British journal of rheumatology最新文献

{"title":"Auranofin.","authors":"W. Kean, L. Hart, W. Buchanan","doi":"10.32388/rx9at4","DOIUrl":"https://doi.org/10.32388/rx9at4","url":null,"abstract":"It has been widely accepted for a number of years that chrysotherapy is a valuable therapeutic agent in the treatment of progressive rheumatoid disease. This therapeutic benefit has, to some extent, been offset by the potential toxicity associated with gold compounds. The development of a gold compound with a greater therapeutic to toxicity ratio would be of considerable interest and benefit, to both patients and physicians. Initial studies with auranofin suggested that this compound was a reliably absorbed agent and that its use would avoid regular gold thiol injections. Its initial therapeutic profile was considered to be similar to that of injectable gold compounds, but with a significantly greater safety margin. The further information that has accrued from the clinical studies reported so far would tend to support these early suggestions in that auranofin has compared very favourably with gold thiols and other disease-remittive agents and that the prevalence of side effects requiring withdrawal of therapy has been approximately 25-30 per cent less. In addition, the reasons for withdrawal have often been less potentially serious side effects, notably nephrotoxicity and haematological reactions. In a review of over 3000 patients treated with auranofin, compared to 465 patients treated with injectable gold, the frequency of withdrawal from studies due to inefficacy of auranofin was approximately two to three times higher than with the gold thiols. It would appear, therefore, that in those patients continuing on therapy, auranofin is similar to injectable gold, but that a higher proportion of patients will fail to get a response within three to six months to the therapy. This potential lack of therapeutic effect is offset by the increased safety margin. In time, it is possible that auranofin will be accepted for earlier treatment in the course of rheumatoid disease than perhaps would normally have been considered. The in vivo and in vitro studies of auranofin on its mechanism of action are of considerable interest. They provide theoretical and valuable information on the mechanism of action of gold compounds and the cellular functions and interactions which may be involved in the pathogenesis of rheumatoid disease. It is interesting to note that auranofin appears to be more potent and have different effects than gold thiols, despite the fact that in terms of clinical therapeutic profile the compounds are similar.(ABSTRACT TRUNCATED AT 400 WORDS)","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"58 1","pages":"560-72"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84021351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antineutrophil cytoplasmic antibodies in primary Sjögren's syndrome: prevalence and clinical significance.","authors":"J Font,&nbsp;M Ramos-Casals,&nbsp;R Cervera,&nbsp;X Bosch,&nbsp;E Mirapeix,&nbsp;M García-Carrasco,&nbsp;R M Morlà,&nbsp;M Ingelmo","doi":"10.1093/rheumatology/37.12.1287","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1287","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prevalence of cytoplasmic (c) and perinuclear (p) antineutrophil cytoplasmic antibodies (ANCA) in patients with primary Sjogren's syndrome (SS), and to correlate the presence of ANCA with extraglandular and immunological manifestations related to SS.</p><p><strong>Methods: </strong>In a cross-sectional study, we included 82 consecutive patients (75 female and seven male; mean age 61 yr; range 33-87 yr) attending our unit. All patients fulfilled four or more of the diagnostic criteria for SS proposed by the European Community Study Group in 1993. Extraglandular manifestations such as arthralgia and/or arthritis, Raynaud's phenomenon, autoimmune thyroiditis, peripheral neuropathy, renal involvement and cutaneous vasculitis were also recorded. Serum samples were examined by indirect immunofluorescence (IIF) and by ELISA using as substrates myeloperoxidase (MPO) and proteinase 3 (PR3).</p><p><strong>Results: </strong>ANCA were detected in nine (11%) patients: seven had pANCA and two an atypical pattern. These two atypical ANCA became cANCA when paraformaldehyde fixation was applied. ELISA findings showed that two patients had antibodies against MPO, and no patient had antibodies to PR3. The most common extraglandular manifestations in the ANCA-positive patients were articular involvement in six (66%) patients, peripheral neuropathy in five (55%), Raynaud's phenomenon in four (44%) and cutaneous vasculitis in four (44%). Of the four patients with cutaneous vasculitis and ANCA, two had a mononuclear inflammatory vascular disease (MIVD) in the biopsy specimen. When compared with patients without ANCA, those with these antibodies had a higher prevalence of cutaneous vasculitis (44% vs 8%, P = 0.01), Raynaud's phenomenon (44% vs 8%, P = 0.01) and peripheral neuropathy (55% vs 7%, P < 0.001).</p><p><strong>Conclusion: </strong>ANCA positivity can be found in patients with primary SS and its detection is associated with the presence of clinical manifestations attributable to vascular involvement (cutaneous vasculitis, peripheral neuropathy and Raynaud's phenomenon).