walters

1976-01-01

41

Ankylosing Spondylitis in Iran; Late Diagnosis and Its Causes  

PubMed Central

Background: Ankylosing spondylitis (AS) is a chronic destructive and inflammatory disease of the axial skeleton manifested by back pain and progressive stiffness of the spine. Objectives: The aim of the present cross-sectional study was to evaluate and identify factors leading to delayed diagnosis of AS in Iranian patients. Patients and Methods: Sixty patients, (53 males, 7 females) with a diagnosis of AS according to the modified New York criteria were recruited. Diagnosis delay was defined as the interval between a patient’s first spondyloarthritic symptoms [inflammatory back pain (IBP), inflammatory arthritis, enthesopathy and uveitis] and a correct diagnosis of AS. Results: The average age of patients at diagnosis of AS was 36.4 ± 4.5 years and the average of delay in diagnosis was 6.2 ± 3.5 years. The most common diagnosis at the first visit was disc herniation (68.3%). Delay in diagnosis of Human Leukocyte Antigen (HLA-B27) positive and negative patients were 4.6 ± 2.2 years and 10.1 ± 3.2 years, respectively (P = 0.0001). Diagnosis delay in patients with morning stiffness and IBP were significantly shorter than that of patients without these symptoms (P = 0.0001 and P = 0.001, respectively). Patients with uveitis had the shortest diagnosis delay (P = 0.02). The Bath Ankylosing spondylitis disease activity index (BASDAI) was not significantly different in early (< 3years) and late (> 3years) diagnosis (3.3 ± 0.9 and 3.6 ± 0.7, respectively) (P = 0.18), but the Both ankylosing spondylitis functional index (BASFI) was significantly different between them (3.3 ± 1.0 and 4.1 ± 0.7 respectively) (P = 0.001). Conclusions: In this study, delay in diagnosis was similar to other studies. Educating physicians to careful history taking especially in the case of IBP, non-musculoskeletal symptoms such as uveitis and precise physical examination are important in early diagnosis. PMID:24910782

Hajialilo, Mehrzad; Ghorbanihaghjo, Amir; Khabbazi, Alireza; Kolahi, Suosan; Rashtchizadeh, Nadereh

2014-01-01

42

Report of 12 cases of ankylosing spondylitis patients treated with Tripterygium wilfordii  

PubMed Central

Objective Description of the clinical response of 12 consecutive cases of disease-active ankylosing spondylitis (AS) treated with the herbal medicine Tripterygium wilfordii Hook f (TwHf; lei gong teng, thunder god vine), which has been reported in controlled studies to be effective in rheumatoid arthritis (RA). Methods The clinical status of 12 patients with active AS who were started on 60 mgday-1 of a commercial tablet preparation of TwHf extract. were monitored at weeks 1, 3, and 6. Results Compared to baseline, there was significant improvement in mean values of physician assessment, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis global score (BAS-G) at weeks 3 and 6, with no changes in liver enzymes or complete blood count (CBC). Conclusion A placebo-controlled double-blind study for Tripterygium is warranted. Until then, this particular report should be considered as case reports and not an endorsement of the use of Tripterygium in clinical practice. PMID:20563618

Li, Juan; Lin, Yue; Song, Ya-nan; Zhang, Miaojia; Ke, Yao; Ren, Yile; Deng, Xiaohu; Zhang, Jianglin; Huang, Feng; Yu, David

2010-01-01

43

Ankylosing Spondylitis: From Cells to Genes  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology, though it is considered an autoimmune disease. HLA-B27 is the risk factor most often associated with AS, and although the mechanism of involvement is unclear, the subtypes and other features of the relationship between HLA-B27 and AS have been studied for years. Additionally, the key role of IL-17 and Th17 cells in autoimmunity and inflammation suggests that the latter and the cytokines involved in their generation could play a role in the pathogenesis of this disease. Recent studies have described the sources of IL-17 and IL-23, as well as the characterization of Th17 cells in autoimmune diseases. Other cells, such as NK and regulatory T cells, have been implicated in autoimmunity and have been evaluated to ascertain their possible role in AS. Moreover, several polymorphisms, mutations and deletions in the regulatory proteins, protein-coding regions, and promoter regions of different genes involved in immune responses have been discovered and evaluated for possible genetic linkages to AS. In this review, we analyze the features of HLA-B27 and the suggested mechanisms of its involvement in AS while also focusing on the characterization of the immune response and the identification of genes associated with AS. PMID:23970995

Zambrano-Zaragoza, José Francisco; Agraz-Cibrian, Juan Manuel; González-Reyes, Christian; Durán-Avelar, Ma. de Jesús; Vibanco-Pérez, Norberto

2013-01-01

44

Coexistence of Ankylosing Spondylitis and L?fgren's Syndrome  

PubMed Central

A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren's syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient's subjective and laboratory assessments. PMID:24741443

Kobak, Senol; Sever, Fidan; Sivrikoz, Oya; Karaarslan, Ahmet

2014-01-01

45

Predictive factors for partial remission according to the Ankylosing Spondylitis Assessment Study working group in patients with ankylosing spondylitis treated with anti-TNF? drugs.  

PubMed

The objective of this study was to evaluate the predictive factors for achieving partial remission (PR) in patients with ankylosing spondylitis (AS) treated with anti-TNF?. We longitudinally enrolled in a multi-center study 214 AS patients, classified according to New York criteria, treated with anti-TNF? drugs adalimumab (ADA), etanercept (ETA) and infliximab (INF) with at least 12 months of follow up. PR was reached when the score was <20 mm (on a visual analogue scale of 0-100 mm) in each of the following 4 domains: 1) patient global assessment (in the last week); 2) pain (spinal pain); 3) function [measured by the bath ankylosing spondylitis functional index (BASFI)]; 4) inflammation [mean of intensity and duration of morning stiffness, from the bath ankylosing spondylitis disease activity index (BASDAI)]. Two hundred fourteen AS patients (M/F=160/54; median age/range=43.2/19-78 years; median disease duration/ range=96/36-189 months) were treated with ADA (15.8%), ETA (28.9%) and INF (55.1%). At 12 and 24 months, high serum level of C reactive protein (CRP) (?2 vs ?0.8 mg/dL) were associated with higher rate of PR in AS patients treated with anti-TNF? drugs. At 24 months, PR was associated with shorter disease duration (?36 vs ?189 months) and higher erythrosedimentation rate (ESR) values (?45 vs ?17 mm/h). In male patients lower bath ankylosing spondylitis metrology index (BASMI) (?2 vs ?6) and absence of psoriasis were associated with higher PR rate only at 12 months. Other parameters assessed before treatment, such as BASDAI, BASFI, peripheral arthritis, inflammatory bowel disease and uveitis were not associated with PR. Our long-term longitudinal study in a setting of clinical practice showed that inflammatory parameters (i.e. CRP, ESR) and disease duration represent the most important predictive variables to achieve PR with an anti-TNF? treatment. PMID:25376955

Perrotta, F M; Addimanda, O; Ramonda, R; D'Angelo, S; Lubrano, E; Marchesoni, A; Olivieri, I; Punzi, L; Salvarani, C; Spadaro, A

2014-01-01

46

Autoimmune thyroid disease in ankylosing spondylitis.  

PubMed

Although autoimmune thyroid disease is well known to be associated with primary Sjögren's syndrome (SjS) and with various autoimmune diseases, it is less clear whether a similar association also exists for ankylosing spondylitis (AS). Therefore, we investigated the frequency of autoimmune thyroid disease in patients with AS. In this cross sectional study, 80 patients with AS fulfilling the 1984 Modified New York Criteria and 80 healthy subjects, age and sex-matched with AS patients, were included. As the positive control group, 62 female patients with primary SjS were also studied. All cases underwent thyroid ultrasonography (USG) by a single endocrinologist. Thyroid function tests and thyroid autoantibodies were measured. The diagnosis of Hashimoto's thyroiditis (HT) was made if the patient had thyroid autoantibody positivity plus at least one of the following criteria: diffuse goiter with physical examination, abnormality in thyroid function tests, and parenchymal heterogeneity with USG. The chi-squared test and Fisher's exact test were used to compare cases and controls. The p values <0.05 were considered statistically significant. The frequencies of parenchymal heterogeneity with USG (30 vs 11.3 %, p?=?0.045), thyroid autoantibody positivity (13.8 vs 2.5 %, p?=?0.017), and concomitant diagnosis of HT (10 vs 1.3 %, p?=?0.034) were significantly higher in AS group compared to healthy controls. Among AS patients having HT, subclinical hypothyroidism was detected only in a single patient. Frequency of autoimmune thyroid disease was significantly higher in AS group, compared to healthy controls. Prospective studies are needed to see the clinical relevance of these findings and outcome in the long term. PMID:24384825

Emmungil, Hakan; Erdogan, Mehmet; Kalfa, Melike; Karabulut, Gonca; Kocanaogullar?, Hayriye; Inal, Vedat; Aksu, Kenan; Oksel, Fahrettin; Kabasakal, Yasemin; Keser, Gokhan

2014-07-01

47

Neck movements in ankylosing spondylitis and their responses to physiotherapy  

Microsoft Academic Search

Cervical spine movements were compared in 35 patients with ankylosing spondylitis (AS) and matched controls. In AS there were limitations of all movements and particularly of lateral flexion. These limitations could not be correlated with any particular features of AS except radiological involvement of the lower apophyseal joints. In 25 patients there were significant improvements in all measurements after 3

S L ODriscoll; M I Jayson; H Baddeley

1978-01-01

48

New therapies for ankylosing spondylitis: etanercept, thalidomide, and pamidronate.  

PubMed

Ankylosing spondylitis (AS) is the most common of a group of diseases called seronegative spondyloarthropathies. This group of diseases shares common demographic, clinical, and genetic features. This article reviews the rationale, clinical efficacy, and safety reports of etanercept, thalidomide, and pamidronate in the treatment of patients who have AS. PMID:12951863

Davis, John C; Huang, Feng; Maksymowych, Walter

2003-08-01

49

Imaging Manifestations of Spinal Fractures in Ankylosing Spondylitis  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Spinal fractures in ankylosing spondylitis (AS) were diffi- cult to diagnose before CT and MR imaging were available. The purpose of our investigation was to characterize spinal fractures and determine the value of different imaging modalities in AS. METHODS: Twelve successive cases of spinal fractures were identified in MR imaging files of AS patients. Conventional radiographs were

Yi-Fen Wang; Michael Mu-Huo Teng; Cheng-Yen Chang; Hung-Ta Wu; Shih-Tien Wang

50

Coexistence of diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis  

Microsoft Academic Search

Summary To the best of our knowledge, only two patients with concurrent diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) have been reported so far. Here we present 3 patients in whom clinical and radiological findings indicative of DISH and AS coexisted. Two of these cases exhibited HLA B27. Although the presence of sacroiliitis would appear to exclude DISH,

O. L. Rillo; E. J. Scheines; C. Moreno; J. C. Barreira; A. A. Porrini; J. A. Maldonado Cocco

1989-01-01

51

Leukocytoclastic Vasculitis in a Patient with Ankylosing Spondylitis  

PubMed Central

A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later. PMID:24653851

Kobak, Senol; Yilmaz, Hatice; Karaarslan, Ahmet; Yalcin, Murat

2014-01-01

52

Leukocytoclastic vasculitis in a patient with ankylosing spondylitis.  

PubMed

A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later. PMID:24653851

Kobak, Senol; Yilmaz, Hatice; Karaarslan, Ahmet; Yalcin, Murat

2014-01-01

53

A Case of Ankylosing Spondylitis and Discussion of the Literature  

PubMed Central

Ankylosing spondylitis (AS) is a systemic inflammatory disease. Its pathogenesis has not been completely understood, but the HLA-B 27 positive immune cells are thought to be involved. Nonsteroidal anti-inflammatory agents are the first line drugs and they effectively relieve the symptoms. Biological agents such as Infliximab may help in targeting the underlying inflammatory process and have been used recently. Here, we are reporting a case of AS with established classical skeletal deformities. PMID:23905135

Ranjith, M.P.; Divya, R.

2013-01-01

54

New directions in classification and outcome assessment in ankylosing spondylitis  

Microsoft Academic Search

In 2003, several manuscripts on the classification of patients as having ankylosing spondylitis and the further development\\u000a of outcome assessment tools have been published. It is obvious that the use of radiographic sacroiliitis is a problematic\\u000a part of the classification criteria because there is major interobserver variation and is one of the causes of a long delay\\u000a between onset of

Désirée van der Heijde

2004-01-01

55

Symptomatic noncompressive motoromyelopathy presents as early manifestation in ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) is an autoimmune spondyloarthropathy involving principally the sacroiliac joint and axial skeleton.\\u000a Spinal cord involvement is an infrequent and late complication. It mostly results from compressive myelopathy due to skeletal\\u000a osteopathy and usually presents with radiculomyelopathic sensory and motor deficits. To report three patients who suffered\\u000a a progressive paraparesis\\/tetraparesis compatible with motor myelopathy without typical skeletal symptom.

Wei-Hsi Chen; Hsin-Ling Yin; Hung-Sheng Lin; Chung-Jen Chen

2011-01-01

56

Diffuse idiopathic skeletal hyperostosis: Differentiation from ankylosing spondylitis  

Microsoft Academic Search

Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) share involvement of the axial skeleton and\\u000a peripheral entheses. Both diseases produce bone proliferations in the later phases of their course. Although the aspect of\\u000a these bone proliferations is dissimilar, confusion of radiologic differential diagnosis between the two diseases exists mostly\\u000a as a consequence of a lack of awareness of their

Ignazio Olivieri; Salvatore D’Angelo; Carlo Palazzi; Angela Padula; Reuven Mader; Muhammad A. Khan

2009-01-01

57

A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity  

Microsoft Academic Search

The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and assess its reliability, validity, and sensitivity to change. The Turkish version was obtained after a translation and back-translation process. Seventy-one patients with ankylosing spondylitis were assessed with it. To assess its validity, patients were also evaluated with the Turkish

Yesim Akkoc; Altinay Goksel Karatepe; Servet Akar; Yesim Kirazli; Nurullah Akkoc

2005-01-01

58

Sacroiliitis in patients with ankylosing spondylitis: association of MR findings with disease activity  

Microsoft Academic Search

The purpose of this study was to determine whether MR findings can correlate disease activity as measured by laboratory markers in ankylosing spondylitis. MR images in 19 patients with ankylosing spondylitis were retrospectively analyzed for cartilage abnormality, periarticular erosion, synovial enhancement, and bone marrow edema. Each MR finding was correlated with laboratory inflammatory markers (erythrocyte sedimentation rate (ESR) and C-reactive

Won-Hee Jee; Thomas R. McCauley; Sang-Heon Lee; Sung-Hoon Kim; Soo-Ah Im; Kee-Yong Ha

2004-01-01

59

Comparison of group-based exercise versus home-based exercise in patients with ankylosing spondylitis: effects on Bath Ankylosing Spondylitis Indices, quality of life and depression  

Microsoft Academic Search

The objective of this non-randomised controlled trial was to evaluate the impact of group-based exercise programme and a home-based\\u000a exercise programme on Bath Ankylosing Spondylitis Indices, depression and quality of life in patients with ankylosing spondylitis\\u000a (AS). Approximately 41 patients in a rehabilitation unit were divided into two groups, either group- or home-based exercise\\u000a programme. Exercise sessions were performed three

Hale Karapolat; Ye?im Akkoc; ?smail Sar?; Sibel Eyigor; Servet Akar; Ye?im Kirazl?; Nurullah Akkoc

2008-01-01

60

Surgical Treatment of Lumbar Hyperextension Injury in Ankylosing Spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic systemic and inflammatory rheumatic disease with a variable course of the axial skeleton. Spinal involvement may accompany ossification of the ligaments, intervertebral disc, end-plates and apophyseal structures, and seems to be "bamboo spine". Because of these natures of the spine in AS, a spinal fracture can be occurred with minor trauma or spontaneously. The fracture of the AS can cause neurological complications extremely high, so special attention to prevent neurological deterioration. Operative management of the injured spine with AS is difficult, and associated with a high complication rate. Extreme care must be taken for surgery to prevent secondary neurological deterioration. PMID:24757488

Lee, Jung Keun; Park, Moon Sun; Kim, Seong Min; Chung, Seung Young; Lee, Do Sung

2013-01-01

61

Pulmonary involvement in ankylosing spondylitis assessed by multidetector computed tomography  

PubMed Central

Summary Background Ankylosing spondylitis (AS) may present with extra-articular involvement in the lungs. We aimed to evaluate the abnormal pulmonary multidetector computed tomography findings of patients with AS and compare them with the clinical symptoms, duration of illness, laboratory results and pulmonary function tests (PFT). Material/Methods We evaluated the chest multidetector computed tomography (MDCT) findings of 41 patients with ankylosing spondylitis (AS) and compared them with pulmonary function test (PFT) results, demographic characteristics, duration of illness and laboratory findings that we were able to obtain. Results The most common abnormalities were nodules, peribronchial thickening, pleural thickening and bronchiectasis. Abnormalities occurred in 96.87% of patients in the early AS group and 77.8% of patients in the late AS group. Patients with early AS included asymptomatic individuals with normal PFT results and abnormal MDCT findings. Conclusions The use of MDCT in AS patients may be beneficial for the evaluation of pulmonary disease, even in asymptomatic patients without any PFT abnormalities and those in the early stages of the disease. PMID:24971158

Yuksekkaya, Ruken; Almus, Ferdag; Cel?kyay, Fatih; Cel?kel, Serhat; Inan?r, Ahmet; Almus, Eda; Ozmen, Zafer

2014-01-01

62

Role of contextual factors in health-related quality of life in ankylosing spondylitis  

Microsoft Academic Search

Background:In the bio-psycho-social model of health, the role of contextual factors, either environmental or personal, is recognised.Objective:To assess the impact of a number of contextual factors on self-reported disease-specific and generic health-related quality of life in patients with ankylosing spondylitis (AS).Methods:522 patients with AS from Canada and Australia completed a postal questionnaire including sociodemographic variables, disease activity (Bath Ankylosing Spondylitis

V S Gordeev; W P Maksymowych; S M A A Evers; A Ament; L Schachna; A Boonen

2010-01-01

63

Coexistence of Diffuse Idiopathic Skeletal Hyperostosis and Ankylosing Spondylitis: A Case Report  

Microsoft Academic Search

:   Diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis are two diseases which are listed in the differential\\u000a diagnosis of each other. There have been limited numbers of case reports regarding the coexistence of both diseases in the\\u000a literature. We describe a patient who demonstrated the features of diffuse idiopathic skeletal hyperostosis with coexisting\\u000a features resembling ankylosing spondylitis in order to

E. Kozanoglu; R. Guzel; F. Guler-Uysal; K. Goncu

2002-01-01

64

Relapsing Polychondritis in a Patient with Ankylosing Spondylitis Using Etanercept  

PubMed Central

Relapsing polychondritis (RP) is an autoimmune disease characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues, especially of the ears, nose, joints, and tracheobronchial tree. Its etiology is not well understood, but some studies have linked its pathophysiology with autoimmune disease and autoantibody production. We described a case of a 46-year-old male patient with ankylosing spondylitis who developed RP after the use of etanercept. Few similar cases have been described in the literature. However, they show a possible association between the use of biological inhibitors of tumor necrosis factor (anti-TNF?), which potentially produces autoantibodies, and the development of RP. The treatment was based on data in the literature and included the cessation of biological therapy and the addition of corticosteroids with substantial improvement.

Azevedo, Valderilio Feijo; Galli, Natalia Bassalobre; Kleinfelder, Alais Daiane Fadini; D'Ippolito, Julia Farabolini; Gulin Tolentino, Andressa; Paiva, Eduardo

2014-01-01

65

Ankylosing Spondylitis: A Late Re-evaluation of 92 Cases  

PubMed Central

Ninety-two patients who satisfied the criteria proposed by Kellgren for the diagnosis of ankylosing spondylitis were re-evaluated by clinical, radiological and laboratory parameters after an average length of illness of 18.7 years. The following associated clinical lesions were studied: aortic insufficiency 8%, heart block 3%, iritis 11%, and other associated lesions. Long-term effects of x-ray therapy were evaluated by comparing irradiated and non-irradiated patients; no significant difference was noted in the clinical course of these two treatment groups. On serum protein electrophoresis no characteristic dysproteinemia was demonstrated; in no instance was there a marked hypergammaglobulinemia. Test results for rheumatoid factor, antinuclear factor and antithyroglobulin were all within the range expected for a normal population. In addition to bilateral sacroiliitis, several other characteristic radiological lesions, such as anterior spondylitis, were present in a high percentage of cases. It is suggested that the diagnostic criteria proposed by Kellgren, although useful, should be enlarged and refined. PMID:5943693

Kinsella, T. Douglas; MacDonald, F. Robert; Johnson, Louis G.

1966-01-01

66

Normative values for the bath ankylosing spondylitis functional index in the general population compared with ankylosing spondylitis patients in Morocco  

PubMed Central

Background The Bath Ankylosing Spondylitis Functional Index (BASFI) has been commonly used in rheumatology to quantify functional disability in patients with Ankylosing Spondylitis (AS). Our aim was to evaluate the discriminating power of BASFI and determine the best cutoff score of this index in the general population compared with AS patients. Methods A cross-sectional study that included 200 patients suffering from AS and 223 subjects from the general population matched for age and sex was carried-out. The discriminating power of the BASFI by strata of age was evaluated by the area under the Receiver Operating Characteristic curve and the best cutoff was determined by the Youden index. Results The mean age of the general population was 39 ± 12 years. 76.7% of them were male. The median BASFI of the healthy subjects and patients was 0.2 and 4.5 (P < 0.001) respectively. The best cutoff of BASFI was 1.5 with a sensitivity of 86% and a specificity of 90%. In the age group of 18-29 years, the best cutoff of the BASFI was 0.9 with a sensitivity of 93% and a specificity of 94%. In the age group of 30-50 years, the best cutoff of the BASFI was 1.5 with a sensitivity of 84% and a specificity of 88%. For those over 50 years of age, the best cutoff of the BASFI was 2.5 with a sensitivity of 84% and a specificity of 97%. Conclusions This study suggests that the discriminating power of BASFI is considered good at any age. The best cutoff of this index increased as age increases as functional disability is associated in part with lifestyle choices and increases with age. The cutoff values of the BASFI that we have presented could be used as a reference benchmark for both clinical practice and research. PMID:22436379

2012-01-01

67

Therapy of ankylosing spondylitis and other spondyloarthritides: established medical treatment, anti-TNF-? therapy and other novel approaches  

PubMed Central

Therapeutic options for patients with more severe forms of spondyloarthritis (SpA) have been rather limited in recent decades. There is accumulating evidence that anti-tumor-necrosis-factor (anti-TNF) therapy is highly effective in SpA, especially in ankylosing spondylitis and psoriatic arthritis. The major anti-TNF-? agents currently available, infliximab (Remicade®) and etanercept (Enbrel®), are approved for the treatment of rheumatoid arthritis (RA) in many countries. In ankylosing spondylitis there is an unmet medical need, since there are almost no disease-modifying antirheumatic drugs (DMARDs) available for severely affected patients, especially those with spinal manifestations. Judging from recent data from more than 300 patients with SpA, anti-TNF therapy seems to be even more effective in SpA than in rheumatoid arthritis. However, it remains to be shown whether patients benefit from long-term treatment, whether radiological progression and ankylosis can be stopped and whether long-term biologic therapy is safe. PMID:12223105

Braun, Juergen; Sieper, Joachim

2002-01-01

68

Therapy of ankylosing spondylitis and other spondyloarthritides: established medical treatment, anti-TNF-alpha therapy and other novel approaches.  

PubMed

Therapeutic options for patients with more severe forms of spondyloarthritis (SpA) have been rather limited in recent decades. There is accumulating evidence that anti-tumor-necrosis-factor (anti-TNF) therapy is highly effective in SpA, especially in ankylosing spondylitis and psoriatic arthritis. The major anti-TNF-alpha agents currently available, infliximab (Remicade(R)) and etanercept (Enbrel(R)), are approved for the treatment of rheumatoid arthritis (RA) in many countries. In ankylosing spondylitis there is an unmet medical need, since there are almost no disease-modifying antirheumatic drugs (DMARDs) available for severely affected patients, especially those with spinal manifestations. Judging from recent data from more than 300 patients with SpA, anti-TNF therapy seems to be even more effective in SpA than in rheumatoid arthritis. However, it remains to be shown whether patients benefit from long-term treatment, whether radiological progression and ankylosis can be stopped and whether long-term biologic therapy is safe. PMID:12223105

Braun, Juergen; Sieper, Joachim

2002-01-01

69

Current evidence for the management of ankylosing spondylitis: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis  

PubMed Central

Objective To assess available management strategies in ankylosing spondylitis (AS) using a systematic approach, as a part of the development of evidence based recommendations for the management of AS. Methods A systematic search of Medline, Embase, CINAHL, PEDro, and the Cochrane Library was performed to identify relevant interventions for the management of AS. Evidence for each intervention was categorised by study type, and outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, rate ratio, number needed to treat, and incremental cost effectiveness ratio were calculated for each intervention where possible. Results from randomised controlled trials were pooled where appropriate. Results Both pharmacological and non?pharmacological interventions considered to be of interest to clinicians involved in the management of AS were identified. Good evidence (level Ib) exists supporting the use of non?steroidal anti?inflammatory drugs (NSAIDs) and coxibs for symptomatic treatment. Non?pharmacological treatments are also supported for maintaining function in AS. The use of conventional antirheumatoid arthritis drugs is not well supported by high level research evidence. Tumour necrosis factor inhibitors (infliximab and etanercept) have level Ib evidence supporting large treatment effects for spinal pain and function in AS over at least 6?months. Level IV evidence supports surgical interventions in specific patients. Conclusion This extensive literature review forms the evidence base considered in the development of the new ASAS/EULAR recommendations for the management of AS. PMID:16126792

Zochling, J; van der Heijde, D; Dougados, M; Braun, J

2006-01-01

70

The impact of ankylosing spondylitis on female sexual functions.  

PubMed

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables, psychological status and the quality of life on the female patients' sexual function measured according to the Female Sexual Function Index (FSFI). Thirty-seven sexually active female AS patients and 33 healthy controls were enroled in this study. Their demographic data were evaluated and the generalised pain in patients with AS was assessed according to the visual analogue scale (0-100?mm). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. In comparison to the healthy control group, patients with AS had significantly lower scores in each of the five domains of the FSFI except for the pain domain (P<0.05). The disease activity, functional status, quality of life, radiological score and CRP levels were negatively correlated with the FSFI (P<0.05). No significant correlation was observed with the disease duration, smoking status, depression, anxiety, pain and ESR when the total scores and the scores from the domains of the FSFI were compared. The sexual function is impaired in female patients with AS. This impairment in the sexual function is especially related to the functional status and disease activity among the clinical and laboratory parameters. PMID:23303332

Sariyildiz, M A; Batmaz, I; Inanir, A; Dilek, B; Bozkurt, M; Bez, Y; Karakoç, M; Cevik, R

2013-05-01

71

Circulating levels of sialic acid and glycosaminoglycans: a diagnostic test for ankylosing spondylitis.  

PubMed Central

The circulating levels of sialic acid (N-acetylneuraminic acid) and glycosaminoglycans (GAGs) were measured in 69 patients with spinal disorders of orthopaedic interest (ankylosing spondylitis 17, osteofluorosis 6, idiopathic backache 10, osteoarthrosis 16, osteoporosis 20). The serum GAG levels showed no statistically significant change from control values in the five disorders investigated in the present study. Although osteoporosis and osteoarthrosis showed a decrease in serum sialic acid (SA) levels, the mean ratio (SA/GAG) demonstrated no change from control values. Idiopathic backache showed no difference in any of the parameters studied when compared with control values. Ankylosing spondylitis and osteofluorosis had a remarkable similarity in their clinical and radiological features, but a divergent mean value of ratio was noted. The mean ratio of both the conditions also showed a statistically significant difference from the control value. This suggests that the SA/GAG ratio can be used as a diagnostic test in ankylosing spondylitis. PMID:2973770

Susheela, A K; Das, T K; Khurana, J S; Jayaswal, A; Dave, P K

1988-01-01

72

Dysphagia and airway obstruction due to large cervical osteophyte in a patient with ankylosing spondylitis.  

PubMed

Anterior cervical osteophytes are excessive bony formation of cervical vertebra bodies. They are common but rarely symptomatic lesions mostly seen in geriatric population. Large anterior cervical osteophytes may cause symptoms such as dysphagia, dyspnea, dysphonia, and odynophagia. They have been attributed to multiple etiologies including diffuse idiopathic skeletal hyperostosis, following trauma, cervical spondylitis, and infectious spondylitis. However, symptomatic large anterior cervical osteophyte with ankylosing spondylitis is extremely rare. Surgical excision is the main treatment for symptomatic cases. We report a case of a 53-year-old man with airway obstruction and dysphagia due to large cervical osteophyte who has a history of ankylosing spondylitis, and we also addressed the etiological factors and management of large symptomatic cervical osteophytes. PMID:24905946

Varsak, Yasin Kür?ad; Eryilmaz, Mehmet Akif; Arba?, Hamdi

2014-07-01

73

Double-blind Cross-over Trial of Flurbiprofen and Phenylbutazone in Ankylosing Spondylitis  

PubMed Central

A double-blind cross-over study in 35 patients with ankylosing spondylitis was carried out comparing flurbiprofen (150 mg daily)—a new non-steroidal anti-inflammatory agent—with phenylbutazone (300 mg daily) over a four-week period. Flurbiprofen was well tolerated and shown to have therapeutic efficacy approaching that of phenylbutazone. The results suggest that flurbiprofen may prove a valuable alternative in the treatment of ankylosing spondylitis, and longterm efficacy and tolerance studies are clearly indicated. PMID:4611579

Calin, A.; Grahame, R.

1974-01-01

74

Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?  

PubMed Central

Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hypertonicity was hypothesized as a potential excessive polymorphic trait which could contribute to chronic biomechanical overloading and exaggerated stresses at entheseal sites. Such a mechanism may help to integrate many of the characteristic host, pathological, and structural features of ankylosing spondylitis and axial spondyloarthritis. Biomechanical stress and strain were recently documented to correlate with peripheral entheseal inflammation and new bone formation in a murine model of spondyloarthritis. Ankylosing spondylitis has traditionally been classified by the modified New York criteria, which require the presence of definite radiographic sacroiliac joint lesions. New classification criteria for axial spondyloarthritis now include patients who do not fulfill the modified New York criteria. The male-to-female sex ratios clearly differed between the two patient categories - 2:1 or 3:1 in ankylosing spondylitis and 1:1 in non-radiographic axial spondyloarthritis - and this suggests a spectral concept of disease and, among females, milder structural alterations. Magnetic resonance imaging of active and chronic lesions in ankylosing spondylitis and axial spondyloarthritis reveals complex patterns, usually interpreted as inflammatory reactions, but shows similarities to acute degenerative disc disease, which attributed to edema formation following mechanical stresses and micro-damage. A basic question is whether mechanically induced microinjury and immunologically mediated inflammatory mechanisms operate in both ankylosing spondylitis and degenerative disc disease but differ in relative degrees. The hypothesized biomechanical properties raised in this commentary require documentation of their association with the onset risk and course of ankylosing spondylitis and axial spondyloarthritis. If particular subsets of ankylosing spondylitis and axial spondyloarthritis patients are confirmed to have altered axial myofascial properties, their biological basis and underlying biomechanical mechanisms promise to become clarified. Understanding how biomechanical and physical properties can affect symptomatic and structural manifestations of these disorders could also improve their management. PMID:25166000

2014-01-01

75

An Epidemiological Study on Ankylosing Spondylitis in Southern Albania  

PubMed Central

Objectives: To evaluate the incidence and prevalence of ankylosing spondylitis (AS) in southern Albania and to assess the association of various demographic risk factors with the severity of disease. Material and methods: This is an observational study with cross-sectional analyses, conducted in the region of Gjirokaster, between 1995 until 2011. The diagnosis of AS was based on the modified New York criteria. Data on population are obtained from the reports of the National Institute of Statistics. Results: Between 1995 and 2011, there were 54 patients diagnosed with AS. Of them, 48 subjects were males (88.9%) and 6 subjects females (11.1%). The AS prevalence in adult population (?14 years of age), in December 2010, was 0.061%. The 5-year incidence (2006–2010) in adult population was 0.006 %. The mean age at the onset of disease was 29.7±8.4 years. The mean age in 2011 (n=50 subjects) was 51.6±12.7 years. The duration of the disease was 22.7±11.2 years. More than two thirds of the patients (70.3%) were in the advanced radiological stages of the disease. A younger age at the onset of the disease, longer delay in diagnosis, lower educational level and smoking were significant independent factors associated with the advanced forms of the disease. Conclusion: In southern Albania, the AS prevalence in 2010 was 0.061% and the 5-year incidence (2006-2010) was 6 new cases per 105 adults. The incidence and prevalence of AS in Southern Albania are close to the respective regional epidemiological data. PMID:24757397

Koko, Vjollca; Ndrepepa, Ana; Skenderaj, Skender; Ploumis, Avraam; Backa, Teuta; Tafaj, Argjend

2014-01-01

76

ASAS/EULAR recommendations for the management of ankylosing spondylitis  

PubMed Central

Objective To develop evidence based recommendations for the management of ankylosing spondylitis (AS) as a combined effort of the ‘ASsessment in AS' international working group and the European League Against Rheumatism. Methods Each of the 22 participants was asked to contribute up to 15 propositions describing key clinical aspects of AS management. A Delphi process was used to select 10 final propositions. A systematic literature search was then performed to obtain scientific evidence for each proposition. Outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, relative risk, number needed to treat, and incremental cost effectiveness ratio were calculated. On the basis of the search results, 10 major recommendations for the management of AS were constructed. The strength of recommendation was assessed based on the strength of the literature evidence, risk?benefit trade?off, and clinical expertise. Results The final recommendations considered the use of non?steroidal anti?inflammatory drugs (NSAIDs) (conventional NSAIDs, coxibs, and co?prescription of gastroprotective agents), disease modifying antirheumatic drugs, treatments with biological agents, simple analgesics, local and systemic steroids, non?pharmacological treatment (including education, exercise, and physiotherapy), and surgical interventions. Three general recommendations were also included. Research evidence (categories I–IV) supported 11 interventions in the treatment of AS. Strength of recommendation varied, depending on the category of evidence and expert opinion. Conclusion Ten key recommendations for the treatment of AS were developed and assessed using a combination of research based evidence and expert consensus. Regular updating will be carried out to keep abreast of new developments in the management of AS. PMID:16126791

Zochling, J; van der Heijde, D; Burgos-Vargas, R; Collantes, E; Davis, J C; Dijkmans, B; Dougados, M; Geher, P; Inman, R D; Khan, M A; Kvien, T K; Leirisalo-Repo, M; Olivieri, I; Pavelka, K; Sieper, J; Stucki, G; Sturrock, R D; van der Linden, S; Wendling, D; Bohm, H; van Royen, B J; Braun, J

2006-01-01

77

Modifiable cardiovascular risk factors in patients with ankylosing spondylitis.  

PubMed

The aim of this study was to evaluate whether modifiable cardiovascular disease (CVD) risk factors, e.g. atherogenic blood lipids, hypertension and lifestyle-related factors such as smoking, diet and physical inactivity, differ among patients with ankylosing spondylitis (AS) in comparison to the general population. Eighty-eight patients diagnosed with AS were identified by analysis of the databases of a previous community intervention programme, the Västerbotten intervention programme. The patients were compared with 351 controls matched for age, sex and study period. These databases include the results of blood samples analysed for cholesterol, triglycerides and plasma glucose, as well as data on hypertension, height, weight, smoking and dietary habits and physical activity. No significant differences were found between patients and controls regarding hypertension, body mass index, physical activity, diet or smoking. Levels of serum triglycerides (p?

Sundström, Björn; Johansson, Gunnar; Johansson, Ingegerd; Wĺllberg-Jonsson, Solveig

2014-01-01

78

Ankylosing spondylitis: recent breakthroughs in diagnosis and treatment.  

PubMed

Ankylosing spondylitis (AS) is generally easy to diagnose when the characteristic findings of the "bamboo" spine and fused sacroiliac joints are present on radiographs. Unfortunately, these changes are usually seen late in the disease after tremendous suffering has been incurred by the patient. Diagnostic delay averages seven to ten years. Historically, once the diagnosis was made, the treatment options were often inadequate or poorly tolerated in many individuals. This condition most often starts in early adulthood when people are typically in the earlier stages of their careers, resulting in diminished workforce participation and decreased quality of life. If an individual has a family physician, this might be the first encounter with a healthcare provider. Quite often, the initial practitioner is sought at a public walk-in clinic or chiropractic office. In recent years, there have been two major developments in the management of AS that make earlier diagnosis possible and offer the hope of alleviating pain and preventing structural changes that result in loss of function. These developments include the use of magnetic resonance imaging (MRI) to visualize the inflammatory changes in the sacroiliac joint and the axial spine, and the demonstration that tumor necrosis factor (TNF) blocking agents are highly efficacious in reducing spinal inflammation and possibly in slowing radiographic progression. This review outlines diagnostic strategies that can help identify AS in its earlier stages. Special attention is focused on treatment advances, including the use of anti-TNF agents, and how these medications have been incorporated into clinical recommendations for daily use. PMID:18060011

Shaikh, Saeed A

2007-12-01

79

Ankylosing spondylitis and symptom-modifying vs disease-modifying therapy.  

PubMed

The main objectives of medical therapy in ankylosing spondylitis (AS) are to relieve pain, stiffness and fatigue and to prevent structural damage. The Assessment in Ankylosing Spondylitis Working Group has proposed different domains with specific instruments to assess the efficacy of therapeutic agents classified as symptom-modifying and disease-controlling antirheumatic drugs. Non-steroidal antiinflammatory drugs (NSAIDs) are still the first-line treatment in the management of AS, and they are effective in controlling symptoms such as pain and stiffness and maintaining mobility in many patients. A recent randomized trial suggested that the progression of radiological damage occurs less on continuous use of celecoxib compared with on-demand use. If such findings were confirmed by other studies, the therapeutic value of NSAIDs in AS may extend beyond symptom control. However, for each individual patient, the expected advantages of treatment with NSAIDs should be weighted against any possible gastrointestinal and cardiovascular disadvantages. Disease-modifying antirheumatic drugs (DMARDs) are widely used for second-line therapy in AS, but the evidence for their efficacy is poor. The term 'DMARD' has been borrowed from rheumatoid arthritis, and none of the DMARDs have been shown to prevent or significantly decrease the rate of progression of structural damage which is required to be qualified as a disease-controlling antirheumatic drug for AS. Sulphasalazine is the most extensively studied DMARD and studies suggest some degree of clinical benefit confined to peripheral joint involvement, but no evidence of benefit in axial disease. Methotrexate, which is the gold standard DMARD in rheumatoid arthritis, does not seem to have a substantial therapeutic effect in AS on axial or peripheral joint involvement. Leflunomide appears to exert little beneficial effect, if any, even on peripheral joint involvement. There is also good evidence that local therapy with corticosteroids is effective and may be used in selected patients. Oral corticosteroids may be somewhat effective in relieving the symptoms of AS, but this has not been formally studied. Small studies have reported favourable results with intravenous methylprednisolone pulse therapy, but the effect is temporary. Pamidronate and thalidomide have been used in some preliminary trials but need further studies to assess their potential role in treating AS patients resistant or intolerant to other forms of treatment. Treatment with tumour necrosis factor blockers is not discussed in this review. PMID:16777581

Akkoc, Nurullah; van der Linden, Sjef; Khan, Muhammad Asim

2006-06-01

80

Surgical Outcomes after Traumatic Vertebral Fractures in Patients with Ankylosing Spondylitis  

PubMed Central

Objective Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability. Results A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases. Conclusions Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient's neurological status. PMID:25328647

An, Seong-Bae; Kim, Keung-Nyun; Chin, Dong-Kyu; Kim, Keun-Su; Cho, Yong-Eun

2014-01-01

81

An investigation of factors limiting aerobic capacity in patients with ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) has been shown to produce exercise limitation and breathlessness. The purpose of this study was to investigate factors which may be responsible for limiting aerobic capacity in patients with AS.Twenty patients with no other cardio-respiratory disease performed integrative cardiopulmonary exercise testing (CPET). The results were compared to 20 age and gender matched healthy controls. Variables that might

R. Carter; P. Riantawan; S. W. Banham; R. D. Sturrock

1999-01-01

82

A case report on nephrotic syndrome associated with ankylosing spondylitis effectively treated with infliximab  

PubMed Central

Renal abnormalities have been reported to occur in patients with ankylosing spondylitis (AS). This study examined a patient who suffered from AS for two years. The 24-hour urine protein of the patient was 4.80 g/day. The result of renal biopsy showed minimal change. The patient was treated with infliximab. After two months, nephrotic syndrome was treated successfully.

Feng, Xin; Li, Yao; Gao, Wei

2014-01-01

83

Ankylosing spondylitis in Ireland: patient access and response to TNF-? blockers.  

PubMed

To investigate a group of Irish ankylosing spondylitis patients: current prescription practice for TNF blockers and patient response. All patients presenting with ankylosing spondylitis (AS) and treated with TNF-alpha between January 2006 and 2008 in the midwestern region of Ireland were studied. Response was evaluated using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and CRP results at 6 months. A total of 47 AS patients (32 men: 15 women, mean age 37.7 years, median disease duration 20 years, 80% HLA B27 positive) were identified; 66% were on disease-modifying anti-rheumatic drugs (DMARDs) concomitantly. All patients satisfied BSR/ASAS disease severity criteria for TNF-alpha at baseline, and mean BASDAI was 6.2, BASFI 6.9, and CRP 27.5 mg/L. At 6 months, these had reduced to a mean BASDAI of 3.8, BASFI 4.6, and CRP of 8.9 mg/L. Patients with advanced AS (disease duration >10 years, mean BASFI 7.5) responded at least as well. No allergies or serious side effects were encountered, and one patient successfully switched TNF agent due to secondary failure. Initial good responses at 6 months were seen to be maintained in sub-group analysis at 12 months. Disease severity in patients gaining access to treatment for active AS with TNF blockers in Ireland is very high. Patients mainly satisfy international guidelines for the use of biologics (BSR, EULAR) with some minor exceptions. High disease activity and long disease duration may predict better treatment response. Response rates were good and treatment was well tolerated, and no differences in response were noted between the 3 agents employed. PMID:21286722

Saeed, Aamir; Khan, Mumtaz; Elmamoun, Musaab; Brady, Mary; Morrissey, Siobhan; Fraser, Alexander Duncan

2012-05-01

84

Fetuin-A is related to syndesmophytes in patients with ankylosing spondylitis: a case control study  

PubMed Central

OBJECTIVES: New bone formation is one of the hallmark characteristics of ankylosing spondylitis, which is thereby associated with syndesmophytes. Fetuin-A is a molecule that is abundantly found in calcified tissues and it shows high affinity for calcium phosphate minerals and related compounds. Considering the role of fetuin-A in the regulation of calcified matrix metabolism, we compared the fetuin-A levels in ankylosing spondylitis patients with syndesmophytes with those in patients without syndesmophytes and in healthy controls. We also studied other biomarkers that are thought to be related to syndesmophytes. METHODS: Ninety-four patients (49 patients without syndesmophytes, 67.3% male, 40.7±8.7 years; 45 patients with syndesmophytes, 71.1% M, 43.9±9.9 years) and 68 healthy controls (44.2±10.6 years and 70.6% male) were included in this study. Syndesmophytes were assessed on the lateral radiographs of the cervical and lumbar spine. The serum levels of fetuin-A, dickkopf-1, sclerostin, IL-6, high-sensitivity C-reactive protein and bone morphogenetic protein-7 were measured with an enzyme-linked immunosorbent assay. RESULTS: Patients with syndesmophytes had significantly higher levels of fetuin-A compared with patients without syndesmophytes and controls (1.16±0.13, 1.05±0.09 and 1.08±0.13 mg/ml, respectively). However, fetuin-A was not different between the patients without syndesmophytes and controls. Bone morphogenetic protein-7 was significantly lower; dickkopf-1 was significantly higher in patients with ankylosing spondylitis compared with controls. The sclerostin concentrations were not different between the groups. In regression analysis, fetuin-A was an independent, significant predictor of syndesmophytes. CONCLUSION: Our results suggest that fetuin-A may a role in the pathogenesis of bony proliferation in ankylosing spondylitis.

Tuylu, Tugba; Sari, Ismail; Solmaz, Dilek; Kozaci, Didem Leyla; Akar, Servet; Gunay, Necati; Onen, Fatos; Akkoc, Nurullah

2014-01-01

85

Thalidomide reduces recurrence of ankylosing spondylitis in patients following discontinuation of etanercept.  

PubMed

A previous study showed that most ankylosing spondylitis (AS) patients presented recurrence within 6 months post-discontinuation of etanercept. How to reduce recurrence following discontinuation of etanercept should be further researched. In this study, 111 ankylosing spondylitis patients meeting the Assessment in AS 20 % response (ASAS20) criteria after 12-week administration of etanercept were randomized into three groups: Group I, 150 mg thalidomide once/day; Group II, 1 g sulfasalazine, twice/day; Group III, NSAIDs for the maintenance treatment. The patients were regularly followed up once a month, and AS recurrence was evaluated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the patient global assessment (PGA), and rachialgia. The follow-up lasted for 1 year, and AS recurrence was considered as the end of a visit. Finally, 100 patients completed the follow-up study, of whom 30 were in Group I, 33 in Group II, and 37 in Group III. The average follow-up period was 5.1 ± 3.9 months and the longest lasted for 12 months. At the end of the follow-up study, the recurrence rates in Groups I, II, and III were, respectively, 60.0 % (18/30), 84.8 % (28/33), and 89.2 % (33/37). The recurrence rates of Group I were statistically significantly lower than that of Group II and III (P = 0.0265; P = 0.0053), while there was no significant difference between Group II and Group III. In addition, we found that PGA, C-reactive protein (CRP), and spinal inflammation could be regarded as predictive factors for AS recurrence by analysis with the Cox proportional hazard model. This study points to a new way for maintenance therapy of AS following discontinuation of etanercept and reveals several useful indicators for prediction of AS recurrence. PMID:23143621

Deng, Xiaohu; Zhang, Jianglin; Zhang, Jie; Huang, Feng

2013-06-01

86

Nonsteroidal anti-inflammatory drug use in ankylosing spondylitis—a population-based survey  

Microsoft Academic Search

The objective of the study is to describe the use, clinical efficacy, and toxicity of nonsteroidal anti-inflammatory drug (NSAID) therapy in patients with ankylosing spondylitis (AS). A cross-sectional population study of 1,080 AS patients was carried out by a written questionnaire in the year 2000. Seventy-eight percent of AS patients had regularly taken NSAIDs for their disease 12 months prior to

Jane Zochling; Martin H. J. Bohl-Bühler; Xenofon Baraliakos; Ernst Feldtkeller; Jürgen Braun

2006-01-01

87

The demographic and clinical spectrum of Arab versus Asian patients with ankylosing spondylitis in the UAE  

Microsoft Academic Search

Ankylosing spondylitis is a rather uncommon condition in the UAE. Over a period of 10 years. 28 hospital-based patients diagnosed\\u000a as having AS were retrospectively studied. They included 17 Arabs and 11 Asians. The onset of AS in most patients in this\\u000a study was in adulthood (mean age at onset was 27.7 years in Arabs and 28.75 years in Asians).

Haider M. Al Attia; Alnadhir M. Sherif; M. Moshaddeque Hossain; Yasser H. Ahmed

1998-01-01

88

Isolated sacroiliitis as monosymptomatic form of ankylosing spondylitis - a possible cause of chronic back pain  

Microsoft Academic Search

Summary  In a retrospective analysis of 770 cases of ankylosing spondylitis or allied disorders 146 patients (19 percent) were found\\u000a to have isolated sacroiliitis without involvement of the spine. The mean disease duration of isolated sacroiliitis was 11.9\\u000a years. The conclusions were based on anamnestic, clinical and radiological data. Of those patients with isolated sacroiliitis\\u000a 29 percent were female, compared to

E. Prohaska

1984-01-01

89

Serum nitric oxide, catalase, superoxide dismutase, and malondialdehyde status in patients with ankylosing spondylitis  

Microsoft Academic Search

In this study, serum antioxidant and oxygen derived free radical status of patients with ankylosing spondylitis (AS) was investigated and compared with that of age- and sex-matched healthy controls. The relationship of these parameters to disease activity indices was also examined. Thirty patients with AS not currently under disease-modifying antirheumatic drug (DMARD) treatment (e.g., sulfasalazine or methotrexate) (15 active and

Salih Ozgocmen; Sad?k Sogut; Ozge Ardicoglu; Ersin Fadillioglu; Irfan Pekkutucu; Omer Akyol

2004-01-01

90

Mortality among patients with ankylosing spondylitis after a single treatment course with x rays  

Microsoft Academic Search

Mortality was studied in 14 111 patients with ankylosing spondylitis given a single course of x-ray treatment during 1935-54. Mortality from all causes combined was 66% greater than that of members of the general population of England and Wales. There were substantial excesses of deaths from non-neoplastic conditions, but these appeared to be associated with the disease itself rather than

P G Smith; R Doll

1982-01-01

91

The coexistence of ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis—a postmortem diagnosis  

Microsoft Academic Search

A 72-year-old male was diagnosed as having ankylosing spondylitis, mainly according to radiological findings, confirmed as\\u000a HLA-B27-negative. Postmortem examination of the skeleton raised doubts on the initial diagnosis, since spinal findings pointed\\u000a out also to diffuse idiopathic skeletal hyperostosis. The authors discuss the differential diagnosis and enhance the postmortem\\u000a findings which allowed the diagnosis of the two clinical entities in

Xavier Jordana; Ignasi Galtés; Ana Rita Couto; Luís Gales; Margarida Damas; Manuela Lima; Jácome Bruges-Armas

2009-01-01

92

Tramadol/acetaminophen combination as add-on therapy in the treatment of patients with ankylosing spondylitis.  

PubMed

This study aimed to determine the safety and efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (Ultracet®) in patients with ankylosing spondylitis (AS). This was a 12-week, randomized, double-blind, placebo-controlled study. Sixty patients with active AS according to the Modified New York Criteria were enrolled. Active disease was defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for more than 3 at randomization. Subjects were randomized equally into two groups: the treatment group received aceclofenac plus Ultracet® one tablet twice a day, and the control group received aceclofenac plus placebo for 12 weeks. The primary endpoint was a difference of Assessment in Ankylosing Spondylitis (ASAS20) response criteria between two groups at week 12. At week 12, ASAS20 was achieved by 53.3 % of the aceclofenac plus Ultracet group and 31 % of the aceclofenac alone group (p?=?0.047). For the pain visual analogue scale at week 12, there was a reduction of 45.6 % in aceclofenac plus Ultracet group and 25.7 % in the aceclofenac alone group (p?=?0.087). There was no statistically significant difference between two groups in BASDAI, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Global Index, Physician Global Assessment, spinal mobility, ESR, hs-CRP, and Ankylosing Spondylitis Quality of Life Questionnaire. A slight increase in total adverse events was noted with dizziness (7.5 vs 1.5 %), vertigo (4.5 vs 1.5 %), and nausea/vomiting (6 vs 0 %) in the Ultracet arm compared to placebo. The tramadol 37.5 mg/acetaminophen 325 mg combination tablet (Ultracet®) might has additional effect to nonsteroidal anti-inflammatory drugs in the treatment of patients with ankylosing spondylitis. It showed marginal benefit in pain and disease activity. However, a slight increase in minor adverse events was noted. PMID:23192419

Chang, Jhi-Kai; Yu, Chen-Tung; Lee, Ming-Yung; Yeo, Kj; Chang, I-Chang; Tsou, Hsi-Kai; Wei, James Cheng-Chung

2013-03-01

93

Two spinal cord lesions in a patient with ankylosing spondylitis and cervical spine injury.  

PubMed

A patient with ankylosing spondylitis sustained C3-C4 vertebral subluxation and C4-C5 myelopathy after a hyperextension trauma. Autopsy showed that several segments below the main cervical cord lesion at the fractured site, there was a second spinal cord lesion at the T1 vertebral level with no corresponding local bony or ligamentous damage. The thoracic cord lesion was probably secondary to traction of the upper thoracic cord, where the blood supply is poor, in a narrow and rigid spinal canal at the moment of extreme hyperextension. PMID:6681663

Foo, D; Bignami, A; Rossier, A B

1983-02-01

94

Cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy.  

PubMed Central

A case of cauda equina syndrome with multiple lumbar arachnoid cysts complicating ankylosing spondylitis (AS) is described. The value of computerised tomography (CT) and magnetic resonance imaging (MRI) as a non-invasive means of establishing the diagnosis is emphasised. In contrast to previously reported cases the patient showed neurological improvement following surgical therapy. Surgery may be indicated in some patients, particularly when there is nerve root compression by the arachnoid cysts and when the patient is seen early before irreversible damage to the cauda equina has occurred. Images PMID:2292702

Shaw, P J; Allcutt, D A; Bates, D; Crawford, P J

1990-01-01

95

Pregabalin for Opioid-Refractory Pain in a Patient with Ankylosing Spondylitis  

PubMed Central

Background. Ankylosing spondylitis (AS) is a systemic inflammatory disease with chronic back pain as the most common presenting symptom. We present a case of a male patient with AS reporting symptoms of severe low back pain, buttock pain, and limited spinal mobility. After chronic treatment with opioids, we administered pregabalin at a dose of 300?mg as an analgesic agent while opioids were discontinued. Findings. Pain symptoms improved progressively, and opioids were gradually discontinued without any withdrawal symptoms reported. Conclusions. Pregabalin is potentially useful in the management of pain in patients with AS while effectively managing the discontinuation of opioid treatment. PMID:23844301

Kontoangelos, Konstantinos A.; Kouzoupis, Anastasios V.; Ferentinos, Panagiotis P.; Xynos, Ioannis D.; Sipsas, Nikolaos V.; Papadimitriou, George N.

2013-01-01

96

REVIEW Adalimumab in the treatment of arthritis  

E-print Network

Abstract: Tumor necrosis factor (TNF) has been implicated in a number of arthritic disease states, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Adalimumab is the first fully human, high-affinity, recombinant immunoglobulin G 1 (IgG

unknown authors

97

[Anterior uveitis in ankylosing spondylitis. A retrospective study].  

PubMed

In ankylosing spondylarthritis (AS), there is sometimes an anterior uveitis (AUV) or a previous history of AUV. The authors have reviewed the medical files of 338 hospitalised AS and 30 AS seen in consultation. They found an AUV in 28 hospitalised AS, or 8.3 p. cent of all cases (7.7 p. cent in men and 14.8 p. cent in women). In 3 cases (0.9 p. cent), the AUV was the first manifestation of the disease, preceding joint involvement. AUV was never found in patients seen in consultation. The findings of this investigation agree, but only partially, with those from the literature which, usually, acknowledge a greater frequency of AUV. Comparison with other previous investigations conducted in Italy enables to confirm that among Italian AS, AUV is less frequent than in other European and out of Europe series. It is possible that in a certain number of cases the AUV is not diagnosed clinically. However, it seems that the reduced incidence of the AUV discovered by a few Italian authors is not fortuitous (genetic factors?). PMID:3238310

Piergiacomi, G; Agostinelli, M; Baccarini, V; Gasparini, M; Pepi, M; Cervini, C

1988-12-01

98

Recommendations Pharmacotherapy (excluding biotherapies) for ankylosing spondylitis: Development of recommendations for clinical practice based on published evidence and expert opinion  

Microsoft Academic Search

Objectives: To develop recommendations about pharmacotherapy (excluding biotherapeutic agents) in patients with axial forms of ankylosing spondylitis (AS) seen in everyday clinical practice. Methods: The recommendations were based on evidence from the literature. First, a scientific committee used a Delphi procedure to select five focal points about which recommendations were needed. Then, a literature task force looked for relevant publications

Frederic Lavie; Stephan Pavy; Emmanuelle Dernis; Philippe Goupille; Alain Cantagrel; Jacques Tebib; Pascal Claudepierre; ReneMarc Flipo; Jean-Francis Maillefert; Xavier Mariette; Alain Saraux; Thierry Schaeverbeke; Daniel Wendling; Bernard Combe

2007-01-01

99

Assessment of radiographic progression in the spines of patients with ankylosing spondylitis treated with adalimumab for up to 2 years  

Microsoft Academic Search

INTRODUCTION: Ankylosing spondylitis (AS) is a chronic rheumatic disease associated with spinal inflammation that subsequently leads to progression of structural damage and loss of function. The fully human anti-tumor necrosis factor (anti-TNF) antibody adalimumab reduces the signs and symptoms and improves overall quality of life in patients with active AS; these benefits have been maintained through 2 years of treatment.

Désirée van der Heijde; David Salonen; Barbara N Weissman; Robert Landewé; Walter P Maksymowych; Hartmut Kupper; Shaila Ballal; Eric Gibson; Robert Wong

2009-01-01

100

The Bath Ankylosing Spondylitis Activity and Function Indices (BASDAI and BASFI) and their correlation with main symptoms experienced by patients with spondyloarthritis.  

PubMed

With the aim of assessing whether the Bath Ankylosing Spondylitis Activity and Function Indices (BASDAI and BASFI) are reliable measures of disease activity and function in patients with spondyloarthritides (SpAs), 341 patients with SpA (representing ankylosing spondylitis (14.5%), psoriatic arthritis (27.3%), enteropathic arthritis (6.3%), reactive arthritis (4.9%), and undifferentiated arthritis (46.5%) were asked to complete the BASDAI and BASFI. They were asked to report what their main problems associated with the disease were from a list of seven symptoms: fatigue, neck pain, upper back pain, lower back pain, stiffness, joint pain or swelling, and pain with pressure on joints. Correlations between the main symptoms experienced by patients with SpAs and the indices, defined by Spearman's correlation coefficient, showed that BASDAI best correlated with neck pain [BASDAI 2 and total BASDAI score correlate strongly (p = 0.003 and 0.001, respectively), and BASDAI 1, 4, and 5 correlate moderately (p = 0.03, 0.02, and 0.01, respectively)], followed by stiffness, upper back pain, pain with pressure, lower back pain, fatigue, and joint pain. Stiffness correlated strongly with nine of ten items on BASFI (BASFI 1 showed moderate correlation, p = 0.01), followed by upper back pain (four of ten items correlated strongly, three of ten correlated moderately), neck pain (three of ten tasks correlated strongly and four of ten correlated moderately), lower back pain (one task correlated strongly, five moderately), joint pain and swelling (four tasks correlated moderately), fatigue (three tasks correlated moderately), and pain with pressure (two tasks correlated moderately). BASDAI and BASFI only partly reflect disease activity and patients' functional capacity in SpAs. An alternate instrument is required to assess SpA disease activity and functional capacity more precisely. PMID:20229262

Roussou, Euthalia; Sultana, Shahzabeen

2010-08-01

101

IGF-1 and ADMA Levels Are Inversely Correlated in Nondiabetic Ankylosing Spondylitis Patients Undergoing Anti-TNF-Alpha Therapy  

PubMed Central

Like rheumatoid arthritis, ankylosing spondylitis (AS) is also an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MeS) features. AS patients often display osteoporosis as well as new bone formation. Insulin-like growth factor 1 (IGF-1) is a protein involved in both inflammation and bone metabolism. In the present study we assessed whether disease activity, systemic inflammation, MeS features, adipokines, and biomarkers of endothelial activation were associated with IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) levels in a series of 30 nondiabetic AS patients without CV disease undergoing TNF-? antagonist-infliximab therapy. All determinations were made in the fasting state, immediately before an infliximab infusion. Although no association of IGF-1 and IGFBP-3 levels with angiopoietin-2 or osteopontin was found, an inverse correlation between IGF-1 levels and asymmetric dimethylarginine (ADMA), an endogenous endothelial nitric oxide synthase inhibitor that impairs nitric oxide production and secretion promoting endothelial dysfunction, was found (r = ?0.397; P = 0.04). However, no significant association was found between IGF-1 and IGFBP-3 levels and disease activity, systemic inflammation, metabolic syndrome features, or adipokines. In conclusion, in nondiabetic patients with AS undergoing periodic anti-TNF-? therapy, IGF-1 and ADMA are inversely correlated. PMID:25295265

Lopez-Mejias, Raquel; Rueda-Gotor, Javier; Miranda-Filloy, Jose A.; Villar-Bonet, Aurelia; Carnero-Lopez, Beatriz; Gomez-Acebo, Ines; Blanco, Ricardo; Pina, Trinitario; Gonzalez-Juanatey, Carlos; Gonzalez-Gay, Miguel A.

2014-01-01

102

Management of a case of ankylosing spondylitis for total hip replacement surgery with the use of ultrasound-assisted central neuraxial blockade  

PubMed Central

Management of a case of ankylosing spondylitis can be very challenging when the airway and the central neuraxial blockade, both are difficult. Ultrasound-assisted central neuraxial blockade may lead to predictable success in the field of regional anaesthesia. We present a young patient with severe ankylosing spondylitis where conventional techniques failed and ultrasound helped in successful combined spinal–epidural technique for total hip replacement surgery. PMID:23716771

Goyal, Rakhee; Singh, Shivinder; Shukla, Ravindra Nath; Singhal, Anuj

2013-01-01

103

Orthotic correction of postural unleveling in a patient with ankylosing spondylitis.  

PubMed

The authors describe the case of a patient with ankylosing spondylitis who was treated with orthotic devices for postural unleveling. The patient described specific pre-existing postural problems, both static and dynamic, that had been present for many years. A unilateral 9-mm gel heel lift was used, followed by custom-molded orthotic devices that incorporated the heel lift. The patient reported immediate resolution of these symptoms after orthotic treatment, as well as increased functionality and satisfaction in activities of daily living, which coincided with the leveling of his posture. The orthotic devices were used until the patient underwent total hip arthroplasty, at which point the orthotic treatment was discontinued. PMID:24481805

Lipton, James A; Mitchell, Lisa J

2014-02-01

104

Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review.  

PubMed

Ankylosing spondylitis (AS) is a complex systemic rheumatological disease which often causes severe disability and impaired quality of life (QoL). We searched the PubMed/MEDLINE electronic database for available literature on QoL and its predictors in patients with AS. Recent evidence indicates that AS patients have poorer QoL compared to the general population, but similar to that of patients with other rheumatological disorders. Disease activity is one of the most powerful predictors of QoL, however latest advances in pharmacological treatment (namely, anti-TNF-?) along with physical exercise can minimize the effects of AS on QoL. Psychological distress symptoms contribute to impaired QoL both directly and indirectly by influencing disease activity. The impact of other psychosocial variables, however, is less studied and more prospective investigations are necessary, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population. PMID:25193010

Kotsis, Konstantinos; Voulgari, Paraskevi V; Drosos, Alexandros A; Carvalho, André F; Hyphantis, Thomas

2014-12-01

105

Intestinal Beh?et's disease appearing during treatment with adalimumab in a patient with ankylosing spondylitis  

PubMed Central

Behçet’s disease (BD) is a chronic inflammatory disease affecting multiple organ systems, such as the skin, joints, blood vessels, central nervous system, and gastrointestinal tract. Intestinal BD is characterized by intestinal ulcerations and gastrointestinal symptoms. The medical treatment of intestinal BD includes corticosteroids and immunosupressants. There have been several reports of tumor necrosis factor-? (TNF-?) blockers being successful in treatment of refractory intestinal BD. Here, we report on a patient who was diagnosed with intestinal BD despite treatment with the fully humanized TNF-? blocker (adalimumab) for underlying ankylosing spondylitis. This patient achieved clinical remission and complete mucosal healing through the addition of a steroid and azathioprine to the adalimumab regimen. PMID:23983446

Chung, Sook Hee; Park, Soo Jung; Hong, Sung Pil; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho

2013-01-01

106

Airway management in cervical spine ankylosing spondylitis: Between a rock and a hard place.  

PubMed

We report the perioperative course of a patient with long standing ankylosing spondylitis with severe dysphagia due to large anterior cervical syndesmophytes at the level of the epiglottis. He was scheduled to undergo anterior cervical decompression and the surgical approach possibly precluded an elective pre-operative tracheostomy. We performed a modified awake fibreoptic nasal intubation through a split nasopharyngeal airway while adequate oxygenation was ensured through a modified nasal trumpet inserted in the other nares. We discuss the role of nasal intubations and the use of both the modified nasopharyngeal airways we used to facilitate tracheal intubation. This modified nasal fibreoptic intubation technique could find the application in other patients with cervical spine abnormalities and in other anticipated difficult airways. PMID:24403620

Eipe, Naveen; Fossey, Susan; Kingwell, Stephen P

2013-11-01

107

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy  

PubMed Central

Introduction: Ankylosing spondylitis (AS) is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has changed, largely due to the introduction of inhibitors of the proinflammatory cytokine tumor necrosis factor (TNF). Adalimumab, a human monoclonal antibody specifically for TNF, is the most recent of the TNF blocking agents that have been approved for the treatment of active, nonsteroidal antiinflammatory drug (NSAID)-refractory patients with AS. Aims: To evaluate the evidence for the therapeutic value of adalimumab in ankylosing spondylitis. Evidence review: There is clear evidence that adalimumab, administered 40 mg subcutaneously every 2 weeks, substantially improves the signs and symptoms of NSAID-refractory, active AS when compared with placebo treatment. There is ample evidence that adalimumab causes significant improvements in physical health status and overall AS-specific, health-related quality of life and physical functioning, which consequently leads to better work productivity. There is substantial evidence that adalimumab improves spinal and sacroiliac joint inflammation in AS patients. Initial results from clinical trials suggest that there is no increased risk of serious infections or malignancies in adalimumab-treated patients with AS. The most common adverse events were injection-site reactions. Limited economic evidence suggests that adalimumab 40 mg may be cost effective when used according to current valid treatment guidelines. Place in therapy: Adalimumab is an effective treatment for patients with active AS. PMID:21221193

Hennigan, Stephanie; Ackermann, Christoph; Kavanaugh, Arthur

2007-01-01

108

Ankylosing Spondylitis  

MedlinePLUS

... is a free service of the U.S. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the ...

109

Ankylosing spondylitis  

MedlinePLUS

... Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology . 9th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap ... systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising ...

110

Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis accompanying ankylosing spondylitis  

Microsoft Academic Search

Objective. To compare magnetic resonance (MR) imaging, computed tomography (CT), and radiography in the detection of sacroiliitis accompanying\\u000a ankylosing spondylitis (AS). Design and subjects. Nine volunteers and 24 patients were recruited. Radiography, CT, and MR imaging were completed within a 1-week period in\\u000a 24 patients with AS. In precontrast MR examination, spin-echo T1, fast spin-echo T2, and gradient echo with

W. Yu; F. Feng; Elizabeth Dion; Hongzen Yang; Ming Jiang; H. K. Genant

1998-01-01

111

Robotic-Assisted Device in Posterior Spinal Fusion for a High Risk Thoraculombar Fracture in Ankylosing Spondylitis  

PubMed Central

Fractures in ankylosing spondylitis (AS) are often difficult to treat and surgical treatment may be fraught with complications. We describe the use of a robotic-assisted device in the surgical treatment of an unstable L1 fracture in an elderly patient with chronic lymphocytic leukemia and AS. The postoperative course was uneventful and the patient was discharged after 3 days. The use of a robotic-assisted device in spine surgery is particularly indicated in difficult high risk cases. PMID:24596607

Suliman, Ali; Bernfeld, Benjamin; Bruskin, Alexander

2014-01-01

112

Thoracic Fracture through a Prior Instrumented Arthrodesis in a Patient with Ankylosing Spondylitis without Hardware Loosening: A Case Report.  

PubMed

The objective of this article is to report a case of a patient with ankylosing spondylitis who sustained a fracture through a prior solid arthrodesis without loosening or changing posterior instrumentation. There have been few cases reported of a patient with ankylosing spondylitis suffering a fracture through a prior instrumented arthrodesis. None have noted the instrumentation remaining intact with the fracture through the middle of the construct. The surgeon must be aware of this possibility to avoid spinal instability that may lead to a neurological deficit. We retrospectively reviewed the case. A review of the literature was performed through a PubMed search. A patient was found to have a fracture within a prior construct despite the presence of a posterior instrumentation. The mechanism of failure was a three-column spine fracture with "bending" of the rods. This patient was treated with a revision posterior/anterior instrumentation and fusion with placement of larger-diameter rods for added stiffness. Fractures through a prior instrumented arthrodesis are rare but still can occur in the ankylosing spondylitis patient. Given the higher risk of epidural hematoma and neurological compromise in this patient population, the surgeon must keep this on the differential diagnosis when treating patients with a prior instrumented arthrodesis. PMID:24353934

Saldua, Nelson S; Harrop, James S

2011-12-01

113

How well are the ASAS/OMERACT Core Outcome Sets for Ankylosing Spondylitis implemented in randomized clinical trials? A systematic literature review.  

PubMed

This study aims to investigate how well the Assessment of SpondyloArthritis international Society (ASAS)/Outcome Measures in Rheumatology Clinical Trials (OMERACT) core set and response criteria for ankylosing spondylitis (AS) have been implemented in randomized controlled trials (RCTs) testing pharmacological and non-pharmacological interventions. A systematic literature search was performed up to June 2013 looking for RCTs in patients with axial spondyloarthritis (SpA) (AS and non-radiographic axial SpA). The assessed domains and instruments belonging to the core sets for disease-controlling anti-rheumatic therapy (DC-ART) and symptom-modifying anti-rheumatic drugs (SMARDs) were extracted. Results were reported separately for those trials published until 2 years after the publication of the core set (1 April 2001; 'control trials') and those trials published at least 2 years after the publication date ('implementation trials'). One hundred twenty-three articles from 99 RCTs were included in the analysis, comparing 48 'control trials' and 51 'implementation trials'. Regarding DC-ART core set, the following domains were significantly more frequently assessed in the 'implementation group' in comparison to the 'control group': 'physical function' (100 vs 41.7 %; p???0.001), 'peripheral joints/entheses' (100 vs 33.3 %; p???0.001) and 'fatigue' (100 vs 0 %; p???0.001). Three instruments were significantly more used in the 'implementation group': Bath Ankylosing Spondylitis Functional Index (BASFI) (100 vs 8.3 %; p?=???0.001), CRP (92.3 vs 58.3 %; p?=?0.01) and Bath Ankylosing Spondylitis Metrology Index (BASMI) (53.8 vs 0 %; p?=?0.001). Regarding SMARD core set domains, physical function (92 vs 23 %; p???0.001) and fatigue (84 vs 17 %; p???0.001), as well as the instruments BASFI (88 vs 14 %; p???0.001) and BASMI (52 vs 0 %; p???0.001), increased significantly in the 'implementation group'. Twenty per cent of trials from the 'implementation group' but none from the 'control group' included all domains of the core set. In conclusion, this study provides evidence for the implementation of the ASAS/OMERACT core set in RCTs of both DC-ART and SMARD. This applies to the use of the domains and, to a lesser extent, to the specific instruments. PMID:24970597

Bautista-Molano, Wilson; Navarro-Compán, Victoria; Landewé, Robert B M; Boers, Maarten; Kirkham, Jamie J; van der Heijde, Désirée

2014-09-01

114

Attenuated insulin response and normal insulin sensitivity in lean patients with ankylosing spondylitis.  

PubMed

Chronic low-grade inflammation is associated with insulin resistance. The aim of this study was to determine insulin response to intravenous glucose load and insulin sensitivity in patients with ankylosing spondylitis (AS). Fourteen nonobese male patients with AS and 14 matched healthy controls underwent frequent-sampling intravenous glucose tolerance test (FSIVGTT). Insulin secretion and insulin sensitivity were calculated using the computer-minimal and homeostasis-model assessment 2 (HOMA2) models. Fasting glucose, insulin, cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, triglyceride levels, HOMA2, glucose effectiveness, insulin sensitivity and insulin response to FSIVGTT did not differ between patients and controls. Tumor necrosis factor-alpha and interleukin (IL)-6 concentrations tended to be higher in AS patients than in controls. Second-phase beta-cell responsiveness was 37% lower (p = 0.05) in AS patients than in controls. A negative correlation was found between the percentage of beta-cell secretion and IL-6 in all subjects (r = -0.54, p = 0.006). We found normal insulin sensitivity but attenuated glucose utilization in the second phase of FSIVGTT in AS patients. Our results indicate that elevated IL-6 levels may play a pathophysiological role in attenuating beta-cell responsiveness, which may explain the association between elevated IL-6 levels and increased risk for type 2 diabetes. PMID:16366418

Penesova, A; Rovensky, J; Zlnay, M; Dedik, L; Radikova, Z; Koska, J; Vigas, M; Imrich, R

2005-01-01

115

Gender differences in ankylosing spondylitis-associated cumulative healthcare utilization: a population-based cohort study  

PubMed Central

BACKGROUND: Ankylosing spondylitis (AS) is one of the most common rheumatic diseases with gender differences in prevalence and clinical presentation. This study aimed to examine whether such gender differences are correlated with cumulative healthcare utilization in Taiwan. METHODS: The National Health Insurance Research Database supplied claim records of one million individuals from 1996 to 2007. Selected cases included patients aged ?16 years. Certified rheumatologists diagnosed the patients in three or more visits and gave prescriptions for AS. Multivariate adjusted logistic regression analyses were used to calculate the influence of gender on cumulative healthcare utilization associated with AS. RESULTS: The study included 228 women and 636 men. After adjustment for potential confounding factors, men had more cumulative outpatient visits associated with AS (odds ratio, 1.59; 95% confidence interval, 1.13 -2.23; p?=?0.008). Men also exhibited a trend for higher frequency of AS-related hospitalization (p?=?0.054). CONCLUSION: Men are more likely to have high cumulative AS-associated healthcare utilization than women. Further investigation of the causal factors is warranted. PMID:21484042

Chen, Hsin-Hua; Chen, Tzeng-Ji; Chen, Yi-Ming; Ying-Ming, Chiu; Chen, Der-Yuan

2011-01-01

116

Ankylosing spondylitis and multiple sclerosis in an HLA-B27 negative patient.  

PubMed

A 41-year-old man presented with vertigo and gait disturbance. He gave a 10-year history of definite ankylosing spondylitis with low back pain, limitation of spinal mobility, decreased chest expansion and radiological evidence of bilateral sacroiliitis. The vertigo attacks started 3 years before and he had insidious evolution of bilateral leg weakness, increased muscle tension and walking disability during the past 2 years. The HLA haplotypes of the patient were A2, A33, B14, B49, Bw4, Bw6, Cw7 and he was HLA-B27 negative. The axial and sagittal cranial magnetic resonance imaging (MRI) showed multiple foci of increased signal intensity in the periventricular white matter and cerebellar hemispheres, suggesting a demyelinating disease process. The MRI of the spine showed centromedullar high intensity lesions at C7, Th7-8, Th9-10 levels. The diagnosis was definite MS (primary progressive MS) as the patient had insidious neurological progression, CSF evidence of inthrathecal production of oligoclonal bands, conduction defects at VEP, multiple brain and additional spinal cord lesions on MRI and continued progression for more than 1 year. PMID:15742608

Tan, Funda Uysal; Tellio?lu, Serdar; Aydin, Gülümser; Erdemo?lu, Ali Kemal; Kele?, I?ik

2004-12-01

117

Adipokines, Biomarkers of Endothelial Activation, and Metabolic Syndrome in Patients with Ankylosing Spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV) disease. AS patients also display a high prevalence of features clustered under the name of metabolic syndrome (MeS). Anti-TNF-? therapy was found to be effective to treat AS patients by suppressing inflammation and also improving endothelial function. Previously, it was demonstrated that a short infusion of anti-TNF-? monoclonal antibodyinfliximab induced a rapid and dramatic reduction in serum insulin levels and insulin resistance along with a rapid improvement of insulin sensitivity in nondiabetic AS patients. The role of adipokines, MeS-related biomarkers and biomarkers of endothelial cell activation and inflammation seem to be relevant in different chronic inflammatory diseases. However, its implication in AS has not been fully established. Therefore, in this review we summarize the recent advances in the study of the involvement of these molecules in CV disease or MeS in AS. The assessment of adipokines and biomarkers of endothelial cell activation and MeS may be of potential relevance in the stratification of the CV risk of patients with AS. PMID:24757680

López-Mejías, Raquel; Miranda-Filloy, José A.; Ubilla, Begońa; Carnero-López, Beatriz; Blanco, Ricardo; Pina, Trinitario; González-Juanatey, Carlos; Llorca, Javier; González-Gay, Miguel A.

2014-01-01

118

Level set based vertebra segmentation for the evaluation of Ankylosing Spondylitis  

NASA Astrophysics Data System (ADS)

Ankylosing Spondylitis is a disease of the vertebra where abnormal bone structures (syndesmophytes) grow at intervertebral disk spaces. Because this growth is so slow as to be undetectable on plain radiographs taken over years, it is necessary to resort to computerized techniques to complement qualitative human judgment with precise quantitative measures on 3-D CT images. Very fine segmentation of the vertebral body is required to capture the small structures caused by the pathology. We propose a segmentation algorithm based on a cascade of three level set stages and requiring no training or prior knowledge. First, the noise inside the vertebral body that often blocks the proper evolution of level set surfaces is attenuated by a sigmoid function whose parameters are determined automatically. The 1st level set (geodesic active contour) is designed to roughly segment the interior of the vertebra despite often highly inhomogeneous and even discontinuous boundaries. The result is used as an initial contour for the 2nd level set (Laplacian level set) that closely captures the inner boundary of the cortical bone. The last level set (reversed Laplacian level set) segments the outer boundary of the cortical bone and also corrects small flaws of the previous stage. We carried out extensive tests on 30 vertebrae (5 from each of 6 patients). Two medical experts scored the results at intervertebral disk spaces focusing on end plates and syndesmophytes. Only two minor segmentation errors at vertebral end plates were reported and two syndesmophytes were considered slightly under-segmented.

Tan, Sovira; Yao, Jianhua; Ward, Michael M.; Yao, Lawrence; Summers, Ronald M.

2006-03-01

119

Spine injury following a low-energy trauma in ankylosing spondylitis: a study of two cases.  

PubMed

We report two cases of spine injury following a low-energy trauma in persons with ankylosing spondylitis (AS) and discuss the forensic considerations. A 60-year-old man presented with a wide anterior fracture of the superior endplate of T8 after an accidental fall down three wooden steps. A 93-year-old man presented with disjunction between C6 and C7 and 90-degree spinal angulation after a fall from a standing height or a fall from a bed. Post-mortem multislice computed tomography (MSCT) was performed before autopsy in both the cases. MSCT and autopsy findings were in agreement with a past medical history of AS. A spine injury occurring after a low-energy trauma is unusual and could be suspicious. In the forensic literature we found only a single case, which concerned multiple spinal fractures after a fall from a bicycle at low speed. Such specific mechanisms must be studied and known to the forensic expert. In this context, MSCT is a useful tool to investigate the spine and knowledge of the victim's entire past medical history is essential. PMID:24911528

Savall, Frederic; Mokrane, Fatima-Zohra; Dedouit, Fabrice; Capuani, Caroline; Guilbeau-Frugier, Céline; Rougé, Daniel; Telmon, Norbert

2014-08-01

120

Sleep disturbances are associated with increased pain, disease activity, depression, and anxiety in ankylosing spondylitis: a case-control study  

PubMed Central

Introduction Literature data suggest that sleep disturbances are prevalent among patients with ankylosing spondylitis (AS) and have a close correlation with pain. Other studies indicate that sleep disturbances are constantly accompanied by depression and anxiety in AS, but their interrelations are poorly understood. This study was designed to evaluate sleep disturbances and their association with demographic variables, pain, disease-specific variables, functional status, covering depression and anxiety in AS patients. Methods The 314 patients with AS and age- and sex-matched controls took part in the study, completed a battery of questionnaires, and participated in long-term follow-up. Blood samples were taken to measure C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR). The association among sleep, pain, disease activity, functional status, depression, and anxiety were assessed by using Pearson/Spearman correlations and multiple regression analysis. Results The Pittsburgh Sleep Quality Index (PSQI) score of the Chinese version was significantly higher in the AS group than in the control group (P = 0.020). Of the 314 patients with AS, 184 (58.6%) had a high risk for sleep disturbances. The PSQI score was associated with age, years of education, ESR, CRP, overall assessment of health, pain, morning stiffness, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), depression, and anxiety (all P < 0.001), but were not associated with disease duration, fingertip-to-floor distance, and Bath Ankylosing Spondylitis Metrology Index (BASMI) (P > 0.05). In hierarchic multiple regression analysis, the medical and psychological variables contributed significantly to the variance in sleep-disturbances scores, adding an additional 23.9% to the overall R2 beyond that accounted for by demographic variables (R-square, 8.5%), resulting in a final R2of 42.6%. Multiple stepwise regression analysis revealed that anxiety was the maximal statistical contribution in predicting sleep disturbances (standardized coefficients, 0.287). Conclusions The prevalence of sleep disturbances in AS patients is higher than it is generally thought to be. Depression, anxiety, nocturnal pain, and total back pain are the major contributors of sleep disturbances in AS. PMID:23058191

2012-01-01

121

Overexpression and Unique Rearrangement of VH2 Transcripts in Immunoglobulin Variable Heavy Chain Genes in Ankylosing Spondylitis Patients  

Microsoft Academic Search

\\u000a To identify immunoglobulin (Ig) variable heavy chain (VH) gene usages in Korean ankylosing spondylitis (AS) patients, expression\\u000a level of VH2 genes from peripheral blood mononuclear cells (PBMCs) of 8 AS patients and 9 healthy donors was analysed by quantitative\\u000a real-time PCR (Q-PCR). Q-PCR results demonstrated VH2 genes were overexpressed in AS patients (Relative amount of mRNA of\\u000a VH2 genes to

Yeon Joo Kim; Nayoung Kim; Min-Kyung Lee; Hyo-Jin Choi; Han Joo Baek; Chang-Hoon Nam

122

Ankylosing spondylitis is associated with the anthrax toxin receptor 2 gene (ANTXR2)  

PubMed Central

Objectives ANTXR2 variants have been associated with ankylosing spondylitis (AS) in two previous genome-wide association studies (GWAS) (p?9×10?8). However, a genome-wide significant association (p<5×10?8) was not observed. We conducted a more comprehensive analysis of ANTXR2 in an independent UK sample to confirm and refine this association. Methods A replication study was carried out with 2978 cases and 8365 controls. Then, these were combined with non-overlapping samples from the two previous GWAS in a meta-analysis. Human leukocyte antigen (HLA)-B27 stratification was also performed to test for ANTXR2-HLA-B27 interaction. Results Out of nine single nucleotide polymorphisms (SNP) in the study, five SNPs were nominally associated (p<0.05) with AS in the replication dataset. In the meta-analysis, eight SNPs showed evidence of association, the strongest being with rs12504282 (OR=0.88, p=6.7×10?9). Seven of these SNPs showed evidence for association in the HLA-B27-positive subgroup, but none was associated with HLA-B27-negative AS. However, no statistically significant interaction was detected between HLA-B27 and ANTXR2 variants. Conclusions ANTXR2 variants are clearly associated with AS. The top SNPs from two previous GWAS (rs4333130 and rs4389526) and this study (rs12504282) are in strong linkage disequilibrium (r2?0.76). All are located near a putative regulatory region. Further studies are required to clarify the role played by these ANTXR2 variants in AS. PMID:25169729

Karaderi, T; Keidel, S M; Pointon, J J; Appleton, L H; Brown, M A; Evans, D M; Wordsworth, B P

2014-01-01

123

TAP1 and TAP2 polymorphisms associated with ankylosing spondylitis in genetically homogenous Chinese Han population.  

PubMed

Human leukocyte antigen (HLA)-B27 is strongly associated with the autoimmune disease ankylosing spondylitis (AS). Other autoimmune disease-associated genes, such as transporter associated with antigen processing (TAP) genes, could also influence AS susceptibility. In this study, we investigated the association of TAP1 and TAP2 polymorphisms in genetically homogenous Chinese AS patients. Six TAP1 single nucleotide polymorphisms (SNPs) and three TAP2 SNPs sites were analyzed in B27-positive AS cases, healthy B27-negative controls, and healthy B27-positive controls. In the allele and genotype analysis, the results indicated that TAP1 site 1910 allele G, genotype AG and TAP2 site 1693 genotype AA were associated with increased AS risk in a case-B27 negative control (p < 0.05). In the haplotype analysis, TAP1 SNP haplotype (GGGGGG, TAP1*020101) and TAP1-TAP2 SNP haplotypes (GGGGGG-GGG, TAP1*020101-TAP2*0101, and GGAAGG-GAG, TAP1*0101-TAP2*0102) increased AS risk in case-B27 negative control (p < 0.05). In contrast, TAP1-TAP2 SNP haplotype GGGGGG-GAG (TAP1*020101-TAP2*0102) was less common in cases than in B27-negative controls (p < 0.05). Moreover, TAP1-TAP2 SNP haplotype GGGAGG-GGG (TAP1*0301-TAP2*0101) was less common in cases than in B27-positive controls. The two haplotypes appeared to confer protection in AS (p < 0.05). These results suggest a potential mechanism of altered antigen-peptide selection and transport in AS pathogenesis. PMID:19480848

Feng, Mingliang; Yin, Biao; Shen, Tong; Ma, Qing; Liu, Lidong; Zheng, Jiewei; Zhao, Yulin; Qian, Kaicheng; Liu, Dazhuang

2009-04-01

124

Cost-Effectiveness Evaluation of Etoricoxib versus Celecoxib and Nonselective NSAIDs in the Treatment of Ankylosing Spondylitis in Norway  

PubMed Central

Objectives. To evaluate the cost-effectiveness of etoricoxib (90?mg) relative to celecoxib (200/400?mg), and the nonselective NSAIDs naproxen (1000?mg) and diclofenac (150?mg) in the initial treatment of ankylosing spondylitis in Norway. Methods. A previously developed Markov state-transition model was used to estimate costs and benefits associated with initiating treatment with the different competing NSAIDs. Efficacy, gastrointestinal and cardiovascular safety, and resource use data were obtained from the literature. Data from different studies were synthesized and translated into direct costs and quality adjusted life years by means of a Bayesian comprehensive decision modeling approach. Results. Over a 30-year time horizon, etoricoxib is associated with about 0.4 more quality adjusted life years than the other interventions. At 1 year, naproxen is the most cost-saving strategy. However, etoricoxib is cost and quality adjusted life year saving relative to celecoxib, as well as diclofenac and naproxen after 5 years of follow-up. For a willingness-to-pay ceiling ratio of 200,000 Norwegian krones per quality adjusted life year, there is a >95% probability that etoricoxib is the most-cost-effective treatment when a time horizon of 5 or more years is considered. Conclusions. Etoricoxib is the most cost-effective NSAID for initiating treatment of ankylosing spondylitis in Norway. PMID:21772851

Jansen, Jeroen P.; Taylor, Stephanie D.

2011-01-01

125

Evaluation of the involvement of axial entheses and sacroiliac joints in relation to diagnosis: Comparison among diffuse idiopathic skeletal hyperostostis (DISH), osteoarthrosis and ankylosing spondylitis  

Microsoft Academic Search

Summary  Since diffuse idiopathic skeletal hyperostosis (DISH) is frequently difficult to differentiate radiologically from the axial involvement of ankylosing spondylitis and osteoarthrosis, some features of these 3 different diseases were compared. The predominantly horizontal nature of the enthesiophyte in DISH and its right preponderance in the thoracic region were demonstrated. This right preponderance was due to the presence of the thoracic

M. Maertens; H. Mielants; K. Verstraete; E. M. Veys

1992-01-01

126

Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study  

PubMed Central

Objectives To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24?weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). Methods Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200?mg every 2?weeks (Q2W) or CZP 400?mg every 4?weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear. Results Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200?mg Q2W and CZP 400?mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p?0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (?2.28 vs ?0.40), BASDAI (?3.05 vs ?1.05), and BASMI (?0.52 vs ?0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported. Conclusions CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients. PMID:24013647

Landewe, R; Braun, J; Deodhar, A; Dougados, M; Maksymowych, W P; Mease, P J; Reveille, J D; Rudwaleit, M; van der Heijde, D; Stach, C; Hoepken, B; Fichtner, A; Coteur, G; de Longueville, M; Sieper, J

2014-01-01

127

Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis  

PubMed Central

Etanercept (ETN) has been widely applied in the treatment of ankylosing spondylitis (AS). As the use of ETN has increased, associated adverse effects have been reported frequently. Previous meta-analyses have focused on comparing the differences in clinical outcomes between ETN and placebo (PBO). The present meta-analysis evaluated randomised controlled trials (RCTs) to compare the effects of ETN and a PBO or sulfasalazine (SSZ) in patients with AS. The study population characteristics and the main results, including the Assessment in AS 20% response (ASAS 20), the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI), were extracted. The pooled odds ratios (ORs) or weighted mean differences (MDs) were calculated using a fixed or random effects model. Fifteen randomised controlled trials (RCTs) involving 2,194 subjects were included. Compared with a PBO, ETN significantly improved the ASAS 20 [P<0.00001; OR, 8.25; 95% confidence interval (CI), 5.92–11.50], BASDAI (P<0.00001; MD, ?18.81; 95% CI, ?24.47 to ?13.15) and BASFI (P<0.00001; standard MD, ?0.68; 95% CI, ?0.85 to ?0.50). In comparison with SSZ, ETN significantly decreased the BASDAI (P<0.00001; MD, ?2.40; 95% CI, ?2.89 to ?1.90) and C-reactive protein (CRP) levels (P<0.0001; MD, ?8.01; 95% CI, ?11.73 to ?4.29). The most common adverse effect of ETN was an injection site reaction. This meta-analysis shows that ETN monotherapy is effective in improving physical function and reducing disease activity in patients with AS. Compared with SSZ, ETN markedly decreased the BASDAI and CRP levels. However, the efficacy of ETN in treating AS requires further evaluation by more RCTs in a larger population of patients prior to recommending ETN as a substitute for synthetic disease-modifying antirheumatic drug (DMARD) monotherapy, or combinations of synthetic DMARDs. PMID:25289064

LIU, YA-FEI; DONG, HUI; TU, SHENG-HAO; ZHENG, CUI-HONG; LIU, PEI-LIN; HU, YONG-HONG

2014-01-01

128

Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial.  

PubMed

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that affects mainly the axial skeleton and causes significant pain and disability. Aquatic (water-based) exercise may have a beneficial effect in various musculoskeletal conditions. The aim of this study was to compare the effectiveness of aquatic exercise interventions with land-based exercises (home-based exercise) in the treatment of AS. Patients with AS were randomly assigned to receive either home-based exercise or aquatic exercise treatment protocol. Home-based exercise program was demonstrated by a physiotherapist on one occasion and then, exercise manual booklet was given to all patients in this group. Aquatic exercise program consisted of 20 sessions, 5× per week for 4 weeks in a swimming pool at 32-33 °C. All the patients in both groups were assessed for pain, spinal mobility, disease activity, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). The baseline and mean values of the percentage changes calculated for both groups were compared using independent sample t test. Paired t test was used for comparison of pre- and posttreatment values within groups. A total of 69 patients with AS were included in this study. We observed significant improvements for all parameters [pain score (VAS) visual analog scale, lumbar flexion/extension, modified Schober test, chest expansion, bath AS functional index, bath AS metrology index, bath AS disease activity index, and short form-36 (SF-36)] in both groups after treatment at week 4 and week 12 (p < 0.05). Comparison of the percentage changes of parameters both at week 4 and week 12 relative to pretreatment values showed that improvement in VAS (p < 0.001) and bodily pain (p < 0.001), general health (p < 0.001), vitality (p < 0.001), social functioning (p < 0.001), role limitations due to emotional problems (p < 0.001), and general mental health (p < 0.001) subparts of SF-36 were better in aquatic exercise group. It is concluded that a water-based exercises produced better improvement in pain score and quality of life of the patients with AS compared with home-based exercise. PMID:24626605

Dundar, U; Solak, O; Toktas, H; Demirdal, U S; Subasi, V; Kavuncu, V; Evcik, D

2014-11-01

129

Ratio of neutrophil/lymphocyte and platelet/lymphocyte in patient with ankylosing spondylitis that are treating with anti-TNF  

PubMed Central

Ankylosing spondylitis (AS) is a type of chronic inflammatory arthritis resulting in ankylosis of the spine and inflammation in the tendons. After NSAIDs, the use of anti-TNF medications has provided a significant contribution to the treatment of patients with AS. The present study was a retrospective, controlled and multicenter study. A total of 105 patients followed in the outpatient clinics of the Department of Physical Therapy in Abant Izzet Baysal University and Harran University and 50 healthy controls were included in the study. The patients had been receiving anti-TNF therapy at least for 6 months. Hemogram results of the patient and control groups examined retrospectively. There was no significant difference between the groups in terms of N/L ratio; however, the P/L ratio was significantly different between the two groups. The present study found a significantly different P/L ratio in patients with AS when compared to the control group. However, the N/L ratio was not significantly different between the groups. The P/L ratio can be used as a marker to monitor disease progression and indicate subclinical inflammation in patients with AS.