</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1287-91"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40728795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital gangrene and anticentromere antibodies without scleroderma.","authors":"U Picillo,&nbsp;M R Marcialis,&nbsp;A Matarazzo,&nbsp;G Italiano,&nbsp;A Petti","doi":"10.1093/rheumatology/37.12.1352","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1352","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1352-3"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual occurrence of acute low back pain in a patient with ruptured urachal cyst.","authors":"A Ambrozic,&nbsp;S Praprotnik,&nbsp;B Rozman","doi":"10.1093/rheumatology/37.12.1354","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1354","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1354-5"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relevance of large-vessel vascular disease and restricted ankle movement to the aetiology of leg ulceration in rheumatoid arthritis.","authors":"E R McRorie,&nbsp;C V Ruckley,&nbsp;G Nuki","doi":"10.1093/rheumatology/37.12.1295","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1295","url":null,"abstract":"<p><p>Leg ulceration in rheumatoid arthritis (RA) without systemic vasculitis is a difficult clinical problem and a common cause of morbidity. We have assessed venous function, arterial pressures and range of ankle movement in 23 RA patients with a leg ulcer and compared the results with those in the non-ulcerated contralateral limb and in 25 RA patients matched for age and duration of arthritis. We found evidence of venous insufficiency in RA ulcer patients compared to disease controls. Ankle movement was more restricted in the ulcerated limb compared to the non-ulcerated contralateral leg. There was no difference in large-vessel arterial function between groups. These findings have implications for therapy and rates of healing.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1295-8"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment with antithymocyte globulin and cyclosporin A of a severe aplastic anaemia associated with an eosinophilic fasciitis.","authors":"B Bonnotte,&nbsp;B Chauffert,&nbsp;D Caillot,&nbsp;F Martin,&nbsp;B Lorcerie","doi":"10.1093/rheumatology/37.12.1358","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1358","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1358-9"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection with an unenveloped DNA virus (TTV) associated with non-A to G hepatitis in patients with rheumatoid arthritis.","authors":"D Hirata,&nbsp;N Kaneko,&nbsp;M Iwamoto,&nbsp;T Yoshio,&nbsp;H Okazaki,&nbsp;A Mimori,&nbsp;J Masuyama,&nbsp;S Minota","doi":"10.1093/rheumatology/37.12.1361","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1361","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1361-2"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Heberden Oration 1997. Treatment of rheumatoid arthritis: from symptomatic relief to potential cure.","authors":"P M Brooks","doi":"10.1093/rheumatology/37.12.1265","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1265","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1265-71"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40728790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GB virus C in systemic medium- and small-vessel necrotizing vasculitides.","authors":"A Servant,&nbsp;M Bogard,&nbsp;C Delaugerre,&nbsp;P Cohen,&nbsp;P Dény,&nbsp;L Guillevin","doi":"10.1093/rheumatology/37.12.1292","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1292","url":null,"abstract":"<p><strong>Background: </strong>Vasculitides are diseases of unknown origin in the majority of cases, but sometimes are the consequence of viral infections; for instance, hepatitis B virus (HBV)-related polyarteritis nodosa (PAN) or hepatitis C virus (HCV)-associated cryoglobulinaemia.</p><p><strong>Objective: </strong>To investigate the role of hepatitis G or GB virus C (GBV-C) in various forms of medium- and small-vessel vasculitides.</p><p><strong>Design: </strong>Retrospective analyses of sera.</p><p><strong>Setting: </strong>Tertiary care hospital in Bobigny, France.</p><p><strong>Patients: </strong>Fifty-six vasculitides: 19 HBV-PAN, 10 PAN without HBV infection, 11 microscopic polyangiitis (MPA), seven Churg-Strauss syndrome (CSS) and nine Wegener's granulomatosis (WG). Every sample was collected before treatment.</p><p><strong>Measurements: </strong>GBV-C RNA was detected using a reverse transcription-polymerase chain reaction assay with primers derived from the conserved GBV-C helicase and NS5a regions.</p><p><strong>Results: </strong>GBV-C was detected in five of the 56 samples (8.9%): four patients with HBV-related PAN and one with MPA; three of these patients (two with HBV-PAN, one with MPA) had been transfused and two HBV-PAN were i.v. drug addicts. GBV-C was not found in CSS or in WG.</p><p><strong>Conclusion: </strong>GBV-C infection was observed only in patients who had been transfused or who were addicts. This virus is unlikely to have a primary role in vasculitides.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1292-4"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40728797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumping or splitting autoimmune rheumatic disorders? Lessons from Sjögren's syndrome.","authors":"H M Moutsopoulos,&nbsp;M N Manoussakis","doi":"10.1093/rheumatology/37.12.1263","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1263","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1263-4"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40728869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}