Boyraz, Ismail; Koc, Bunyamin; Boyac?, Ahmet; Tutoglu, Ahmet; Sarman, Hakan; Ozkan, Hilal

2014-01-01

130

Psychological correlates of self-reported functional limitation in patients with ankylosing spondylitis  

E-print Network

exercise (yes) Physical therapy (yes) Resilience coping (BRCS) Arthritis internality Arthritis helplessness Depression (exercise Physical therapy Psychological variables Arthritis internality (6-36) Arthritis helplessness (5-25) Resilience coping (BRCS) (0-20) Depression (

2009-01-01

131

Golimumab for the treatment of ankylosing spondylitis: a NICE single technology appraisal.  

PubMed

As part of the National Institute for Health and Clinical Excellence (NICE) single technology appraisal (STA) process, the Evidence Review Group (ERG) produced a report to comment on the clinical and cost effectiveness of golimumab (Simponi(®), Merck Sharp & Dohme) for the treatment of ankylosing spondylitis (AS) relative to other comparators as presented in the manufacturer's submission (MS) to NICE. The population was those with active disease who had not responded to conventional therapy. The specified comparators were conventional care and two other tumour necrosis factor alpha (TNF-?) inhibitors (adalimumab and etanercept). Outcomes to be considered were disease activity, functional capacity, disease progression, adverse effects of treatment and health-related quality of life (HR-QOL). There were no head-to-head trials comparing TNF-? inhibitors. The submission included one trial of golimumab versus placebo (the GO-RAISE trial) and additionally seven placebo-controlled randomized controlled trials (RCTs) of other TNF-? inhibitor agents (five with etanercept, and two with adalimumab). The results of these trials were generally a statistically significant improvement from each of the TNF-? inhibitors. A Bayesian mixed treatment comparison (MTC) showed there was generally overlap in the 95 % credible intervals (CrIs) between the TNF-? inhibitors. Exceptions included a greater risk of discontinuation of treatment for golimumab than for etanercept (relative risk [RR] 4.30; 95 % CrI 1.01-18.50). The cost-effectiveness analysis (CEA) compared all of these TNF-? inhibitors. Relative effectiveness was informed only by RR of response (proportion achieving at least a 50 % improvement in Bath AS Disease Activity Index [BASDAI] score; BASDAI50) from the MTC. In the base-case analysis, the incremental cost-effectiveness ratio (ICER) of golimumab versus conventional care was Ł26,597 and adalimumab and etanercept were extendedly dominated by golimumab. The manufacturer concluded that golimumab is a cost-effective treatment option. Generally, the ERG agreed with the MTC analyses. The main problem was that the MS used data from one trial, which included a period of cross-over. The ERG found some problems with the CEA model, mainly that it did not allow for comparison of TNF-? inhibitor sequences and did not use MTC estimates for treatment discontinuation or adverse events (AEs). The ERG could not correct the sequencing problem, but re-ran the CEA with discontinuations and AEs estimated from the MTC and using the correct trial data. The results of the ERG analysis were that golimumab was extendedly dominated by etanercept, and the preferred treatment was either conventional treatment or etanercept, depending on the ICER threshold. Uncertainty was also substantial. NICE issued guidance (technology appraisal [TA] 233), which recommended golimumab according to the indications described in TA143 for etanercept and adalimumab, i.e. as first-line therapy among the TNF-? inhibitors unless patients are intolerant to one or both alternatives. Given the factors cited by NICE for their decision, the ERG recommends that there should be greater clarity in the NICE methods guidance on handling uncertainty in CEAs as well as the incorporation of benefit from process of care. PMID:23580355

Armstrong, Nigel; Joore, Manuela; van Asselt, Thea; Misso, Kate; Manning, Nathan; Tomini, Florian; Kleijnen, Jos; Riemsma, Rob

2013-05-01

132

Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes  

PubMed Central

Introduction Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density. Methods High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS patients (NY criteria). Spinal radiographs were assessed for vertebral fractures and syndesmophyte formation (mSASSS). The HRpQCT measurements were compared with the measurements of healthy controls. Results The AS patients had lower cortical vBMD in radius (P?=?0.004) and lower trabecular vBMD in tibia (P?=?0.033), than did the controls. Strong correlations were found between trabecular vBMD in lumbar spine, radius (rS?=?0.762; P?

2013-01-01

133

Comparison of three types of lumbar osteotomy for ankylosing spondylitis: a case series and evolution of a safe technique for instrumented reduction  

Microsoft Academic Search

Introduction  The principles of correction of thoraco-lumbar kyphotic deformity (TKLD) in ankylosing spondylitis (AS) are essentially centred\\u000a on lordosing osteotomies such as pedicle subtraction closing wedge osteotomy (CWO), polysegmental posterior lumbar wedge osteotomies\\u000a (PWO) and Smith Peterson’s open wedge osteotomy (OWO) of the lumbar spine. There have been no studies that compared the results\\u000a of the three osteotomies performed by a

Ranganathan ArunH; H. V. Dabke; H. Mehdian

134

Risk factors for poor hip flexion after total hip arthroplasty for the treatment of ankylosing spondylitis a multivariate analysis.  

PubMed

The purpose of this study is to investigate the clinical and radiographic results of total hip arthroplasty (THA) for the treatment of ankylosing spondylitis (AS) and to evaluate the effects of patient, prosthesis design, and surgical technique-related risk factors on postoperative functional results. We retrospectively reviewed the clinical and radiographic results of THA performed in 167 hips for 100 patients with AS. The average follow-up period was 54.8 months (range, 32-129 months). The hip passive-flexion arc averaged only 0 ° (0-40.0 °) before surgery, compared with 100.0 ° (85.0-110.0 °) at the most recent follow-up examination (P?

Zhang, Liang; Yang, Dejin; Yin, Xinghua; Zhou, Yixin

2014-09-01

135

Killer-Cell Immunoglobulin-Like Receptors (KIR) and HLA-Class I Heavy Chains in Ankylosing Spondylitis.  

PubMed

Postmarketing Phase IV HLA-B27 (B27) interactions with the killer-cell immunoglobulin-like receptors (KIR) have been implicated in the pathogenesis of ankylosing spondylitis (AS), with consistent differences among populations. KIR3DL1 and possibly KIR3DS1 interact with classical B27, whereas KIR3DL2 binds B27 heavy chain dimers. The aim of this review is to summarize data from recent studies performed in our laboratory and from the literature, which provide support for a possible role of KIR3DL2/B27 dimer interactions in the pathogenesis of AS. Recent studies in cells from AS patients and from health controls carrying the predisposing B*2705 and the nonpredisposing B*2709 haplotypes, have shown a higher percentage of positive cells and a higher surface expression of KIR3DL2 receptors on natural killer (NK) and CD4+ T cells in B*2705 AS patients compared with B*2705, B*2709 and B27-negative healthy controls. Increased expression of HC10-reactive molecules on AS monocytes was seen, supporting the possible role of the KIR3DL2/B272 pair in the pathogenesis of AS. These results underline the importance of NK cells and innate immunity, and of CD4+ T cells in the inflammatory pathogenesis of AS. PMID:25381967

Cauli, Alberto; Piga, Matteo; Dessole, Grazia; Porru, Giovanni; Floris, Alberto; Vacca, Alessandra; Desogus, Elisabetta; La Nasa, Giorgio; Mathieu, Alessandro

2014-11-01

136

Translation into Brazilian Portuguese, cross-cultural adaptation and validation of the Stanford presenteeism scale-6 and work instability scale for ankylosing spondylitis.  

PubMed

Loss of productivity at work, as a result of health problems, is becoming an issue of interest due to the high burden it represents in society. The measurement of such phenomenon can be made using generic and specific scales for certain diseases such as the Stanford Presenteeism Scale (SPS-6) and the Work Instability Scale for Ankylosing Spondylitis (AS-WIS), specific for patients with ankylosing spondylitis (AS). The aim of this study was to translate and perform a cross-cultural adaptation of SPS-6 and AS-WIS into Portuguese and check their psychometric properties. The study also aimed to evaluate the relationship between the general scores of the scales and the main sociodemographic and clinical data, lifestyles, and absenteeism in patients with AS and correlate these variables with SPS-6 and AS-WIS scales. A sample of 120 patients with AS and 80 workers at a university hospital was evaluated. The processes for the translation and cross-cultural adaptation of the instruments followed preestablished steps and rules presented in the literature. For the evaluation of measurement properties and correlations between scales, intra-class correlation coefficient (reproducibility analysis), Cronbach alpha (internal consistency), and Pearson correlation coefficient (validity) were employed. The inter-observer (0.986) and intra-observer (0.992) reproducibilities of the AS-WIS were shown to be high as well as the internal consistency (0.995). Similarly, the inter-observer reliability of SPS-6 was considered good (0.890), although it showed a poorer performance when considering the same observer (Pearson correlation coefficient?=?0.675 and intra-class correlation?=?0.656). Internal consistency, for the total number of items, as measured by Cronbach alpha, was 0.889. The validity of the scales was evaluated thru the comparison of the achieved scores with the results of the WLQ, SF-36, ASQoL, BASFI, BASDAI, HAQ-S, and SRQ-20 instruments. Correlations between loss of productivity at work, worse quality of life, presence of emotional disturbances, and worse health conditions were positive. The process of translation, cross-cultural adaptation, and validation of the SPS-6 as a generic measurement for the loss of productivity at work and of the AS-WIS as a specific measurement for patients with AS are valid, reproducible, and specific instruments to be used in Brazil. In both scales, productivity at work was associated to advanced age, higher rate of absenteeism in the last month and year, presence of peripheral arthritis, and a larger number of comorbidities in patients with AS. The AS-WIS and SPS-6 showed a good correlation among them although they are not mutually exclusive but supplementary. PMID:24221505

Frauendorf, Renata; de Medeiros Pinheiro, Marcelo; Ciconelli, Rozana Mesquita

2014-12-01

137

Cardiovascular risk parameters in men with ankylosing spondylitis in comparison with non-inflammatory control subjects: relevance of systemic inflammation.  

PubMed

Men with AS (ankylosing spondylitis) are at elevated risk for CHD (coronary heart disease) but information on risk factors is sparse. We compared a range of conventional and novel risk factors in men with AS in comparison with healthy controls and, in particular, determined the influence of systemic inflammation. Twenty-seven men with confirmed AS and 19 controls matched for age were recruited. None of the men was taking lipid-lowering therapy. Risk factors inclusive of plasma lipids, IL-6 (interleukin-6), CRP (C-reactive protein), vWF (von Willebrand factor), fibrin D-dimer, ICAM-1 (intercellular cell-adhesion molecule-1) and fibrinogen were measured, and blood pressure and BMI (body mass index) were determined by standard techniques. A high proportion (70%) of men with AS were smokers compared with 37% of controls (P = 0.024). The AS patients also had a higher BMI. In analyses adjusted for BMI and smoking, men with AS had significantly higher IL-6 and CRP (approx. 9- and 6-fold elevated respectively; P < 0.001), fibrinogen (P = 0.013) and vWF (P = 0.008). Total cholesterol and HDL-C (high-density lipoprotein cholesterol) were lower (P < 0.05 and P = 0.073 respectively) in AS and thus the ratio was not different. Pulse pressure was also significantly higher in AS (P = 0.007). Notably, adjustment for IL-6 and CRP levels rendered all case-control risk factor differences, except pulse pressure, non-significant. In accordance with this finding, IL-6 correlated positively (r = 0.74, P < 0.001) with fibrinogen, but negatively (r = -0.46, P = 0.016) with total cholesterol concentration. In conclusion, men with AS have perturbances in several CHD risk factors, which appear to be driven principally by systemic inflammatory mediators. Inflammation-driven atherogenesis potentially contributes to the excess CHD risk in AS. PMID:15801904

Divecha, Hiren; Sattar, Naveed; Rumley, Ann; Cherry, Lynne; Lowe, Gordon D O; Sturrock, Roger

2005-08-01

138

Susceptibility to ankylosing spondylitis is independent of the Bw4 and Bw6 epitopes of HLA-B27 alleles.  

PubMed

We have characterized HLA-B27 alleles in a sample of the population from the Azores (n=46) with the aim of investigating the contribution of different subtypes to ankylosing spondylitis (AS). The study was carried out using PCR-SSOP and in some samples genomic sequencing was conducted. Some significant new finding have arisen from this study. First, B*2705,B*2702,B*2703,B*2707 and B*2708 alleles were found to be represented in this population. The polymorphism of B27 alleles found in a sample of the population from the Azores is higher than the Caucasian groups described. B*2703 and B*2707 have not previously been described to be represented in Caucasians and this could indicate admixtures with different populations of the world. In addition, the B*2708 allele was found to be associated with AS in a large family from the Azores. This association has not been previously reported in either ethnic group and needs to be confirmed in other population studies. This is of considerable interest since has only been described as a rare subtype underrepresented in the British population and has not been previously found to be associated with AS. B*2708 carries the sequence specifying the Bw6 epitope in contrast to most B27 alleles which carry a Bw4 sequence. Differences in this region (residues 77-83) can alter the F-pocket and affect T-cell recognition. The importance that these molecular changes can play in the pathogenesis of AS is discussed. PMID:10203016

Armas, J B; Gonzalez, S; Martinez-Borra, J; Laranjeira, F; Ribeiro, E; Correia, J; Ferreira, M L; Toste, M; López-Vazquez, A; López-Larrea, C

1999-03-01

139

Spinal inflammation by magnetic resonance imaging in patients with ankylosing spondylitis: association with disease activity and outcome parameters.  

PubMed

Magnetic resonance imaging (MRI) has major contribution in early diagnosis of ankylosing spondylitis (AS). As it is difficult to determine disease activity owing to the lack of close relation between laboratory tests, clinical findings and imaging, MRI has been used as an objective outcome measure. The aim of this study is to investigate the relation between spinal MRI findings with disease activity and other outcome measures. Fifty patients fulfilling modified New York criteria for AS were enrolled to the study. All the patients were evaluated with Bath AS Disease Activity Index (BASDAI), AS Disease Activity Score (ASDAS), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), Bath AS Radiology Index (BASRI) and As Quality of Life. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured as laboratory parameters, and ASspiMR scores were determined by spinal MRI. The median total ASspiMR-a score was 5.2. Spinal inflammation was evaluated in spinal segments, and thoracic segments had the highest mean ASspiMR-a level (3.1 ± 5.94). Cervical and lumbar ASspiMR were correlated with only BASRI, and total ASspiMR score was correlated with BASRI, BASMI and CRP. Thoracic ASspiMR score was correlated with patient's and doctor's global assessments, BASFI, BASMI, BASRI, ASDAS A, ASDAS B, ASDAS C, ASDAS D, ESR and CRP (P < 0.05). According to our results, the thoracic spine was the most related region with disease activity parameters and clinical outcome measures, so we suggest thoracic spine MRI evaluation in order to determine the disease activity. PMID:22159818

Konca, Sefika; Keskin, Dilek; C?l?z, Deniz; Bodur, Hatice; Sakman, Bülent

2012-12-01

140

Genetic variations in the KIR gene family may contribute to susceptibility to ankylosing spondylitis: a meta-analysis.  

PubMed

The present meta-analysis of relevant case-control studies was conducted to investigate the possible relationships between genetic variations in the killer cell immunoglobulin-like receptor (KIR) gene clusters of the human KIR gene family and susceptibility to ankylosing spondylitis (AS). The following electronic databases were searched for relevant articles without language restrictions: the Web of Science, the Cochrane Library Database, PubMed, EMBASE, CINAHL, the Chinese Biomedical Database (CBM) and Chinese National Knowledge Infrastructure (CNKI) databases, covering all papers published until 2013. STATA statistical software was adopted in this meta-analysis as well. We also calculated the crude odds ratios (OR) and its 95% confidence intervals (95 % CI). Seven case-control studies with 1,004 patients diagnosed with AS and 2,138 healthy cases were implicated in our meta-analysis, and 15 genes in the KIR gene family were also evaluated. The results of our meta-analysis show statistical significance between the genetic variations in the KIR2DL1, KIR2DS4, KIR2DS5 and KIR3DS1 genes and an increased susceptibility to AS (KIR2DL1: OR 7.82, 95% CI 3.87-15.81, P< 0.001; KIR2DS4: OR 1.91, 95% CI 1.16-3.13, P = 0.010; KIR2DS5: OR1.51, 95% CI 1.14-2.01, P = 0.004; KIR3DS1: OR 1.58, 95% CI 1.34-1.86, P< 0.001; respectively). However, we failed to found positive correlations between other genes and susceptibility to AS (all P >0.05). The current meta-analysis provides reliable evidence that genetic variations in the KIR gene family may contribute to susceptibility to AS, especially for the KIR2DL1, KIR2DS4, KIR2DS5 and KIR3DS1 genes. PMID:24880650

Zuo, Hai-Ning; Wang, Zhi-Long; Cui, Dao-Ran; Xin, Da-Jiang

2014-08-01

141

Are clinical measures influenced by various ethnic origins in Iranian patients with ankylosing spondylitis?A pilot study  

PubMed Central

Background: Ankylosing spondylitis (AS) may manifest with heterogeneous patterns according to ethnic origins. The purpose of this study was to describe the influence of various Iranian ethnic origins on clinical measures in patients with AS. Methods: 0ne hundred sixty-three AS patients diagnosed by modified New York 1984 criteria were enrolled consecutively. The patients were classified into Fars, Turk, Kord, Lor and other ethnic origins. Several clinical measures were described and compared between the ethnic origins. Results: The highest and the lowest finger to floor distance was observed for Fars ethnicity (20.4±14.8) and other ethnicities (5.9±8.1), respectively (P=0.04). The frequency of severe decrease in cervical slope was significantly different between various ethnicities (P=0.025). The most and the least frequency of severe decrease in cervical slope was observed in Fars patients (61.3%) and other ethnicities (20%), respectively. The frequency of severe thoracic kyphosis was significantly dissimilar between various ethnicities (P=0.006). The most and the least frequency of severe increase in thoracic kyphosis was observed in Fars (68.8%) and Lor patients (25%), respectively. A significant relationship was seen only between other ethnicities and finger to floor distance, lateral lumbar flexion, chest expansion and BASDAI (P<0.05). Conclusion: Clinical expression variations in AS disease might be influenced by various Iranian ethnic origins. A larger sample size with other Iranian ethnicities (Baluch, Arab, etc) is required to clear the definite relationship between Iranian ethnicities and clinical expression. PMID:24778778

Fallahi, Sasan; Jamshidi, Ahmad Reza; Mahmoudi, Mahdi; Qorbani, Mostafa

2014-01-01

142

HLA alleles and HLA-B27 haplotypes associated with susceptibility and severity of ankylosing spondylitis in a Portuguese population.  

PubMed

Human leukocyte antigen (HLA)-B27 is the mostly known major histocompatibility complex (MHC) gene associated with ankylosing spondylitis (AS). Nonetheless, there is substantial evidence that other MHC genes appear to be associated with the disease, although it has not yet been established whether these associations are driven by direct associations or by linkage disequilibrium (LD) mechanisms. We aimed to investigate the contributions of HLA class I and II alleles and B27-haplotypes for AS in a case-control study. A total of 188 HLA-B27 AS cases and 189 HLA-B27 healthy controls were selected and typed for HLA class I and II by the Luminex polymerase chain reaction-sequence specific oligonucleotide probe (PCR-SSOP) method. Allelic and haplotypic distributions were estimated by maximum likelihood method using Arlequin v3.11 and statistical analysis were performed by Stata10.1. No associations were found between non-HLA-B27 loci and AS susceptibility, but several associations were observed for phenotypic features of the disease. DRB1*08 was identified as a risk factor for uveitis and DQB1*04 seems to provide protection for AS severity (functional, metrological and radiological indexes). A*02/B27/C*02/DRB1*01/DQB1*05 [P<0.0001; odds ratio (OR)?=?39.06; 95% confidence interval (CI) (2.34-651)] is the only haplotype that seems to confer susceptibility to AS. Moreover, the haplotype A*02/B27/C*01/DRB1*08/DQB1*04 seems to provide protection for disease functional and radiological repercussions. Our findings are compatible with the hypothesis that other genes within the HLA region besides HLA-B27 might play some role in AS susceptibility and severity. PMID:24498993

Pimentel-Santos, F M; Matos, M; Ligeiro, D; Mourăo, A F; Ribeiro, C; Costa, J; Santos, H; Barcelos, A; Pinto, P; Cruz, M; Sousa, E; Santos, R A; Fonseca, J E; Trindade, H; Guedes-Pinto, H; Branco, J C

2013-12-01

143

Spectrum of ankylosing spondylitis in Portugal. Development of BASDAI, BASFI, BASMI and mSASSS reference centile charts.  

PubMed

The availability of population-specific normative data regarding disease severity measures is essential for patient assessment. The goals of the current study were to characterize the pattern of ankylosing spondylitis (AS) in Portuguese patients and to develop reference centile charts for BASDAI, BASFI, BASMI and mSASSS, the most widely used assessment tools in AS. AS cases were recruited from hospital outpatient clinics, with AS defined according to the modified New York criteria. Demographic and clinical data were recorded. All radiographs were evaluated by two independent experienced readers. Centile charts for BASDAI, BASFI, BASMI and mSASSS were constructed for both genders, using generalized linear models and regression models with duration of disease as independent variable. A total of 369 patients (62.3% male, mean?±?(SD) age 45.4?±?13.2 years, mean?±?(SD) disease duration 11.4?±?10.5 years, 70.7% B27-positive) were included. Family history of AS in a first-degree relative was reported in 17.6% of the cases. Regarding clinical disease pattern, at the time of assessment 42.3% had axial disease, 2.4% peripheral disease, 40.9% mixed disease and 7.1% isolated enthesopatic disease. Anterior uveitis (33.6%) was the most common extra-articular manifestation. The centile charts suggest that females reported greater disease activity and more functional impairment than males but had lower BASMI and mSASSS scores. Data collected through this study provided a demographic and clinical profile of patients with AS in Portugal. The development of centile charts constitutes a useful tool to assess the change of disease pattern over time and in response to therapeutic interventions. PMID:22009195

Pimentel-Santos, Fernando M; Mourăo, Ana Filipa; Ribeiro, Célia; Costa, José; Santos, Helena; Barcelos, Anabela; Pinto, Patricia; Godinho, Fátima; Cruz, Margarida; Vieira-Sousa, Elsa; Santos, Rui André; Rabiais, Sara; Félix, Jorge; Fonseca, Joăo Eurico; Guedes-Pinto, Henrique; Brown, Matthew A; Branco, Jaime C

2012-03-01

144

Combined Home Exercise Is More Effective Than Range-of-Motion Home Exercise in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial  

PubMed Central

Home exercise is often recommended for management of patients with ankylosing spondylitis (AS); however, what kind of home exercise is more beneficial for patients with AS has not been determined yet. We aimed to compare the effectiveness of combined home exercise (COMB) and range-of-motion home exercise (ROM) in patients with AS. Nineteen subjects with AS completed either COMB (n = 9) or ROM (n = 10) program. The COMB program included range-of-motion, strengthening, and aerobic exercise while the ROM program consisted of daily range-of-motion exercise only. After exercise instruction, subjects in each group performed home exercise for 3 months. Assessment included cardiopulmonary exercise test, pulmonary function test, spinal mobility measurement, chest expansion, Bath Ankylosing Spondylitis Functional Index (BASFI), and other functional ability and laboratory tests. After exercise, the COMB group showed significant improvement in peak oxygen uptake (12.3%, P = 0.008) and BASFI (P = 0.028), and the changed score between pre- and postexercise data was significantly greater in the COMB group regarding peak oxygen uptake and BASFI. Significant improvement in finger-to-floor distance after 3-month exercise was found only in the COMB group (P = 0.033). This study demonstrates that a combined home exercise is more effective than range-of-motion home exercise alone in aerobic capacity and functional ability. PMID:25276785

Chuang, Chih-Cheng; Tseng, Ching-Shiang; Wei, James Cheng-Chung; Hsu, Wei-Chun; Lin, Yi-Jia

2014-01-01

145

JARID1A, JMY, and PTGER4 Polymorphisms Are Related to Ankylosing Spondylitis in Chinese Han Patients: A Case-Control Study  

PubMed Central

Susceptibility to ankylosing spondylitis (AS) is largely genetically determined. JARID1A, JMY and PTGER4 have recently been found to be associated with AS in patients of western European descent. We aim to examine the influence of JARID1A, JMY, and PTGER4 polymorphisms on the susceptibility to and the severity of ankylosing spondylitis in Chinese ethnic majority Han population. This work can lead the clinical doctors to intervene earlier. Blood samples were drawn from 396 AS patients and 404 unrelated healthy controls. Both the AS patients and the controls are Han Chinese. The AS patients are classified based on the severity of the disease. Thirteen tag single nucleotide polymorphisms (tagSNPs) in JARID1A, JMY and PTGER4 are selected and genotyped. Frequencies of different genotypes and alleles are analyzed among the different severity AS patients and the controls. The rs2284336 SNP in JARID1A, the rs16876619 and rs16876657 SNPs in JMY are associated with susceptibility of AS. The rs11062357 SNP in JARID1A, the rs2607142 SNP in JMY and rs10440635 in PTGER4 are related to severity of AS. Haplotype analyses indicate PTGER4 is related to susceptibility to AS; JARID1A and JMY are related to severity of AS. PMID:24069348

Chen, Chao; Liu, Jingyi; Shi, Lewis L.; Wang, Yan

2013-01-01

146

Population pharmacokinetics of rhTNFR-Fc in healthy Chinese volunteers and in Chinese patients with Ankylosing spondylitis  

PubMed Central

Aim: To investigate the population pharmacokinetics of recombinant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR-Fc) administered via subcutaneous (SC) injection in healthy Chinese volunteers and in Chinese patients with ankylosing spondylitis (AS). Methods: Thirty-two healthy volunteers were randomly assigned to receive a single SC injection of 12.5, 25, 37.5, or 50 mg of rhTNFR-Fc. Twenty male patients with moderate AS were randomly assigned to receive seven consecutive SC injections of rhTNFR-Fc at either 25 mg twice a week (BIW) or 50 mg once a week (QW). Population pharmacokinetic (PK) analysis was applied to obtain PK parameters of rhTNFR-Fc by the NONMEM method. Results: The data were best described by a one-compartment model with lag time. We found that gender had a significant effect on the apparent clearance (CL/F), with the male CL/F ratio being only 0.665 times the female ratio; the absorption coefficient (F) of multiple dosages of rhTNFR-Fc was only 0.674 times that of a single dosage. The outcome parameters were CL/F (female: 0.168 L/h, male: 0.110 L/h), the apparent volume of distribution (Vd/F: 15.5 L), the absorption rate constant (Ka) (single dosage: 0.0605 h?1, multiple dosage: 0.0408 h?1), and the lag time (Tlag: 1.03 h). The inter-individual variability in the CL/F, Vd/F, Ka, and Tlag were 33.3%, 42.7%, 55.6%, and 81.8%, respectively. Conclusion: Chinese females have a higher CL/F than Chinese males, and multiple dosings can significantly decrease the absorption of rhTNFR-Fc (SC). The population PK parameters of rhTNFR-Fc in healthy Chinese volunteers and patients with AS were similar to those reported for subjects in published American studies. PMID:20953211

Fang, Yi; Li, Lu-jin; Wang, Rui; Huang, Feng; Song, Hai-feng; Tang, Zhong-ming; Li, Yu-zhen; Guan, Hua-shi; Zheng, Qing-shan

2010-01-01

147

The permanent improvement of proteinuria and renal failure with colchicine and enalapril in a leukemic patient with renal amyloidosis secondary to ankylosing spondylitis: a review of the literature.  

PubMed

Acute leukemia has been reported as secondary to radiation therapy in patients with ankylosing spondylitis (AS). AA amyloidosis secondary to AS causes progressive organ failure. Although new therapeutic choices can be used, response to therapy in secondary amyloidosis is not good enough. In AA amyloidosis, clinical symptoms partially regress with colchicine. Here, we report a patient with acute leukemia and AS. After complete remission of acute leukemia, pulmonary tuberculosis, acute renal failure and nephrotic syndrome developed. After treatment of leukemia and tuberculosis, Colchicine and enalapril therapy resulted in an improvement of clinical symptoms. He was followed up for >15 years and is doing very well and has minimal symptoms related to AS. PMID:22975660

Paydas, Saime; Paydas, Semra; Balal, Mustafa

2013-01-01

148

The prevalence of sacroiliitis in psoriatic arthritis: new perspectives from a large, multicenter cohort  

Microsoft Academic Search

Objective. To determine the prevalence of radiographic evidence of sacroiliitis in a large population of patients with psoriatic arthritis.\\u000a Patients and design. Patients were recruited from 15 clinical centers. This was part of a large, multicenter study of patients with an established\\u000a diagnosis of ankylosing spondylitis, psoriatic arthritis, or reactive arthritis. For this cohort, an established diagnosis\\u000a of psoriatic arthritis

Michael J. Battistone; B. J. Manaster; Domenic J. Reda; Daniel O. Clegg

1999-01-01

149

Symptoms of Ankylosing Spondylitis  

MedlinePLUS

... women than in men. Quoting Dr. Elaine Adams, "Women often present in a little more atypical fashion so it's even harder to make the diagnoses in women." For example, anecdotally we have heard from women ...

150

Evaluation of cardiac autonomic functions in patients with ankylosing spondylitis via heart rate recovery and heart rate variability  

Microsoft Academic Search

Objective  The aim of this study was to evaluate heart rate variability (HRV) and heart rate recovery (HRR) in otherwise healthy ankylosing\\u000a spondlitis (AS) patients and control subjects.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 28 patients with AS and 30 volunteers matched for age and sex were enrolled. All subjects underwent HRV analysis,\\u000a exercise testing (ET), and transthoracic echocardiography. HRR indices were calculated by

Ergun Baris Kaya; Sercan Okutucu; Hakan Aksoy; Ugur Nadir Karakulak; Erol Tulumen; Oya Ozdemir; Fatma Inanici; Kudret Aytemir; Giray Kabakci; Lale Tokgozoglu; Hilmi Ozkutlu; Ali Oto

2010-01-01

151

Reduced immunomodulation potential of bone marrow-derived mesenchymal stem cells induced CCR4+CCR6+ Th/Treg cell subset imbalance in ankylosing spondylitis  

PubMed Central

Introduction Ankylosing spondylitis (AS) is a chronic autoimmune disease, and the precise pathogenesis is largely unknown at present. Bone marrow-derived mesenchymal stem cells (BMSCs) with immunosuppressive and anti-inflammatory potential and Th17/Treg cells with a reciprocal relationship regulated by BMSCs have been reported to be involved in some autoimmune disorders. Here we studied the biological and immunological characteristics of BMSCs, the frequency and phenotype of CCR4+CCR6+ Th/Treg cells and their interaction in vitro in AS. Methods The biological and immunomodulation characteristics of BMSCs were examined by induced multiple-differentiation and two-way mixed peripheral blood mononuclear cell (PBMC) reactions or after stimulation with phytohemagglutinin, respectively. The interactions of BMSCs and PBMCs were detected with a direct-contact co-culturing system. CCR4+CCR6+ Th/Treg cells and surface markers of BMSCs were assayed using flow cytometry. Results The AS-BMSCs at active stage showed normal proliferation, cell viability, surface markers and multiple differentiation characteristics, but significantly reduced immunomodulation potential (decreased 68 ± 14%); the frequencies of Treg and Fox-P3+ cells in AS-PBMCs decreased, while CCR4+CCR6+ Th cells increased, compared with healthy donors. Moreover, the AS-BMSCs induced imbalance in the ratio of CCR4+CCR6+ Th/Treg cells by reducing Treg/PBMCs and increasing CCR4+CCR6+ Th/PBMCs, and also reduced Fox-P3+ cells when co-cultured with PBMCs. Correlation analysis showed that the immunomodulation potential of BMSCs has significant negative correlations with the ratio of CCR4+CCR6+ Th to Treg cells in peripheral blood. Conclusions The immunomodulation potential of BMSCs is reduced and the ratio of CCR4+CCR6+ Th/Treg cells is imbalanced in AS. The BMSCs with reduced immunomodulation potential may play a novel role in AS pathogenesis by inducing CCR4+CCR6+ Th/Treg cell imbalance. PMID:21338515

2011-01-01

152

Whole blood transcriptional profiling in ankylosing spondylitis identifies novel candidate genes that might contribute to the inflammatory and tissue-destructive disease aspects  

PubMed Central

Introduction A number of genetic-association studies have identified genes contributing to ankylosing spondylitis (AS) susceptibility but such approaches provide little information as to the gene activity changes occurring during the disease process. Transcriptional profiling generates a 'snapshot' of the sampled cells' activity and thus can provide insights into the molecular processes driving the disease process. We undertook a whole-genome microarray approach to identify candidate genes associated with AS and validated these gene-expression changes in a larger sample cohort. Methods A total of 18 active AS patients, classified according to the New York criteria, and 18 gender- and age-matched controls were profiled using Illumina HT-12 whole-genome expression BeadChips which carry cDNAs for 48,000 genes and transcripts. Class comparison analysis identified a number of differentially expressed candidate genes. These candidate genes were then validated in a larger cohort using qPCR-based TaqMan low density arrays (TLDAs). Results A total of 239 probes corresponding to 221 genes were identified as being significantly different between patients and controls with a P-value <0.0005 (80% confidence level of false discovery rate). Forty-seven genes were then selected for validation studies, using the TLDAs. Thirteen of these genes were validated in the second patient cohort with 12 downregulated 1.3- to 2-fold and only 1 upregulated (1.6-fold). Among a number of identified genes with well-documented inflammatory roles we also validated genes that might be of great interest to the understanding of AS progression such as SPOCK2 (osteonectin) and EP300, which modulate cartilage and bone metabolism. Conclusions We have validated a gene expression signature for AS from whole blood and identified strong candidate genes that may play roles in both the inflammatory and joint destruction aspects of the disease. PMID:21470430

2011-01-01

153

Spondyloarthritis in women: differences in disease onset, clinical presentation, and Bath Ankylosing Spondylitis Disease Activity and Functional indices (BASDAI and BASFI) between men and women with spondyloarthritides.  

PubMed

The aim of this study is to assess the gender differences in spondyloarthritides (SpAs) in terms of disease onset, clinical presentation, and the Bath Ankylosing Spondylitis Disease Activity and Functional indices (BASDAI and BASFI). We analysed data from a predominantly female cohort. Five hundred and 16 patients (male:female?=?172:344) with SpA who were assessed at our clinic were asked to complete a questionnaire addressing data related to their disease onset (first symptom at presentation, age at which the first symptom presented, age of diagnosis, and delay in diagnosis), clinical presentation (main problem the disease caused them, night pain/sleep disturbance, well-being over the past week, and well-being over the previous 6 months), disease activity indices (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and BASDAI), and functional index (BASFI). Compared with men, women had greater age at presentation, longer disease duration, more delayed diagnoses and greater age at diagnosis. Back pain was the main presenting symptom equally distributed for both genders. Women had more neck, knee and hip pain as presenting symptoms, while men experienced more feet pain. Back pain is also the main problem that the disease is causing to both sexes. More women had lower back pain, fatigue, neck pain, and pain with pressure as the main problems caused by the disease, while men had more joint pains. Women had significantly greater night pain and sleep disturbance than men. Furthermore, they experienced a worse well-being over past week and over past 6 months in addition to a higher mean ESR (P?

Roussou, Euthalia; Sultana, Shahzabeen

2011-01-01

154

[The effect of Xinfeng capsule treatment on the number of BTLA(+)T cells and oxidative stress of patients with ankylosing spondylitis].  

PubMed

Objective To investigate the changes of B and T lymphocyte attenuator (BTLA), reactive oxygen species (ROS), reactive nitrogen species (RNS), malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), total antioxidative capacity (TAOC) in the patients with ankylosing spondylitis (AS) and the effect of Xinfeng capsule (XFC) on them. Methods AS patients (n=140) were randomly divided into two groups, XFC group (3 tablets each time, tid, n=70) and salicylazosulfapyridine (SASP) group (4 pills each time, bid, n=70). Continuous treatment lasts 3 months. The study also enrolled 60 healthy volunteers as a control group. Flow cytometry was used to test BTLA expression. ELISA was performed to detect the oxidative stress indicators (ROS, RNS, MDA, SOD, CAT, TAOC) and cytokines (IL-4, IL-10, IL-1?, TNF-?). Western blotting was adopted to examine the blood sedimentation (ESR). HITACHI 7060 automatic biochemical analyzer was used to determine the level of high sensitive C-reactive protein (Hs-CRP). Results Clinical efficacy of XFC group was significantly better than that of SASP group (P<0.01). Compared with the healthy control group, AS patients had significantly lower BTLA expression in CD3(+) T cells and CD4(+) T cells from the peripheral blood (P<0.01 or P<0.05), the decreased levels of SOD, CAT and TAOC, and significantly increased ROS, RNS and MDA values (P<0.01 or P<0.05). In addition, the levels of serum IL-1?, TNF-?, ESR and Hs-CRP were significantly higher (P<0.01) and IL-4, IL-10 were significantly lower in AS patients (P<0.01 or P<0.05). Compared with pre-treatment, both XFC and SASP significantly elevated the expressions of BTLA(+)CD3(+) T, BTLA(+)CD4(+) T, BTLA, SOD, TAOC, IL-4, SF-36 (PF, SF, RP, RE, BP, MH, VT, GH) eight dimension scores, and reduced ROS, MDA, TNF-?, ESR, Hs-CRP, VAS, BASDAI, BASFI and BAS-G in the peripheral blood (P<0.01 or P<0.05). The differences between XFC group and SASP group were statistically significant (P<0.01 or P<0.05). Pearson correlation analysis showed that BTLA expression level in the peripheral blood was positively correlated with SOD, RP, BP, SF and RE. BTLA(+)CD3(+) T cells and BTLA*CD4(+) T cells were significantly negatively correlated with ROS, MDA, IL-1?, TNF-?, ESR, VAS and BASDAI, and they were positively correlated with TAOC, IL-4 and IL-10. BTLA(+)CD3(+) T cells were significantly negatively correlated with RNS, Hs-CRP and BASFI; BTLA(+)CD4(+) T cells were positively correlated with CAT. Conclusion XFC can improve BTLA expression in the peripheral blood of AS patients and regulate negatively the activation and proliferation of T cells. PMID:25270214

Qi, Yajun; Liu, Jian; Zheng, Li; Cao, Yunxiang; Wan, Lei

2014-10-01

155

A 17 year old with isolated proximal tibiofibular joint arthritis  

PubMed Central

The proximal tibiofibular joint (TFJ) is rarely affected in rheumatic diseases, and we frequently interpret pain of the lateral knee as the result of overuse or trauma. Nonetheless, the TFJ is a synovial joint that communicates with the tibiofemoral joint in a proportion of patients. While proximal TFJ arthritis has been rarely associated with existing spondyloarthritis, isolated TFJ arthritis as the presenting manifestation of spondyloarthritis has not yet been described. Here, we report the clinical and radiographic presentation of an adolescent with chronic proximal TFJ arthritis heralding spondyloarthritis highly suggestive of ankylosing spondylitis. PMID:23302539

2013-01-01

156

Alternative Treatments for Ankylosing Spondylitis  

MedlinePLUS

... works on the body remains unclear, but stimulation of acupuncture points by puncturing the skin with hair-thin ... although some health plans cover a certain number of acupuncture treatments per year for a variety of conditions. ...

157

Incidental findings of massive heel spurs in a veteran with a variant of psoriatic arthritis.  

PubMed

A middle-aged man presented for left foot diabetic ulcer care. Pedal radiographs were negative for signs of osteomyelitis. However, asymptomatic incidental osseous findings demonstrated significant plantar and posterior calcaneal spurring possibly consistent with diffuse idiopathic skeletal hyperostosis (DISH). A differential of DISH, psoriatic arthritis, Reiter's, and ankylosing spondylitis was developed. Subsequent spinal imaging and laboratory work-up did not satisfy the diagnostic criteria for DISH. This case illustrates radiographic changes characteristic of multiple seronegative arthropathies. On initial presentation a diagnosis of DISH was most likely, but with further imaging studies a diagnosis of a variant of psoriatic arthritis may be more correct. PMID:23001738

Lowell, Danae L; Osher, Lawrence S; Grady, Angela F

2012-01-01

158

[Other rheumatic diseases with uveitis besides juvenile idiopathic arthritis].  

PubMed

In childhood and adolescence, uveitis is part of the clinical spectrum of many inflammatory-rheumatic diseases. Besides juvenile idiopathic arthritis juvenile, ankylosing spondylitis, infection-associated arthritides, infantile sarcoidosis, systemic vasculitides, inflammatory bowel diseases, hereditary autoinflammatory syndromes and the TINU syndrome have to be excluded. These inflammatory diseases can be differentiated clinically in connection with immunogenetic and molecular genetic investigations. Early diagnosis of uveitis as well as the underlying diseases is mandatory for an early treatment and therefore for a good prognosis. PMID:17594615

Michels, H; Greiner, K; Heinz, C; Horneff, G; Ganser, G

2007-06-01

159

Microbes, the gut and ankylosing spondylitis  

PubMed Central

It is increasingly clear that the interaction between host and microbiome profoundly affects health. There are 10 times more bacteria in and on our bodies than the total of our own cells, and the human intestine contains approximately 100 trillion bacteria. Interrogation of microbial communities by using classic microbiology techniques offers a very restricted view of these communities, allowing us to see only what we can grow in isolation. However, recent advances in sequencing technologies have greatly facilitated systematic and comprehensive studies of the role of the microbiome in human health and disease. Comprehensive understanding of our microbiome will enhance understanding of disease pathogenesis, which in turn may lead to rationally targeted therapy for a number of conditions, including autoimmunity. PMID:23750937

2013-01-01

160

Reactive Arthritis Treatment  

MedlinePLUS

Reactive Arthritis (ReA): Quick Links Overview >>> Symptoms >>> Diagnosis >>> Treatment >>> Medication >>> Doctor Q&A From Spondylitis Plus >>> REACTIVE ARTHRITIS Overview Seeing a rheumatologist is essential to beginning ...

161

Psoriatic arthritis assessment tools in clinical trials  

PubMed Central

In order to measure disease activity, progression, and change with therapy in psoriatic arthritis (PsA), it is important to use accurate, reliable, and feasible outcome measures that can ideally be employed in longitudinal cohorts, clinical trials, and clinical practice. Until recently, there has been little focus on this methodology in PsA. Clinical trials and long term clinical registries have used disparate outcome measures. With emerging therapies, the focus on the methodology of outcome assessment has increased to ensure that discriminant and responsive instruments are used. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), in conjunction with the society, Outcome Measures in Rheumatology (OMERACT), is focused on refining and developing outcome measures for a variety of disease domains reviewed in this report. Key domains to assess include joints, skin, enthesitis, dactylitis, spine, joint damage as assessed radiologically, quality of life, and function. These domains can be assessed by individual and composite measures. A number of measures have been "borrowed" from the fields of rheumatoid arthritis, ankylosing spondylitis, and psoriasis and adapted to PsA. Others are being developed specifically for PsA. Few are validated but most have been shown to perform well in distinguishing placebo from treatment response. This report reviews the current state of the art of assessment in PsA and points toward future directions of development of this field. PMID:15708937

Mease, P; Antoni, C; Gladman, D; Taylor, W

2005-01-01

162

The role of intracellular organisms in the pathogenesis of inflammatory arthritis.  

PubMed

Inflammatory arthritis is a condition which is characterised by recurrent episodes of joint pain and swelling. It encompasses a spectrum of disorders ranging from rheumatoid arthritis to ankylosing spondylitis. In these conditions, for reasons that are poorly understood, the immune system raises an inflammatory response within the joint space. In some cases, autoantigens have been identified (e.g., anticitrullinated peptides in rheumatoid arthritis), but the absence of these, in the seronegative arthritides, for example, raises question as to the underlying pathogenesis. Interest has, therefore, turned to host-pathogen interactions and whether aberrant immune responses to these could explain the development of arthritis. This has been most widely studied in reactive arthritis (ReA), where an infectious episode precedes the development of the joint symptoms. In this review, we present the evidence for the role of host-bacterial interactions in the pathogenesis of joint inflammation with particular emphasis on ReA. We discuss a range of possible mechanisms including molecular mimicry, persistent low grade infections, and abnormal host responses to common bacterial causes of reactive arthritis as well as discussing some of the clinical challenges that we face in making the diagnosis and in treatment of persistent symptoms. PMID:24995143

Singh, Animesh; Karrar, Sarah

2014-01-01

163

The Role of Intracellular Organisms in the Pathogenesis of Inflammatory Arthritis  

PubMed Central

Inflammatory arthritis is a condition which is characterised by recurrent episodes of joint pain and swelling. It encompasses a spectrum of disorders ranging from rheumatoid arthritis to ankylosing spondylitis. In these conditions, for reasons that are poorly understood, the immune system raises an inflammatory response within the joint space. In some cases, autoantigens have been identified (e.g., anticitrullinated peptides in rheumatoid arthritis), but the absence of these, in the seronegative arthritides, for example, raises question as to the underlying pathogenesis. Interest has, therefore, turned to host-pathogen interactions and whether aberrant immune responses to these could explain the development of arthritis. This has been most widely studied in reactive arthritis (ReA), where an infectious episode precedes the development of the joint symptoms. In this review, we present the evidence for the role of host-bacterial interactions in the pathogenesis of joint inflammation with particular emphasis on ReA. We discuss a range of possible mechanisms including molecular mimicry, persistent low grade infections, and abnormal host responses to common bacterial causes of reactive arthritis as well as discussing some of the clinical challenges that we face in making the diagnosis and in treatment of persistent symptoms. PMID:24995143

2014-01-01

164

Arthritis  

MedlinePLUS Videos and Cool Tools

... to treat arthritis. These include various types of steroids. Steroids are very helpful medications but they have numerous possible side effects. Steroids should be taken as prescribed, and should never ...

165

Scientists Gain New Insights into Genetic Mechanisms of Ankylosing Spondylitis  

MedlinePLUS

... Leslie S, Wordsworth T, Kenna TJ, Karaderi T, Thomas GP, Ward MM, Weisman MH, Farrar C, Bradbury LA, ... espańol | Asian-Language Publications Contact Us | Disclaimer | Accessibility | Privacy Statement | FOIA | FAQs | Comments Moderation Policy Site Map | ...

166

Chronic arthritis associated with the presence of intrasynovial rubella virus.  

PubMed Central

In this report we present 21 instances in which live rubella virus was isolated from synovial fluid obtained from 6 cases of inflammatory oligoarthritis or polyarthritis over a period of 2 years in the absence of firm clinical evidence of rubella. In 3 cases (cases 1, 2, 6,) a persistent oligoarthritis predominantly affecting the knee joints occurred in 2 adult women and one man, lasting to date 27, 29, and 18 months respectively, and in one of these cases virions were found in cells of the synovial membrane. In case 3 a boy of 9 presented with an illness indistinguishable from the systemic variety of juvenile chronic arthritis (Still's disease). In case 4 a young man with persistent monoarthritis was found to have ankylosing spondylitis, and in case 5 a progressive erosive polyarthritis developed 5 years after an attack of rubella complicated by rubella arthritis. The virus was identified by a variety of virological techniques and infection confirmed by immunofluorescence and (in one case) electron microscopy. Images PMID:6830322

Grahame, R; Armstrong, R; Simmons, N; Wilton, J M; Dyson, M; Laurent, R; Millis, R; Mims, C A

1983-01-01

167

Rheumatoid arthritis, spondyloarthropathies, and relapsing polychondritis.  

PubMed

The neurologic complications of rheumatic disease are highly variable and their manifestations are linked to the pathogenesis and clinical phenotype of the specific rheumatologic syndrome. In active rheumatoid arthritis (RA), the peripheral nervous system is most commonly involved and mononeuritis multiplex, nerve entrapment and vascultitic sensorimotor neuropathy are not uncommon. Central nervous system complications such as pachymeningitis and cerebral vasculitis are rare. TNF blockade therapy of RA is rarely associated with demyelinating syndromes. In the spondyloarthropathies, especially ankylosing spondylitis (AS), neurologic complications are more frequent in long-standing, advanced disease and include atlantoaxial subluxation, cauda equina syndrome, spinal stenosis, and acute vertebral fractures. Peripheral nervous system involvement in any of the spondyloarthropaties is rare. Relapsing polychondritis (RP) is characterized by recurring bouts of inflammation, destruction of cartilaginous structures, and systemic and rarely central nervous system vasculitis. Visual-oculo and auditory complications are common. Definitive treatment of the neurologic complications and prevention of subsequent ones is dependent upon effective treatment of RA, AS or RP. PMID:24365312

Ostrowski, Rochella A; Takagishi, Troy; Robinson, John

2014-01-01

168

Induction of Regulatory t Cells by Low Dose il2 in Autoimmune and Inflammatory Diseases  

ClinicalTrials.gov

Rheumatoid Arthritis; Ankylosing Spondylitis; Systemic Lupus Erythematosus; Psoriasis; Behcet's Disease; Wegener's Granulomatosis; Takayasu's Disease; Crohn's Disease; Ulcerative Colitis; Autoimmune Hepatitis; Sclerosing Cholangitis

2014-02-06

169

[Trends of work force participation of patients with rheumatic diseases : results from German social insurance data and the national database of the German collaborative arthritis centers].  

PubMed

Positive therapeutic effects on the work force participation derived from international clinical trials may not be directly transferable to the community based care in Germany. Therefore recent changes of data regarding sick leave (SL), work disability pension (WDP) and employment from the social insurance and from the national database of the German collaborative arthritis centers were analyzed covering a time period of at least 10 years. Health insurance data showed a steeper decline in the average duration of SL caused by rheumatoid arthritis (RA), ankylosing spondylitis (AS) and systemic lupus erythematosus (SLE) compared with all other diseases. In RA patients from the collaborative arthritis centers the mean duration of SL was much more reduced than the average duration of SL for members of the compulsory health insurance. The proportion of gainfully employed RA patients in collaborative arthritis centers has particularly increased in women. According to data from the pension insurance fund less incident cases of WDP due to RA, AS, and SLE have been observed than WDP caused by all other diseases. Thus different nationwide data show positive changes of the work force participation of individuals suffering from inflammatory rheumatic diseases in Germany. PMID:24402233

Mau, W; Thiele, K; Lamprecht, J

2014-02-01

170

Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period  

PubMed Central

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34–0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97–2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13–4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. PMID:16507128

Gomez-Reino, Juan J; Carmona, Loreto

2006-01-01

171

Spondylitis: Frequently Asked Questions  

MedlinePLUS

... Juvenile Spondyloarthropathy, is the medical term for a group of childhood rheumatic diseases, which cause arthritis before the age of 16 and may span through adult life. JSpA typically causes pain and inflammation in the joints in the lower part of the body, for ...

172

VEGF, FGF1, FGF2 and EGF gene polymorphisms and psoriatic arthritis  

PubMed Central

Background Angiogenesis appears to be a first-order event in psoriatic arthritis (PsA). Among angiogenic factors, the cytokines vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and fibroblast growth factors 1 and 2 (FGF1 and FGF2) play a central role in the initiation of angiogenesis. Most of these cytokines have been shown to be upregulated in or associated with psoriasis, rheumatoid arthritis (RA) or ankylosing spondylitis (AS). As these diseases share common susceptibility associations with PsA, investigation of these angiogenic factors is warranted. Methods Two hundred and fifty-eight patients with PsA and 154 ethnically matched controls were genotyped using a Sequenom chip-based MALDI-TOF mass spectrometry platform. Four SNPs in the VEGF gene, three SNPs in the EGF gene and one SNP each in FGF1 and FGF2 genes were evaluated. Statistical analysis was performed using Fisher's exact test, and the Cochrane-Armitage trend test. Associations with haplotypes were estimated by using weighted logistic models, where the individual haplotype estimates were obtained using Phase v2.1. Results We have observed an increased frequency in the T allele of VEGF +936 (rs3025039) in control subjects when compared to our PsA patients [Fisher's exact p-value = 0.042; OR 0.653 (95% CI: 0.434, 0.982)]. Haplotyping of markers revealed no significant associations. Conclusion The T allele of VEGF in +936 may act as a protective allele in the development of PsA. Further studies regarding the role of pro-angiogenic markers in PsA are warranted. PMID:17204151

Butt, Christopher; Lim, Sooyeol; Greenwood, Celia; Rahman, Proton

2007-01-01

173

Phenotypic and clinical differences between Caucasian and South Asian patients with psoriatic arthritis living in North East London.  

PubMed

To test for demographic and clinical differences between Caucasian and South Asian patients with psoriatic arthritis (PsA) living in the same environment and for differences between sexes. The demographic characteristics of patients attending outpatient clinics were obtained using a semi-structured questionnaire. Clinical parameters included disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), C-reactive protein), function (Bath Ankylosing Spondylitis Functional Index (BASFI)) and visual analogue scale (VAS) scores for well-being and night pain (10 cm, where 10 = worst possible response). The first symptom experienced at disease onset and the main symptoms during the disease course were recorded in the questionnaire. A total of 217 patents were assessed of whom 151 were Caucasians and 66 were Asians. South Asian patients were significantly younger [(mean) 45.9 years [(SD)(±11.4)] for Asians and 53.1 years (±14.2) for Caucasians (p < 0.005)] and were diagnosed at an earlier age [40.7 years (±11.7) for Asians and 46.7 years (±15.8) for Caucasians (p < 0.05)] compared to Caucasians patients. Asian females with PsA had worse disease in terms of activity (ESR = 23.9 mmHg/h; BASDAI = 6.7), function (BASFI = 5.5), night pain (7.1 on VAS) and well-being (6.6 on VAS) compared with Asian males (13.2 mmHg/h, 5.3, 3.6, 4.1, 4.6, respectively) or Caucasian males and females (15.8 mmHg/h, 5.9, 5.3, 5.4, 5.4; 18.9 mmHg/h, 6.1, 6.1, 5.3, 5.8, respectively). There were no significant differences in symptoms at disease onset or the main symptoms during the disease course between Caucasian and Asian patients, although there was a trend towards more frequent enthesitis in Asian females during the course of disease suggested by pain with pressure compared to Asian males. South Asian patients may develop PsA earlier in life than Caucasian patients do, but their clinical characteristics are generally similar. Asian females with PsA have worse disease activity, function, night pain and well-being than Asian males and Caucasian males and females. PMID:23247553

Roussou, Euthalia; Chopra, Sunil; Ngandu, Danny Lunda

2013-05-01

174

Tuberculous Spondylitis: a case report  

PubMed Central

A 21 year old oriental male presented with a one month history of neck pain associated with neck stiffness and dysphagia. A five week course of chiropractic treatment relieved most of his symptoms. Due to persistent tenderness in the suboccipital region and substantial weight loss, he was subsequently hospitalized. Further investigations revealed tuberculous osteomyelitis affecting the left lateral mass of C1 and likely the C2 vertebra. Tuberculous spondylitis accounts for more than 50% of all cases of skeletal tuberculosis and is the most common cause of vertebral infection, particularly in young people. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6

Thiel, Haymo; Gotlib, Allan

1986-01-01

175

In-vitro Effect of Sulfasalazine and Its Metabolites on Human T Lymphocyte Activation.  

National Technical Information Service (NTIS)

Sulfasalazine (SF) is an anti-inflammatory sulfonamide used in the treatment of rheumatoid arthritis, ulcerative colitis and ankylosing spondylitis. Its mechanism of action is not fully understood. The possible immunomodulatory role of sufasalazine and it...

R. H. McBride

1994-01-01

176

316. A ONE-DAY EXERCISE PROGRAMME: COACHING FOR EXERCISE FOR ANKYLOSING SPONDYLITIS (COAX-AS)  

Microsoft Academic Search

Background: Rheumatologist-performed musculoskeletal ultrasound (MSUS) has gained popularity in the UK. A UK-based survey in 2005 suggested interest and motivation to learn this skill and identified the need for structured training with assessment. Our aim was to review the current status of MSUS in the UK and explore suggestions to improve training. Methods: We sent a questionnaire electronically to all

Claire Dubois; Sarang Chitale; Robert N. Thompson; Christina Estrach; Lorraine A. McFarland; Sheila Leddington Wright; Jane Tooby; Julie Barlow

177

Association of HLA-B27 status and gender with sacroiliitis in patients with ankylosing spondylitis  

PubMed Central

Objective: To observe the influence of human leucocyte antigen B27 (HLA-B27) status and gender on sacroiliitis on computed tomography (CT) in ankylosingspondylitis (AS). Methods: We reviewed the archived medical records of the AS inpatients admitted in the Rheumatology Department of the First Affiliated Hospital of Wenzhou Medical University during the period from January 2007 through January 2013 and finally 386 patients were included in the study. The severity of sacroiliitis on CT was evaluated according to the grading used in the modified New York criteria for AS. Two-way classification analysis of variance (ANOVA) was employed to examine the effect of HLA-B27 status and gender on age at disease onset. The impact of HLA-B27 and gender on sacroiliitis on CT was tested by univariate and multivariate logistic regression analyses. Results: There were 350 HLA-B27 positive patients (90.7%) and 36 HLA-B27 negative patients (9.3%). The ANOVA test indicated that HLA-B27 positive patients and male patients respectively had an earlier age at disease onset than HLA-B27 negative patients and female patients. The logistic regression analysis indicated that positive HLA-B27 status (OR 2.601, p=0.004) and male gender (OR 1.923, p=0.004) were significant predictors of worse sacroiliitis. In addition, elevated ESR (OR 2.181, p=0.013) and longer disease duration (OR 1.100, p<0.001) contributed to worse sacroiliitis likewise. Conclusion: Positive HLA-B27 status and male gender are associated with worse sacroiliitis on CT, acting as predictors of sacroiliitis. Elevated ESR and longer disease duration also contribute to worse sacroiliitis. Meanwhile, positive HLA-B27 status and male gender are associated with earlier age at disease onset. PMID:24639824

Xiong, Jiangbiao; Chen, Jing; Tu, Jianxin; Ye, Wenjing; Zhang, Zhiyong; Liu, Qiaoqiong; Zhu, Xiaochun

2014-01-01

178

Suppression of Inflammation and Effects on New Bone Formation in Ankylosing Spondylitis  

MedlinePLUS

... been shown to prevent new bone formation." Meaning, TNF-a Inhibitor / biologic class medications have not been ... and they are not in an advanced stage, TNF-a inhibitors may be much more effective in ...

179

Coccidioidal spondylitis: usual and unusual radiographic manifestations.  

PubMed

A review of four cases of disseminated coccidioidomycosis involving the spine shows a variety of radiographic manifestations. Classic features of coccidioidal spondylitis include multiple spinal foci with preservation of disk spaces and indiscriminate involvement of the vertebral bodies and appendages. There are often associated paraspinous soft-tissue masses without gibbous deformity of the spine. In this series, the unusual manifestations of coccidioidal spondylitis include gibbous deformity, cystic lesions of the vertebral bodies, and sclerosis. An unusual pattern of healing of coccidioidomycosis is shown in one case. PMID:7384522

McGahan, J P; Graves, D S; Palmer, P E

1980-07-01

180

The association between schizophrenia and rheumatoid arthritis: a nationwide population-based Swedish study on intraindividual and familial risks.  

PubMed

Numerous studies have reported a reduced risk of rheumatoid arthritis (RA) in schizophrenia. The mechanisms are unknown, but recent genome-wide association studies of schizophrenia have shown strong associations with markers spanning the major histocompatibility complex region, indicating a possible role for adaptive immunity also in schizophrenia. In this population-based cohort study, we assess the associations between RA and schizophrenia and the extent to which any observed associations are specific to RA/schizophrenia. We then extend the assessments per RA subtype and to risks in first-degree relatives. The study population included every individual identified in the Swedish Population Register born in Sweden between 1932 and 1989. The risk for RA in schizophrenia was significantly decreased (hazard ratio [HR] = 0.69, 95% CI = 0.59-0.80), but similar reductions were noted for osteoarthritis (a noninflammatory joint disorder) and ankylosing spondylitis (a non-RA inflammatory disorder). Comparable associations were seen in schizoaffective subjects while no significant associations were observed in bipolar disorder. Overall, first-degree relatives of schizophrenia patients were not at reduced risk of RA, but the risk for seronegative RA was significantly decreased in children and siblings of schizophrenia probands (HR = 0.13, 95% CI = 0.02-0.95 and HR = 0.67, 95% CI = 049-0.92, respectively). In conclusion, our intraindividual analyses suggest that differential misclassification bias is an important factor for the observed inverse association and emphasize the need of optimized care-provision for nonpsychiatric symptoms in schizophrenia patients. Our familial analyses indicted the possibility of an inverse coinheritance of schizophrenia and seronegative RA. PMID:24714379

Sellgren, Carl; Frisell, Thomas; Lichtenstein, Paul; Landčn, Mikael; Askling, Johan

2014-11-01

181

Salmonella paratyphi spondylitis: a case report  

PubMed Central

This is a case report of acute L3/4 vertebral osteomyelitis due to Salmonella paratyphi A confirmed by culture from vertebral needle biopsy. From a review of the literature this is the first reported case with bacteriological confirmation. The rarity of Salmonella paratyphi spondylitis and the options for treatment are discussed. PMID:18008092

Mahmoodi, Seyed Mohsen; Kalaparambil Moosa, Nooruddin; Edgar, Michael; Samt, Hussain Al; Hussain, Riyaz Amirali

2007-01-01

182

Seronegative arthritides of the anterior chest wall: a follow-up study  

Microsoft Academic Search

Fourteen patients with arthritis of the anterior chest wall (ACW) as part of ankylosing spondylitis, reactive arthritis, and arthritis associated with psoriasis and\\/ or pustulosis palmoplantaris (PPP) were re-examined after periods of 5–15 years (mean 9 years) using tomography. The findings were compared with those of 24 similarly examined patients with predominant osseous sclerotic ACW lesions or monarthritis of the

A. G. Jurik

1991-01-01

183

Gut inflammation and spondyloarthropathies  

Microsoft Academic Search

Spondyloarthropathies (SpA) are a group of related disorders with common clinical and genetic characteristics. The prototype\\u000a disease in this group is ankylosing spondylitis; other entities include reactive arthritis, psoriatic arthritis, and arthritis\\u000a in patients with inflammatory bowel disease. Over recent years, there has been a special interest in the relation between\\u000a spondylitis\\/ synovitis and gut inflammation in patients with SpA.

Filip De Keyser; Dominique Baeten; Filip Van den Bosch; Martine De Vos; Claude Cuvelier; Herman Mielants; Eric Veys

2002-01-01

184

Psoriatic Arthritis  

MedlinePLUS

... of arthritis with similar symptoms. If you have psoriasis and start to develop joint pain, it’s important to see your doctor. Early diagnosis and treatment of psoriatic arthritis can help prevent irreparable joint ...

185

Juvenile Arthritis  

MedlinePLUS

... Juvenile Arthritis? Most forms of juvenile arthritis are autoimmune disorders, which means that the body’s immune system—which ... the self, these proteins are called autoantibodies. Like autoimmune disorders, autoinflammatory conditions also cause inflammation. And like autoimmune ...

186

Endotoxin-induced uveitis in rats as a model for human disease  

Microsoft Academic Search

Acute anterior uveitis is a relatively common disease of uncertain aetiology. Its association with a wide variety of systemic disorders including ankylosing spondylitis, Reiter's syndrome, Behçet's disease, juvenile rheumatoid arthritis, psoriatic arthritis, inflammatory bowel disease and sarcoidosis and the prevalence of the HLA antigen B27 (ref. 1) in cases without associated disease have been noted but not explained. In general,

J. T. Rosenbaum; H. O. McDevitt; R. B. Guss; P. R. Egbert

1980-01-01

187

Rationale for the use of cyclooxygenase-2-specific nonsteroidal antiinflammatory drugs in ankylosing spondylitis: the available evidence  

Microsoft Academic Search

of patients with AS, but little specific information on the frequency of such NSAID toxicities in patients with spondylarthritides is available [6]. Most recently, Ward and Kuzis [6] provided data examining the duration of treatment and discontinuations caused by side effects of new courses of traditional NSAIDs and celecoxib from a prospective longitudinal study of 241 patients with AS. The

Lars Köehler; Jens G. Kuipers; Henning Zeidler

2003-01-01

188

Hip joint disease in psoriatic arthritis: risk factors and natural history  

PubMed Central

Patients and methods: 504 patients with PsA according to ESSG criteria were studied. Mean follow up was 5.7 years (range <1–45). Mean age at onset of psoriasis was 32 years and of PsA, 39 years. The most common pattern of PsA at onset was oligoarticular (49%) and at the latest examination, polyarticular (65%). Sacroiliitis or spondylitis was diagnosed in 94 (18.7%) patients. Results: 32 (6.3%) patients developed psoriatic hip arthropathy, and of these, 26 (81%) also had sacroiliitis or spondylitis. In 7/17 (41%) patients the hip became affected within 1 year after the onset of PsA. Hip disease occurred more often in younger patients. Sex, pattern of peripheral arthritis, duration of psoriasis before arthritis affected the distal interphalangeal joints, dactylitis, or enthesitis were not associated with the risk of hip disease. Seventeen patients were followed up and nine required hip arthroplasty. Sixteen (50%) first had arthroplasty within 5 years after the onset of hip pain. Conclusions: Psoriatic hip arthropathy occurs infrequently in PsA and is associated with earlier onset of arthritis and psoriatic spondylitis. Bilateral hip involvement and rapid progression to hip arthroplasty are common. PMID:15958761

Michet, C; Mason, T; Mazlumzadeh, M

2005-01-01

189

A case of psoriasis vulgaris with diffuse idiopathic skeletal hyperostosis involved with ossifications of posterior and anterior longitudinal ligament  

Microsoft Academic Search

Diffuse idiopathic skeletal hyperostosis (DISH) is difficult to distinguish from various forms of inflammatory arthritis,\\u000a including psoriatic arthritis (PsA), rheumatoid arthritis, and ankylosing spondylitis. A 67-year-old Japanese male had been\\u000a treated for psoriasis vulgaris for 13 years. Numbness of his right arm and lower limbs and spinal stiffening had developed\\u000a 7 years prior to his initial evaluation at our facility. He noticed

Tomonori Taniguchi; Hideki Maejima; Akira Watarai; Ryoichi Aki; Kensei Katsuoka

190

Expression of CD147 on monocytes/macrophages in rheumatoid arthritis: its potential role in monocyte accumulation and matrix metalloproteinase production  

PubMed Central

Monocytes/macrophages play an important role in rheumatoid arthritis (RA) pathogenesis. They can activate fibroblasts through many molecules, including IL-1 and tumor necrosis factor-alpha, but there have been very few reports on the role of CD147 in RA. In our study, the results of flow cytometry reveal that the mean fluorescence intensity (MFI) of CD147 expression on CD14+ monocytes of peripheral blood from RA patients was higher than that in normal control and ankylosing spondylitis (AS) patients. The MFI of CD147 expression on the CD14+ monocytes in RA synovial fluid was higher than that in RA peripheral blood. Immunohistochemical staining shows that CD147 expression in RA synovium correlated with matrix metalloproteinase (MMP)-1 expression. A double immunofluorescent assay shows that CD147 was expressed on CD68+ cells in RA synovium. The potential role of CD147 in cyclophilin A (CyPA)-mediated cell migration was studied using a chemotaxis assay in vitro and it was found that the addition of anti-CD147 antibody or a CD147 antagonistic peptide significantly decreased the chemotactic index of the mononuclear cells. The role of CD147 in MMP production and cell invasion in vitro were studied through the co-culture of human CD14+ monocytes or monocytic line THP-1 cells and human fibroblasts, as well as by gel zymography and an invasion assay. Significantly elevated release and activation of MMP-9 and/or MMP-2 were seen in the co-culture of human monocytes/THP-1 cells and fibroblasts compared with cultures of the cells alone. An increased number of cells invading through the filters in the invasion assays was also observed in the co-cultured cells. The addition of CD147 antagonistic peptide had some inhibitory effect, not only on MMP production but also on cell invasion in the co-culture. Our study demonstrates that the increased expression of CD147 on monocytes/macrophages in RA may be responsible for elevated MMP secretion, cell invasion and CyPA-mediated cell migration into the joints, all of which may contribute to the cartilage and bone destruction of RA. These findings, together with a better understanding of CD147, CyPA and RA, will help in the development of innovative therapeutic interventions for RA. PMID:16207318

Zhu, Ping; Ding, Jin; Zhou, Jun; Dong, Wei-Jia; Fan, Chun-Mei; Chen, Zhi-Nan

2005-01-01

191

Traitement des spondylarthropathies. Nouveautés et perspectives en 2001  

Microsoft Academic Search

The management of patients with spondyloarthropathy is undergoing radical changes in several areas and for several reasons. The main reason seems to be improved awareness of the fairly high prevalence of this group of disorders, which is close to that of rheumatoid arthritis. Evaluation of the various treatment modalities has benefited from work by the international ASsessment in Ankylosing Spondylitis

Maxime Dougados

2001-01-01

192

Utilidad de los fármacos modificadores de enfermedad (FAME) en el tratamiento de las espondiloartropatías  

Microsoft Academic Search

Disease-modifying antirheumatic drugs (DMARDs), a heterogeneous group of drugs, are widely used in rheumatoid arthritis management. The scientific evidence on the management of spondyloarthropathy with DMARDs is limited and the results are inconclusive. In this article, we review the role of DMARDs in the management of axial involvement in spondyloarthropathies, emphasizing its paradigm, ankylosing spondylitis. We review the data published

Alejandro Prada Ojeda; Teresa Otón Sánchez; Jesús Sanz Sanz

2010-01-01

193

Treatment of spondyloarthropathies. Recent advances and prospects in 2001  

Microsoft Academic Search

The management of patients with spondyloarthropathy is undergoing radical changes in several areas and for several reasons. The main reason seems to be improved awareness of the fairly high prevalence of this group of disorders, which is close to that of rheumatoid arthritis. Evaluation of the various treatment modalities has benefited from work by the international Assessment in Ankylosing Spondylitis

Maxime Dougados

2001-01-01

194

Updated guidelines for the management of axial disease in psoriatic arthritis.  

PubMed

Axial involvement in patients with psoriatic arthritis (PsA) remains common and can be defined in terms of spinal disease alone or in combination with peripheral manifestations. Diagnosis is based upon inflammatory spinal symptoms or the presence of radiological sacroiliitis and other radiographic signs of spondylitis, or by criteria for axial spondyloarthritis (SpA) defined by ASAS (Assessment of SpondyloArthritis International Society). Although recent data are scarce for efficacy of traditional therapies for axial disease (e.g., nonsteroidal antiinflammatory drugs, methotrexate, etc.), limited data are available for targeted biologics and novel agents. We identify and evaluate the efficacy of therapeutic interventions for treatment of axial disease in PsA. This review is an update of the axial PsA section of the treatment recommendations project by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). PMID:25362712

Nash, Peter; Lubrano, Ennio; Cauli, Alberto; Taylor, William J; Olivieri, Ignazio; Gladman, Dafna D

2014-11-01

195

Manifestation of palmoplantar pustulosis during or after infliximab therapy for plaque-type psoriasis: report on five cases  

Microsoft Academic Search

Infliximab is a monoclonal antibody directed against TNF-?. It has been approved for use in rheumatoid arthritis, ankylosing\\u000a spondylitis, inflammatory bowel disease, psoriatic arthritis and plaque-type psoriasis. In case reports, positive effects\\u000a on pustular variants of psoriasis have also been reported. However, paradoxically, manifestation of pustular psoriasis and\\u000a plaque-type psoriasis has been reported in patients treated with TNF antagonists including

Rotraut Mössner; Diamant Thaci; Johannes Mohr; Sylvie Pätzold; Hans Peter Bertsch; Ullrich Krüger; Kristian Reich

2008-01-01

196

Manifestation of palmoplantar pustulosis during or after inXiximab therapy for plaque-type psoriasis: report on Wve cases  

Microsoft Academic Search

InXiximab is a monoclonal antibody directed against TNF-. It has been approved for use in rheumatoid arthritis, ankylosing spondylitis, inXammatory bowel dis- ease, psoriatic arthritis and plaque-type psoriasis. In case reports, positive eVects on pustular variants of psoriasis have also been reported. However, paradoxically, manifes- tation of pustular psoriasis and plaque-type psoriasis has been reported in patients treated with TNF

Rotraut Mössner; Diamant Thaci; Johannes Mohr; Sylvie Pätzold; Hans Peter Bertsch; Ullrich Krüger; Kristian Reich

197

Etanercept-induced cystic acne.  

PubMed

Tumor necrosis factor ? antagonists are potent biologics used to treat a variety of autoimmune disorders such as rheumatoid arthritis, ankylosing spondylitis, Crohn disease, psoriasis, and psoriatic arthritis. These medications are known to have many side effects (eg, infusion reactions, cytopenia, risk for infection, heart failure); however, only a few cases of acne vulgaris have been associated with the use of these biologics, particularly infliximab and adalimumab. We report a rare case of etanercept-induced cystic acne. PMID:25101341

Kashat, Maria; Caretti, Katherine; Kado, Jessica

2014-07-01

198

Golimumab: Review of the efficacy and tolerability of a recently approved tumor necrosis factor-? inhibitor  

Microsoft Academic Search

Background: Golimumab (GLM) is a tumor necrosis factor-? (TNF-?) inhibitor that was approved in the United States in 2009 for use with methotrexate (MTX) in adults with moderate to severe active rheumatoid arthritis (RA), and with or without MTX or other non-biologic disease-modifying antirheumatic drugs in adults with active psoriatic arthritis (PsA) or active ankylosing spondylitis (AS). GLM is administered

Eric G. Boyce; Jenana Halilovic; Oby Stan-Ugbene

2010-01-01

199

[Magnetic resonance tomography in the diagnosis of tuberculous spondylitis].  

PubMed

The examination included 35 patients with clinical and X-ray signs of tuberculous spondylitis. Magnetic resonance tomography (MRT) was performed on a Maganview apparatus (Finland). MRT helped to diagnose an active process in 5 patients. The most manifested changes were found on T2-suspended tomograms to indicate an inflammatory reaction of the bone marrow. MRT was effective in detecting bone marrow compression, its early atrophy, hydromyelia and postoperative changes. MRT can obviously fully replace pneumomyelography and myelography with contrast substances. PMID:1603786

Kholin, A V

1992-01-01

200

Arthritis: Frequently Asked Questions  

MedlinePLUS

... developing osteoarthritis. Top of Page How many people in the United States have arthritis? Currently, an estimated 52.5 million Americans reported that their doctor told them they had arthritis. As our nation’s ... children under age 18 (or 1 in 250 children) have been diagnosed with arthritis or ...

201

Rheumatoid Arthritis Educational Video Series  

MedlinePLUS

Rheumatoid Arthritis Educational Video Series This series of five videos was designed to help you learn more about Rheumatoid Arthritis (RA). You will ... Activity Role of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic ...

202

Genetic Determinants of Psoriatic Arthritis.  

E-print Network

??Psoriatic Arthritis (PsA) is an inflammatory arthritis associated with psoriasis that leads to progressive joint damage. Genetic variants in the Major Histocompatibility Complex (MHC) region… (more)

Chandran, Vinod

2014-01-01

203

Virus-associated arthritis  

Microsoft Academic Search

The occurrence of arthritis in patients who were infected by a virus has been widely observed. In some cases, the clinical appearance seems to resemble that of rheumatoid arthritis. The mechanism by which the viral infection proceeds to the arthritic manifestation is, however, still to be investigated. Several biological and immunological pathways are suggested to be involved in the pathogenesis.

Kusuki Nishioka

2003-01-01

204

Quick Stats on Arthritis  

MedlinePLUS

... of symptomatic osteoarthritis Prevalence 52.5 million adults in the United States have doctor-diagnosed arthritis (just over 1 in ... Arthritis is the most common cause of disability in the United States. Read more . View graph . Number of U. S. Adults ...

205

Postinfectious Arthritis in Pediatric Practice  

PubMed Central

ABSTRACT Postinfectious arthritis is a relatively often encountered in pediatric practice. The authors present the most important data concerneing this pathology, with up to date informations exemplifying with case presentations. Clinical cases bring to attention the most common forms of postinfectious arthritis (reactive arthritis, postinfectious arthritis bacterial, viral, spirochete, and so on). Although highly studied and commonly found in current pediatric practice, arthritis occurring after infections remains controversial entities, especially regarding terminology. While, according to some authors, postinfectious arthritis belongs to the large group of reactive arthritis, by other authors, these joint events are independent entities. PMID:24371480

PLESCA, Doina Anca; LUMINOS, Monica; SPATARIU, Luminita; STEFANESCU, Mihaela; CINTEZA, Eliza; BALGRADEAN, Mihaela

2013-01-01

206

Video-Assisted Thoracic Surgery for Tubercular Spondylitis  

PubMed Central

The present study evaluated the outcome of video-assisted thoracic surgery (VATS) in 9 patients (males = 6, females = 3) with clinico-radiological diagnosis of tubercular spondylitis of the dorsal spine. The mean duration of surgery was 140.88 ± 20.09 minutes, mean blood was 417.77 ± 190.90?mL, and mean duration of postoperative hospital stay was 5.77 ± 0.97 days, Seven patients had a preoperative Grade A neurological involvement, while at the time of final followup the only deficit was Grade D power in 2 patients. In patients without bone graft placement (n = 6), average increase in Kyphosis angle was 16°, while in patients with bone graft placement (n = 3) the deformity remained stationary. At the time of final follow up, fusion was achieved in all patients, the VAS score for back pain improved from a pretreatment score of 8.3 to 2, and the function assessment yielded excellent (n = 4) to good (n = 5) results. In two patients minithoracotomy had to be resorted due to extensive pleural adhesions (n = 1) or difficulty in placement of graft (n = 1). Videoassisted thoracoscopic surgery provides a safe and effective approach in the management of spinal tuberculosis. It has the advantages of decreased blood loss and post operative morbidity with minimal complications. PMID:24804092

Singh, Roop; Gogna, Paritosh; Parshad, Sanjeev; Karwasra, Rajender Kumar; Karwasra, Parmod Kumar; Kaur, Kiranpreet

2014-01-01

207

Lessons from Lyme arthritis.  

PubMed

Lyme arthritis is the late manifestation of a multi-systemic infectious disease designated Lyme borreliosis (LB) which is caused by the spirochete Borrelia burdorferi. Its arthritic manifestations were first recognized in the small New England villages, "Lyme" and "Old Lyme", for which the disorder is named. While this illness was initially regarded as a rather random clustering of several cases of juvenile chronic arthritis, it now serves as the best example of a chronic arthritis with a recognized infectious origin. Even though the agent has clearly been identified, many riddles concerning Lyme arthritis still exist which demonstrate that even the identification of the causative agent does not solve the problems of an arthritis which so far frequently cannot be properly diagnosed and treated. The intensive study of this disorder, however, has taught important lessons which may also be true for other forms of chronic arthritis in which an infectious cause has not been elucidated. Rather than just adding another review on Lyme arthritis to the many good ones that already exist, this paper will focus on these messages. PMID:8324947

Burmester, G R

1993-01-01

208

Gene therapy for arthritis  

PubMed Central

Arthritis is among the leading causes of disability in the developed world. There remains no cure for this disease and the current treatments are only modestly effective at slowing the disease's progression and providing symptomatic relief. The clinical effectiveness of current treatment regimens has been limited by short half-lives of the drugs and the requirement for repeated systemic administration. Utilizing gene transfer approaches for the treatment of arthritis may overcome some of the obstacles associated with current treatment strategies. The present review examines recent developments in gene therapy for arthritis. Delivery strategies, gene transfer vectors, candidate genes, and safety are also discussed. PMID:18176779

Traister, Russell S.

2008-01-01

209

Osteomalacia in rheumatoid arthritis.  

PubMed Central

Fifty-four patients with rheumatoid arthritis and severe osteomalacia were found to have considerable bone and general deficiency problems. In 46 of them 14 stress fractures occurred and 32 minimal trauma fractures necessitating admission to hospital. Radiological abnormalities of absorption were found in nearly 25% of the total, implying that dietary factors alone are not always responsible for osteomalacia in patients with rheumatoid arthritis. A high index of suspicion is necessary in the diagnosis of osteomalacia in patients with rheumatoid arthritis, so they may benefit from treatment. Images PMID:7377853

O'Driscoll, S; O'Driscoll, M

1980-01-01

210

Complex Role of TNF Variants in Psoriatic Arthritis and Treatment Response to Anti-TNF Therapy: Evidence and Concepts.  

PubMed

Psoriatic arthritis (PsA) is a chronic inflammatory disease affecting joints, and it may manifest as peripheral arthritis, dactylitis, enthesitis, spondylitis, or sacroiliitis. In the great majority of patients, PsA is accompanied by the most frequent psoriatic manifestation-psoriasis vulgaris. The major genetic risk factor for PsA is an HLA-C allele, and in recent genome-wide association studies few other susceptibility loci have as yet been identified. In this issue, Murdaca et al. (2014) describe an association of an intronic single-nucleotide polymorphism at the TNF locus (+489) with PsA, disease severity, and treatment responses to tumor necrosis factor-? blockers. PMID:25219647

Hüffmeier, Ulrike; Mössner, Rotraut

2014-10-01

211

Diclofenac induced toxic manifestations on adjuvant induced arthritic rats pheripheral and reproductive organ of male wistar rats rattus norvegicus  

Microsoft Academic Search

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are the most frequently prescribed therapeutic agents, used for the treatment of rheumatic diseases, because they have analgesic, antipyretic and anti- inflammatory actions. Diclofenac (Voltaren) is a well-known member of the acetic acid family of NSAIDs, used to reduce inflammation and pain associated with arthritis osteoarthritis, and ankylosing spondylitis. There is considerable interest in the toxicity

Sambandam Subramanian

2009-01-01

212

Perspectives on autoimmunity  

SciTech Connect

The contents of this book are: HLA and Autoimmunity; Self-Recognition and Symmetry in the Immune System; Immunology of Insulin Dependent Diabetes Mellitus; Multiple Sclerosis; Autoimmunity and Immune Pathological Aspects of Virus Disease; Analyses of the Idiotypes and Ligand Binding Characteristics of Human Monoclonal Autoantibodies to DNA: Do We Understand Better Systemic Lupus Erythematosus. Autoimmunity and Rheumatic Fever; Autoimmune Arthritis Induced by Immunization to Mycobacterial Antigens; and The Interaction Between Genetic Factors and Micro-Organisms in Ankylosing Spondylitis: Facts and Fiction.

Cohen, I.R.

1987-01-01

213

Physical Therapy Management of Select Rheumatic Conditions in Older Adults  

Microsoft Academic Search

\\u000a Rheumatic diseases and their resultant musculoskeletal and cardiopulmonary impairments are primary conditions limiting activity\\u000a and function in older adults. Certain rheumatologic conditions such as polymyalgia rheumatica, degenerative spinal stenosis,\\u000a and osteoporosis occur later in life. Other conditions such as rheumatoid arthritis, osteoarthritis (OA), and ankylosing spondylitis\\u000a manifest at younger ages but their clinical manifestations may exacerbate with advancing age and

Maura Daly Iversen; Madhuri K. Kale

214

Exercise and Arthritis  

MedlinePLUS

... made up of daily tasks, both occupational and leisure activities that are usually affected by arthritis. Exercise ... of exercise are 1) therapeutic/rehabilitative; 2) recreational/leisure; and 3) competitive/elite. Finding the right balance ...

215

Juvenile Idiopathic Arthritis  

MedlinePLUS

... Us My Cart Healthy Children > Health Issues > Conditions > Orthopedic > Juvenile Idiopathic Arthritis Health Issues Listen Juvenile Idiopathic ... Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & Emergencies ...

216

What Is Psoriatic Arthritis?  

MedlinePLUS

About psoriasis Treating psoriasis Psoriatic arthritis Pso what? Bullying Info for parents Childhood psoriasis Treatments Diet Support your child Get involved At school Bullying Resources Parent's forum Find a pediatric derm Further ...

217

Juvenile Idiopathic Arthritis  

Microsoft Academic Search

\\u000a The term juvenile idiopathic arthritis (JIA) describes a heterogeneous group of several disease subtypes characterized by\\u000a arthritis beginning before the age of 16 years and where symptoms persist for more than 6 weeks. All subtypes of JIA are of\\u000a unknown cause. Although the pathogenesis for each subtype is likely to be different, JIA is generally regarded to be an autoimmune

Günther E. Dannecker; Martin N. Arbogast; Carol B. Lindsley; H. Schacherl; H. J. Girschick; C. Huemer; A. Heiligenhaus; U. Neudorf

218

Paradoxical Reaction to Golimumab: Tumor Necrosis Factor ? Inhibitor Inducing Psoriasis Pustulosa  

PubMed Central

Importance Golimumab is a human monoclonal antibody, used for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. Adverse reactions are increasing with this class of medication (tumor necrosis factor ? inhibitors). Observations The authors present a case of a female patient who presented with psoriasis pustulosa after the use of golimumab for rheumatoid arthritis. Conclusions and Relevance Paradoxically, in this case, golimumab, which is used for psoriasis, induced the pustular form of this disease. We are observing an increasing number of patients who develop collateral effects with tumor necrosis factor ? inhibitors, and the understanding of the mechanism of action and how these adverse reactions occur may contribute to avoid these sometimes severe situations. PMID:24348382

Soto Lopes, Marien Siqueira; Trope, Beatriz Moritz; Rochedo Rodriguez, Maria Paula Rua; Grynszpan, Rachel Lima; Cuzzi, Tullia; Ramos-e-Silva, Marcia

2013-01-01

219

What epidemiology has told us about risk factors and aetiopathogenesis in rheumatic diseases  

PubMed Central

This article will review how epidemiological studies have advanced our knowledge of both genetic and environmental risk factors for rheumatic diseases over the past decade. The major rheumatic diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus, scleroderma, osteoarthritis, gout, and fibromyalgia, and chronic widespread pain, will be covered. Advances discussed will include how a number of large prospective studies have improved our knowledge of risk factors, including diet, obesity, hormones, and smoking. The change from small-scale association studies to genome-wide association studies using gene chips to reveal new genetic risk factors will also be reviewed. PMID:19490599

Oliver, Jacqueline E; Silman, Alan J

2009-01-01

220

Reconstruction of ankylosed temporomandibular joint: Sternoclavicular grafting as an approach to management.  

PubMed

A retrospective analysis of 15 cases of ankylosed temporomandibular joint (TMJ) reconstructed, with sternoclavicular joint graft (SCG), during the period 2002-2007 was undertaken. All cases were analyzed for functional adaptation of the graft, considering maximum interincisal opening, and protrusive and laterotrusive movement of the jaw. Significant improvement was noticed in all cases except one, although maximum improvement was seen 3-6 months postoperatively. Radiological evaluation was carried out at regular intervals for 2-3 years to assess the anatomical adaptation of the graft. No major postoperative complications were observed and all the cases showed complete regeneration of the clavicle during follow up. This finding indicates that reconstruction of ankylosed TMJ with sternoclavicular joint graft is a satisfactory method of treatment. PMID:21115326

Singh, V; Verma, A; Kumar, I; Bhagol, A

2011-03-01

221

Literature Review and Clinical Presentation of Cervical Spondylitis Due to Salmonella Enteritidis in Immunocompetent  

PubMed Central

A 48-year-old woman was presented to our clinic with some fever and neck pains for about one month. Based on the symptoms and results of image, an empirical diagnosis of tuberculous cervical spondylitis was made. The pain was not significantly decreased after anti-tuberculosis therapy. And, 3 weeks later, she was re-admitted to our hospital for the unbearable pain. An exploration of the C4/5 by the anterior medial approach was recommended to evaluate the germ and debridement. Bacteriological tests showed that the pathogen was Salmonella Enteritidis. The pain was relieved significantly after operation and sensitive antibiotic treatments. Infections with Salmonella Typhi or Salmonella Paratyphi have been well-documented, while there are few reports of cervical spondylitis caused by Salmonella Enteritidis. We reported a case of a healthy woman with whom pyogenic cervical spondylitis of Salmonella Enteritidis was corroborated and treated and reviewed according to previous reports about spondylitis caused by Salmonella Enteritidis in the literature. PMID:24761205

Feng, Zhi-Yun; Guo, Fang

2014-01-01

222

Surgical Treatment of Pyogenic Spondylitis with the Use of Freeze-Dried Structural Allograft  

PubMed Central

Objective Radical debridement and reconstruction is necessary for surgical treatment of pyogenic spondylitis to control infection and to provide segmental stability. The authors identified 25 patients who underwent surgery for pyogenic spondylitis using freeze-dried structural allograft for reconstruction. This study aimed to evaluate and demonstrate the effectiveness and safety of a freeze-dried structural allograft during the surgical treatment of pyogenic spondylitis. Methods From January 2011 to May 2013, we retrospectively reviewed 25 surgically treated patients of pyogenic spondylitis. Surgical techniques used were anterior radical debridement and reconstruction with a freeze-dried structural allograft and instrumentation. In these 25 patients, we retrospectively examined whether the symptoms had improved and the infection was controlled after surgery by evaluating laboratory data, clinical and radiological outcomes. The average follow-up period was 15.7 months (range, 12.2-37.5 months). Results The infection resolved in all of the patients and there were no cases of recurrent infection. The mean Visual Analog Scale score was 6.92 (range, 5-10) before surgery and 1.90 (range, 0-5) at the time of the last follow-up. Preoperatively, lower extremity motor deficits related to spinal infection were noted in 10 patients, and they improved in 7 patients after surgery. Follow-up computed tomographic scans were obtained from 10 patients, and osseous union between the vertebral body and the structural allograft was achieved in 2 patients. Conclusion The freeze-dried structural allograft can be a safe and effective alternative for surgical treatment of pyogenic spondylitis, and another option for vertebral reconstruction instead of using the other materials.

Kim, Seung-Soo; Yoon, Jong-Won; Park, Hyun; Lee, Chul-Hee; Hwang, Soo-Hyun

2014-01-01

223

Interstitial granulomatous dermatitis with arthritis.  

PubMed

Interstitial granulomatous dermatitis with arthritis is an uncommon disorder. In its original description, the presence of linear inflammatory indurations on the lateral aspects of the trunk (the rope sign) in association with arthritis were considered the pathognomonic clinical features. Later cases presenting with plaques and papules have been reported. Herein we describe a case of interstitial granulomatous dermatitis with arthritis without the rope sign. The present case supports the idea that interstitial granulomatous dermatitis with arthritis may have variable clinical appearances. PMID:15257555

Altaykan, Asli; Erkin, Gül; Boztepe, Gonca; Gököz, Aytaç

2004-07-01

224

Interstitial granulomatous dermatitis with arthritis  

Microsoft Academic Search

Interstitial granulomatous dermatitis with arthritis is an uncommon disorder. In its original description, the presence of linear inflammatory indurations on the lateral aspects of the trunk (the rope sign) in association with arthritis were considered the pathognomonic clinical features. Later cases presenting with plaques and papules have been reported. Herein we describe a case of interstitial granulomatous dermatitis with arthritis

Asli Altaykan; Gül Erkin; Gonca Boztepe; Aytaç Gököz

2004-01-01

225

Occupational therapy for rheumatoid arthritis  

Microsoft Academic Search

Background: For persons with rheumatoid arthritis (RA) the physical, personal, familial, social and vocational consequences are extensive. Occupational therapy (OT), with the aim to facilitate task performance and to decrease the consequences of rheumatoid arthritis for daily life activities, is considered to be a cornerstone in the management of rheumatoid arthritis. Till now the efficacy of occupational therapy for patients

E. M. J. Steultjens; J. Dekker; L. M. Bouter; D. J. van Schaardenburg; M. A. H. van Kuyk; C. H. M. van den Ende

2004-01-01

226

Acute Septic Arthritis  

PubMed Central

Acute septic arthritis may develop as a result of hematogenous seeding, direct introduction, or extension from a contiguous focus of infection. The pathogenesis of acute septic arthritis is multifactorial and depends on the interaction of the host immune response and the adherence factors, toxins, and immunoavoidance strategies of the invading pathogen. Neisseria gonorrhoeae and Staphylococcus aureus are used in discussing the host-pathogen interaction in the pathogenesis of acute septic arthritis. While diagnosis rests on isolation of the bacterial species from synovial fluid samples, patient history, clinical presentation, laboratory findings, and imaging studies are also important. Acute nongonococcal septic arthritis is a medical emergency that can lead to significant morbidity and mortality. Therefore, prompt recognition, rapid and aggressive antimicrobial therapy, and surgical treatment are critical to ensuring a good prognosis. Even with prompt diagnosis and treatment, high mortality and morbidity rates still occur. In contrast, gonococcal arthritis is often successfully treated with antimicrobial therapy alone and demonstrates a very low rate of complications and an excellent prognosis for full return of normal joint function. In the case of prosthetic joint infections, the hardware must be eventually removed by a two-stage revision in order to cure the infection. PMID:12364368

Shirtliff, Mark E.; Mader, Jon T.

2002-01-01

227

Dermatoglyphics in rheumatoid arthritis.  

PubMed

Patients with rheumatoid arthritis have been referred to Division of Human Genetics for counselling. Qualitative dermatoglyphics comprising of finger print pattern, interdigital pattern, hypothenar pattern and palmar crease were studied on 26 female and 11 male rheumatoid arthritis patients. Comparison between patient male and control male; and patient female and control female has been done. 'Chi' square test was performed. In male patients, with hands together, arches were increased, loops/ whorls were decreased. Partial Simian crease was significantly increased. In the right hand, patterns were increased in the 3rd interdigital area. On the other hand, in female patients there was a significant increase in whorls and decrease in loops on the first finger on both the hands, increase in arches on the 3rd finger; both arches and whorls on the 4th finger of left hand. Present study has emphasized that dermatoglyphics could be applied as a diagnostic tool to patients with rheumatoid arthritis. PMID:14573963

Ravindranath, Roopa; Shubha, R; Nagesh, H V; Johnson, Job; Rajangam, Sayee

2003-10-01

228

Neonatal Candida arthritis  

PubMed Central

Fungal arthritis is an uncommon yet serious disorder in the newborn. Delay in diagnosis and management can lead to significant morbidity. We report our experience with management of two such cases. Two preterm neonates with multifocal arthritis caused by Candida were studied. Diagnosis was made by clinical examination, laboratory investigations, radiological investigations and culture. Both were treated by aspiration, arthrotomy and antifungal therapy. One patient recovered fully from the infection while the other had growth disturbances resulting in limb length inequality at recent followup. Prompt and expeditious evacuation of pus from joints and antifungal therapy is imperative for treatment. Associated osteomyelitis leads to further difficulty in treatment. PMID:24932046

Sharma, Saurabh; Gangwal, Kapil

2014-01-01

229

Organizing Pneumonia Preceding Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis patients are susceptible to interstitial lung disease, and joint manifestations of rheumatoid arthritis usually precede lung involvements by several years. Organizing pneumonia, as the first manifestation of rheumatoid arthritis, is extremely rare, and its clinical features remain currently unknown. We present a case and a literature review of patients who were pathologically diagnosed with organizing pneumonia first and met the diagnostic criteria of rheumatoid arthritis later. In this review, we observed the following: (1) patients with organizing pneumonia preceding rheumatoid arthritis have a high prevalence of rheumatoid factor or anticyclic citrullinated peptide antibodies; (2) almost all patients developed rheumatoid arthritis within one year after the diagnosis of organizing pneumonia. We suggest that patients with organizing pneumonia and positive for either rheumatoid factor or anticyclic citrullinated peptide antibody should be cautiously followed up regarding the development of rheumatoid arthritis, particularly during the first year after the diagnosis of organizing pneumonia. PMID:24600522

Kinoshita, Yoshiaki; Sakamoto, Atsuhiko; Hidaka, Kouko

2014-01-01

230

Neonatal septic arthritis.  

PubMed

Neonatal septic arthritis has always been considered as separate from its counterpart in older children. The condition is uncommon but serious. Affected neonates usually survive, but with permanent skeletal deformities. Ten cases of neonatal septic arthritis were diagnosed between January 1989 and December 1993 in the neonatal intensive care units of two referral hospitals in the state of Kelantan, Malaysia. All except one neonate was born prematurely. The mean age of presentation was 15.6 days. Joint swelling (10/10), increased warmth (7/10) and erythema of the overlying skin (7/10) were the common presenting signs. Vague constitutional symptoms preceded the definitive signs of septic arthritis in all cases. The total white cell counts were raised with shift to the left. The knee (60%) was not commonly affected, followed by the hip (13%) and ankle (13%). Three neonates had multiple joint involvement. Coexistence of arthritis with osteomyelitis was observed in seven neonates. The commonest organism isolated was methicillin resistant Staphylococcus aureus (9/10). Needle aspiration was performed in nine neonates and one had incision with drainage. Follow up data was available for five neonates and two of these had skeletal morbidity. Early diagnosis by frequent examination of the joints, prompt treatment and control of nosocomial infection are important for management. PMID:9185277

Halder, D; Seng, Q B; Malik, A S; Choo, K E

1996-09-01

231

Juvenile idiopathic arthritis  

Microsoft Academic Search

One of the most enigmatic problems in rheumatology has been juvenile idiopathic arthritis (JIA). Firstly, the classification has often depended on clinical features that have variations between patients. Secondly, there are different classification schemes in usage and there are few objective serologic tests that help to resolve the differences between the criteria sets. Thirdly, only recently have significant advances been

Andrea T. Borchers; Carlo Selmi; Gurtej Cheema; Carl L. Keen; Yehuda Shoenfeld; M. Eric Gershwin

2006-01-01

232

Psoriasis and arthritis  

Microsoft Academic Search

In a population survey of 3659 persons aged 20 years or older, no association was found between psoriasis and rheumatoid arthritis. Inflammatory, degenerative and soft tissue rheumatic diseases occurred in 59% of the psoriatics and 46% of the controls. However, the mean number of rheumatological diagnoses in the psoriatics was 1.1 and in the controls 1.3. Features of psoriasis were

H. A. Valkenburg; W. Swart-Bruinsma; A. Cats; J. Hermans

1984-01-01

233

A case of SAPHO syndrome with destructive spondylodiscitis suspicious of tuberculous spondylitis  

Microsoft Academic Search

We report a rare case of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome in which the differential diagnosis\\u000a included tuberculous spondylitis and the patient ultimately required reconstructive spinal surgery. The patient was a 60-year-old\\u000a woman who presented with severe low-back and leg pain after treatment for tuberculosis. Roentgenography and magnetic resonance\\u000a imaging of the lumbar spine revealed destructive changes suggestive

Jun-ichiro Nakamura; Katsutaka Yamada; Naoto Mitsugi; Tomoyuki Saito

2010-01-01

234

Percutaneous Drainage Combined with Hyperbaric Oxygen Therapy for Pyogenic Spondylitis with Iliopsoas Abscess  

PubMed Central

Study Design A retrospective study. Purpose The purpose of this study was to evaluate outcomes in patients with pyogenic spondylitis accompanied by iliopsoas abscess who were treated by percutaneous drainage combined with hyperbaric oxygen (HBO) therapy. Overview of Literature To the best of our knowledge, there have been no previous reports of the use of percutaneous drainage combined with HBO therapy for the treatment of this condition. Methods Twenty-three patients (13 men, 10 women; mean age, 69.0 years; range, 45-85 years) were treated with percutaneous drainage combined with HBO therapy in addition to commonly used conservative therapy. Mean follow-up duration was 27.7 months (range, 12-48 months). Clinical outcomes and imaging examinations were retrospectively investigated. Results Symptoms such as low back pain, radicular pain, and hip pain resolved in all patients immediately after treatment. Mean time from the start of treatment to the return of C-reactive protein levels to normal or baseline values recorded before the onset of spondylitis was 28.3 days (range, 8-56 days). In the final set of follow-up radiographic studies, all patients were free from progressive destructive changes. Follow-up magnetic resonance images or computed tomography with contrast enhancement confirmed the disappearance or near-total resolution of the iliopsoas abscess cavity with healing of the pyogenic spondylitis in all 23 patients. No recurrences were observed during follow-up. Conclusions The present study suggests that patients with pyogenic spondylitis accompanied by iliopsoas abscess can be cured without a prolonged period of therapy or recurrence using this treatment. PMID:24967038

Koga, Hiroaki; Komiya, Setsuro

2014-01-01

235

SAPHO syndrome with rapidly progressing destructive spondylitis: two cases treated surgically.  

PubMed

The authors present two cases of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome with rapidly progressing destructive spondylitis treated surgically. The spinal lesions in SAPHO syndrome generally have a good prognosis and rarely cause the structural destruction or neurological deterioration. Case 1: a 63-year-old female had palmoplantar pustulosis for 2 years. At first, she only felt a pain in the nape with no inducing factor. Two months later, she had incomplete quadriplegia (ASIA scale C). Magnetic resonance imaging showed destruction of C4-C7, kyphotic deformity, and severe compression of the spinal cord. Decompression and reconstruction surgery using anterior and posterior approach improved her paralysis. Case 2: a 69-year-old female complained of persistent back pain. Magnetic resonance imaging revealed spondylitis of T7-T9. Although there were no typical skin lesions, we diagnosed SAPHO syndrome by hyperostosis of the sternocostoclavicular joint and sacral joint. Destruction with kyphotic deformity of the spine progressed gradually for 3 months. Curettage and reconstruction surgery using thoracic endoscope relieved her pain and prevented the destruction of the spine. The histopathology of the specimen obtained surgically showed non-specific inflammation in both cases. Spondylitis in SAPHO syndrome may cause severe destruction and kyphotic deformity followed by paralysis. PMID:18389286

Takigawa, Tomoyuki; Tanaka, Masato; Nakahara, Shinnosuke; Sugimoto, Yoshihisa; Ozaki, Toshifumi

2008-09-01

236

A case of back pain caused by Salmonella spondylitis -A case report-  

PubMed Central

Salmonella spondylitis is a rare illness, and it generally occurs in patients who have already had sickle cell anemia, and it is even rarer in patients who are without sickle cell anemia. A 61-year-old male patient was hospitalized for the evaluation of his renal function and then treatment was started for his back pain. His back pain had developed about 2 months previously without any specific trauma. Only a bulging disc was detected on the initial lumbar MRI. Regarding his fever, it was diagnosed as possible atypical pneumonia, scrub typhus, etc., and multiple antibiotic therapy was administered. At the time of transfer, the leucocytes and hs-CRP were normal and the ESR was elevated. A diagnostic epidural block was performed for his back pain, but his symptoms were not improved. Lumbar MRI was performed again and it showed findings of infective spondylitis. Salmonella D was identified on the abscess culture and so he was diagnosed as suffering from Salmonella spondylitis. After antibiotic treatment, his back pain was improved and the patient was able to walk. PMID:21286449

Cho, Woo-Jin; Yun, So-Hui; Lee, Seung-Yun; Park, Sang Hyun; Park, Jong Cook; Jang, Eun Hee; Shin, Hhe-Young

2010-01-01

237

Arthritis of the Base of the Thumb  

MedlinePLUS

... other aspects of aging, we adapt to thumb arthritis and treatment is often unnecessary. Options for treatment include non- ... zag deformity Figure 3 - Grind Test Figure 4 - Treatment Diagram PDF Arthritis - Base of the Thumb Related Conditions Psoriatic Arthritis ...

238

Th17 cytokines and arthritis  

Microsoft Academic Search

Th17 cells are implicated in human autoimmune diseases, such as rheumatoid arthritis (RA), although it has not been established\\u000a whether this persistent destructive arthritis is driven by Th1 and\\/or Th17 cells. Interleukin-17A (IL-17A) contributes to\\u000a the pathogenesis of arthritis as has been shown in several experimental arthritis models. Importantly, recent data from first\\u000a clinical trials with anti-IL-17A antibody treatment in

Erik Lubberts

2010-01-01

239

Management of Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis is a common disease, for which every physician should have a sound approach. This paper details the global management of the disease. Guidelines are given for educating the patient and assessing the level of disease activity. Common questions about the indications and uses of non-steroidal anti-inflammatory drugs, local corticosteroid injections, slow-acting agents, immunosuppressive drugs and steroids are discussed. PMID:21278947

Carette, Simon

1984-01-01

240

[Comorbidity in rheumatoid arthritis].  

PubMed

Patients with rheumatoid arthritis (RA) often have one or more comorbid conditions. The prevalence of comorbidities increases with age and disease duration. Comorbidities influence the outcome of RA and limit therapeutic options. Besides suppressing disease activity of RA, screening and tight control of existing comorbidities is essential to avoid further damage. A close cooperation between general practitioners, rheumatologists and attending specialists is important for a successful treatment, taking into account the complex interaction of RA and its comorbidities. PMID:25181002

Albrecht, K

2014-09-01

241

Gene therapy for arthritis  

Microsoft Academic Search

\\u000a Gene therapy has a potential for effective therapeutic intervention in rheumatoid arthritis (RA). Proof of concept has been\\u000a demonstrated in animal models, either through local gene delivery to the joint space or through systemic gene delivery for\\u000a immune intervention. This chapter reviews how certain clinical applications of gene therapy would be beneficial for RA patients\\u000a and discusses the roadblocks that

Florence Apparailly; Paul Peter Tak; Christian Jorgensen

242

Nosocomial neonatal septic arthritis  

Microsoft Academic Search

Between August 1993 and August 1994, 17 cases of neonatal septic arthritis occurred at the intensive care baby unit of Princess\\u000a Badia' Teaching Hospital in Northern Jordan.Klebsiella species was the causative pathogen in 10 patients (59%), which indicates a nosocomial acquired infection. The hip was the\\u000a main joint involved in 94% of cases. An epidemiological survey showed that the spread

F. Abuekteish; A. S. Daoud; M. Mesmar; A. Obeidat

1996-01-01

243

Off-Label Dermatologic Uses of Anti-TNF-a Therapies  

Microsoft Academic Search

Background  Tumor necrosis factor-alpha (TNF-a) is a proinflammatory cytokine that plays an immunomodulatory role in a variety of systemic\\u000a and dermatologic diseases. Currently, three anti-TNF-a drugs are available in North America— infliximab (approved in the U.S.\\u000a for the treatment of rheumatoid arthritis, Crohn’s disease, ankylosing spondylitis, ulcerative colitis, and psoriatic arthritis),\\u000a etanercept (approved in the U.S. for the treatment of rheumatoid

Andrew F. Alexis; Bruce E. Strober

2005-01-01

244

Overview of the radiology of juvenile idiopathic arthritis (JIA)  

Microsoft Academic Search

Plain films remain the basic tool for diagnosis and follow-up evaluation of juvenile idiopathic arthritis (JIA). In this paper, we review the new classification of JIA: systemic arthritis, oligoarthritis (persistent), oligoarthritis (extended), polyarticular arthritis (rheumatoid factor negative), polyarticular arthritis (rheumatoid factor positive), enthesitis related arthritis, psoriatic arthritis and unclassified arthritis. We will also review regional abnormalities of three stages: an

P. A Cohen; C. H Job-Deslandre; G Lalande; C Adamsbaum

2000-01-01

245

Rubella and juvenile chronic arthritis.  

PubMed Central

A 9-year-old boy with a clinical illness similar to juvenile rheumatoid arthritis was found to have rubella virus in the synovial fluid. There was complete remission of symptoms after 3 months. The role of rubella virus as a possible possible aetiological agent in juvenile rheumatoid arthritis is discussed. PMID:7247445

Smith, M F; Haycock, G B; Grahame, R

1981-01-01

246

Juvenile idiopathic arthritis: an update  

Microsoft Academic Search

Juvenile idiopathic arthritis (JIA) is the most com- mon chronic arthropathy of childhood. Previous ter- minology identified this entity as juvenile rheumatoid arthritis. The 7 subsets of JIA identified under the new classification system are discussed, as are current treatments. A differential diagnosis of JIA is included as this condition continues to be diagnosed by exclu- sion. Recent studies, which

S Singh; KR Jat

2008-01-01

247

Subchondral pseudocysts in rheumatoid arthritis.  

PubMed

Subchondral cyst formation (geode) is a not uncommon manifestation of rheumatoid arthritis which may at times impede correct radiologic interpretation. Four patients with rheumatoid arthritis who demonstrated striking subarticular cystic erosive disease are described. These cases emphasize the nature and appearance of this interesting finding. PMID:413361

Rennell, C; Mainzer, F; Multz, C V; Genant, H K

1977-12-01

248

The microbiome and psoriatic arthritis.  

PubMed

Psoriatic arthritis is a chronic inflammatory joint disease, seen in combination with the chronic inflammatory skin disease psoriasis and belonging to the family of spondylarthritides (SpA). A link is recognized between psoriatic arthritis and inflammatory bowel disease (IBD). Environmental factors seem to induce inflammatory disease in individuals with underlying genetic susceptibility. The microbiome is a subject of increasing interest in the etiology of these inflammatory immune-mediated diseases. The intestinal microbiome is able to affect extra-intestinal distant sites, including the joints, through immunomodulation. At this point, evidence regarding a relationship between the microbiome and psoriatic arthritis is scarce. However, we hypothesize that common immune-mediated inflammatory pathways seen in the "skin-joint-gut axis" in psoriatic arthritis are induced or at least mediated by the microbiome. Th17 has a crucial function in this mechanism. Further establishment of this connection may lead to novel therapeutic approaches for psoriatic arthritis. PMID:24474190

Eppinga, Hester; Konstantinov, Sergey R; Peppelenbosch, Maikel P; Thio, H Bing

2014-03-01

249

Capillaroscopic pattern in inflammatory arthritis  

PubMed Central

Background There are limited data about the role of nailfold capillaroscopy in inflammatory arthritis. Objectives To study the role of capillaroscopy in inflammatory arthritis — rheumatoid arthritis (RA), psoriatic arthritis (PsA) and early arthritis. Methods Patients from the following groups were included in the study: 62 patients with RA; 34 patients with PsA with involvement of the joints of the hands; 9 women with early arthritis. Nailfold capillaroscopy was performed with videocapillaroscope. Results Raynaud's phenomenon (RP) was found in 30.6% (19/62) of RA patients, in 32.4% (11/34) of PsA patients and 44.4%, (4/9) of cases with early arthritis. The most frequent found capillaroscopic changes in RA patients were presence of elongated capillaries in 58% of cases (36/62) and prominent subpapillary plexus in 69% (43/62). Dilated capillaries were found in 78.9% (15/19) of patients with secondary RP and in 62.8% (27/43) of those without RP. “Scleroderma-like” capillaroscopic pattern was observed with low frequency in RA patients (14.5%/9/62). “Scleroderma-like” capillaroscopic pattern was also found in 11.1% (1/9) in the group of patients with early arthritis. The low frequency of the last type of capillaroscopic pattern in RA requires patients with such changes to be observed during regular follow-up for the development of systemic rheumatic disease different from inflammatory arthritis. In patients with PsA capillaries with specific morphology (tight terminal convolutions) were found in 58.8% (20/34) of cases. Conclusions Results from the present study confirm the necessity for inclusion of the nailfold capillaroscopy in the diagnostic algorithm in patients with inflammatory arthritis. PMID:22426123

Lambova, Sevdalina Nikolova; Muller-Ladner, Ulf

2012-01-01

250

Clotrimazole in rheumatoid arthritis.  

PubMed Central

Forty-seven patients with active rheumatoid arthritis took part in an 8-week controlled study in which clotrimazole was compared with a standard nonsteroidal anti-inflammatory agent, ketoprofen. Although clotrimazole was shown to be effective in the treatment of the disease and superior to ketoprofen in certain measurements, if was also responsible for a high incidence of adverse effects. Improvement with clotrimazole took place more slowly but was more sustained than with ketoprofen. A significant rise in plasma cortisol and a fall in white cell count was observed in the clotrimazole treated patients. PMID:7002065

Wojtulewski, J A; Gow, P J; Walter, J; Grahame, R; Gibson, T; Panayi, G S; Mason, J

1980-01-01

251

Pain and microcrystalline arthritis.  

PubMed

Microcrystals are responsible for some of the most common and complex arthropathies which are often accompanied by intense, severe pain and inflammatory reactions. The main pathogens are crystals of monosodium urate (MSU), responsible for the gout, calcium pyrophosphate (CPP), which deposits also in various clinical forms of arthopathies, and basic calcium phosphate associated with osteoarthritis. In this context, the microcrystal arthritis is characterized by multiple, acute attacks followed by chronic pain, disability, impaired quality of life, and increased mortality. Given their chronic nature, they represent an ever more urgent public health problem. MSU and CPP crystals are also able to activate nociceptors. The pain in mycrocrystalline arthritis (MCA) is an expression of the inflammatory process. In the course of these diseases there is an abundant release of inflammatory molecules, including prostaglandins 2 and kinins. Interleukin-1 represents the most important cytokine released during the crystal-induced inflammatory process. Therefore, clinically, pain is the most important component of MCA, which lead to functional impairment and disability in a large proportion of the population. It is fundamental to diagnose these diseases as early as possible, and to this aim, to identify appropriate and specific targets for a timely therapeutic intervention. PMID:24938197

Ramonda, R; Frallonardo, P; Oliviero, F; Lorenzin, M G; Ortolan, A; Scanu, A; Punzi, L

2014-01-01

252

Efectos del tratamiento con anti-TNF-a, infliximab, sobre la resistencia insulínica, adipocinas (visfatina, leptina, adiponectina, resistina y apelina) y angiopoyetina-2 en pacientes con espondilitis anquilosante.  

E-print Network

??Ankylosing Spondylitis (AS) is a chronic inflammatory disease that affects the spine causing sacroiliitis. These patients have accelerated atherogenesis and insulin resistance, which promotes endothelial… (more)

Miranda Filloy, José Alberto

2014-01-01

253

[Case of pyogenic spondylitis and epidural abscess after chemoradiotherapy for hypopharyngeal cancer].  

PubMed

Osteomyelitis is one of the most severe late complications of radiation therapy. The condition can arise from osteoradionecrosis and can be fatal if it occurrs in vertebrae. A 71-year-old woman, who had undergone chemoradiotherapy for hypopharyngeal cancer 6 months previously, presented with severe neck pain. An MRI examination revealed pyogenic spondylitis and an epidural abscess of the neck. Neurological disturbance in the extremities developed despite the administration of antibiotics for 5 days. Drainage and a laminectomy were performed to control the infection and to relieve spinal cord compression. The patient had no postoperative complications at 15 months after surgery. Previous case reports of osteomyelitis and epidural abscess following radiation therapy for head and neck cancer with surgical treatment tended to have a good clinical course. Severe neck pain and a limitation in the range of motion of the neck are considered to be serious clinical features of osteomyelitis. Since infection in the necrotic mucosa leads to pyogenic spondylitis, a repeated cultivation survey of the mucosa is nessesary for adequate antibiotics therapy. For osteomyelitis and epidural abscess following radiation therapy, immediate specific surgical treatment of the involved region is strongly suggested if antibiotics are not effective or spinal cord compression develops. PMID:24558949

Kuba, Kiyomi; Inoue, Hitoshi; Matsumura, Satoko; Minami, Kazuhiko; Takajo, Fumihiko; Morita, Kei; Nakahira, Mitsuhiko; Sugasawa, Masashi

2013-12-01

254

Handout on Health: Rheumatoid Arthritis  

MedlinePLUS

... many other rheumatic diseases, rheumatoid arthritis is an autoimmune disease ( auto means self), so-called because a person’s ... risk; it may also help explain why different autoimmune diseases tend to run in families. Other studies have ...

255

Inflammatory arthritis in children with osteochondrodysplasias  

PubMed Central

Osteochondrodysplasias are a heterogeneous group of genetic skeletal dysplasias. Patients with these diseases commonly develop an early degenerative arthritis or osteoarthritis. Occasional observations of inflammatory arthritis have been made in this population but such observations are based on clinical grounds alone without confirmatory imaging studies. Four patients followed up in a paediatric rheumatology clinic with three different skeletal dysplasias, who had both clinical and radiological evidence of an inflammatory arthritis and coexistent degenerative arthritis, are described.?? PMID:11053062

Scuccimarri, R.; Azouz, E; Duffy, K.; Fassier, F.; Duffy, C.

2000-01-01

256

Paralysis Developing as a Paradoxical Response During the Treatment for Tuberculous Spondylitis: A Case Report  

PubMed Central

It can be difficult for clinicians to distinguish a paradoxical response to antituberculous therapy, worsening of an existing lesion despite adequate treatment, treatment failure, and drug resistance. We report a case of a 69-year-old woman who experienced bilateral lower extremity paralysis secondary to a paradoxical response. She had been suffering for 1 month from low back pain, due to tuberculous spondylitis. Her low back pain improved after antituberculous therapy. The low back pain, however, reappeared 2 months after treatment, accompanied by newly developed lower extremity weakness. Imaging studies showed an increased extent of her previous lesions. Consequently, the patient underwent a vertebral corpectomy with interbody fusion of the thoracolumbar spine. Histopathological examination showed chronic inflamed granulation tissue with no microorganisms. Although the antituberculous medication was not changed, the patient's symptoms and signs, including the paralysis, resolved after surgery. PMID:25024967

Park, Jae Hyeon; Kim, Yeo Hyung; Kwon, Chan Hyuk

2014-01-01

257

Interstitial granulomatous dermatitis with arthritis.  

PubMed

A 54-year-old woman with a history of arthritis presented for a long-standing history of symmetric, indurated plaques on her thighs and lateral aspects of the trunk. Histopathologic examination of skin biopsy specimens was consistent with interstitial granulomatous dermatitis, and a diagnosis of interstitial granulomatous dermatitis with arthritis was made. Administration of topical potent glucocorticoids, intralesional glucocorticoids, and narrow-band ultraviolet B phototherapy, in addition to continuation of systemic glucocorticoids and methotrexate, resulted in improvement of her cutaneous and musculoskeletal disease. PMID:19891930

Jabbari, Ali; Cheung, Wang; Kamino, Hideko; Soter, Nicholas A

2009-01-01

258

Current Therapy of Rheumatoid Arthritis  

PubMed Central

The well informed and well motivated patient with rheumatoid arthritis today has an excellent chance of avoiding serious disability and deformity. No available pharmacologic agent can permanently alter the course of the disease, and no pharmacologic agent can preclude the need for a balanced program emphasizing moderation, rest and constant attention to physical therapy. Early synovectomy is enjoying increasing popularity although the long-term benefits have yet to be established. The several drugs now undergoing trial hold little promise of materially altering the management of rheumatoid arthritis in the near future. The skills of physician, surgeon, and physiatrist must be brought to bear to provide optimal care. PMID:4883503

Kamin, Edward J.; Multz, Carter V.

1969-01-01

259

[The effectiveness of BACTEC MGIT 960 system hit analysis of surgery material of patients with tubercular spondylitis].  

PubMed

The article considers the comparison of effectiveness of cultivation of 290 surgery samples from focus of destruction in patients with tubercular spondylitis in liquid medium Middlebrook 7119 with fluorescent detection of growth and two dense egg medium -Levenschtein-Yensen and Finn-II. The sensitivity of methods of inoculation in liquid medium Middlebrook 7H9 and in dense egg mediums has no difference (38.2% and 43.1%, p = 0.271). The duration of growth consisted 2 +/- 2.3 days for liquid mediums and 40.6 +/- 3.2 days for dense mediums. The method of pre-inoculation processing of surgery material. In case of inoculation of 440 samples in liquid mediums contamination consisted 3.9%. In case of inoculation of bone fragments of focus of destruction in liquid medium Middlebrook 7119 the culture was isolated in 43.5% of samples of patients with tubercular spondylitis. PMID:24757865

Solov'eva, N S; Manicheva, O A; Steklova, L N; Ole?nik, V V; Shul'gina, M V

2013-12-01

260

Leprosy and rheumatoid arthritis: consequence or association?  

PubMed

Leprosy or Hansen's disease is a chronic granulomatous infectious disease caused by Mycobacterium leprae with a high prevalence in some developing countries however, it is rarely seen in non-endemic regions. Arthritis has been described in all types of Hansen's disease. Chronic arthritis is known to exist even in paucibacillary forms, resolved or treated disease and in patients without reaction, suggesting a perpetuated inflammatory process. In these cases leprosy can mimic some autoimmune diseases such as rheumatoid arthritis. When a patient with a history of leprosy presents with a symmetric, distal, polyarthritis the diagnosis may not be linear. Possibly it is a rheumatoid-like leprous arthritis with M leprae acting as the trigger element for the chronic process or it is an overlap condition, with a concomitant rheumatoid arthritis? A case report of a patient with a chronic inflammatory arthritis with 10 years of evolution is presented. The differential diagnosis between leprous and rheumatoid arthritis is discussed. PMID:22891014

Henriques, Celia Coelho; Lopéz, Begońa; Mestre, Tiago; Grima, Bruno; Panarra, António; Riso, Nuno

2012-01-01

261

[The early diagnosis of spondyloarthritis].  

PubMed

The most frequent early symptoms of spondyloarthritides are inflammatory back pain and asymetric peripheral arthritis. Currently the mean delay between the onset of first symptoms and diagnosing ankylosing spondylitis which is the frequent type of spondyloarthritis is over 5 years. The availability of effective therapies makes an early diagnosis mandatory. The clinical symptoms of inflammatory back pain, active inflamation on MR, and positivity for HLA-B27 are the most important parameters for an early diagnosis of spondyloarthritis, especially in combination. Moreover, the combination of clinical and laboratory parameters is necessary for the early diagnosis. PMID:22232947

Novak, Srdan

2011-01-01

262

Preparation, characterization and dissolution studies of fast release diclofenac sodium tablets from PVP solid dispersions.  

PubMed

Diclofenac sodium is a non-steroidal anti-inflammatory drug widely used in the treatment of ankylosing spondylitis, rheumatoid arthritis and osteoarthritis. In this context, a rapid onset of action is required. Thus, the aim of this study was to formulate diclofenac sodium-PVP K-30 fast release tablets from solid dispersions. The physical state and drug:carrier interactions were analyzed by X-ray diffraction and scanning electron microscopy and stability upon storage was also studied. Dissolution rate of diclofenac sodium from solid dispersions was markedly enhanced by increasing the polymer concentration. PMID:19589124

Lamas, Maria Celina; Leonardi, Darío; Lambri, Osvaldo A; Bassani, Georgina; Barrera, María G; Bolmaro, Raúl E; Salomon, Claudio J

2010-01-01

263

Therapeutic strategies for rheumatoid arthritis  

Microsoft Academic Search

Recent years have seen considerable advances in our understanding of both the clinical and basic-research aspects of rheumatoid arthritis. Clinical progress has come from a better recognition of the natural history of the disease, the development and validation of outcome measures for clinical trials and, consequently, innovative trial designs. In parallel, basic research has provided clues to the pathogenic events

Günter Steiner; Josef S. Smolen

2003-01-01

264

Interstitial granulomatous dermatitis with arthritis  

Microsoft Academic Search

Background: Interstitial granulomatous dermatitis with arthritis is an uncommon systemic disorder involving the cutaneous and musculoskeletal systems. The eruption may mimic other dermatoses including granuloma annulare, erythema chronicum migrans, and the inflammatory stage of morphea. Key histopathologic characteristics, along with clinical correlation, allow accurate diagnosis.Objective: We describe the clinical, serologic, and histologic features in three patients with interstitial granulomatous dermatitis

David Long; Diane M Thiboutot; Joseph T Majeski; David B Vasily; Klaus F Helm

1996-01-01

265

Somatostatin Involvement in Rheumatoid Arthritis  

Microsoft Academic Search

Somatostatin (somatotropin release inhibitory factor; SRIF) peptides are widely distributed in the mammalian body and, acting through a family of genetically homologous cell surface receptors (sst1-5), regulate cellular secretion and proliferation. Compelling evidence implicates SRIF peptides and peptidyl analogues in chronic inflammatory diseases such as rheumatoid arthritis (RA). SRIF membrane receptors exist on immune and synovial cells, thereby providing mo-

Allan D. Blake; Frances Mae West; Sadia Ghafoor; Petros Efthimiou

2007-01-01

266

Lyme arthritis of the pediatric ankle.  

PubMed

Lyme arthritis results from acute inflammation caused by the spirochete Borrelia burgdorferi. The number of cases per year has been rising since 2006, with a majority of patients being affected in the northeastern United States. Development of Lyme arthritis is of particular importance to the orthopedic surgeon because Lyme arthritis often presents as an acute episode of joint swelling and tenderness and may be confused with bacterial septic arthritis. Considering the vast difference in treatment management between these 2 pathologies, differentiating between them is of critical importance. Septic arthritis often needs to be addressed surgically, whereas Lyme arthritis can be treated with oral antibiotics alone. Laboratory testing for Lyme disease often results in a delay in diagnosis because many laboratories batch-test Lyme specimens only a few times per week because of increased expense. The authors present a case of Lyme arthritis in the pediatric ankle in an endemic region. No clear algorithm exists to delineate between septic arthritis and Lyme arthritis of the joint. Improved clinical guidelines for the identification and diagnosis of Lyme arthritis of the ankle are important so that appropriate antibiotics can be used and surgery can be avoided. PMID:25275987

Aiyer, Amiethab; Walrath, Jessica; Hennrikus, William

2014-09-01

267

Health Tip: Cooking Can Be Challenging with Arthritis  

MedlinePLUS

... JavaScript. Health Tip: Cooking Can Be Challenging With Arthritis Meal planning can help ease the strain (*this ... Kohnle Tuesday, October 28, 2014 Related MedlinePlus Page Arthritis (HealthDay News) -- Arthritis can make cooking difficult, but ...

268

Epigenetics in the pathogenesis of rheumatoid arthritis  

PubMed Central

An increasing number of studies show that besides the inherited genetic architecture (that is, genomic DNA), various environmental factors significantly contribute to the etiology of rheumatoid arthritis. Epigenetic factors react to external stimuli and form bridges between the environment and the genetic information-harboring DNA. Epigenetic mechanisms are implicated in the final interpretation of the encoded genetic information by regulating gene expression, and alterations in their profile influence the activity of the immune system. Overall, epigenetic mechanisms further increase the well-known complexity of rheumatoid arthritis by providing additional subtle contributions to rheumatoid arthritis susceptibility. Although there are controversies regarding the involvement of epigenetic and genetic factors in rheumatoid arthritis etiology, it is becoming obvious that the two systems (genetic and epigenetic) interact with each other and are ultimately responsible for rheumatoid arthritis development. Here, epigenetic factors and mechanisms involved in rheumatoid arthritis are reviewed and new, potential therapeutic targets are discussed. PMID:24568138

2014-01-01

269

Which Psoriasis Patients Develop Psoriatic Arthritis?  

PubMed Central

Psoriatic arthritis is a major comorbidity of psoriasis that significantly impairs quality of life and physical function. Because skin lesions classically precede joint symptoms, dermatologists are in a unique position to identify patients at risk for psoriatic arthritis before irreversible joint damage occurs. Here we review the literature to identify the clinical and genetic factors most highly associated with development of psoriatic arthritis, with the goal of assisting dermatologists in risk-stratifying their psoriasis patients.

Busse, Kristine; Liao, Wilson

2013-01-01

270

An Unusual Case of Post-Operative Spondylitis Caused by Mycobacterium Intracellulare in an Immunosuppressed Patient  

PubMed Central

There are few reported cases of post-operative spondylitis caused by Mycobacterium intracellulare. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were positive for acid-fast bacilli and traditional anti-tuberculous medications were started. Because the Polymerase Chain Reaction for non-tuberculous mycobacterium (NTM) was positive, the anti-tuberculous medications were changed to anti-NTM drugs. However, the neurologic deficits did not improve and persistent elevation of erythrocyte sedimentation rate and C-reactive protein were noted. Eight weeks after the revision, Mycobacterium intracellulare was detected in the specimen cultures. Despite supportive care with medication, the patient died due to multiple organ failure. PMID:22259695

Kim, Sung Hoon; Lee, Sang Weon; Song, Geun Sung

2011-01-01

271

Arthritis - Multiple Languages: MedlinePlus  

MedlinePLUS

... Multiple Languages Arabic (???????) Chinese - Simplified (????) French (français) Hindi (??????) Japanese (???) Korean (???) Russian ( ... Chinese - Simplified) Bilingual PDF Health Information Translations French (français) Arthritis Arthrite - français (French) Bilingual PDF Health Information ...

272

[Antibiotic treatment in Lyme arthritis].  

PubMed

Primary cause of Lyme arthritis (LA) is an invasion and survival of Borrelia burgdorferi s.l. spirochetes within joint tissues. Elimination of the pathogen is an effective treatment method in a great majority of patients and can be achieved by a number of antibiotic regimens of confirmed efficacy. Antibiotic therapy lasting for 2 to 4 weeks enables eradication of the infection, followed by resolution of arthritis within weeks to months. If insufficient, the course of therapy may be repeated up to 3 times in a few months' intervals, although effectiveness of repeated treatment is not so well confirmed and probably small. Further symptoms, persisting in spite of proper antibiotherapy, typically are not caused by ongoing infection, but rather by autoimmune phenomena or persistent damage to the joint, so further administration of antibiotics in such patients seems of no benefit. PMID:22320035

Grygorczuk, Sambor; Zajkowska, Joanna; Kondrusik, Maciej; Moniuszko, Anna; Pancewicz, S?awomir

2008-01-01

273

Biologic therapies for juvenile arthritis  

PubMed Central

A group of therapies with exciting potential has emerged for children and young people with severe juvenile idiopathic arthritis (JIA) uncontrolled by conventional disease modifying drugs. Theoretical understanding from molecular biologic research has identified specific targets within pathophysiological pathways that control rheumatoid arthritis (RA) and JIA. This review identifies the pathways of autoimmunity to begin to show how biologic agents have been produced to replicate, mimic, or block culpable molecules and so promote or inhibit cellular activity or proliferation. Of these agents, cytokine antagonists have shown greatest promise, and early clinical studies of tumour necrosis factor (TNF) blockade have identified dramatic clinical benefit in many children with JIA. However, as will also be discussed, overlap of pathways within a complex immune system makes clinical response unpredictable and raises additional ethical and administrative concerns. PMID:12598373

Wilkinson, N; Jackson, G; Gardner-Medwin, J

2003-01-01

274

Two forms of reactive arthritis?  

PubMed Central

Inflammatory arthritides developing after a distant infection have so far been called reactive or postinfectious, quite often depending on the microbial trigger and/or HLA-B27 status of the patient. For clarity, it is proposed that they all should be called reactive arthritis, which, according to the trigger, occurs as an HLA-B27 associated or non-associated form. In addition to the causative agents and HLA-B27, these two categories are also distinguished by other characteristics. Most important, HLA-B27 associated arthritis may occur identical to the Reiter's syndrome with accompanying uretheritis and/or conjunctivitis, whereas in the B27 non-associated form this has not been clearly described. Likewise, only the B27 associated form belongs to the group of spondyloarthropathies.?? PMID:10577958

Toivanen, P.; Toivanen, A.

1999-01-01

275

Microbial Infection and Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a complex autoimmune disease affecting 1–2% of general worldwide population. The etiopathogenesis of RA involves the interplay of multiple genetic risk factors and environmental triggers. Microbial infections are believed to play an important role in the initiation and perpetuation of RA. Recent clinical studies have shown the association of microbial infections with RA. Accumulated studies using animal models have also found that microbial infections can induce and/or exaggerate the symptoms of experimental arthritis. In this review, we have identified the most common microbial infections associated with RA in the literature and summarized the current evidence supporting their pathogenic role in RA. We also discussed the potential mechanisms whereby infection may promote the development of RA, such as generation of neo-autoantigens, induction of loss of tolerance by molecular mimicry, and bystander activation of the immune system. PMID:25133066

Li, Song; Yu, Yangsheng; Yue, Yinshi; Zhang, Zhixin; Su, Kaihong

2014-01-01

276

Treatment recommendations for psoriatic arthritis  

PubMed Central

Objective: To develop comprehensive recommendations for the treatment of the various clinical manifestations of psoriatic arthritis (PsA) based on evidence obtained from a systematic review of the literature and from consensus opinion. Methods: Formal literature reviews of treatment for the most significant discrete clinical manifestations of PsA (skin and nails, peripheral arthritis, axial disease, dactylitis and enthesitis) were performed and published by members of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Treatment recommendations were drafted for each of the clinical manifestations by rheumatologists, dermatologists and PsA patients based on the literature reviews and consensus opinion. The level of agreement for the individual treatment recommendations among GRAPPA members was assessed with an online questionnaire. Results: Treatment recommendations were developed for peripheral arthritis, axial disease, psoriasis, nail disease, dactylitis and enthesitis in the setting of PsA. In rotal, 19 recommendations were drafted, and over 80% agreement was obtained on 16 of them. In addition, a grid that factors disease severity into each of the different disease manifestations was developed to help the clinician with treatment decisions for the individual patient from an evidenced-based perspective. Conclusions: Treatment recommendations for the cardinal physical manifestations of PsA were developed based on a literature review and consensus between rheumatologists and dermatologists. In addition, a grid was established to assist in therapeutic reasoning and decision making for individual patients. It is anticipated that periodic updates will take place using this framework as new data become available. PMID:18952643

Ritchlin, C T; Kavanaugh, A; Gladman, D D; Mease, P J; Helliwell, P; Boehncke, W-H; de Vlam, K; Fiorentino, D; FitzGerald, O; Gottlieb, A B; McHugh, N J; Nash, P; Qureshi, A A; Soriano, E R; Taylor, W J

2009-01-01

277

The Management of Psoriatic Arthritis  

Microsoft Academic Search

The management of psoriatic arthritis (PsA) begins with education. Each consultation provides an opportunity for the physician\\u000a to counsel the patient and family about the disease and its clinical course that is unique to that individual. It is a chance\\u000a for the patient and family to learn and adapt. There are also a variety of further ways for instruction to

Philip J. Mease

278

Acute non-infectious arthritis of the hip in rheumatoid arthritis: synovial membrane findings.  

PubMed

A case of acute hip pain in rheumatoid arthritis is presented, with synovial membrane findings. A patient with classical rheumatoid arthritis suffered three unusual bouts of sudden, severe but transient hip pain. The hips were clinically normal between these episodes. The clinical picture on two of these occasions strongly suggested septic arthritis. Although the synovial fluid was highly inflammatory, cultures were negative. The synovial membrane showed mild lining cell hyperplasia, vascular congestion, and scattered inflammatory cells, predominantly lymphocytes. These findings were not compatible with either pyogenic infection or longstanding rheumatoid arthritis. The clinical and pathological features of acute non-infectious arthritis of the hip appear to delineate a distinct syndrome. PMID:2930281

Wohlgethan, J R; Stilmant, M M; Harris, J M; Smith, H R

1989-03-01

279

Atypical mycobacterial spondylitis as a challenging differential diagnosis to metastatic disease of the spine: a case report.  

PubMed

Disseminated Mycobacterium avium complex (MAC) infection is rarely seen in patients without acquired immune deficiency syndrome. A disseminated MAC infection presenting with symptoms that mimic tumor metastasis had not previously been reported. Few disseminated MAC infections have been reported, and all image patterns in these cases indicated destructive lesions. We present a case involving a tumor-like disseminated MAC infection with spondylitis in a 68-year-old man whose symptoms started with severe lower back pain and fever. Treatment for malignancy was performed initially but soon stopped after tissue proving MAC infection. Symptoms then improved dramatically after a four-drug combined anti-nontuberculous mycobacteria treatment. PMID:23412200

Wang, Chien-Shun; Feng, Shang-Wen; Huang, Ling-Ju; Yu, Jung-Kuang; Chang, Ming-Chau; Wang, Shih-Tien; Liu, Chien-Lin

2013-11-01

280

[The multidisciplinary practice guideline "The responsible use of biologicals"].  

PubMed

A multidisciplinary working group has developed a practice guideline containing various recommendations on the responsible and efficient use of biologicals. These biologicals include both soluble immune-receptor proteins and monoclonal antibodies that are aimed at immune mediators, receptors or cells. They are produced by biotechnology. Biologicals are used to treat patients with immune-mediated inflammatory disorders (IMIDs) such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis, juvenile idiopathic arthritis (JIA), psoriasis, ulcerative colitis, Crohn's disease, uveitis and sarcoidosis. This article summarises the most important recommendations contained in the practice guideline. The practice guideline is intended for members of the medical profession in addition to patients, who are considering, or are already, using biologicals. PMID:22085508

Bijlsma, J W J Hans; Hagemeijer, J W Annemarie; Bijl, Marc; Jansen, Tim L Th A; van de Laar, Mart A F J; Landewé, Robert B M; Nurmohamed, Mike T

2011-01-01

281

Refractory vertebral sarcoidosis responding to infliximab.  

PubMed

Treatment of refractory sarcoidosis may be challenging for clinicians. Despite treatment with conventional therapy, sarcoidosis may be progressive and debilitating. Previous studies have implicated a role for tumor necrosis factor-alpha in granuloma formation as seen in sarcoidosis. Tumor necrosis factor-alpha inhibitors are currently approved to treat rheumatoid arthritis, Crohn disease, psoriasis, psoriatic arthritis, ankylosing spondylitis, and juvenile rheumatoid arthritis. There have been recent case-reports supporting treatment of refractory and multisystem sarcoidosis with such agents. We report a case of sarcoidosis, involving the lung and vertebrae, which was refractory to conventional therapy. Our patient's clinical symptoms and radiologic lesions of vertebral sarcoid dramatically improved after treatment with infliximab. PMID:18766126

Garg, Sanjay; Garg, Kusum; Altaf, Mujeeb; Magaldi, John A

2008-08-01

282

Differentiating the efficacy of the tumor necrosis factor inhibitors.  

PubMed

The tumor necrosis factor inhibitors are a diverse group of biologic agents. Although there are no studies that directly compare these agents, data from noncomparative trials suggest that all 3 agents have therapeutic activity in rheumatoid arthritis. Etanercept and infliximab have also demonstrated beneficial activity in other inflammatory arthritides (ie, psoriatic arthritis and ankylosing spondylitis [both agents] and juvenile rheumatoid arthritis [etanercept only]) and inflammatory diseases (ie, psoriasis and uveitis). Their effects in granulomatous diseases are more variable, with only infliximab demonstrating clear efficacy in the treatment of Crohn's disease, sarcoidosis, and Wegener's granulomatosis. The purpose of this brief review is to summarize current efficacy data and explore possible explanations for observed clinical differences. PMID:15852248

Haraoui, Boulos

2005-04-01

283

Role of biological agents in immune-mediated inflammatory diseases.  

PubMed

A new era in the treatment of immune-mediated inflammatory disorders has begun with the clinical availability of anticytokine therapy. Biological agents that are currently available include 3 agents that decrease the activity of tumor necrosis factor-alpha (infliximab, adalimumab, etanercept) and an interleukin-1 receptor antagonist (anakinra), with many more in development. Those extraordinarily effective medications are an important addition to our therapeutic armamentarium, and, although originally developed for rheumatoid arthritis and Crohn disease, have been found to be efficacious in the treatment of seronegative spondyloarthropathies (psoriatic arthritis, ankylosing spondylitis) and juvenile rheumatoid arthritis. Their role is currently being defined in other autoimmune disorders such as uveitis, sarcoidosis, interstitial lung disease, vasculitis, inflammatory myopathies, graft-versus-host disease, and Sjögren syndrome. PMID:15759950

Efthimiou, Petros; Markenson, Joseph A

2005-02-01

284

Differentiating the efficacy of tumor necrosis factor inhibitors.  

PubMed

Blockade of tumor necrosis factor (TNF) has emerged as one of the most promising therapies in rheumatoid arthritis (RA). Three agents are currently available as specific TNF antagonists, etanercept (Enbrel), infliximab (Remicade), and adalimumab (Humira). Data from noncomparative trials suggest that all 3 agents have comparable therapeutic activity in RA. Etanercept and infliximab have also demonstrated beneficial activity in other inflammatory arthritides [i.e., psoriatic arthritis and ankylosing spondylitis (both agents) and juvenile rheumatoid arthritis (etanercept only)] and inflammatory diseases (i.e., psoriasis and uveitis). Their effects in granulomatous diseases are more variable, with only infliximab demonstrating clear efficacy in the treatment of Crohn's disease, sarcoidosis, and Wegener's vasculitis. In this brief review current efficacy data are summarized and possible explanations for observed clinical differences are explored. PMID:15742457

Haraoui, Boulos

2005-03-01

285

Treatment of thalidomide resistant pyoderma gangrenosum with etenercept.  

PubMed

Tumor necrosis factor alfa (TNF-?) is a cytokine with a central role in inflammation. Its blockade can be achieved by using specific inhibitors like etanercept. At present, etanercept is approved for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and psoriasis treatment. However, it has been used with promising results in other inflammatory dermatoses. A case is presented of a 54-year-old man diagnosed with pyoderma gangrenosum. He completed treatment with oral prednisolone with favorable outcome, but with recurrence after glucocorticoid therapy withdrawal. Thalidomide was introduced, but after complaints of glove and sock paresthesia and hypoesthesia, the drug was discontinued. Taking into account the favorable outcome with thalidomide and the necessity of drug withdrawal, it was decided to introduce therapy acting on the same step in the inflammation cascade. In this regard, etanercept was initiated. The aim of this article is to present an alternative therapy for refractory pyoderma gangrenosum, along with a literature review. PMID:23069303

Guedes, Rita; Moreira, Ana; Menezes, Nuno; Baptista, Armando; Varela, Paulo

2012-01-01

286

Autoimmune correlation of rheumatoid arthritis and periodontitis  

PubMed Central

Rheumatoid arthritis and periodontitis, both, chronic inflammatory diseases share certain common diagnostic, pathological, immunogenetic and therapeutic features. A recently discovered enzymatic mimicry between human and bacterial species is novel and it opens up a new terrain for therapeutic blockade in the management of rheumatoid arthritis.

Arunachalam, Lalitha Tanjore

2014-01-01

287

Schizophrenia, rheumatoid arthritis and natural resistance genes  

Microsoft Academic Search

The strong negative correlation between schizophrenia and rheumatoid arthritis might provide clues as to the aetiology of these two diseases. An immunological explanation has been sought in the HLA sector of the major histocompatibility complex, which has been shown to have a role in the development of rheumatoid arthritis. The search for an association between schizophrenia and HLA haplotypes, however,

Gertrude Rubinstein

1997-01-01

288

Septic arthritis caused by noncapsulated Haemophilus influenzae.  

PubMed

Since the introduction of type b Haemophilus influenzae vaccination, noncapsulated H. influenzae has become responsible for most cases of invasive H. influenzae diseases. In our two cases of septic arthritis, we isolated strains with ?-lactamase-positive amoxicillin-clavulanate resistance (BLPACR). Thus, the increasing prevalence of BLPACR should be taken into account when empirical therapy is chosen for septic arthritis. PMID:23515545

Le Quellec, Sandra; Gaillot, Olivier; Chotel, Franck; Freydičre, Anne-Marie; Laurent, Frédéric; Vandenesch, François; Doléans-Jordheim, Anne

2013-06-01

289

Drug foundto reduce pain from arthritis  

E-print Network

Drug foundto reduce pain from arthritis BY CONNIE FILLETTI A team of Canadian medical researchers receiving thedrug after six months of treatment, the researchers report. Previously, cyclosporine hasoffered from an experi- mental procedureto a practical therapy. Rheumatoid arthritis, a chronic, recumng

Farrell, Anthony P.

290

Adverse Drug Reactions of Long-term Intravenous Antibiotics in Patients with Pyogenic Spondylitis  

PubMed Central

Objective The purpose of this study was to investigate the incidence, cause, and influence of the adverse drug reactions (ADRs) associated with long-term intravenous antibiotics in patients with pyogenic spondylitis (PS). Methods We retrospectively reviewed the medical records of 84 patients with PS who underwent intravenous antibiotic therapy in our hospital from January 2001 to December 2012. ADRs were categorized to drug eruption, acute renal failure (ARF), hematologic toxicity, toxic hepatitis, pseudomembranous colitis (PMC), drug fever, and neuronal toxicity. Incidence and onset time of each ADR after antibiotic therapy were analyzed with the incidence of ADRs according to types of antibiotics. Results ADRs occurred in 38 of the 84 patients (incidence: 45.2%). The use of antibiotics was longer in the patients with ADRs (62.7 days) than in the patients without ADRs (44.3 day). The incidence of drug eruption, ARF, hematologic toxicity, toxic hepatitis, PMC, drug fever, and neuronal toxicity were 22.6, 11.9, 11.9, 10.7, 7.1, 3.6%, and 1.2%, respectively. The duration of antibiotics administration was related to the occurrence of PMC (p=0.001). ADRs were more common in patients treated by glycopeptides including vacomycin and teicoplanin. Conclusion The incidence of ADRs due to long-term intravenous antibiotics was as high as 45.2% in patients with PS. Therefore, we speculate that the possibility of delayed ADRs should be considered after long-term use of the antibiotics. Furthermore, close observation is mandatory to identify and treat ADRs promptly, even though PS revealed the improvement after antibiotic therapy. PMID:25346755

Kim, Dong Hwan; Kim, Hwan Soo; Nam, Kyoung Hyup; Choi, Byung Kwan

2014-01-01

291

Arthritis: An Overview Michael McKee, MD,  

E-print Network

treatments ­ Medications are to reduce immune response that causes damage to body ­ Treat pain ­ Medications.cedars-sinai.edu/Patients/Health-Conditions/Arthritis---Rheumatoid-Arthritis- Osteoarthritis-and-Spinal-Arthritis.aspx #12;Lupus Inflammatory arthritis due to autoimmune disorder Affects many If you have gout, you should eat a low purine diet which helps ­ Limit meat, poultry and fish. Animal

Goldman, Steven A.

292

Circadian rhythms: glucocorticoids and arthritis.  

PubMed

Circadian rhythms are driven by biological clocks and are endogenous in origin. Therefore, circadian changes in the metabolism or secretion of endogenous glucocorticoids are certainly responsible in part for the time-dependent changes observed in the inflammatory response and arthritis. More recently, melatonin (MLT), another circadian hormone that is the secretory product of the pineal gland, has been found implicated in the time-dependent inflammatory reaction with effects opposite those of cortisol. Interestingly, cortisol and MLT show an opposite response to the light. The light conditions in the early morning have a strong impact on the morning cortisol peak, whereas MLT is synthesized in a strictly nocturnal pattern. Recently, a diurnal rhythmicity in healthy humans between cellular (Th1 type) or humoral (Th2 type) immune responses has been found and related to immunomodulatory actions of cortisol and MLT. The interferon (IFN)-gamma/interleukin (IL)-10 ratio peaked during the early morning and correlated negatively with plasma cortisol and positively with plasma MLT. Accordingly, the intensity of the arthritic pain varies consistently as a function of the hour of the day: pain is greater after waking up in the morning than in the afternoon or evening. The reduced cortisol and adrenal androgen secretion, observed during testing in rheumatoid arthritis (RA) patients not treated with glucocoticoids, should be clearly considered as a "relative adrenal insufficiency" in the presence of a sustained inflammatory process, and allows Th1 type cytokines to be produced in higher amounts during the late night. In conclusion, the right timing (early morning) for the glucocorticoid therapy in arthritis is fundamental and well justified by the circadian rhythms of the inflammatory mechanisms. PMID:16855156

Cutolo, Maurizio; Sulli, Alberto; Pizzorni, Carmen; Secchi, Maria Elena; Soldano, Stefano; Seriolo, Bruno; Straub, Rainer H; Otsa, Kati; Maestroni, Georges J

2006-06-01

293

Glucocorticoids in juvenile idiopathic arthritis.  

PubMed

Glucocorticoid (GC) drugs are a potent and rapidly effective therapeutic option for the treatment of juvenile idiopathic arthritis (JIA). These medications are mainly used for the management of the extra-articular features of systemic-onset disease. A course of low-dose prednisone may be considered for achieving a rapid disease control in patients with severe polyarthritis refractory to other therapies or while awaiting the full therapeutic effect of a recently initiated disease-modifying antirheumatic drug or biologic agent. Short-term systemic GC administration may also be indicated for chronic iridocyclitis unresponsive to topical therapy. The general objective of GC therapy is to limit the maximum dose and exposure to the highest doses to what is needed to achieve disease control, and then to gradually taper the dose until the minimum level sufficient to maintain disease quiescence over time is reached. High-dose intravenous 'pulse' methylprednisolone administration is sometimes chosen to treat the most severe or acute disease manifestations of systemic JIA, particularly macrophage activation syndrome. Intra-articular GC injection is a safe and rapidly effective treatment for synovitis in children with chronic arthritis. Triamcinolone hexacetonide is the optimal GC preparation for pediatric patients. Local injection therapy is used most frequently to treat oligoarthritis, but the strategy of performing multiple injections to induce disease remission, while simultaneously initiating therapy with second-line or biologic agents, has also been proposed for children with polyarticular JIA. Administration of GCs is associated with potentially deleterious adverse effects, some of which can be irreversible. This highlights the need of a judicious use of these medications and careful monitoring of their toxicity. The recently published recommendations for the management of JIA provide useful guidance to the clinicians for the administration of GCs in children with chronic arthritis. © 2014 S. Karger AG, Basel. PMID:25227183

Schiappapietra, Benedetta; Varnier, Giulia; Rosina, Silvia; Consolaro, Alessandro; Martini, Alberto; Ravelli, Angelo

2015-01-01

294

Optical imaging of rheumatoid arthritis  

PubMed Central

Optical Imaging (OI) for rheumatoid arthritis is a novel imaging modality. With the high number of people affected by this disease, especially in western countries, the availability of OI as an early diagnostic imaging method is clinically highly relevant. In this article we describe the current techniques of OI and discuss potential future applications of this promising technology. Overall, we demonstrate that OI is a fast, inexpensive, noninvasive, nonionizing and accurate imaging modality. Furthermore, OI is a clinically applicable tool allowing for the early detection of inflammation and potentially facilitating the monitoring of therapy. PMID:21826190

Golovko, Daniel; Meier, Reinhard; Rummeny, Ernst; Daldrup-Link, Heike

2011-01-01

295

Chemokines and angiogenesis in rheumatoid arthritis  

PubMed Central

In rheumatoid arthritis, chemokines mediate the migration of inflammatory leukocytes into the synovium. Among the four known chemokine families, CXC, CC chemokines and fractalkine seem to be of outstanding importance in this process. Angiogenesis, the formation of new vessels, is also important during the perpetuation of inflammation underlying rheumatoid arthritis. In this review, authors discuss the role of the most important chemokines and chemokine repetors in arthritis-associated neovascularization. The process and regulation of angiogenesis are described in this context as well. Apart from discussing the pathogenic role of chemokines and chemokine receptors in arthritic vessel formation, authors also review the important relevance of chemokines and angiogenesis for therapeutic intervention. PMID:19482623

Szekanecz, Zoltan; Pakozdi, Angela; Szentpetery, Agnes; Besenyei, Timea; Koch, Alisa E.

2010-01-01

296

Outcome of minimally invasive surgery in the management of tuberculous spondylitis  

PubMed Central

Introduction: With the advancement of instrumentation and minimally access techniques in the field of spine surgery, good surgical decompression and instrumentation can be done for tuberculous spondylitis with known advantage of MIS (minimally invasive surgery). The aim of this study was to assess the outcome of the minimally invasive techniques in the surgical treatment of patients with tuberculous spondylodiscitis. Materials and Methods: 23 patients (Group A) with a mean age 38.2 years with single-level spondylodiscitis between T4-T11 treated with video-assisted thoracoscopic surgery (VATS) involving anterior debridement and fusion and 15 patients (Group B) with a mean age of 32.5 years who underwent minimally invasive posterior pedicle screw instrumentation and mini open posterolateral debridement and fusion were included in study. The study was conducted from Mar 2003 to Dec 2009 duration. The indication of surgery was progressive neurological deficit and/or instability. The patients were evaluated for blood loss, duration of surgery, VAS scores, improvement in kyphosis, and fusion status. Improvement in neurology was documented and functional outcome was judged by oswestry disability index (ODI). Results: The mean blood loss in Group A (VATS category) was 780 ml (330-1180 ml) and the operative time averaged was 228 min (102-330 min). The average preoperative kyphosis in Group A was 38° which was corrected to 30°. Twenty-two patients who underwent VATS had good fusion (Grade I and Grade II) with failure of fusion in one. Complications occurred in seven patients who underwent VATS. The mean blood loss was 625 ml (350-800 ml) with an average duration of surgery of 255 min (180-345 min) in the percutaneous posterior instrumentation group (Group B). The average preoperative segmental (kyphosis) Cobb's angle of three patients with thoracic TB in Group B was 41.25° (28-48°), improved to 14.5°(11°- 21°) in the immediate postoperative period (71.8% correction). The average preoperative segmental kyphosis in another 12 patients in Group B with lumbar tuberculosis of 20.25° improved to –12.08° of lordosis with 32.33° average correction of deformity. Good fusion (Grade I and Grade II) was achieved in 14 patients and Grade III fusion in 1 patient in Group B. One patient suffered with pseudoarthrosis/doubtful fusion with screw loosening in the percutaneous group. Conclusion: Good fusion rate with encouraging functional results can be obtained in caries spine with minimally invasive techniques with all the major advantages of a minimally invasive procedures including reduction in approach-related morbidity. PMID:22448053

Kandwal, Pankaj; Garg, Bhavuk; Upendra, BN; Chowdhury, Budhadev; Jayaswal, A

2012-01-01

297

Interstitial granulomatous dermatitis with plaques and arthritis.  

PubMed

Interstitial granulomatous dermatitis (IGD) is a histopathological disorder characterised by an infiltration of the reticular dermis with a predominance of interstitial and palisadic histiocytes with a few areas of degenerating collagen bundles associated with a variable number of polynuclear neutrophils and eosinophils. There are several clinical conditions with a pattern of IGD. The linear form associated with arthritis was the first variety described. There is also a second form, which presents with plaques. This variety may be associated with arthritis, use of certain drugs or the presence of different systemic disorders. We report a case of IGD with plaques and arthritis. We discuss the differential clinical and histological diagnosis with other inflammatory skin lesions, which may be associated with joint disorders and collagen degeneration. We believe that it should be considered in patients presenting with arthritis and skin lesions. PMID:12804998

Bańuls, José; Betlloch, Isabel; Botella, Rafael; Jiménez, Maria José; Blanes, Mar; Pascual, José Carlos; Belinchón, Isabel; Silvestre, Juan Francisco

2003-01-01

298

T cells in rheumatoid arthritis  

PubMed Central

Over the past decade and a half, advances in our understanding of the pathogenesis of immune-mediated diseases such as rheumatoid arthritis (RA) have translated directly into benefit for patients. Much of this benefit has arisen through the introduction of targeted biological therapies. At the same time, technological advances have made it possible to define, at the cellular and molecular levels, the key pathways that influence the initiation and persistence of chronic inflammatory autoimmune reactions. As our understanding grows, it is likely that this knowledge will be translated into a second generation of biological therapies that are tailor-made for the patient. This review summarizes current perspectives on RA disease pathogenesis, with particular emphasis on what RA T cells look like, what they are likely to see, and how they contribute to persistence of the chronic inflammatory response. PMID:19007421

Cope, Andrew P

2008-01-01

299

Laryngeal Manifestations of Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis is a destructive autoimmune disease that affects 3% of the adult population. It is characterized by the formation of both articular and extra-articular lesions with predilection for small joints. There are ubiquitous reports on the head and neck manifestations of RA with emphasis on the larynx. The laryngeal presenting features of this systemic disease may mimic a plethora of medical conditions, inflammatory and neoplastic. The main phonatory and respiratory symptoms are often subtle and misleading. This paper represents a literature review of the laryngeal manifestations of RA with emphasis on the clinical symptoms, laryngeal findings, diagnosis, and treatment. An early diagnosis of laryngeal involvement may prevent drastic complications. PMID:23864939

Hamdan, A. L.; Sarieddine, D.

2013-01-01

300

Synovial cyst in juvenile idiopathic arthritis  

Microsoft Academic Search

Small synovial cysts are a common manifestation of juvenile idiopathic arthritis; large brachial cysts, however, are a rare\\u000a sign of the disease and they must be differentiated from other soft tissue swelling which are not related to articular involvement.\\u000a We describe the case of three children with juvenile idiopathic arthritis who came to our attention with large synovial cysts.\\u000a Ultrasonographic

L. Dell’Era; P. Vercellesi; L. V. Forzenigo; V. Carnelli; F. Corona

2008-01-01

301

Can Rheumatoid Arthritis Be Prevented?  

PubMed Central

The discovery of elevations of rheumatoid arthritis (RA)-related biomarkers prior to the onset of clinically apparent RA raises hopes that individuals who are at risk for future RA can be identified in a preclinical phase of disease that is defined as abnormalities of RA-related immune activity prior to the clinically apparent onset of joint disease. Additionally, there is a growing understanding of the immunologic processes that are occurring in preclinical RA, as well as a growing understanding of risk factors that may be mechanistically related to RA development. Furthermore, there are data supporting that treatment of early RA can lead to drug free remission. Taken as a whole, these findings suggest that it may be possible to use biomarkers and other factors to accurately identify the likelihood and timing of onset of future RA, and intervene with immunomodulatory therapies and/or risk factor modification to prevent the future onset of RA in at-risk individuals. Importantly, several clinical prevention trials for RA have already been tried, and one is underway. However, while our understanding of the growing understanding of the mechanisms and natural history of RA development may be leading us to the implementation of prevention strategies for RA, there are still several challenges to be met. These include developing sufficiently accurate methods of predicting those at high risk for future RA so that clinical trials can be developed based on accurate rates of development of arthritis and subjects can be adequately informed of their risk for disease, identifying the appropriate interventions and biologic targets for optimal prevention, and addressing the psychosocial and economic aspects that are crucial to developing broadly applicable prevention measures for RA. These issues notwithstanding, prevention of RA may be within reach in the near future. PMID:24315049

Deane, Kevin

2013-01-01

302

Arthritis  

MedlinePLUS

... tai chi. Eat a healthy diet full of fruits and vegetables, which contain important vitamins and minerals, especially vitamin E. Eat foods rich in omega-3 fatty acids, such as cold water fish (salmon, mackerel, and ...

303

The national database of the German Collaborative Arthritis Centres: II. Treatment of patients with rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVETo describe current treatment of patients with rheumatoid arthritis (RA) in German rheumatology.METHODSData from the German rheumatological database of 1998, comprising clinical and patient questionnaire data of 12 992 outpatients with RA seen at 24 collaborative arthritis centres in Germany, were analysed.RESULTSAt the time of documentation, 88% of the patients with RA were undergoing disease modifying antirheumatic drug (DMARD) treatment.

A Zink; J Listing; M Niewerth; H Zeidler

2001-01-01

304

Arthritis induced by proteoglycan aggrecan G1 domain in BALB/c mice. Evidence for t cell involvement and the immunosuppressive influence of keratan sulfate on recognition of t and b cell epitopes.  

PubMed Central

Our previous work showed that the proteoglycan aggrecan can induce erosive polyarthritis and spondylitis in BALB/c mice, and that the G1 domain of the proteoglycan aggrecan (G1) is the arthritogenic region. In this study, two T cell epitopes residing on G1 within residues 70-84 (peptide G5) and 150-169 (peptide G9) were identified using synthetic peptides and aggrecan-specific T cell lines. Two G1-specific T cell hybridomas exclusively responded to peptide G5. When the G5-specific T cell line was injected intraperitoneally into BALB/c mice, it induced acute inflammatory arthritis in joints, but only in those that had been injected with the epitope recognized by these T cells. Furthermore, we also demonstrate that the keratan sulfate chain(s) (KS) on G1 possess immunosuppressive properties with respect to T and B cell epitope recognition. T cell lines that recognize both G1 and peptide G5 show an increased response to G1 after KS is removed. Antibodies in hyperimmune sera of mice immunized with G1 show increased epitope recognition (quantitative and qualitative) after KS removal before immunization. These studies reveal that a T cell line specific to an epitope on the G1 domain of aggrecan, also recognizing a corresponding mouse G1 epitope, can induce arthritis by adoptive transfer and homing to the intraarticular epitope, thereby implicating T cells in arthritis development caused by immunity to the G1 domain of aggrecan. Moreover, the presence of KS on G1 can inhibit arthritis development by suppressing T and B cell epitope recognition. PMID:9541498

Zhang, Y; Guerassimov, A; Leroux, J Y; Cartman, A; Webber, C; Lalic, R; de Miguel, E; Rosenberg, L C; Poole, A R

1998-01-01

305

Spinal Inflammation in the Absence of Sacroiliac Joint Inflammation on Magnetic Resonance Imaging in Patients With Active Nonradiographic Axial Spondyloarthritis  

PubMed Central

Objective To evaluate the presence of spinal inflammation with and without sacroiliac (SI) joint inflammation on magnetic resonance imaging (MRI) in patients with active nonradiographic axial spondyloarthritis (SpA), and to compare the disease characteristics of these subgroups. Methods ABILITY-1 is a multicenter, randomized, controlled trial of adalimumab versus placebo in patients with nonradiographic axial SpA classified using the Assessment of SpondyloArthritis international Society axial SpA criteria. Baseline MRIs were centrally scored independently by 2 readers using the Spondyloarthritis Research Consortium of Canada (SPARCC) method for the SI joints and the SPARCC 6–discovertebral unit method for the spine. Positive evidence of inflammation on MRI was defined as a SPARCC score of ?2 for either the SI joints or the spine. Results Among patients with baseline SPARCC scores, 40% had an SI joint score of ?2 and 52% had a spine score of ?2. Forty-nine percent of patients with baseline SI joint scores of <2, and 58% of those with baseline SI joint scores of ?2, had a spine score of ?2. Comparison of baseline disease characteristics by baseline SI joint and spine scores showed that a greater proportion of patients in the subgroup with a baseline SPARCC score of ?2 for both SI joints and spine were male, and patients with spine and SI joint scores of <2 were younger and had shorter symptom duration. SPARCC spine scores correlated with baseline symptom duration, and SI joint scores correlated negatively with the baseline Bath Ankylosing Spondylitis Disease Activity Index, but neither correlated with the baseline Ankylosing Spondylitis Disease Activity Score, total back pain, the patient's global assessment of disease activity, the Bath Ankylosing Spondylitis Functional Index, morning stiffness, nocturnal pain, or C-reactive protein level. Conclusion Assessment by experienced readers showed that spinal inflammation on MRI might be observed in half of patients with nonradiographic axial SpA without SI joint inflammation. PMID:24574227

van der Heijde, Desiree; Sieper, Joachim; Maksymowych, Walter P; Brown, Matthew A; Lambert, Robert G W; Rathmann, Suchitrita S; Pangan, Aileen L

2014-01-01

306

Acute non-infectious arthritis of the hip in rheumatoid arthritis: synovial membrane findings.  

PubMed Central

A case of acute hip pain in rheumatoid arthritis is presented, with synovial membrane findings. A patient with classical rheumatoid arthritis suffered three unusual bouts of sudden, severe but transient hip pain. The hips were clinically normal between these episodes. The clinical picture on two of these occasions strongly suggested septic arthritis. Although the synovial fluid was highly inflammatory, cultures were negative. The synovial membrane showed mild lining cell hyperplasia, vascular congestion, and scattered inflammatory cells, predominantly lymphocytes. These findings were not compatible with either pyogenic infection or longstanding rheumatoid arthritis. The clinical and pathological features of acute non-infectious arthritis of the hip appear to delineate a distinct syndrome. Images PMID:2930281

Wohlgethan, J R; Stilmant, M M; Harris, J M; Smith, H R

1989-01-01

307

Evaluation of Role of Anterior Debridement and Decompression of Spinal Cord and Instrumentation in Treatment of Tubercular Spondylitis  

PubMed Central

Study Design Prospective study with simple randomization. Purpose To evaluate the results of anterior spinal instrumentation, debridement and decompression of cord and compare it with results of a similar procedure done without the use of anterior instrumentation. Overview of Literature Use of anterior spinal instrumentation in treatment of tubercular spondylitis is still an infrequently followed modality of treatment and data regarding its usefulness are still emerging. Methods Thirty-two patients of tubercular paraplegia with involvement of dorsal and dorso-lumbar vertebrae were operated with anterior spinal cord decompression, autofibular strut grafting with anterior instrumentation in 18 patients and no implant in 14 patients. Results were compared on the basis of improvement in Frankel grade, correction of local kyphosis, decrease in canal compromise and further progression of kyphosis. Results The mean local kyphosis correction in the immediate postoperative period was 24.1° in the instrumented group and was 6.1° in the non instrumented group. The mean late loss of correction of local kyphosis at 3 years follow-up was 1.7° in the instrumented and 6.7° in the non instrumented group. The mean improvement in canal compression was 39.5% in the instrumented group and 34.8% in the non instrumented group. Conclusions In treatment of tubercular spondylitis by anterior debridement and decompression of the spinal cord and autofibular strut grafting, the use of instrumentation has no relation with the improvement in neurological status, however the correction of local kyphosis and prevention of further progression of local kyphosis was better with the use anterior spinal instrumentation. PMID:22977698

Singh, Saurabh; Kumaraswamy, Vinay; Saraf, Shyam Kumar; Khare, Ghanshyam Narayan

2012-01-01

308

Appropriate management of axial spondyloarthritis.  

PubMed

The management of axial spondyloarthritis includes a structured baseline assessment of the disease and follow-up of treatment efficacy using validated instruments. The treatment will depend on the severity and predominant manifestations of the disease. The cornerstone of management remains physical therapy and nonsteroidal anti-inflammatory drugs. Disease-modifying antirheumatic drugs such as sulfasalazine have shown efficacy only in treating peripheral arthritis, whereas thalidomide and pamidronate have shown some efficacy in treating axial inflammation. Anti-tumor necrosis factor-alpha agents are an efficacious option for treating signs and symptoms of axial disease, peripheral arthritis, and enthesitis, and for improving functional outcomes. They have not shown efficacy in reducing radiographic progression in axial disease. Recent evidence suggests that the new bone formation in ankylosing spondylitis may be due to upregulation of Wnt signaling in the osteoblastic pathway secondary to low serum DKK-1 levels, which are further suppressed by tumor necrosis factor inhibitor therapy. PMID:17915093

LaSalle, Sean P; Deodhar, Atul A

2007-10-01

309

Manifestation of palmoplantar pustulosis during or after infliximab therapy for plaque-type psoriasis: report on five cases.  

PubMed

Infliximab is a monoclonal antibody directed against TNF-alpha. It has been approved for use in rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, psoriatic arthritis and plaque-type psoriasis. In case reports, positive effects on pustular variants of psoriasis have also been reported. However, paradoxically, manifestation of pustular psoriasis and plaque-type psoriasis has been reported in patients treated with TNF antagonists including infliximab for other indications. Here, we report on 5 patients with chronic plaque-type psoriasis who developed palmoplantar pustulosis during or after discontinuation of infliximab therapy. In two of the five cases, manifestation of palmoplantar pustulosis was not accompanied by worsening of plaque-type psoriasis. Possibly, site-specific factors or a differential contribution of immunological processes modulated by TNF inhibitors to palmoplantar pustulosis and plaque-type psoriasis may have played a role. PMID:18239925

Mössner, Rotraut; Thaci, Diamant; Mohr, Johannes; Pätzold, Sylvie; Bertsch, Hans Peter; Krüger, Ullrich; Reich, Kristian

2008-03-01

310

Manifestation of palmoplantar pustulosis during or after infliximab therapy for plaque-type psoriasis: report on five cases  

PubMed Central

Infliximab is a monoclonal antibody directed against TNF-?. It has been approved for use in rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, psoriatic arthritis and plaque-type psoriasis. In case reports, positive effects on pustular variants of psoriasis have also been reported. However, paradoxically, manifestation of pustular psoriasis and plaque-type psoriasis has been reported in patients treated with TNF antagonists including infliximab for other indications. Here, we report on 5 patients with chronic plaque-type psoriasis who developed palmoplantar pustulosis during or after discontinuation of infliximab therapy. In two of the five cases, manifestation of palmoplantar pustulosis was not accompanied by worsening of plaque-type psoriasis. Possibly, site-specific factors or a differential contribution of immunological processes modulated by TNF inhibitors to palmoplantar pustulosis and plaque-type psoriasis may have played a role. PMID:18239925

Thaci, Diamant; Mohr, Johannes; Pätzold, Sylvie; Bertsch, Hans Peter; Krüger, Ullrich; Reich, Kristian

2008-01-01

311

Ten-Year Drug Survival of Anti-TNF Agents in the Treatment of Inflammatory Arthritides.  

PubMed

Postmarketing Phase IV Tumor necrosis factor (TNF) inhibitor therapies (anti-TNFs) are used routinely as first-line biotherapy for the treatment of rheumatoid arthritis (RA) and spondyloarthritis (SpA: psoriatic arthritis [PsA] and ankylosing spondylitis [AS]) in patients who have failed traditional non-biologic disease-modifying anti-rheumatic drugs (DMARDs). However, about 30% of patients experience failure of first-line anti-TNF agent because of inefficacy or adverse events. This study analyzed long-term anti-TNF? drug survival in a clinical practice setting. The overall 10-year retention rate of first-line anti-TNF agent is about 23%, being significantly higher for SpA compared with RA patients. ETN is the most persistent anti-TNF with a drug survival rate significantly higher than IFX and ADA. PMID:25381973

Biggioggero, Martina; Favalli, Ennio Giulio

2014-11-01

312

For more information about the Organization of Teratology Information  

E-print Network

Specialists or to find a service in your area, call (866) 626-6847 or visit us online at: www.OTISpregnancy.org. Adalimumab (Humira ? ) and Pregnancy This sheet talks about the risks that exposure to adalimumab can have during pregnancy. With each pregnancy, all women have a 3 % to 5 % chance of having a baby with a birth defect. This information should not take the place of medical care and advice from your health care provider. What is adalimumab? Adalimumab is a prescription medication used to treat some kinds of autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and Crohn’s disease. Adalimumab is called a tumor necrosis factor (TNF) inhibitor because it binds and blocks TNF, a substance in the body that causes inflammation in the joints, spine, and skin. Adalimumab is given as an injection directly below the skin. Adalimumab is marketed under the brand name

unknown authors

313

Biological therapies in rheumatic diseases.  

PubMed

The development of the biological drugs has revolutionized the therapeutic approach of the chronic inflammatory rheumatic diseases, particularly in patients resistant to standard treatment. These drugs are characterized by an innovative mechanism of action, based on the targeted inhibition of specific molecular or cellular targets directly involved in the pathogenesis of the diseases: pro-inflammatory cytokines (tumor necrosis factor, interleukin-1 and 6), CTLA-4, and molecules involved in the activation, differentiation and maturation of B cells. Their use has indeed allowed for a better prognosis in several rheumatic diseases (such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus) and to obtain a clinical remission. In the present review we give an overview of the biological drugs currently available for the treatment of the rheumatic diseases, analyzing the different mechanism of action, the therapeutic indications and efficacy data, and adverse events. PMID:24217844

Conti, F; Ceccarelli, F; Massaro, L; Cipriano, E; Di Franco, M; Alessandri, C; Spinelli, F R; Scrivo, R

2013-01-01

314

ARTHRITIS & RHEUMATISM Vol. 46, No. 4, April 2002, pp 11091120  

E-print Network

and that single administration of PLGA-CII may hold promise as a new treatment strategy in rheumatoid arthritisARTHRITIS & RHEUMATISM Vol. 46, No. 4, April 2002, pp 1109­1120 DOI 10.1002/art.10198 © 2002, American College of Rheumatology Suppression of Collagen-Induced Arthritis by Single Administration of Poly

Park, Jong-Sang

315

Remission-inducing drugs in rheumatoid arthritis.  

PubMed Central

The administration of certain drugs to patients with established rheumatoid arthritis frequently results in improvement that is slow to appear but persists for long periods, even after the drug is discontinued. The three main drugs with this effect, whose efficacy and toxicity are reviewed in this paper, are gold salts, D-penicillamine and chloroquine. The cytotoxic agents used to treat rheumatoid arthritis, which likely have nonspecific anti-inflammatory actions and have serious long-term side effects, are also briefly reviewed. A new drug, levamisole, is currently being tested in patients with rheumatoid arthritis. It is suggested that the time for considering the introduction of a remission-inducing drug in patients with progressive rheumatoid arthritis is after an adequate trial of therapy with salicylates or other nonsteroidal anti-inflammatory agents, or both, and before the oral administration of steroids. It is difficult, however, on the basis of rigorous clinical comparisons, to recommend which of the three main remission-inducing drugs should be tried first, although gold salts have been used the most. Patients who have improved with 6 months of chrysotherapy may continue treatment for at least 3 years, during which time the frequency of mucocutaneous and renal toxic effects will steadily decrease. Some aspects of the medical economics of therapy with remission-inducing drugs for rheumatoid arthritis are discussed. PMID:6768438

Anastassiades, T. P.

1980-01-01

316

Anterior sacral meningocele and tuberculous spondylitis of the sacrum in a patient with neurofibromatosis. Case report and review of the literature.  

PubMed

We report a case of an adult male with neurofibromatosis and chronic low back pain. Evaluation revealed an anterior sacral meningocele, pulmonary tuberculosis, and later in the course of his illness, an osteolytic tuberculous mass in the sacrum. The patient was treated medically with a good outcome. The nature of anterior sacral meningoceles and tuberculosis spondylitis, the differential diagnoses, and relevant treatment options are discussed. PMID:2518511

Mellion, B T; George, R E; Fischer, D K; Lidsky, M D; Baskin, D S

1989-01-01

317

Apoptosis in rheumatoid arthritis synovium.  

PubMed Central

RA synovial tissue (ST) was studied to determine if and where apoptosis occurs in situ. Genomic DNA was extracted from 5 RA and 1 osteoarthritis ST samples. Agarose gel electrophoresis demonstrated DNA ladders characteristic for apoptosis from each tissue. In situ and labeling (ISEL) was used to identify DNA strand breaks consistent with apoptosis in frozen sections. 12 RA and 4 osteoarthritis ST were studied by ISEL and all were positive, but only 2 of 4 normal tissues were positive. The primary location of apopotic cells was the synovial lining. Some sublining cells were also positive, but lymphoid aggregate staining was conspicuously absent. Immunohistochemistry and ISEL were combined and showed that the lining cells with DNA strand breaks were mainly macrophages, although some fibroblastlike cells were also labeled. Sublining cells with fragmented DNA included macrophages and fibroblasts, but T cells in lymphoid aggregates, which expressed large amounts of bcl-2, were spared. DNA strand breaks in cultured fibroblastlike synoviocytes was assessed using ISEL. Apoptosis could be induced by actinomycin D, anti-fas antibody, IL-1, and TNF-alpha but not by IFN-gamma. Fas expression was also detected on fibroblast-like synoviocytes using flow cytometry. Therefore, DNA strand breaks occur in synovium of patients with arthritis. Cytokines regulate this process, and the cytokine profile in RA (high IL-1/TNF; low IFN-gamma) along with local oxidant injury might favor induction of apoptosis. Images PMID:7657832

Firestein, G S; Yeo, M; Zvaifler, N J

1995-01-01

318

HLA-linked rheumatoid arthritis.  

PubMed Central

Twenty-eight pedigrees were ascertained through pairs of first-degree relatives diagnosed with rheumatoid arthritis (RA). RA was confirmed in 77 pedigree members including probands; the absence of disease was verified in an additional 261 pedigree members. Pedigree members were serologically typed for HLA. We used likelihood analysis to statistically characterize the HLA-linked RA susceptibility locus. The genetic model assumed tight linkage to HLA. The analysis supported the existence of an HLA-linked RA susceptibility locus, estimated the susceptibility allele frequency as 2.16%, and estimated the lifetime penetrance as 41% in male homozygotes and as 48% in female homozygotes. Inheritance was recessive in males and was nearly recessive in females. In addition, the analysis attributed 78% of the variance within genotypes to genetic or environmental effects shared by siblings. The genetic model inferred in this analysis is consistent with previous association, linkage, and familial aggregation studies of RA. The inferred HLA-linked RA susceptibility locus accounts for approximately one-half of familial RA, although it accounts for only approximately one-fifth of the RA in the population. Although other genes may account for the remaining familial RA, a large portion of RA cases may occur sporadically. PMID:7942852

Hasstedt, S. J.; Clegg, D. O.; Ingles, L.; Ward, R. H.

1994-01-01

319

Cardiovascular risk in rheumatoid arthritis.  

PubMed

The objectives of this review are to discuss data on the cardiovascular risk increase associated with rheumatoid arthritis (RA), the effects of RA treatments on the cardiovascular risk level, and the management of cardiovascular risk factors in patients with RA. Overall, the risk of cardiovascular disease is increased 2-fold in RA patients compared to the general population, due to the combined effects of RA and conventional risk factors. There is some evidence that the cardiovascular risk increase associated with nonsteroidal anti-inflammatory drug therapy may be smaller in RA patients than in the general population. Glucocorticoid therapy increases the cardiovascular risk in proportion to both the current dose and the cumulative dose. Methotrexate and TNF? antagonists diminish cardiovascular morbidity and mortality rates. The management of dyslipidemia remains suboptimal. Risk equations may perform poorly in RA patients even when corrected using the multiplication factors suggested by the EUropean League Against Rheumatism (EULAR) (multiply the score by 1.5 when two of the following three criteria are met: disease duration longer than 10 years, presence of rheumatoid factor or anti-cyclic citrullinated peptide (CCP) antibodies, and extraarticular manifestations). Doppler ultrasonography of the carotid arteries in patients at moderate cardiovascular risk may allow a more aggressive approach to dyslipidemia management via reclassification into the high-risk category of patients with an intima-media thickness greater than 0.9 mm or atheroma plaque. PMID:24880190

Soubrier, Martin; Chamoux, Nicolas Barber; Tatar, Zuzana; Couderc, Marion; Dubost, Jean-Jacques; Mathieu, Sylvain

2014-07-01

320

Cricoarytenoid arthritis: a cause of acute upper airway obstruction in rheumatoid arthritis  

Microsoft Academic Search

Purpose  To report acute upper airway obstruction due to cricoarytenoid arthritis, a well known but uncommon complication of rheumatoid\\u000a arthritis.\\u000a \\u000a \\u000a \\u000a Clinical features  We report the case of a 70-yr-old female scheduled for a colostomy who had been suffering from rheumatoid arthritis for 17\\u000a years. Preoperative history and physical examination revealed no cardiopulmonary compromise. Anesthesia was induced while\\u000a an assistant immobilized the cervical

Jacelyn Kolman; Ian Morris

2002-01-01

321

Effects of Telephone Intervention on Arthritis Self-Efficacy, Depression, Pain, and Fatigue in Older Adults with Arthritis  

Microsoft Academic Search

Purpose :A rthritis self-efficacy (ASE) characterizes individ- uals' confidence in managing their arthritis. This study's pur- pose was to examine the effects of a telephone intervention on ASE, depression, pain, and fatigue in older adults with arthritis. Methods: Eighty-five elders with arthritis were ran- domly assigned to the intervention or control group. Participants in both groups: (a) completed baseline assess-

Ann O'Hanlon; Luis Espinoza

322

[Failures of antibiotic treatment in Lyme arthritis].  

PubMed

Antibiotic treatment has been proven to be effective in about 90% of patients with Lyme arthritis in controlled studies. Overt arthritis persisting in spite of antibiotic therapy is rare and most likely has an autoimmune background. More frequently, patients with history of Lyme borreliosis present with non-specific articular and musculosceletal symptoms, which seem to be permanent sequelae of arthritis or constitute part of so called post-Lyme disease syndrome, of unclear pathogenesis. As persistence of active infection after proper antibiotic therapy is unlikely, repeated treatment seems of no benefit in most of the patients. No more than 2-3 attempts of antibiotic therapy should be undertaken; if symptoms persist, symptomatic and anti-inflammatory treatment should be introduced. Lack of response to antibiotics should also point to co-existing musculoskeletal morbidity or to improper diagnosis of Lyme borreliosis, which is frequent due to common occurrence of false-positive serologic tests results. PMID:19108522

Grygorczuk, Sambor; Zajkowska, Joanna; Kondrusik, Maciej; Moniuszko, Anna; Pancewicz, S?awomir; Pawlak-Zalewska, Wioletta

2008-01-01

323

Induction of adjuvant arthritis in mice.  

PubMed Central

Adjuvant arthritis, induced by injections of Freund's complete adjuvant into the footpads of some rat strains, has been recognized as a useful animal model for many years. There has, however, been notable lack of success in reproducing this model in other species. We now describe the development of adjuvant arthritis in healthy strain mice approximately 2 months after injection of Freund's complete adjuvant. Although the clinical appearance of the mice and the joint histopathology closely resemble the adjuvant arthritis reported in the rat, we were unable to detect rheumatoid factor in sera from the affected animals. In parallel studies of T cell proliferation, affected animals responded to some mycobacterial antigens but not to the 65-kD heat shock protein of Mycobacterium tuberculosis, suggesting that some other epitope is important in the development of the disease. Images Fig. 1 Fig. 2 Fig. 2 PMID:1458683

Knight, B; Katz, D R; Isenberg, D A; Ibrahim, M A; Le Page, S; Hutchings, P; Schwartz, R S; Cooke, A

1992-01-01

324

Chemokines and chemokine receptors in arthritis  

PubMed Central

Chemokines are involved in leukocyte recruitment to inflammatory sites, such as the synovial tissue in rheumatoid arthritis (RA). There is a structural and a functional classification of chemokines. The former includes four groups: CXC, CC, C and CX3C chemokines. Chemokines may also be either inflammatory or homeostatic, however, these functions often overlap. Anti-chemokine and anti-chemokine receptor targeting may be therapeutically used in the future biological therapy of arthritis. Most data in this field have been obtained from animal models of arthritis as only very few human RA trials have been completed. However, it is very likely that various specific chemokine and chemokine receptor antagonists will be developed and administered to RA patients. PMID:20036936

Szekanecz, Zoltan; Vegvari, Aniko; Szabo, Zoltan; Koch, Alisa E.

2010-01-01

325

Economics of stratified medicine in rheumatoid arthritis.  

PubMed

Clinically relevant examples of stratified medicine are available for patients with rheumatoid arthritis (RA). The aim of this study was to understand the current economic evidence for stratified medicine in RA. Two systematic reviews were conducted to identify: (1) all economic evaluations of stratified treatments for rheumatoid arthritis, or those which have used a subgroup analysis, and (2) all stated preference studies of treatments for rheumatoid arthritis. Ten economic evaluations of stratified treatments for RA, 38 economic evaluations including with a subgroup analysis and eight stated preference studies were identified. There was some evidence to support that stratified approaches to treating a patient with RA may be cost-effective. However, there remain key gaps in the economic evidence base needed to support the introduction of stratified medicine in RA into healthcare systems and considerable uncertainty about how proposed stratified approaches will impact future patient preferences, outcomes and costs when used in routine practice. PMID:25366935

Gavan, Sean; Harrison, Mark; Iglesias, Cynthia; Barton, Anne; Manca, Andrea; Payne, Katherine

2014-12-01

326

How citrullination invaded rheumatoid arthritis research  

PubMed Central

Citrullination and the immune response to citrullinated proteins have been fundamental for the early recognition of rheumatoid arthritis by serological tests and a better understanding of its pathophysiology. In the first years after the initial publications, the focus was on the antibodies directed to citrullinated proteins. It is now realized that citrullinating enzymes and citrullinated proteins may have important roles in the maintenance of the inflammatory processes in the joints. There is also accumulating evidence for a direct role of citrullination in tissue destruction in the rheumatoid synovium. Here we will discuss the development and importance of anti-citrullinated protein antibodies in rheumatoid arthritis as well as recent findings implicating citrullination in the pathophysiology of rheumatoid arthritis. PMID:24472574

2014-01-01

327

NONSPECIFIC ANTI-INFLAMMATORY AGENTS--Some Notes on Their Practical Application, Especially in Rheumatic Disorders  

PubMed Central

A number of acute and chronic inflammatory disorders are amenable to varying degrees of therapeutic control with the administration of nonspecific anti-inflammatory drugs. An evaluation of these suppressive agents in the field of rheumatic diseases and practical suggestions regarding their administration are presented. Eight synthetically modified corticosteroid compounds are available commercially. Each of them exhibits qualitative differences in one or several physiologic actions, each has certain advantages and disadvantages in therapy, and each shares the major deterrent features of corticosteroids. Prednisone, prednisolone, methylprednisolone, fluprednisolone and paramethasone have similar therapeutic indices, and there is little choice between them for the usual rheumatoid patient requiring steroid therapy. Conversely, the therapeutic indices of dexamethasone, betamethasone and triamcinolone are lower than that of prednisolone; they are less desirable for routine use and should be reserved for specially selected cases. Salicylates are preferred to adrenocortical steroids in the treatment of the ordinary patient with acute rheumatic fever. Steroid therapy should be reserved for resistant cases and for those with significant carditis. Salicylates are mainstays for pain relief in rheumatoid arthritis, but with the analgesic doses usually employed their anti-inflammatory action is slight. Phenylbutazone is a highly useful anti-inflammatory agent, especially in management of acute gouty arthritis and ankylosing (rheumatoid) spondylitis; its metabolite, oxyphenylbutazone, does not exhibit clear-cut advantages. Colchicine specifically suppresses acute gouty arthritis. Its analogues, desacetylcolchicine and desacetylthiocolchicine, produce fewer unpleasant gastrointestinal symptoms, but may promote agranulocytosis and alopecia. A number of indole preparations with anti-inflammatory activity have been tested clinically. One of them, indomethacin, has received extensive therapeutic trial; with dosages that can be tolerated the drug is fairly effective in the symptomatic control of ankylosing (rheumatoid) spondylitis but it is of questionable value in peripheral rheumatoid arthritis. PMID:14131394

Boland, Edward W.

1964-01-01

328

Tumor necrosis factor-alpha antagonists improve aortic stiffness in patients with inflammatory arthropathies: a controlled study.  

PubMed

The chronic inflammatory state of rheumatoid arthritis and other inflammatory arthropathies, such as ankylosing spondylitis and psoriatic arthritis, contributes to the accelerated atherosclerosis associated with these conditions. This study evaluates the effect of treatment with tumor necrosis factor (TNF)-alpha antagonists on arterial stiffness in patients with inflammatory arthropathies. A total of 60 patients with rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis and clinical indication for anti-TNF-alpha therapy were included. Thirty-five patients started with anti-TNF-alpha therapy and were compared with a nontreatment group of 25 patients. Aortic stiffness (aortic pulse wave velocity), augmentation index, and disease activity were assessed at baseline and after 3 months. Aortic pulse wave velocity (mean+/-SD) was reduced in the treatment group but not in the control group (-0.50+/-0.78 m/s versus 0.05+/-0.54 m/s, respectively; P=0.002). Concomitantly, C-reactive protein and the disease activity score were reduced in the treatment group (-9.3+/-20.2 mg/L [P<0.001] and -0.74+/-0.91 [P=0.004]). Augmentation index remained unchanged in both groups (0.1+/-7.1% versus -1.0+/-5.8%, respectively; P=0.53). In a multivariate linear regression model, only treatment with TNF-alpha antagonist and change in mean arterial pressure predicted alterations in aortic pulse wave velocity. In summary, anti-TNF-alpha therapy improved aortic stiffness in patients with inflammatory arthropathies. These findings support the idea that anti-inflammatory treatment has a favorable effect on cardiovascular risk in patients with inflammatory arthropathies. PMID:20038753

Angel, Kristin; Provan, Sella Aarrestad; Gulseth, Hanne Lřvdahl; Mowinckel, Petter; Kvien, Tore Kristian; Atar, Dan

2010-02-01

329

Urokinase-type plasminogen activator and arthritis progression: contrasting roles in systemic and monoarticular arthritis models  

PubMed Central

Introduction Urokinase-type plasminogen activator (u-PA) has been implicated in tissue destruction/remodeling. The absence of u-PA results in resistance of mice to systemic immune complex-driven arthritis models; monoarticular arthritis models involving an intra-articular (i.a.) antigen injection, on the other hand, develop more severe arthritis in its absence. The aims of the current study are to investigate further these contrasting roles that u-PA can play in the pathogenesis of inflammatory arthritis and to determine whether u-PA is required for the cartilage and bone destruction associated with disease progression. Methods To determine how the different pathogenic mechanisms leading to arthritis development in the different models may explain the contrasting requirement for u-PA, the systemic, polyarticular, immune complex-driven K/BxN arthritis model was modified to include an i.a. injection of saline as a local trauma in u-PA-/- mice. This modified model and the antigen-induced arthritis (AIA) model were also used in u-PA-/- mice to determine the requirement for u-PA in joint destruction. Disease severity was determined by clinical and histologic scoring. Fibrin(ogen) staining and the matrix metalloproteinase (MMP)-generated neoepitope DIPEN staining were performed by immunohistochemistry. Gene expression of inflammatory and destructive mediators was measured in joint tissue by quantitative PCR. Results In our modified arthritis model, u-PA-/- mice went from being resistant to arthritis development following K/BxN serum transfer to being susceptible following the addition of an i.a. injection of saline. u-PA-/- mice also developed more sustained AIA compared with C57BL/6 mice, including reduced proteoglycan levels and increased bone erosions, fibrin(ogen) deposition and DIPEN expression. Synovial gene expression of the proinflammatory mediators (TNF and IL-1?), aggrecanases (ADAMTS-4 and -5) and MMPs (MMP3 and MMP13) were all sustained over time following AIA induction in u-PA-/- mice compared with C57BL/6 mice. Conclusions We propose that u-PA has a protective role in arthritis models with 'wound healing-like' processes following local trauma, possibly through u-PA/plasmin-mediated fibrinolysis, but a deleterious role in systemic models that are critically dependent on immune complex formation and complement activation. Given that cartilage proteoglycan loss and bone erosions were present and sustained in u-PA-/- mice with monoarticular arthritis, it is unlikely that u-PA/plasmin-mediated proteolysis is contributing directly to this tissue destruction/remodeling. PMID:20973954

2010-01-01

330

Acute non-infectious arthritis of the hip in patients with rheumatoid arthritis.  

PubMed Central

Five patients with rheumatoid arthritis and no previous hip joint disease developed an acute disabling arthritis in one hip joint. Roentgenograms were negative and synovial fluid from the hip joint was inflammatory, but no crystals were seen and cultures were negative. Four of the five patients responded rapidly to intra-articular corticosteroids, and none of the five has had further hip joint symptoms during a mean follow up period of two years. PMID:3632068

Halla, J T; Hardin, J G

1987-01-01

331

AA amyloidosis in the renal allograft: a report of two cases and review of the literature  

PubMed Central

AA amyloidosis is a disorder characterized by the abnormal formation, accumulation and systemic deposition of fibrillary material that frequently involves the kidney. Recurrent AA amyloidosis in the renal allograft has been documented in patients with tuberculosis, familial Mediterranean fever, ankylosing spondylitis, chronic pyelonephritis and rheumatoid arthritis. De novo AA amyloidosis is rarely described. We report two cases of AA amyloidosis in the renal allograft. Our first case is a 47-year-old male with a history of ankylosing spondylitis who developed end-stage renal disease reportedly from tubulointerstitial nephritis from non-steroidal anti-inflammatory agent use. A biopsy was never performed. One year after transplantation, AA amyloidosis was identified in the femoral head and 8 years post-transplantation, AA amyloidosis was identified in the renal allograft. He was treated with colchicine and adalimumab and has stable renal function at 1 year-follow-up. Our second case is a 57-year-old male with a long history of intravenous drug use and hepatitis C infection who developed end-stage kidney disease due to AA amyloidosis. Our second patient's course was complicated by renal adenovirus, pulmonary aspergillosis and hepatitis C with AA amyloidosis subsequently being identified in the allograft 2.5 years post-transplantation. Renal allograft function remains stable 4-years post-transplantation. These reports describe clinical and pathologic features of two cases of AA amyloidosis presenting with proteinuria and focal involvement of the renal allograft. PMID:22833808

Rojas, Rebecca; Josephson, Michelle A.; Chang, Anthony; Meehan, Shane M.

2012-01-01

332

Glucocorticosteroids in pregnant patients with rheumatoid arthritis  

Microsoft Academic Search

Zusammenfassung Der günstige Einfluss einer Schwangerschaft auf die rheumatoide Arthritis (RA) ist seit 1938 bekannt und wurde mehrfach für 75% der RA-Schwangerschaften bestätigt. Eine Besserung der Symptome macht sich in der Regel schon im ersten Trimester bemerkbar und nimmt im Verlauf der Schwangerschaft zu. Eine Verschlechterung der RA wird bei den meisten Patienten innerhalb von 6 Monaten nach der Entbindung

M. Řstensen

2000-01-01

333

Mud pack therapy in rheumatoid arthritis  

Microsoft Academic Search

Summary Twenty-eight patients with classical or definite rheumatoid arthritis were randomly divided into two groups of fourteen patients each. All patients were treated once a day with mud packs derived from the Dead Sea heated to 40°C and applied over the four extremities, neck and back for 20 minutes. Group 1 was treated with the true mud packs and Group

S. Sukenik; D. Buskila; L. Neumann; A. Kleiner-Baumgarten

1992-01-01

334

Neurofibromatosis induced hip arthritis. An unusual presentation  

PubMed Central

Patient: Male, 43 Final Diagnosis: Neurofibromatosis Symptoms: Hip pain Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Neurofibromatosis type 1 is a disease known for orthopedic manifestations such as spine deformities, congenital pseudarthrosis of the tibia and other bony dysplasias; joint dislocations are rare. Joint arthritis caused by neurofibromatosis, with a stable hip, has never been reported in the English literature before. Case Report: A 43-year-old man diagnosed with neurofibromatosis type 1 (NF-1) presented with hip pain of 5 years duration, with no history of trauma and no clinical or radiological signs of dislocation. He had classical clinical and radiological signs of hip arthritis, with acetabular erosions and femoral head arthritis. The patient was treated with total hip arthroplasty metal-on-metal (MoM). Conclusions: Hip arthritis alone without subluxation or dislocation due to NF-1 is an extremely rare presentation. This is the first reported presentation and provisional treatment with total hip arthroplasty. PMID:24587854

Alrumaih, Husam; Ilyas, Imran; Kashif, Syed

2014-01-01

335

Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis.  

PubMed

Palisaded neutrophilic granulomatous dermatitis (PNGD) is an entity that has not been clearly defined either clinically or histopathologically. It is seen in patients with rheumatoid arthritis and other connective tissue diseases. In the past, many cases of PNGD have been described under several different names including palisaded neutrophilic and granulomatous dermatitis, linear subcutaneous bands, interstitial granulomatous dermatitis with cutaneous cords and arthritis, rheumatoid papules, and Churg-Strauss granuloma. We report 7 additional cases of PNGD. Clinically, 6 patients presented with erythematous to violaceous plaques, papules, and nodules on multiple body sites; one presented with subcutaneous linear bands on the shoulder. Five had rheumatoid arthritis; one had adult-onset Still's disease; and one showed clinical signs of rheumatoid arthritis, although serologically the rheumatoid factor was negative. On histologic examination, a spectrum of changes was observed ranging from urticaria-like infiltrates to leukocytoclastic vasculitis and granuloma annulare with neutrophils. We report these cases to expand the histologic spectrum of this entity and to further delineate the different forms of clinical presentation. PMID:12140472

Sangueza, Omar P; Caudell, Misty D; Mengesha, Yebabe M; Davis, Loretta S; Barnes, Cheryl J; Griffin, Julia E; Fleischer, Alan B; Jorizzo, Joseph L

2002-08-01

336

Interstitial granulomatous dermatitis with plaques and arthritis.  

PubMed

Interstitial granulomatous dermatitis and arthritis (IGDA) is a rare disease entity with female predominance. The case of a 53-year-old woman with erythemas, plaques and nodules associated with polyarthritis is presented. She was treated with cyclosporin A, with improvement of the joint affliction and complete clearance of skin lesions. The differential diagnosis of IGDA is discussed briefly. PMID:14579165

Wollina, U; Schönlebe, J; Unger, L; Weigel, K; Köstler, E; Nüsslein, H

2003-10-01

337

Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis  

Microsoft Academic Search

Palisaded neutrophilic granulomatous dermatitis (PNGD) is an entity that has not been clearly defined either clinically or histopathologically. It is seen in patients with rheumatoid arthritis and other connective tissue diseases. In the past, many cases of PNGD have been described under several different names including palisaded neutrophilic and granulomatous dermatitis, linear subcutaneous bands, interstitial granulomatous dermatitis with cutaneous cords

Omar P. Sangueza; Misty D. Caudell; Yebabe M. Mengesha; Loretta S. Davis; Cheryl J. Barnes; Julia E. Griffin; Alan B. Fleischer; Joseph L. Jorizzo

2002-01-01

338

Interstitial granulomatous dermatitis with plaques and arthritis  

Microsoft Academic Search

Interstitial granulomatous dermatitis and arthritis (IGDA) is a rare disease entity with female predominance. The case of a 53-year-old woman with erythemas, plaques and nodules associated with polyarthritis is presented. She was treated with cyclosporin A, with improvement of the joint affliction and complete clearance of skin lesions. The differential diagnosis of IGDA is discussed briefly.

U. Wollina; J. Schönlebe; L. Unger; K. Weigel; E. Köstler; H. Nüsslein

2003-01-01

339

[Cystic Rheumatoid Arthritis--case report].  

PubMed

Among the many radiological findings seen in Rheumatoid Arthritis RA small subchondral geodes and erosions are typical. Large geodes are far less common abnormalities and their presence may indicate diagnostic and therapeutic difficulties. We present a case report of a 55-year old woman with seronegative RA that developed a large geode in the knee with extensive joint destruction. PMID:18159206

Mourăo, Ana Filipa; Santos, Fernando Pimentel; Falcăo, Sandra; Pinto, Teresa Laura; Barros, Rita; de Matos, António Alves; Branco, Jaime Cunha

2007-01-01

340

Rheumatoid arthritis in a military aviator.  

PubMed

Rheumatoid arthritis is a chronic inflammatory condition whose pathogenesis is determined partially by genetic and environmental factors. Without treatment, 20 to 30% of individuals with this condition will become permanently disabled in a few years. Rheumatoid arthritis and its potential complications can cause significant disability and could seriously affect the performance of an aviator. Traditionally, disease-modifying anti-rheumatic drugs (DMARD) and biologics have not been used until disease progression occurs, but they recently have been added earlier in the course of disease for a more aggressive approach to treatment. It has been shown to significantly reduce the number of affected joints, pain, and disability. This newer treatment regimen has helped a military pilot continue his aviation career. We present the case of an experienced designated military pilot who was diagnosed with rheumatoid arthritis. He was initially treated early with a DMARD and biologic medication. He has remained in remission and currently only uses etanercept (biologic medication) and a non-steriodal anti-inflammatory drug to control his disease. He has responded favorably to therapy and has few limitations. Due to his positive response to treatment, the aviator was granted military aeromedical waivers for rheumatoid arthritis and chronic medication use. PMID:17225486

Moszyk, Danielle J; Sulit, Daryl J

2007-01-01

341

Treatment of rheumatoid arthritis using photodynamic therapy  

NASA Astrophysics Data System (ADS)

The only early therapy of rheumatoid arthritis in orthopedic surgery is a synovectomy, which is restricted to more or less big joints. A laser-synovectomy of small joints is ineffective yet. An alternative method may be photodynamic therapy. In our study we describe the photodynamic effect of Photosan 3 in a cell culture study.

Hendrich, Christian; Diddens, Heyke C.; Nosir, Hany R.; Siebert, Werner E.

1995-03-01

342

Treatment of rheumatoid arthritis using photodynamic therapy  

NASA Astrophysics Data System (ADS)

The only early therapy of rheumatoid arthritis in orthopedic surgery is a synovectomy, which is restricted to more or less big joints. A laser-synovectomy of small joints is ineffective yet. An alternative method may be photodynamic therapy. In our study we describe the photodynamic effect of Photosan 3 in a cell culture study.

Hendrich, Christian; Diddens, Heyke C.; Nosir, Hany R.; Siebert, Werner E.

1994-10-01

343

Upper gastrointestinal disease in rheumatoid arthritis  

Microsoft Academic Search

Upper gastrointestinal series were done in 140 consecutive patients with rheumatoid arthritis, irrespective of the presence or absence of symptoms suggesting upper gastrointestinal disease. In addition, intraluminal pH and manometric studies of the esophagus and esophagoscopy were done in 66 of these 140 patients. Gastric ulcers were found in 12 patients, and duodenal ulcers in 27, an incidence of peptic

David C. H. Sun; Sanford H. Roth; Charles S. Mitchell; DeWitt W. Englund

1974-01-01

344

[The post-traumatic arthritis - a challenge?].  

PubMed

Total knee replacement in patients with post-traumatic arthritis is not fundamentally different from total knee replacement in patients with primary arthritis. Because of a 10-times higher infection rate, ordinary surgical planning should be implemented by the best possible exclusion of site infection based on actual information. Extra-articular deformities have to be preoperatively identified and individually treated with either an incomplete or a complete intra-articular correction or a single or double correction osteotomy. The commonly found combination of a contracted knee joint and an insufficient ligament balancing can mask instabilities of the knee joint. Consequently the definitive grade of a constrained knee prosthesis can only be determined intraoperatively. Existing osseous defects can be addressed with autologous bone grafts left from the total knee arthroplasty. Depending on the osseous defective site and the grade of constraints, prosthesis stems may be necessary but so far no clear recommendation can be given for either a cemented or a cementless fixation of the stem. The approach to the knee joint should be guided according to existing scars in order to prevent wound healing disorders. Even given optimal surgical planning and an optimum procedure of total knee arthroplasty postoperative results of post-traumatic arthritis are significantly inferior to results of primary arthritis. Therefore it is important to induce the commonly younger patients to form realistic expectations. PMID:25313706

Matziolis, G; Windisch, C

2014-10-01

345

The clinical features of rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by progressive damage of synovial-lined joints and variable extra-articular manifestations. Tendon and bursal involvement are frequent and often clinically dominant in early disease. RA can affect any joint, but it is usually found in metacarpophalangeal, proximal interphalangeal and metatarsophalangeal joints, as well as in the wrists and knee. Articular and periarticular

Walter Grassi; Rossella De Angelis; Gianni Lamanna; Claudio Cervini

1998-01-01

346

A New Era in Rheumatoid Arthritis Treatment  

Microsoft Academic Search

Rheumatoid Arthritis (RA) is a systemic autoimmune disease that primarily manifests as a chronic symmetric polyarthritis. Treatment in the past was aimed at symp- tomatic pain relief. The initiation of disease modifying anti-rheumatic drugs (DMARDs) was historically started only after significant disease activity was pres- ent in order to reduce side effects from drug toxicities. Unfortunately, irreversible joint damage may

Jill C. Costello; Paul B. Halverson

2003-01-01

347

Peteosthor - a medical disaster due to Radium224  

Microsoft Academic Search

Up to the end of World War II, there was no effective therapy against bone tuberculosis, and even today there is no treatment for ankylosing spondylitis. However, in the 1940s up to about 1956, radiotherapy with \\

Heinz Spiess

2002-01-01

348

Complications: How Is a Person Affected?  

MedlinePLUS

... treated using cortcosteroid eyedrops and dilating agent eyedrops. Fatigue In Ankylosing Spondylitis As reported in our News Section on November 20, 2006 . "Fatigue has been recognized as one of the major ...

349

Rheumatoid Arthritis When Your Immune System Attacks Your Body | NIH MedlinePlus the Magazine  

MedlinePLUS

... Rheumatoid Arthritis (RA) Rheumatoid Arthritis When Your Immune System Attacks Your Body Past Issues / Summer 2014 Table ... which means the arthritis results from your immune system attacking your body's own tissues. The course of ...

350

Davignon et al. Arthritis Research & Therapy 2010, 12:R142 http://arthritis-research.com/content/12/4/R142  

E-print Network

-cell response in rheumatoid arthritis patients receiving anti-tumor necrosis factor treatments Jean-Luc Davignon the treatment of rheumatoid arthritis (RA). However, serious infections are a major concern in patientsDavignon et al. Arthritis Research & Therapy 2010, 12:R142 http://arthritis-research.com/content/12

Paris-Sud XI, Université de

351

The temporomandibular joint in juvenile idiopathic arthritis: frequently used and frequently arthritic  

PubMed Central

Recent recognition of the markedly high prevalence of temporomandibular joint (TMJ) arthritis in children with juvenile idiopathic arthritis (JIA) coupled with the significant morbidity associated with TMJ damage has prompted increased interest in both the clinical and pathological aspects of TMJ arthritis. This review focuses on the prevalence of TMJ arthritis in JIA, the imaging modalities used to detect TMJ arthritis, and the treatment of TMJ arthritis in children with JIA. PMID:19480670

Ringold, Sarah; Cron, Randy Q

2009-01-01

352

Sacroiliitis detected by bone scintiscanning: a clinical, radiological, and scintigraphic follow-up study  

Microsoft Academic Search

Twenty-four patients had abnormal sacroiliac joints detected by quantitative sacroiliac scintigraphy but no radiological evidence of sacroiliitis on original investigation. We studied them again after intervals of 12 to 36 months. Four patients developed radiological change. Two young, HLA B27-positive men had undoubted ankylosing spondylitis, and a young woman had possible ankylosing spondylitis. A middle-aged man had changes that could

I M Chalmers; B C Lentle; J S Percy; A S Russell

1979-01-01

353

Pattern of Lyme arthritis in Europe: report of 14 cases.  

PubMed Central

Fourteen cases of Lyme arthritis are reported. The most frequent picture was that of oligoarthritis appearing in that part of the leg where the cutaneous or neurological complications, or both, of Lyme disease had developed before the arthritis. In most cases recovery followed a single 10 day course of intravenous (IV) penicillin therapy. Arthritis was the presenting feature of Lyme disease in three cases. PMID:3355251

Huaux, J P; Bigaignon, G; Stadtsbaeder, S; Zangerle, P F; Nagant de Deuxchaisnes, C

1988-01-01

354

A child with interstitial granulomatous dermatitis and juvenile idiopathic arthritis.  

PubMed

We describe a case of interstitial granulomatous dermatitis (IGD) with juvenile idiopathic arthritis (JIA) in an 11-year-old girl. She complained of erythematous plaques on her thighs and polyarthritis for 1 year. Histopathologic examination revealed the features of IGD. This case indicates that IGD with arthritis can occur in children and should be considered in the differential diagnosis of cutaneous lesions associated with arthritis in children. PMID:23735003

Moon, Hye-Rim; Lee, Ji-Hyun; Won, Chong Hyun; Chang, Sung Eun; Lee, Mi Woo; Choi, Jee Ho; Moon, Kee Chan

2013-01-01

355

Arthritis Critically Dependent on Innate Immune System Players  

Microsoft Academic Search

K\\/BxN T cell receptor transgenic mice are a model of inflammatory arthritis, similar to rheumatoid arthritis. Disease in these animals is focused specifically on the joints but stems from autoreactivity to a ubiquitously expressed antigen, glucose-6-phosphate isomerase (GPI). T and B cells are both required for disease initiation, but anti-GPI immunoglobulins (Igs), alone, can induce arthritis in lymphocyte-deficient recipients. Here,

Hong Ji; Koichiro Ohmura; Umar Mahmood; David M Lee; Frans M. A Hofhuis; Susan A Boackle; Kazue Takahashi; V. Michael Holers; Mark Walport; Craig Gerard; Alan Ezekowitz; Michael C Carroll; Michael Brenner; Ralph Weissleder; J. Sjef Verbeek; Veronique Duchatelle; Claude Degott; Christophe Benoist; Diane Mathis

2002-01-01

356

HLA-DR antigens and disease patterns of rheumatoid arthritis  

Microsoft Academic Search

HLA-DR antigens were determined in 111 patients with classic or definite rheumatoid arthritis. HLA-DR4 was significantly (P corr. -6) increased in patients with rheumatoid arthritis (54%) compared with controls (23.2%). HLA-DR 5 was decreased in rheumatoid arthritis (12.6% vs 26.4% of controls); however, the corrected P value was not significant. There were no significant differences with regard to various clinical,

O. Scherak; J. S. Smolen; W. R. Mayr

1983-01-01

357

Septic arthritis of the knee joint secondary to Prevotella bivia.  

PubMed

Prevotella bivia is an obligatory anaerobic, gram-negative rod, which often produces a detectable beta-lactamase. To date, there has been only 3 descriptions of septic arthritis secondary to this microorganism in a patients pre-existing sever joint disease like rheumatoid arthritis and osteoarthritis or after joint prosthesis. We are reporting the first case of septic arthritis due to Prevotella bivia in a patient with no pre-existing joint symptoms. PMID:19271076

Salman, Salman A; Baharoon, Salim A

2009-03-01

358

Clinical characteristics of patients with spondyloarthritides and HLA-B27 positive antigen.  

PubMed

The aim of this study was to present our experiences in diagnosing spondyloarthritides (SpA), and to list the most common clinical features of HLA-B27 positive patients. The study included 65 HLA-B27 positive patients with confirmed diagnosis of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) who were analyzed between 2009 and 2010 in Clinic of Internal Medicine in Osijek. The diagnosis of seronegative spondyloarthritides was based on the ASAS (Assessment in AS Working Group) classification criteria for axial and then supplemented with ASAS criteria for peripheral SpA and was confirmed by radiological techniques. For diagnosing the ankylosing spondylitis (AS), there have been applied the modified New York criteria. Radiological criteria for definite sacroiliitis according to the modified New York criteria is bilateral sacroiliitis, grade 2-4 (> or = 2) or unilateral sacroiliitis, grade 3-4. For diagnosing the psoriatic arthritis (PsA), there were used CASPAR diagnostic criteria. Other features of SpA are defined within the existing classification criteria. HLA-B27 antigen was determined by direct immune-fluorescence technique using flow cytometer. The average age of patients was 50.34 years, of whom 27 female (41.53%), 38 male (58.46%). Duration of illness was 15.79 years on average. With 75.38% of patients, there had been determined the diagnosis of AS; 24.62% of patients had the diagnosis of PsA. The most common clinical characteristics that patients had were: inflammatory back pain (pain Inflammation along the lumbosacral spine), peripheral arthritis, intermittent pain in the gluteus, sacroiliitis, enthesitis, uveitis, dactilitis. PMID:21755709

Glasnovi?, Marija; Bosnjak, Ivica; Sram, Miroslav; Vranjes, Zeljko; Vcev, Aleksandar; Dobrosevi?, Blazenka; Petricevi?, Jasminka Sinci?; Horvati?, Elizabeta; Orki?, Zelimir; Tadzi?, Refmir; Soldo, Anamarija; Sisljagi?, Dina; Dinjar, Kristijan

2011-06-01

359

Naproxen in rheumatoid arthritis. Extended trial.  

PubMed Central

121 patients with active rheumatoid arthritis, 91 of whom had proved intolerant of other nonsteroidal anti-inflammatory agents, were treated for a mean of 10 months with naproxen. A dosage of 250 mg twice daily produced sustained improvement in most of the standard clinical measurements. 28 patients complained of side effects, with a lower than expected incidence of gastrointestinal complaints and no drug-induced rash being recorded. 19 patients withdrew from the trial because of side effects, while a further 22 withdrew because the drug was ineffective. Naproxen is a useful drug for long-term use in patients with rheumatoid arthritis, including those who have proved intolerant of or experienced inadequate symptomatic relief from other nonsteriodal anti-inflammatory agents. PMID:795386

Mowat, A G; Ansell, B M; Gumpel, J M; Hill, H F; Hill, A G; Stoppard, M

1976-01-01

360

Patient advocacy and arthritis: moving forward.  

PubMed Central

Patient advocacy is based on the premise that people have the right to make their own choices about their health care. Personal advocacy is centred on the experiential expertise of the individual affected by the condition, whereas group advocacy is grounded on patient-centred strategies and actions. The first patient advocacy groups for arthritis were set up over 20 years ago in the USA and have subsequently spread to many other countries. This paper discusses the growth and impact of personal advocacy as well as recent developments in group advocacy in the Asia-Pacific region, Europe, and North America, in terms of arthritis awareness, research, corporate partnerships, and the Bone and Joint Decade global initiative. PMID:15042233

Leong, Amye L.; Euller-Ziegler, Liana

2004-01-01

361

The burden of illness of rheumatoid arthritis  

Microsoft Academic Search

It is necessary to understand the full burden of illness of a disease before the value of interventions can be assessed. Rheumatoid\\u000a arthritis (RA) has an impact on a variety of stakeholders, including patients, healthcare systems, and society as a whole.\\u000a This overview discusses the societal and patient perspectives, distinguishing several domains of impact. Epidemiology is important from a societal

Annelies Boonen; Johan L. Severens

2011-01-01

362

Arthritis associated with pityriasis rubra pilaris  

PubMed Central

Pityriasis rubra pilaris (PRP) is a rare papulosquamous disease of unknown aetiology, with an estimated prevalence of 2.5 per million.1 It is clinically characterised by the presence of follicular hyperkeratotic papules, but the histopathology is usually non-specific. An interesting case of asymmetric, inflammatory arthritis of the hand in a patient who also presented with PRP is presented, along with a review of the few previously reported cases the literature. PMID:22766575

Liu, Paul Y; Prete, Pamela E

2010-01-01

363

Arthritis associated with pityriasis rubra pilaris.  

PubMed

Pityriasis rubra pilaris (PRP) is a rare papulosquamous disease of unknown aetiology, with an estimated prevalence of 2.5 per million.1 It is clinically characterised by the presence of follicular hyperkeratotic papules, but the histopathology is usually non-specific. An interesting case of asymmetric, inflammatory arthritis of the hand in a patient who also presented with PRP is presented, along with a review of the few previously reported cases the literature. PMID:22766575

Liu, Paul Y; Prete, Pamela E

2010-01-01

364

Chitotriosidase activity in juvenile idiopathic arthritis  

Microsoft Academic Search

Juvenile idiopathic arthritis (JIA) is an inflammatory joint disease of unknown etiology. The pathogenesis is driven by T\\u000a and B cells. The role of macrophages remains unclear. Chitotriosidase belongs to the chitinase protein family and is secreted\\u000a by activated macrophages. The chitinases are able to catalyze the hydrolysis of chitin or chitin-like substrates such as 4-methylumbelliferyl\\u000a chitotrioside. Chitotriosidase activity was

Jürgen K. H. Brunner; Sabine Scholl-Bürgi; David Hössinger; Petra Wondrak; Martina Prelog; Lothar-Bernd Zimmerhackl

2008-01-01

365

Update on autoantibodies in rheumatoid arthritis  

Microsoft Academic Search

Detection of rheumatoid factor (RF) in the serum of patients with rheumatoid arthritis (RA) was one of the first indications\\u000a of autoimmunity in RA. The role of RF in the diagnosis of RA has been well-documented, but it has suboptimal sensitivity and\\u000a specificity. Although patients with RF-positive RA generally have more severe disease than those with RF-negative RA, RF is

S. Louis Bridges

2004-01-01

366

Cutaneous manifestations associated with rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis presents various cutaneous manifestations, either specific or nonspecific skin features, which are induced\\u000a by the activation of inflammatory cells (neutrophils, lymphocytes, macrophages), vasculopathy, vasculitis, acral deformity,\\u000a drugs, and so on. These include (1) specific findings, (2) findings due to vascular impairment, (3) findings due to immune\\u000a dysfunction, (4) characteristic neutrophilic conditions, and (5) miscellaneous conditions. On the other

T. Yamamoto

2009-01-01

367

Profiling of rheumatoid arthritis associated autoantibodies  

Microsoft Academic Search

An increasing number of rheumatoid arthritis (RA)-associated autoantibodies (AAB) are available for AAB profiling that may improve the early diagnosis of RA and provide prognostic and, probably theranostic information. To select AAB specificities for optimal AAB combinations, known AAB should be evaluated with standardized methods by means of standardized study designs and subjected to statistical analysis. Profiling of anti-citrullinated peptide\\/protein

Karsten Conrad; Dirk Roggenbuck; Dirk Reinhold; Thomas Dörner

2010-01-01

368

B cell targets in rheumatoid arthritis  

Microsoft Academic Search

B cells are critical to the pathogenesis of rheumatoid arthritis (RA). There is substantial evidence of the efficacy of depletion\\u000a of B cells in many patients with RA using the first licensed agent, rituximab. Recent research has focused on enhancing efficacy\\u000a using other targets to inhibit B cell function, including other B cell-depleting antibodies and cytokines critical to B cell

Edward M. Vital; Shouvik Dass; Paul Emery

369

Cell-mediated immunity in rheumatoid arthritis  

Microsoft Academic Search

Cell-mediated immunity in rheumatoid arthritis (RA) was assessed by skin testing with six antigens in 107 patients, 94 of whom were age, sex, and race-matched with healthy individuals or patients with diseases unrelated to immunological abnormalities. 20% of RA patients were anergic. Impaired cell-mediated immunity in the RA patients was manifested by a decrease in the magnitude of skin reactivity

A A Andrianakos; J T Sharp; D A Person; M D Lidsky; J Duffy

1977-01-01

370

The early phase of psoriatic arthritis  

Microsoft Academic Search

Evaluation of the preclinical phases of the classic autoimmune diseases including rheumatoid arthritis has been facilitated by the availability of autoantibody and genetic markers that point firmly towards the early dysregulation of the adaptive immune responses. The association of psoriatic disease with the human leucocyte antigen—Cw0602 (HLA-Cw0602) gene has likewise led to the perception that autoimmunity has a pivotal role

Dennis McGonagle; Zoe Ash; Laura Dickie; Michael McDermott; Sibel Zehra Aydin

2011-01-01

371

Sternoclavicular septic arthritis: review of 180 cases.  

PubMed

We review 170 previously reported cases of sternoclavicular septic arthritis, and report 10 new cases. The mean age of patients was 45 years; 73% were male. Patients presented with chest pain (78%) and shoulder pain (24%) after a median duration of symptoms of 14 days. Only 65% were febrile. Bacteremia was present in 62%. Common risk factors included intravenous drug use (21%), distant site of infection (15%), diabetes mellitus (13%), trauma (12%), and infected central venous line (9%). No risk factor was found in 23%. Serious complications such as osteomyelitis (55%), chest wall abscess or phlegmon (25%), and mediastinitis (13%) were common. Staphylococcus aureus was responsible for 49% of cases, and is now the major cause of sternoclavicular septic arthritis in intravenous drug users. Pseudomonas aeruginosa infection in injection drug users declined dramatically with the end of an epidemic of pentazocine abuse in the 1980s. Sternoclavicular septic arthritis accounts for 1% of septic arthritis in the general population, but 17% in intravenous drug users, for unclear reasons. Bacteria may enter the sternoclavicular joint from the adjacent valves of the subclavian vein after injection of contaminated drugs into the upper extremity, or the joint may become infected after attempted drug injection between the heads of the sternocleidomastoid muscle. Computed tomography or magnetic resonance imaging should be obtained routinely to assess for the presence of chest wall phlegmon, retrosternal abscess, or mediastinitis. If present, en-bloc resection of the sternoclavicular joint is indicated, possibly with ipsilateral pectoralis major muscle flap. Empiric antibiotic therapy may need to cover methicillin-resistant Staphylococcus aureus (MRSA). PMID:15118542

Ross, John J; Shamsuddin, Hala

2004-05-01

372

New autoantibodies associated with early rheumatoid arthritis  

Microsoft Academic Search

Background and objectivesRheumatoid arthritis (RA) is an autoantibody mediated disease. Among the various autoantibodies known in RA, autoantibodies to citrullinated proteins (ACPA) are highly specific. ACPAs are detected by an ELISA using synthetic cyclic citrullinated peptides (anti-CCP). Anti-CCP antibodies identify 60% of RA patients. A negative result in anti-CCP antibody testing does not exclude RA. Therefore, there is a great

C Charpin; M Martin; N Balandraud; E Toussirot; D Wendling; J Roudier; I Auger

2011-01-01

373

Development of autoimmunity in Lyme arthritis.  

PubMed

Treatment-resistant Lyme arthritis (TRLA) develops in 10% of Lyme arthritis patients and is characterized by continuous joint inflammation that does not resolve with antibiotic therapy. TRLA is associated with HLA-DRB1*0401 and related alleles, as well as with an immune response to the Borrelia burgdorferi (Bb) outer surface protein A (OspA). The immunodominant epitope of OspA in the context of HLA-DRB1*0401 corresponds to amino acids 165-173 (OspA165-173). The human Lymphocyte Function Antigen-1 (hLFA1alpha) contains a peptide with homology to OspA165-173. Treatment-resistant Lyme arthritis patients' T cells, cloned based on their ability to bind OspA165-173-loaded HLA-DRB1*0401 tetramers, respond to OspA and hLFA1alpha with a different cytokine profile, suggesting that hLFA1alpha acts as a partial agonist with a potential role in the perpetuation of joint inflammation. PMID:12118172

Guerau-de-Arellano, Mireia; Huber, Brigitte T

2002-07-01

374

Immunomodulation of Autoimmune Arthritis by Herbal CAM  

PubMed Central

Rheumatoid arthritis (RA) is a debilitating autoimmune disease of global prevalence. The disease is characterized by synovial inflammation leading to cartilage and bone damage. Most of the conventional drugs used for the treatment of RA have severe adverse reactions and are quite expensive. Over the years, increasing proportion of patients with RA and other immune disorders are resorting to complementary and alternative medicine (CAM) for their health needs. Natural plant products comprise one of the most popular CAM for inflammatory and immune disorders. These herbal CAM belong to diverse traditional systems of medicine, including traditional Chinese medicine, Kampo, and Ayurvedic medicine. In this paper, we have outlined the major immunological pathways involved in the induction and regulation of autoimmune arthritis and described various herbal CAM that can effectively modulate these immune pathways. Most of the information about the mechanisms of action of herbal products in the experimental models of RA is relevant to arthritis patients as well. The study of immunological pathways coupled with the emerging application of genomics and proteomics in CAM research is likely to provide novel insights into the mechanisms of action of different CAM modalities. PMID:21234398

Venkatesha, Shivaprasad H.; Rajaiah, Rajesh; Berman, Brian M.; Moudgil, Kamal D.

2011-01-01

375

Angiogenesis and its targeting in rheumatoid arthritis?  

PubMed Central

Angiogenesis, the development of new capillaries, is involved in leukocyte ingress into the synovium during the development and progression of rheumatoid arthritis. Several soluble and cell surface-bound mediators including growth factors, cytokines, chemokines, proteolytic matrix-degrading enzymes, cell adhesion molecules and others may promote synovial neovascularization. On the other hand, endogenous angiostatic factors, such as angiostatin, endostatin, interleukin-4 (IL-4), IL-13, interferons and some angiostatic chemokines are also produced within the rheumatoid synovium, however, their effects are insufficient to control synovial angiogenesis and inflammation. Several specific and non-specific strategies have been developed to block the action of angiogenic mediators. The first line of angiostatic agents include vascular endothelial growth factor (VEGF), angiopoietin, ?V?3 integrin antagonist, as well as non-specific angiogenesis inhibitors including traditional disease-modifying agents (DMARDs), anti-tumor necrosis factor biologics, angiostatin, endostatin, fumagillin analogues or thalidomide. Potentially any angiostatic compound could be introduced to studies using animal models of arthritis or even to human rheumatoid arthritis trials. PMID:19217946

Szekanecz, Zoltan; Koch, Alisa E.

2010-01-01

376

Clinical and radiological damage in psoriatic arthritis  

PubMed Central

Background Psoriatic arthritis may progress to joint damage. Joint damage may be assessed clinically, by identifying deformed, fused, or flail joints, or radiologically, by recording erosions, joint space narrowing, ankylosis, lysis, or surgery. The relation between clinical and radiological damage is unclear. Objective To study the ordering of clinical and radiological damage detection, and the clinical features associated with the type of damage detected first. Methods The University of Toronto psoriatic arthritis database was used to relate clinical and radiological damage in the hand joints in 655 patients followed prospectively between 1978 and 2003. Generalised estimating equations were used to fit logistic regression models to identify factors that predict classification of damage by radiographic assessment first. Results The majority of the joints were not informative, as they either had evidence of damage by both methods at entry, or remained undamaged. Of the remainder, 81% of the joints showed radiological damage first and 19% had clinical damage first. Development of radiological damage first was related to previous detection of swollen joints, and was inversely related to duration of arthritis. Conclusions Radiological damage is often detected before clinical damage is observed. Clinical inflammation often precedes the detection of radiological damage. PMID:16126794

Siannis, F; Farewell, V T; Cook, R J; Schentag, C T; Gladman, D D

2006-01-01

377

Sirt2 suppresses inflammatory responses in collagen-induced arthritis  

SciTech Connect

Highlights: •Sirt2 expression decreases in collagen-induced arthritis (CIA). •Sirt2 knockout aggravates severity of arthritis in mice with CIA. •Sirt2 knockout increases levels of pro-inflammatory factors in the serum. •Sirt2 deacetylates p65 and inhibits pro-inflammatory factors expression. •Sirt2 rescue abates severity of arthritis in mice with CIA. -- Abstract: Arthritis is a common autoimmune disease that is associated with progressive disability, systemic complications and early death. However, the underling mechanisms of arthritis are still unclear. Sirtuins are a NAD{sup +}-dependent class III deacetylase family, and regulate cellular stress, inflammation, genomic stability, carcinogenesis, and energy metabolism. Among the sirtuin family members, Sirt1 and Sirt6 are critically involved in the development of arthritis. It remains unknown whether other sirtuin family members participate in arthritis. Here in this study, we demonstrate that Sirt2 inhibits collagen-induced arthritis (CIA) using in vivo and in vitro evidence. The protein and mRNA levels of Sirt2 significantly decreased in joint tissues of mice with CIA. When immunized with collagen, Sirt2-KO mice showed aggravated severity of arthritis based on clinical scores, hind paw thickness, and radiological and molecular findings. Mechanically, Sirt2 deacetylated p65 subunit of nuclear factor-kappa B (NF-?B) at lysine 310, resulting in reduced expression of NF-?B-dependent genes, including interleukin 1? (IL-1?), IL-6, monocyte chemoattractant protein 1(MCP-1), RANTES, matrix metalloproteinase 9 (MMP-9) and MMP-13. Importantly, our rescue experiment showed that Sirt2 re-expression abated the severity of arthritis in Sirt2-KO mice. Those findings strongly indicate Sirt2 as a considerably inhibitor of the development of arthritis.

Lin, Jiangtao [Department of Orthopaedics, Qilu Hospital, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong 250012 (China) [Department of Orthopaedics, Qilu Hospital, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong 250012 (China); Department of Orthopaedics, Yantaishan Hospital, 91 Jiefang Road, Yantai, Shandong 264001 (China); Sun, Bing; Jiang, Chuanqiang; Hong, Huanyu [Department of Orthopaedics, Yantaishan Hospital, 91 Jiefang Road, Yantai, Shandong 264001 (China)] [Department of Orthopaedics, Yantaishan Hospital, 91 Jiefang Road, Yantai, Shandong 264001 (China); Zheng, Yanping, E-mail: yanpingzheng@yahoo.com [Department of Orthopaedics, Qilu Hospital, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong 250012 (China)] [Department of Orthopaedics, Qilu Hospital, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong 250012 (China)

2013-11-29

378

The value of quantitative sacroiliac scintigraphy in detection of sacroiliitis  

Microsoft Academic Search

Summary  To evaluate clinical usefulness of quantitative sacroiliac scintigraphy (QSS) in detecting sacroiliitis, we used a modified, pixel by pixel technique for calculating sacroiliac joint\\/sacrum uptake ratios (sacroiliac joint index - SII). We studied 90 controls, 18 selected patients with active sacroiliitis, 2 ankylosing spondylitis patients with completely ankylosed sacroiliac joints, 14 patients with nonspecific low back pain and 5 patients

S. D. Miron; M. A. Khan; E. J. Wiesen; I. Kushner; E. M. Bellon

1983-01-01

379

ARTHRITIS & RHEUMATISM Vol. 60, No. 8, August 2009, pp 22422247  

E-print Network

years). The rate of joint destruction between genotype groups was compared using a linear mixed model01-AR-44422). Dr. Toes' work was supported by the Dutch Arthritis Foundation, the European Commission of Joint Destruction in Rheumatoid Arthritis Michael P. M. van der Linden,1 Anouk L. Feitsma,1 Saskia le

Raychaudhuri, Soumya

380

The pathogenesis of bone erosions in gouty arthritis  

Microsoft Academic Search

The characteristic radiographic hallmarks of chronic gouty arthritis are the presence of macroscopic tophi and erosions with overhanging edges and relative preservation of the joint space. In recent years there has been more insight into the processes underlying the development of bone erosions in gouty arthritis. This review discusses the mechanical, pathological, cellular and immunological factors that may have a

Naomi Schlesinger; Ralf G Thiele

2010-01-01

381

MIF: a new cytokine link between rheumatoid arthritis and atherosclerosis  

Microsoft Academic Search

Macrophage migration inhibitory factor (MIF) is well established as a key cytokine in immuno-inflammatory diseases such as rheumatoid arthritis. Inflammation is now also recognized as having a crucial role in atherosclerosis, and recent evidence indicates that MIF could also be important in this disease. Here, we review the role of MIF in rheumatoid arthritis and atherosclerosis, discuss the ways in

Michelle Leech; Jürgen Bernhagen; Eric F. Morand

2006-01-01

382

Early onset sarcoidosis masquerading as juvenile rheumatoid arthritis.  

PubMed

Symptoms of early onset sarcoidosis characterized by skin eruptions, arthritis, and uveitis mimic those of systemic type juvenile rheumatoid arthritis (JRA). We report 2 Japanese patients with early onset sarcoidosis, both of whom were initially diagnosed and treated as having JRA. Intermittent fever and synovial swelling may mask sarcoidosis in children less than 4 years old. PMID:11044836

Yotsumoto, S; Takahashi, Y; Takei, S; Shimada, S; Miyata, K; Kanzaki, T

2000-11-01

383

Early onset sarcoidosis masquerading as juvenile rheumatoid arthritis  

Microsoft Academic Search

Symptoms of early onset sarcoidosis characterized by skin eruptions, arthritis, and uveitis mimic those of systemic type juvenile rheumatoid arthritis (JRA). We report 2 Japanese patients with early onset sarcoidosis, both of whom were initially diagnosed and treated as having JRA. Intermittent fever and synovial swelling may mask sarcoidosis in children less than 4 years old. (J Am Acad Dermatol

Shinichi Yotsumoto; Yoshihiro Takahashi; Shuji Takei; Shoko Shimada; Koichiro Miyata; Tamotsu Kanzaki

2000-01-01

384

Cells of the synovium in rheumatoid arthritis. B cells  

Microsoft Academic Search

There is significant evidence arising from experimental models that autoantibodies play a key role in the pathogenesis of inflammatory arthritis. In addition to autoantibody production, B cells efficiently present antigen to T cells, produce soluble factors, including cytokines and chemokines, and form B cell aggregates in the target organ of rheumatoid arthritis. In this review we analyze the multifaceted role

Claudia Mauri; Michael R Ehrenstein

2007-01-01

385

Salmonella enteridis Septic Arthritis: A Report of Two Cases  

PubMed Central

Introduction. Nontyphoidal salmonellosis causes significant morbidity, is transmitted via fecal-oral route, and is a worldwide cause of gastroenteritis, bacteremia, and local infections. Salmonella is a less common etiologic factor for septic arthritis compared with other gram-negative bacteria. Cases. We present two septic arthritis cases with Salmonella enteridis as a confirmed pathogen and also discuss the predisposing factors and treatment. Discussion. Septic arthritis is an orthopedic emergency. The gold standard treatment of septic arthritis is joint debridement, antibiotic therapy according to the culture results, and physiotherapy, which should start in the early postoperative period to prevent limitation of motion. Salmonella is an atypical agent for septic arthritis. It must be particularly kept in mind as an etiologic factor for the acute arthritis of a patient with sickle cell anemia and systemic lupus erythematosus. Clinicians should be cautious that the white blood cell count in synovial fluid can be under 50.000/mm3 in immune compromised individuals with septic arthritis. The inflammatory response can be deficient, or the microorganism may be atypical. Conclusion. Atypical bacteria such as Salmonella species in immune compromised patients can cause joint infections. Therefore, Salmonella species must always be kept in mind for the differential diagnosis of septic arthritis in a clinically relevant setting. PMID:24251049

Uygur, Esat; Reddy, Krishna; Ozkan, Feyza Unlu; Soylemez, Salih; Aydin, Ozlem; Senol, Serkan

2013-01-01

386

Lysosomal ?-glucuronidase regulates Lyme and rheumatoid arthritis severity.  

PubMed

Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most prevalent arthropod-borne illness in the United States and remains a clinical and social challenge. The spectrum of disease severity among infected patients suggests that host genetics contribute to pathogenic outcomes, particularly in patients who develop arthritis. Using a forward genetics approach, we identified the lysosomal enzyme ?-glucuronidase (GUSB), a member of a large family of coregulated lysosomal enzymes, as a key regulator of Lyme-associated arthritis severity. Severely arthritic C3H mice possessed a naturally occurring hypomorphic allele, Gusbh. C57BL/6 mice congenic for the C3H Gusb allele were prone to increased Lyme-associated arthritis severity. Radiation chimera experiments revealed that resident joint cells drive arthritis susceptibility. C3H mice expressing WT Gusb as a transgene were protected from severe Lyme arthritis. Importantly, the Gusbh allele also exacerbated disease in a serum transfer model of rheumatoid arthritis. A known GUSB function is the prevention of lysosomal accumulation of glycosaminoglycans (GAGs). Development of Lyme and rheumatoid arthritis in Gusbh-expressing mice was associated with heightened accumulation of GAGs in joint tissue. We propose that GUSB modulates arthritis pathogenesis by preventing accumulation of proinflammatory GAGs within inflamed joint tissue, a trait that may be shared by other lysosomal exoglycosidases. PMID:24334460

Bramwell, Kenneth K C; Ma, Ying; Weis, John H; Chen, Xinjian; Zachary, James F; Teuscher, Cory; Weis, Janis J

2014-01-01

387

Home Care Guide on Juvenile Rheumatoid Arthritis (For Parents).  

ERIC Educational Resources Information Center

The booklet, written by the medical staff of a children's hospital, provides information for parents of children with juvenile rheumatoid arthritis (JRA). Arthritis is a swelling of the joint(s) in children and lasts for over 6 weeks (sometimes many years). Aspirin is the main medicine given for JRA, and it works not only to control pain but also,…

Giesecke, Linda L.; And Others

388

Alpha-interferon-induced arthritis: clinical presentation, treatment, and prevention  

Microsoft Academic Search

Objective:The therapeutic applications of alpha-interferon (IFN) have expandedgreatly to include chronic viral hepatitis and malignant disorders. Autoimmune phenomena occur frequently with IFN therapy, but arthritis is uncommon. We describe the clinical features and treatment of IFN-induced arthritis.

Gideon Nesher; Rosa Ruchlemer

1998-01-01

389

Optimizing Long-Term Treatment of Rheumatoid Arthritis  

E-print Network

Optimizing Long-Term Treatment of Rheumatoid Arthritis with Systematic Documentation K. M. Simonic- toid arthritis. They not only experience pain, but during the course of the disease their mobility for treatment optimization and as a measure for the quality of patient outcome. Graphical data acquisition

Hammerton, James

390

ARTHRITIS & RHEUMATISM Vol. 56, No. 11, November 2007, pp 37263737  

E-print Network

prescribed for the treatment of many noninfectious inflammatory conditions, including arthritis, pulmonaryARTHRITIS & RHEUMATISM Vol. 56, No. 11, November 2007, pp 3726­3737 DOI 10.1002/art.22976 © 2007 of fragility-related fractures. The purpose of this study was to assess whether concurrent treatment with GCs

Ritchie, Robert

391

Auranofin. New oral gold compound for treatment of rheumatoid arthritis  

Microsoft Academic Search

Eight patients with rheumatoid arthritis were treated with SK & F D-39162 (auranofin), a new oral gold compound which was effective in suppressing adjuvant-induced arthritis in rats. Clinical and humoral parameters were studied during a 3-month period of drug administration followed by a 3-month period under placebo. The drug was absorbed, well tolerated, and its action was manifested by a

A E Finkelstein; D T Walz; V Batista; M Mizraji; F Roisman; A Misher

1976-01-01

392

A Cognitive-Behavioral Treatment for Rheumatoid Arthritis  

Microsoft Academic Search

This experiment tested a cognitive-behavioral rheumatoid arthritis treatment designed to confer skills in managing stress, pain, and other symptoms of the disease. We hypothesized that a mediator of the magnitude of treatment effects might be enhancement of perceived self-efficacy to manage the disease. It was predicted that the treatment would reduce arthritis symptoms and possibly would improve both immunologic competence

Ann O’Leary; Stanford Shoor; Kate Lorig; Halsted R. Holman

1988-01-01

393

Collagen-induced arthritis in common marmosets: a new nonhuman primate model for chronic arthritis  

Microsoft Academic Search

INTRODUCTION: There is an ever-increasing need for animal models to evaluate efficacy and safety of new therapeutics in the field of rheumatoid arthritis (RA). Particularly for the early preclinical evaluation of human-specific biologicals targeting the progressive phase of the disease, there is a need for relevant animal models. In response to this requirement we set out to develop a model

Michel PM Vierboom; Elia Breedveld; Ivanela Kondova; Bert A't Hart

2010-01-01

394

Jointly managing arthritis: Information needs of children with juvenile idiopathic arthritis (JIA) and their parents  

Microsoft Academic Search

The objective of this article is to explore information needs of children with juvenile idiopathic arthritis (JIA) and their parents in order to develop a web-based psychoeducational program aimed at improving their quality of life. A qualitative study design was used. A purposive sample of children (n = 41; 8–11 years) with JIA and parents (n = 48) participated in

Jennifer N Stinson; Brian M Feldman; Ciaran M Duffy; Adam M Huber; Lori B Tucker; Patrick J McGrath; Shirley ML Tse; Ross Hetherington; Lynn R Spiegel; Sarah Campillo; Susanne Benseler; Navreet Gill; Meghan E White; Natalie Baker; Abi Vijenthira

2012-01-01

395

Comprehensive assessment of rheumatoid arthritis susceptibility loci in a large psoriatic arthritis cohort  

PubMed Central

Objective A number of rheumatoid arthritis (RA) susceptibility genes have been identified in recent years. Given the overlap in phenotypic expression of synovial joint inflammation between RA and psoriatic arthritis (PsA), the authors explored whether RA susceptibility genes are also associated with PsA. Methods 56 single nucleotide polymorphisms (SNPs) mapping to 41 genes previously reported as RA susceptibility loci were selected for investigation. PsA was defined as an inflammatory arthritis associated with psoriasis and subjects were recruited from the UK and Ireland. Genotyping was performed using the Sequenom MassArray platform and frequencies compared with data derived from large UK control collections. Results Significant evidence for association with susceptibility to PsA was found toa SNP mapping to the REL (rs13017599, ptrend=5.2×104) gene, while nominal evidence for association (ptrend<0.05) was found to seven other loci including PLCL2 (rs4535211, p=1.7×10?3); STAT4 (rs10181656, p=3.0×10?3) and the AFF3, CD28, CCL21, IL2 and KIF5A loci. Interestingly, three SNPs demonstrated opposite effects to those reported for RA. Conclusions The REL gene, a key modulator of the NF?B pathway, is associated with PsA but the allele conferring risk to RA is protective in PsA suggesting that there are fundamental differences in the aetiological mechanisms underlying these two types of inflammatory arthritis. PMID:22328738

Bowes, John; Ho, Pauline; Flynn, Edw; Ali, Faisal; Marzo-Ortega, Helena; Coates, Laura C; Warren, Rich B; McManus, Ross; Ryan, Anthony W; Kane, David; Korendowych, Eleanor; McHugh, Neil; FitzGerald, Oliver; Packham, Jonathon; Morgan, Ann W; Bruce, Ian N; Barton, Anne

2012-01-01

396

Biomarkers to Diagnose Early Arthritis in Patients With Psoriasis  

PubMed Central

Background Psoriatic arthritis is a potentially destructive, inflammatory joint disease that affects 20% to 30% of patients with psoriasis. Psoriasis precedes the onset of joint inflammation by approximately 10 years, providing a unique opportunity to intervene and prevent or delay onset of musculoskeletal manifestations. The emergence of sensitive imaging modalities and cellular biomarkers may facilitate early identification of patients with psoriasis who have subclinical joint disease and might help stratify patients with an early onset of arthritis. Methods The translational studies described herein are focused on the development of cellular biomarkers identified with flow cytometry and cell culture techniques in patients with psoriasis and psoriatic arthritis. Results and Conclusion The combination of power Doppler ultrasound imaging and cellular biomarkers (ie, CD16 and dendritic cell specific transmembrane protein) to diagnose early psoriatic arthritis and to stratify patients with established psoriatic arthritis provides a new opportunity to optimize treatment outcomes in this potentially disabling disease.

Chiu, Ya-Hui Grace; Ritchlin, Christopher T.

2014-01-01

397

Current concepts in psoriatic arthritis: pathogenesis and management.  

PubMed

Psoriatic arthritis occurs in a subset of psoriasis patients and is therefore commonly encountered in dermatology practice. Although its exact pathogenesis is unknown, psoriatic arthritis is thought to share common mechanisms with psoriatic skin symptoms. Innate and adaptive immune responses are abnormally activated in psoriasis and may acquire the ability to attack peripheral joints and other sites following an environmental trigger (e.g. mechanical stress, trauma, infection) in genetically susceptible patients. The increased cardiovascular risk inherent in psoriasis appears further enhanced in psoriatic arthritis, likely reflecting the overall burden of systemic inflammation contributing to atherogenic processes. Basic research and clinical trials have suggested that tumour necrosis factor is important in psoriatic arthritis pathophysiology, and accumulating evidence suggests that Th17 cells and interleukin-17A may also be important. Basic research and clinical trials inform our understanding of psoriatic arthritis pathophysiology and, in turn, help dermatologists to make better treatment decisions. PMID:24573106

de Vlam, Kurt; Gottlieb, Alice B; Mease, Philip J

2014-10-23

398

Glucocorticoid treatment in spondyloarthritis.  

PubMed

Spondyloarthritides (SpA) are chronic inflammatory rheumatic diseases that usually affect the axial skeleton and may involve entheses and peripheral joints. The main subtypes are ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Other subtypes are reactive arthritis, arthritis associated with chronic inflammatory bowel diseases and undifferentiated axial and peripheral spondyloarthritis. Although SpA were regarded as variants of rheumatoid arthritis (RA) until the 1970s, it is now well established that the pathogenesis of SpA is quite different from that of RA. There is a lack of good clinical studies on glucocorticoid therapy in the SpA. While there is no reasonable doubt that intraarticular local therapies in SpA are as effective as in RA and other forms of arthritis, the evidence for a systemic use is at best marginal. While very high doses may be effective in some patients with AS, the possible value of low-dose corticosteroid therapy in patients with PsA has never been well addressed, with respect to either clinical efficacy or inhibition of radiographic progression. Future studies are needed to clarify this important issue for usual patient care. PMID:22018200

Fendler, C; Baraliakos, X; Braun, J

2011-01-01

399

Australian Paediatric Rheumatology Group standards of care for the management of juvenile idiopathic arthritis.  

PubMed

This standards document outlines accepted standards of management for children, adolescents and young adults with juvenile idiopathic arthritis (JIA) in Australia. This document acknowledges that the chronic inflammatory arthritis conditions (JIA) in childhood are different diseases from inflammatory arthritis in adults and that specific expertise is required in the care of children with arthritis. PMID:25156704

Munro, Jane; Murray, Kevin; Boros, Christina; Chaitow, Jeffrey; Allen, Roger C; Akikusa, Jonathan; Adib, Navid; Piper, Susan E; Singh-Grewal, Davinder

2014-09-01

400

Diagnosis and course of early-onset arthritis: results of a special early arthritis clinic compared to routine patient care  

Microsoft Academic Search

SUMMARY Objective. Early arthritis patients referred to an Early Arthritis Clinic (EAC ) (n= 233) were compared to 241 patients from the routine out-patient clinic with respect to lag time between the onset of symptoms and the visit to the rheumatologist, clinical presentation and the consistency of the diagnosis after 1 yr. Results. The reduction in median lag time for

I. E. VAN DER HORST-BRUINSMA; I. SPEYER; H. VISSER; F. C. BREEDVELD; J. M. W. HAZES

1998-01-01

401

Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation --- United States, 2007-2009.  

PubMed

Arthritis is a large and growing public health problem in the United States, resulting in costs of $128 billion annually, and continues to be the most common cause of disability. With the aging of the U.S. population, even assuming that the prevalence of obesity and other risk factors remain unchanged, the prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation (AAAL) is expected to increase significantly by 2030. To update previous U.S. estimates of doctor-diagnosed arthritis and AAAL, CDC analyzed National Health Interview Survey (NHIS) data from 2007--2009. This report summarizes the results of that analysis, which found that 22.2% (49.9 million) of adults aged ?18 years had self-reported doctor-diagnosed arthritis, and 9.4% (21.1 million or 42.4% of those with arthritis) had AAAL. Among persons who are obese, an age-adjusted 33.8% of women and 25.2% of men reported doctor-diagnosed arthritis. Arthritis and AAAL represent a major public health problem in the United States that can be addressed, at least in part, by implementing proven obesity prevention strategies and increasing availability of effective physical activity programs and self-management education courses in local communities. PMID:20930703

2010-10-01

402

Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation--United States, 2010-2012.  

PubMed

Arthritis is the most common cause of disability among U.S. adults and is particularly common among persons with multiple chronic conditions. In 2003, arthritis in the United States resulted in an estimated $128 billion in medical-care costs and lost earnings. To update previous U.S. estimates of the prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation (AAAL), CDC analyzed 2010-2012 data from the National Health Interview Survey (NHIS). This report summarizes the results of that analysis, which found that 52.5 million (22.7%) of adults aged ?18 years had self-reported doctor-diagnosed arthritis, and 22.7 million (9.8%, or 43.2% of those with arthritis) reported AAAL, matching and exceeding previous projected increases, respectively. Among persons with heart disease, diabetes, and obesity, the prevalences of doctor-diagnosed arthritis were 49.0%, 47.3%, and 31.2%, respectively; the prevalences of AAAL among persons with these specific conditions were 26.8%, 25.7%, and 15.2%, respectively. Greater use of evidence-based interventions, such as chronic disease self-management education and physical activity interventions that have been proven to reduce pain and improve quality-of-life among adults with chronic diseases might help reduce the personal and societal burden of arthritis. PMID:24196662

2013-11-01

403

Collagen-induced arthritis in common marmosets: a new nonhuman primate model for chronic arthritis  

PubMed Central

Introduction There is an ever-increasing need for animal models to evaluate efficacy and safety of new therapeutics in the field of rheumatoid arthritis (RA). Particularly for the early preclinical evaluation of human-specific biologicals targeting the progressive phase of the disease, there is a need for relevant animal models. In response to this requirement we set out to develop a model of collagen-induced arthritis (CIA) in a small-sized nonhuman primate species (300 to 400 g at adult age); that is, the common marmoset (Callithrix jacchus). Methods Twenty-two animals divided into three experiments were immunized with collagen type II (CII) of either bovine or chicken origin with different immunization strategies. The animals were analyzed for clinical manifestation of arthritis, hematology and clinical chemistry, immunological responses against CII and histopathological features of the arthritis. Results Clinically manifest arthritis was observed in almost 100% (21 out of 22) of the animals. Fifty percent of the animals developed semi-acute CIA while the other 50% displayed a more chronic disease. Both cellular (CD3/CD4 and CD3/CD8) and humoral responses (IgM and IgG) against CII were involved in the development of the disease. Besides mild histopathological changes in bone and cartilage, severe inflammation in extraarticular tissues like periosteum and subcutaneous tissues was observed. Conclusions This new model in marmosets more closely resembles chronic RA with respect to the chronic disease course and pathomorphological presentation than the more acute monophasic and destructive CIA model in macaques. This model can therefore fill a niche in preclinical testing of new human specific therapeutics. PMID:20977720

2010-01-01

404

Genetics of Rheumatoid Arthritis -- A Comprehensive Review  

PubMed Central

The “Bermuda triangle” of genetics, environment and autoimmunity is involved in the pathogenesis of rheumatoid arthritis (RA). Various aspects of genetic contribution to the etiology, pathogenesis and outcome of RA are discussed in this review. The heritability of RA has been estimated to be about 60 %, while the contribution of HLA to heritability has been estimated to be 11–37 %. Apart from known shared epitope (SE) alleles, such as HLA-DRB1*01 and DRB1*04, other HLA alleles, such as HLA-DRB1*13 and DRB1*15 have been linked to RA susceptibility. A novel SE classification divides SE alleles into S1, S2, S3P and S3D groups, where primarily S2 and S3P groups have been associated with predisposition to seropositive RA. The most relevant non-HLA gene single nucleotide polymorphisms (SNPs) associated with RA include PTPN22, IL23R, TRAF1, CTLA4, IRF5, STAT4, CCR6, PADI4. Large genome-wide association studies (GWAS) have identified more than 30 loci involved in RA pathogenesis. HLA and some non-HLA genes may differentiate between anti-citrullinated protein antibody (ACPA) seropositive and seronegative RA. Genetic susceptibility has also been associated with environmental factors, primarily smoking. Some GWAS studies carried out in rodent models of arthritis have confirmed the role of human genes. For example, in the collagen-induced (CIA) and proteoglycan-induced arthritis (PgIA) models, two important loci — Pgia26/Cia5 and Pgia2/Cia2/Cia3, corresponding the human PTPN22/CD2 and TRAF1/C5 loci, respectively — have been identified. Finally, pharmacogenomics identified SNPs or multiple genetic signatures that may be associated with responses to traditional disease-modifying drugs and biologics. PMID:23288628

Kurko, Julia; Besenyei, Timea; Laki, Judit; Glant, Tibor T.; Mikecz, Katalin

2013-01-01

405

Genetics of rheumatoid arthritis - a comprehensive review.  

PubMed

The "Bermuda triangle" of genetics, environment and autoimmunity is involved in the pathogenesis of rheumatoid arthritis (RA). Various aspects of genetic contribution to the etiology, pathogenesis and outcome of RA are discussed in this review. The heritability of RA has been estimated to be about 60 %, while the contribution of HLA to heritability has been estimated to be 11-37 %. Apart from known shared epitope (SE) alleles, such as HLA-DRB1*01 and DRB1*04, other HLA alleles, such as HLA-DRB1*13 and DRB1*15 have been linked to RA susceptibility. A novel SE classification divides SE alleles into S1, S2, S3P and S3D groups, where primarily S2 and S3P groups have been associated with predisposition to seropositive RA. The most relevant non-HLA gene single nucleotide polymorphisms (SNPs) associated with RA include PTPN22, IL23R, TRAF1, CTLA4, IRF5, STAT4, CCR6, PADI4. Large genome-wide association studies (GWAS) have identified more than 30 loci involved in RA pathogenesis. HLA and some non-HLA genes may differentiate between anti-citrullinated protein antibody (ACPA) seropositive and seronegative RA. Genetic susceptibility has also been associated with environmental factors, primarily smoking. Some GWAS studies carried out in rodent models of arthritis have confirmed the role of human genes. For example, in the collagen-induced (CIA) and proteoglycan-induced arthritis (PgIA) models, two important loci - Pgia26/Cia5 and Pgia2/Cia2/Cia3, corresponding the human PTPN22/CD2 and TRAF1/C5 loci, respectively - have been identified. Finally, pharmacogenomics identified SNPs or multiple genetic signatures that may be associated with responses to traditional disease-modifying drugs and biologics. PMID:23288628

Kurkó, Júlia; Besenyei, Timea; Laki, Judit; Glant, Tibor T; Mikecz, Katalin; Szekanecz, Zoltán

2013-10-01

406

Association between low density lipoprotein and rheumatoid arthritis genetic factors with low density lipoprotein levels in rheumatoid arthritis and non-rheumatoid arthritis controls  

E-print Network

Objectives: While genetic determinants of low density lipoprotein (LDL) cholesterol levels are well characterised in the general population, they are understudied in rheumatoid arthritis (RA). Our objective was to determine ...

Liao, K. P.

407

Rheumatoid arthritis association at 6q23.  

PubMed

The Wellcome Trust Case Control Consortium (WTCCC) identified nine single SNPs putatively associated with rheumatoid arthritis at P = 1 x 10(-5) - 5 x 10(-7) in a genome-wide association screen. One, rs6920220, was unequivocally replicated (trend P = 1.1 x 10(-8)) in a validation study, as described here. This SNP maps to 6q23, between the genes oligodendrocyte lineage transcription factor 3 (OLIG3) and tumor necrosis factor-alpha-induced protein 3 (TNFAIP3). PMID:17982455

Thomson, Wendy; Barton, Anne; Ke, Xiayi; Eyre, Steve; Hinks, Anne; Bowes, John; Donn, Rachelle; Symmons, Deborah; Hider, Samantha; Bruce, Ian N; Wilson, Anthony G; Marinou, Ioanna; Morgan, Ann; Emery, Paul; Carter, Angela; Steer, Sophia; Hocking, Lynne; Reid, David M; Wordsworth, Paul; Harrison, Pille; Strachan, David; Worthington, Jane

2007-12-01

408

Pseudophakia in children with juvenile arthritis  

Microsoft Academic Search

  \\u000a \\u000a Background: Cataract secondary to juvenile rheumatoid arthritis is a severe, vision-threatening complication in early childhood. Intraocular\\u000a lens implantation is controversial. The follow-up of four pseudophakic eyes of three patients and their perioperative therapeutic\\u000a regimen were retrospectively analyzed. Early and late postoperative complications are reported.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and methods: Both girls had lens aspiration and posterior lens implantation at the ages

Heike Häberle; Karl-Heinrich Velhagen; Uwe Pleyer

1998-01-01

409

Septic arthritis due to Cellulosimicrobium cellulans.  

PubMed

Cellulosimicrobium cellulans has been reported as a rare cause of human pathogenesis. Infections mainly occur in immunocompromised patients and very often are associated with a foreign body. We report the first case of septic arthritis caused by C. cellulans in an immunocompetent patient. Our patient suffered a penetrating palm tree thorn injury to his left knee 8 weeks before admission. Although no foreign objects were found, they were suspected because previous reports suggest a frequent association with this microorganism, and open debridament was performed. Removal of foreign bodies related to this organism must be considered a high-priority treatment in these patients to achieve a complete recovery. PMID:21998421

Magro-Checa, César; Chaves-Chaparro, Lara; Parra-Ruiz, Jorge; Peńa-Monje, Alejandro; Rosales-Alexander, José Luis; Salvatierra, Juan; Raya, Enrique

2011-12-01

410

Septic Arthritis Due to Cellulosimicrobium cellulans?  

PubMed Central

Cellulosimicrobium cellulans has been reported as a rare cause of human pathogenesis. Infections mainly occur in immunocompromised patients and very often are associated with a foreign body. We report the first case of septic arthritis caused by C. cellulans in an immunocompetent patient. Our patient suffered a penetrating palm tree thorn injury to his left knee 8 weeks before admission. Although no foreign objects were found, they were suspected because previous reports suggest a frequent association with this microorganism, and open debridament was performed. Removal of foreign bodies related to this organism must be considered a high-priority treatment in these patients to achieve a complete recovery. PMID:21998421

Magro-Checa, Cesar; Chaves-Chaparro, Lara; Parra-Ruiz, Jorge; Pena-Monje, Alejandro; Rosales-Alexander, Jose Luis; Salvatierra, Juan; Raya, Enrique

2011-01-01

411

Laser treatment of experimentally induced chronic arthritis  

NASA Astrophysics Data System (ADS)

In this work, we investigated the effects of He-Ne laser irradiation on the inflammatory process induced in the articular cartilage of the right knee of guinea pigs. Through electron microscopy analysis it was possible to identify the induced arthritis in the articular cartilage and its modification after the laser treatment. The laser radiation promoted a reduction in the proliferation of the inflammatory cells in the damaged tissue and also induced the formation of cartilage bridges that tied the destroyed parts favoring the formation of a repaired tissue in the injured cartilage.

Guerino, M. R.; Baranauskas, V.; Guerino, A. C.; Parizotto, N.

2000-02-01

412

Low free testosterone levels in rheumatoid arthritis.  

PubMed Central

The androgen status of 25 male patients with rheumatoid arthritis (RA) was assessed and compared with that of age matched controls with osteoarthritis (OA). Significantly reduced levels of serum free testosterone were found in the RA group. Within that group free testosterone was unrelated to all indices of disease activity measured, though it was strongly related to latex positivity. These results support the hypothesis that male sex hormones may have a protective role in RA, though prospective studies would be necessary to determine whether the relation was one of cause or effect. PMID:3345107

Spector, T D; Perry, L A; Tubb, G; Silman, A J; Huskisson, E C

1988-01-01

413

[Symptomatic intermittent fever of inflammatory diseases].  

PubMed

Intermittent fever has a wide variety of causes such as infectious, cancers, or inflammatory disease. Intermittent fever is sometimes a diagnostic challenge when fever appears as the first and isolated sign of the disease. Adult onset Still disease and juvenile chronic arthritis are mainly the most common cause of intermittent inflammatory fever. Some frequent diseases gives intermittent fever in few cases like ankylosing spondylitis, pulmonary embolism, sarcoidosis or Crohn's disease. Some rare inflammatory disease gives typical intermittent fever like genetic periodic fever. Other rare diseases give sometimes intermittent fever like vasculitis, polychondritis, Castleman disease, etc. Drug fever and factitious fever are other classical causes of intermittent fever. Diagnosis of inflammatory intermittent fever is frequently based on the clinical course but some biological tests and computerized tomographic scans are worthwhile tools. Follow-up of undiagnosed cases is needed. PMID:11915560

Hachulla, Eric

2002-01-15

414

Thalidomide: focus on its employment in rheumatologic diseases.  

PubMed

Thalidomide is an immunomodulatory agent; although its mechanisms of action are not fully understood, many authors have described its anti-inflammatory and immunosuppressive properties. More interestingly, thalidomide has shown the ability to suppress tumor necrosis factor alpha (TNF alpha) production and to modify the expression of TNF alpha induced adhesion molecules on endothelial cells and on human leukocytes. Thalidomide has been used in several diseases (i.e. dermatological, autoimmune, gastrointestinal). In this review we focus specifically on the use of this drug in disorders with rheumatological features such as lupus erythematosus, rheumatoid arthritis and Still's disease, ankylosing spondylitis, and Behçet's disease. Despite its well known side effects, first of all peripheral nerve involvement and teratogenesis, which can be avoided by following strict guidelines, thalidomide could represent an alternative drug in some rheumatological conditions, particularly in patients who show resistance, contraindication or toxicity with other conventional treatments. PMID:12412207

Ossandon, A; Cassarŕ, E A M; Priori, R; Valesini, G

2002-01-01

415

Osteitis Condensans Ilii.  

PubMed

Osteitis Condensans Ilii (OCI) is a benign cause of axial low back pain. Although no clear etiology has been identified, the prevailing theory is that mechanical strain affects the auricular portion of the ilium and causes premature arthritis. The location of the sclerosis has been traditionally confined to the ilium and may give the false impression of sacro-iliac joint involvement. Clinicians must be guided by history, radiographic findings, and laboratory studies in differentiating OCI with other disorders; furthermore additional causes of low back pain including metastatic disease and ankylosing spondylitis must be ruled out. Treatments for the condition are primarily conservative (therapies, non-steroidal anti-inflammatory medications, and steroid injections), with surgical resection being reserved for refractory cases. PMID:19711079

Mitra, Raj

2010-01-01

416

Antibody to intermediate filaments of the cytoskeleton.  

PubMed Central

IgM antibodies against cultures of intermediate filaments (IMF) of the cytoskeleton were demonstrated by immunofluorescence in the sera of 94 (80%) of 118 patients with seropositive rheumatoid arthritis. These antibodies reacted with IMF in cultures of both human fetal fibroblasts and laryngeal carcinoma (HEp2) cells. Of 10 patients from whom paired synovial fluids were also available 8 had anti-IMF antibodies in both serum and fluid. In seronegative RA the incidence of anti-IMF was 40%, in ankylosing spondylitis 25%, in osteoarthrosis 16%, and in normal subjects 14%. Only a minority of RA sera positive for anti-IMF antibodies were also positive for smooth muscle antibody. Absorption experiments suggest that in RA anti-IMF is directed at the intermediate filament protein, vimentin. Images PMID:7039524

Osung, O A; Chandra, M; Holborow, E J

1982-01-01

417

Pathogenicity of Misfolded and Dimeric HLA-B27 Molecules.  

PubMed

The association between HLA-B27 and the group of autoimmune inflammatory arthritic diseases, the spondyloarthropathies (SpAs) which include ankylosing spondylitis (AS) and Reactive Arthritis (ReA), has been well established and remains the strongest association between any HLA molecule and autoimmune disease. The mechanism behind this striking association remains elusive; however animal model and biochemical data suggest that HLA-B27 misfolding may be key to understanding its association with the SpAs. Recent investigations have focused on the unusual biochemical structures of HLA-B27 and their potential role in SpA pathogenesis. Here we discuss how these unusual biochemical structures may participate in cellular events leading to chronic inflammation and thus disease progression. PMID:21547037

Antoniou, Antony N; Lenart, Izabela; Guiliano, David B

2011-01-01

418

Pathogenicity of Misfolded and Dimeric HLA-B27 Molecules  

PubMed Central

The association between HLA-B27 and the group of autoimmune inflammatory arthritic diseases, the spondyloarthropathies (SpAs) which include ankylosing spondylitis (AS) and Reactive Arthritis (ReA), has been well established and remains the strongest association between any HLA molecule and autoimmune disease. The mechanism behind this striking association remains elusive; however animal model and biochemical data suggest that HLA-B27 misfolding may be key to understanding its association with the SpAs. Recent investigations have focused on the unusual biochemical structures of HLA-B27 and their potential role in SpA pathogenesis. Here we discuss how these unusual biochemical structures may participate in cellular events leading to chronic inflammation and thus disease progression. PMID:21547037

Antoniou, Antony N.; Lenart, Izabela; Guiliano, David B.

2011-01-01

419

The Prevalence of Fibromyalgia in Other Chronic Pain Conditions  

PubMed Central

Central sensitivity syndromes (CSS) include fibromyalgia syndrome (FMS), irritable bowel syndrome, temporomandibular disorder, restless legs syndrome, chronic fatigue syndrome, and other similar chronic painful conditions that are based on central sensitization (CS). CSS are mutually associated. In this paper, prevalence of FMS among other members of CSS has been described. An important recent recognition is an increased prevalence of FMS in other chronic pain conditions with structural pathology, for example, rheumatoid arthritis, systemic lupus, ankylosing spondylitis, osteoarthritis, diabetes mellitus, and inflammatory bowel disease. Diagnosis and proper management of FMS among these diseases are of crucial importance so that unwarranted use of such medications as corticosteroids can be avoided, since FMS often occurs when RA or SLE is relatively mild. PMID:22191024

Yunus, Muhammad B.

2012-01-01

420

Hamster and murine models of severe destructive Lyme arthritis.  

PubMed

Arthritis is a frequent complication of infection in humans with Borrelia burgdorferi. Weeks to months following the onset of Lyme borreliosis, a histopathological reaction characteristic of synovitis including bone, joint, muscle, or tendon pain may occur. A subpopulation of patients may progress to a chronic, debilitating arthritis months to years after infection which has been classified as severe destructive Lyme arthritis. This arthritis involves focal bone erosion and destruction of articular cartilage. Hamsters and mice are animal models that have been utilized to study articular manifestations of Lyme borreliosis. Infection of immunocompetent LSH hamsters or C3H mice results in a transient synovitis. However, severe destructive Lyme arthritis can be induced by infecting irradiated hamsters or mice and immunocompetent Borrelia-vaccinated hamsters, mice, and interferon-gamma- (IFN-?-) deficient mice with viable B. burgdorferi. The hamster model of severe destructive Lyme arthritis facilitates easy assessment of Lyme borreliosis vaccine preparations for deleterious effects while murine models of severe destructive Lyme arthritis allow for investigation of mechanisms of immunopathology. PMID:22461836

Munson, Erik; Nardelli, Dean T; Du Chateau, Brian K; Callister, Steven M; Schell, Ronald F

2012-01-01

421

Autoimmunity to collagen in adjuvant arthritis of rats.  

PubMed Central

Arthritis can be induced in rats by intradermal injection of oil containing bacterial derivatives (adjuvant-induced arthritis) or cartilage collagen (type II collagen-induced arthritis). It was of interest, therefore, to determine whether collagen functions as an autoantigen in rats with adjuvant arthritis. Blood mononuclear cells from the majority of rats with adjuvant arthritis exhibited enhanced thymidine incorporation to homologous types I and II collagens, as well as to purified protein derivative of tuberculin. In contrast, cells from rats remaining nonarthritic after injection of adjuvant did not respond to collagen, although they did react to tuberculin. Similar results were obtained with a radiometric ear assay used to quantify intradermal delayed-type hypersensitivity in vivo. Using passive hemagglutination, autoantibodies to these collagens and their denatured alpha-chains were frequently detected in the sera of rats late in the course of adjuvant arthritis. Rats with inflammation of a hindlimb induced by turpentine did not acquire sensitivity to collagen. These data indicate that autoimmunity to collagen is a common feature of adjuvant- and collagen-induced arthritis, both of which are considered to be mediated by immunologic mechanisms. PMID:7430345

Trentham, D E; McCune, W J; Susman, P; David, J R

1980-01-01

422

Cartilage Oligomeric Matrix Protein (COMP): A Biomarker of Arthritis  

PubMed Central

Arthritis is a chronic disease with a significant impact on the population. It damages the cartilage, synovium, and bone of the joints causing pain, impairment, and disability in patients. Current methods for diagnosis of and monitoring the disease are only able to detect clinical manifestations of arthritis late in the process. However, with the recent onset of successful treatments for rheumatoid arthritis and osteoarthritis, it becomes important to identify prognostic factors that can predict the evolution of arthritis. This is especially critical in the early phases of disease so that these treatments can be started as soon as possible to slow down progression of the disease. A valuable approach to monitor arthritis would be by measuring biological markers of cartilage degradation and repair to reflect variations in joint remodeling. One such potential biological marker of arthritis is cartilage oligomeric matrix protein (COMP). In various studies, COMP has shown promise as a diagnostic and prognostic indicator and as a marker of the disease severity and the effect of treatment. This review highlights the progress in the utilization of COMP as a biomarker of arthritis. PMID:19652761

Tseng, Susan; Reddi, A. Hari; Di Cesare, Paul E.

2009-01-01

423

Managed care implications in managing rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is a systemic inflammatory form of arthritis characterized by joint inflammation, pain, swelling, and stiffness. While contemporary treatment strategies based on early diagnosis, aggressive treatment, and regular monitoring have helped a significant number of patients achieve evidence-based treatment goals, RA still presents substantial management challenges to both clinicians and patients, and has the potential to lead to severe disability over time. In addition to its significant clinical consequences, RA has important economic implications. Both direct and indirect medical costs associated with RA are significant, including costs of medications, ambulatory and office-based care, and quality-of-life and productivity costs. In addition, a significant proportion of patients with prevalent RA have associated cardiovascular disease and other comorbidities, further compounding healthcare costs and complicating management of this disorder. Clinically favorable and cost-effective management must focus on prevention of disease progression and the improved patient health status and productivity than can result from optimal disease control. With the myriad of treatment options both available and emerging, managed care organizations are faced with difficult decisions surrounding the most clinically and cost-effective allocation of treatments designed to improve disease outcomes for patients with RA. It is vital that managed care clinicians and providers analyze both the overall burden and the specific costs of RA. This will allow a better understanding of how costs and issues relating to healthcare utilization affect the treatment of patients with RA and impact individualized therapy, care coordination, and outcomes. PMID:25180623

Owens, Gary M

2014-05-01

424

Biomarkers in psoriatic arthritis: recent progress.  

PubMed

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. About a quarter of patients with psoriasis of the skin will develop PsA, although it is currently challenging-if not impossible-to determine a priori which individuals will progress. Identification of biomarkers for screening, disease activity, joint damage, treatment response and comorbidities are therefore perceived as important clinical needs in the field. Over the last few years, several lines of investigation have advanced our knowledge of new markers for PsA and its outcomes, including genomic, proteomic, cellular and tissue studies. Imaging studies utilizing ultrasonography have been applied to better understand the natural history of the disease. Novel biomarkers, such as soluble proteins and microbiomics, are also being described. Although no biomarker has yet been validated for use in clinical practice, discovery studies are in progress and validation cohorts are being designed. In this report, we review the latest progress in biomarker research in PsA and its potential implications in pathogenesis, diagnosis and therapy. PMID:25218735

Chandran, Vinod; Scher, Jose U

2014-11-01

425

Prevalence of arthritis in India and Pakistan: a review.  

PubMed

Recent studies of rheumatoid arthritis worldwide suggest that prevalence of arthritis is higher in Europe and North America than in developing countries. Prevalence data for major arthritis disorders have been compiled in West for several decades, but figures from the third world are just emerging. A coordinated effort by WHO and ILAR (International League Against Rheumatism) has resulted in collecting data for countries like Philippines, China, Malaysia, Indonesia, and rural South Africa but the information about prevalence of arthritis in India and Pakistan is scarce. Since both countries, i.e., India and Pakistan, share some ethnic identity, we reviewed published literature to examine the prevalence of arthritis in these countries. Medline and Pubmed were searched for suitable articles about arthritis from 1980 and onwards. Findings from these articles were reviewed and summarized. The prevalence, clinical features, and laboratory findings of rheumatoid arthritis are compiled for both India and Pakistan. Data collected from these two countries were compared with each other, and some of the characteristics of the disease were compared with Europe and North America. It is found to be quite similar to developed countries. Additionally, juvenile rheumatoid arthritis is of different variety than reported in West. It is more of polyarticular onset type while in West pauciarticular predominates. Additionally, in systemic onset, JRA uveitis and ANA are common finding in developed countries; on the other hand, they are hardly seen in this region. Although the prevalence of arthritis in Pakistan and India is similar to Western countries, there are inherent differences (clinical features, laboratory findings) in the presentation of disease. The major strength of the study is that it is the first to pool reports to provide an estimate of the disease in the Indian subcontinent. Scarcity of data is one of the major limitations. This study helps to understand the pattern of disease in this part of country that can be stepping-stone for policy makers to draft policies that can affect target population more appropriately. PMID:21331574

Akhter, Ehtisham; Bilal, Saira; Kiani, Adnan; Haque, Uzma

2011-07-01

426

Arthritis among veterans - United States, 2011-2013.  

PubMed

Arthritis is among the most common chronic conditions among veterans and is more prevalent among veterans than nonveterans. Contemporary population-based estimates of arthritis prevalence among veterans are needed because previous population-based studies predate the Persian Gulf War, were small, or studied men only despite the fact that women comprise an increasing proportion of military personnel and typically have a higher prevalence of arthritis than men. To address this knowledge gap, CDC analyzed combined 2011, 2012, and 2013 Behavioral Risk Factor Surveillance System (BRFSS) data among all adults aged ?18 years, by veteran status, to estimate the total and sex-specific prevalence of doctor-diagnosed arthritis overall and by sociodemographic categories, and the state-specific prevalence (overall and sex-specific) of doctor-diagnosed arthritis. This report summarizes the results of these analyses, which found that one in four veterans reported that they had arthritis (25.6%) and that prevalence was higher among veterans than nonveterans across most sociodemographic categories, including sex (prevalence among male and female veterans was 25.0% and 31.3%, respectively). State-specific, age-standardized arthritis prevalence among veterans ranged from 18.8% in Hawaii to 32.7% in West Virginia. Veterans comprise a large and important target group for reducing the growing burden of arthritis. Those interested in veterans' health can help to improve the quality of life of veterans by ensuring that they have access to affordable, evidence-based, physical activity and self-management education classes that reduce the adverse effects of arthritis (e.g., pain and depression) and its common comorbidities (e.g., heart disease and diabetes). PMID:25375071

Murphy, Louise B; Helmick, Charles G; Allen, Kelli D; Theis, Kristina A; Baker, Nancy A; Murray, Glen R; Qin, Jin; Hootman, Jennifer M; Brady, Teresa J; Barbour, Kamil E

2014-11-01

427

Demyelinating Disease following Anti-TNFa Treatment: A Causal or Coincidental Association? Report of Four Cases and Review of the Literature  

PubMed Central

Tumor necrosis factor antagonists (anti-TNFa) are an established therapeutic option for several autoimmune and inflammatory bowel diseases. Despite their clinical effectiveness, neurological adverse events have been reported and literature data suggest a potential role of anti-TNFa in the induction of demyelination of the CNS. We present four patients treated with anti-TNFa who developed symptoms suggestive of CNS demyelination. The first patient, a 17-year-old male who received etanercept for psoriatic arthritis for eight months, presented with dysesthesias up to T4 level. The second patient, a 30-year-old male treated with adalimumab for three years due to ankylosing spondylitis, presented with right unilateral tinnitus. The third case, a 47-year-old female, received etanercept for four years because of psoriatic arthritis and developed persistent headache and left-sided face and head numbness. Finally, the fourth patient, a 57-years-old female treated with etanercept for six years due to ankylosing spondylitis, presented with difficulty in speech, swallowing, and ptosis of the right corner of the mouth. In all cases, brain MRI showed lesions suggestive of demyelination, while positive oligoclonal bands were detected in the CSF. Anti-TNFa treatments were discontinued and patients showed clinical improvement with pulsed intravenous corticosteroid therapy. CNS demyelination following anti-TNFa treatment represents a relatively rare but potential serious complication. Close follow-up and MRI monitoring of these patients is mandatory to elucidate whether the clinical manifestations represent adverse events occurring during anti-TNFa therapy or a first demyelinating episode. PMID:23762678

Andreadou, E.; Kemanetzoglou, E.; Brokalaki, Ch.; Evangelopoulos, M. E.; Kilidireas, C.; Rombos, A.; Stamboulis, E.

2013-01-01

428

Psychological Interventions and Lifestyle Modifications for Arthritis Pain Management  

PubMed Central

This article provides an overview of self-management interventions used to manage pain in patients with arthritis. The article is divided in two major sections. In the first section, we review psychological interventions used to manage arthritis pain including pain coping skills training/cognitive behavioral therapy for pain management, emotional disclosure interventions, and partner-assisted interventions. In the second section, we address lifestyle behavioral weight loss interventions used to reduce arthritis pain. In each section we briefly describe the rationale and nature of the interventions, present data on their efficacy, and highlight potential future research directions. PMID:18638681

Keefe, Francis J.; Somers, Tamara J.; Martire, Lynn M.

2008-01-01

429

Trace element analysis in rheumatoid arthritis under chrysotheraphy  

NASA Astrophysics Data System (ADS)

Proton induced X-ray emission (PIXE) analysis is used to measure trace element concentrations in blood serum from patients with rheumatoid arthritis. Initially trace element contaminations in blood-collecting and storing devices are determined. Then mean values and nyctemeral cycles are measured both in normal subjects and patients with rheumatoid arthritis and other similar pathologies. Abnormal concentrations of Cu and Zn and anomalies in the nyctemeral cycle are found in the patients. In the second phase of the project, the special case of chrysotherapeutically treated (gold salt treatment) rheumatoid arthritis patients is studied for extended periods of time (up to 53 weeks).

Lecomte, R.; Paradis, P.; Monaro, S.; Barrette, M.; Lamoureux, G.; Menard, H.-A.

1981-03-01

430

Readiness to manage arthritis: a pilot study using a stages-of-change measure for arthritis rehabilitation.  

PubMed

The purpose of this pilot study was to evaluate the Readiness to Manage Arthritis Questionnaire (RMAQ), a new multibehavior measure of readiness for change in arthritis management. Data were obtained from 46 patients with chronic inflammatory arthritis admitted for intensive treatment. Test-retest reliability, correlations with clinical variables and theoretically related constructs, and responsiveness to change were assessed. Test-retest reliability indicated reasonable stability, with intraclass correlation coefficients ranging from 0.30 to 0.75. A significant association was observed between psychological well-being and readiness status. Clinical variables of disease duration, disease severity, pain, and function were not related to readiness status. Correlations between stages-of-change scores and self-efficacy for managing arthritis symptoms were mostly nonsignificant, with the exception of modest agreement between readiness to engage in physical activity and exercise self-efficacy (0.43). Significant changes were observed in mean RMAQ scores from initial assessment to 12 weeks posttreatment for the behaviors of using joint protection, dealing with frustration, learning about arthritis, engaging in physical activity, and stress management. Findings from this pilot study suggest that the RMAQ has adequate psychometric properties in patients with chronic inflammatory arthritis and can be used to assess an individual's readiness to adopt important arthritis self-management behaviors. PMID:19271660

Arthur, A Barbara; Kopec, Jacek A; Klinkhoff, Alice V; Adam, Paul M; Carr, Susan L; Prince, Jane M; Dumont, Kelly E; Nigg, Claudio R

2009-01-01

431

Heat shock protein 60 and adjuvant arthritis: a model for T cell regulation in human arthritis  

Microsoft Academic Search

Heat shock proteins (hsp) are highly conserved, immune-dominant microbial proteins, whose expression is increased at sites of inflammation. In the experimental model of adjuvant arthritis (AA) immune responses to hsp determine the outcome of disease. AA can be transferred with a single T cell clone specific for a sequence of mycobacterial hsp65 (Mhsp65). Immunization with whole Mhsp65 on the other

Berent J. Prakken; Sarah Roord; Arash Ronaghy; Marca Wauben; Salvatore Albani; Willem van Eden

2003-01-01

432

The role of Chlamydia and Chlamydophila infections in reactive arthritis.  

PubMed

Chlamydia trachomatis and Chlamydophila pneumoniae are human pathogens; the former being the etiologic agent for trachoma as well as a prevalent sexually transmitted bacterium, while C. pneumoniae is a respiratory pathogen responsible for community-acquired pneumonia. Patients with reactive arthritis show evidence of present or past Chlamydial infection. Chlamydia spp., has been strongly implicated as a triggering factor for reactive arthritis. We describe the simultaneous occurrence of C. pneumoniae and C. trachomatis infections in a subject with reactive arthritis. We suggest treatment for a patient with Chlamydia-associated arthritis to define a means by which persistent organisms can be induced to return to the active developmental cycle, thereby making them more accessible to antibiotic activity. PMID:22214635

Rizzo, Antonietta; Domenico, Marina Di; Carratelli, Caterina Romano; Paolillo, Rossella

2012-01-01