British journal of rheumatology最新文献

{"title":"Serum levels of vascular endothelial growth factor (VEGF) are markedly elevated in patients with Wegener's granulomatosis.","authors":"C G Li,&nbsp;I Reynolds,&nbsp;J M Ponting,&nbsp;P J Holt,&nbsp;M C Hillarby,&nbsp;S Kumar","doi":"10.1093/rheumatology/37.12.1303","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1303","url":null,"abstract":"<p><strong>Objectives: </strong>Necrotizing vasculitis and granuloma formation are the predominant features of Wegener's granulomatosis (WG). We have investigated the importance of vascular endothelial growth factor (VEGF) in monitoring disease activity in WG.</p><p><strong>Methods: </strong>Serum VEGF levels were determined in 23 patients with active WG, 21 healthy controls and 25 patients with urinary infection, by ELISA using commercially available antibodies to VEGF.</p><p><strong>Results: </strong>VEGF levels were enormously elevated in patients with WG compared to both controls and patients with urinary infection (P < 0.0001). Of the 23 patients, 21 (91.3%) had VEGF levels above the cut-off value (3.3 ng/ml, calculated as the mean of the controls + 2 S.D.). Further analysis of the data showed that VEGF levels did not correlate with age, sex, incidence of classic antineutrophil cytoplasmic antibodies (c-ANCA) or duration of the disease (P > 0.05), but there was correlation with disease activity (r = 0.51, P < 0.01). VEGF levels were higher in patients with major compared to those with minor disease activity (P < 0.01). However, there was no significant correlation between VEGF levels and the Birmingham scores for vascular activity and damage.</p><p><strong>Conclusion: </strong>VEGF levels are raised in WG patients compared to normal controls and may be a marker of disease activity. Further studies on serial blood samples from a large cohort of patients with WG and other systemic vasculitides are needed to evaluate the specificity and usefulness of VEGF levels in monitoring disease activity.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1303-6"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729215","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":"Cerebral calcification in a patient with systemic lupus erythematosus and a monoclonal IgG reactive with glial fibrillary acidic protein.","authors":"B M Stuart,&nbsp;N A Gregson","doi":"10.1093/rheumatology/37.12.1355","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1355","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1355-7"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729275","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":"Aortitis in relapsing polychondritis.","authors":"U A Walker,&nbsp;S M Weiner,&nbsp;P Vaith,&nbsp;M Uhl,&nbsp;H H Peter","doi":"10.1093/rheumatology/37.12.1359","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1359","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1359-61"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729278","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":"Electron microscopy and capillaroscopically guided nailfold biopsy in connective tissue diseases: detection of ultrastructural changes of the microcirculatory vessels.","authors":"A von Bierbrauer,&nbsp;P Barth,&nbsp;J Willert,&nbsp;C Baerwald,&nbsp;H D Mennel,&nbsp;J A Schmidt","doi":"10.1093/rheumatology/37.12.1272","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1272","url":null,"abstract":"<p><p>The aims of the study were to describe and compare the frequency and nature of histologically detectable microvascular lesions in patients with various connective tissue diseases (CTD). An electron microscopic examination of specimens obtained by the technique of capillaroscopically guided nailfold biopsy was performed in 52 patients with CTD [nine systemic lupus erythematosus (SLE), eight mixed CTD, 18 scleroderma, 17 undifferentiated CTD] and 27 controls. The microvascular changes most frequently observed by electron microscopy were multilayering of the basal lamina (approximately 70% of the CTD patients), an increased amount of perivascular connective tissue, perivascular oedema formation, and an increased number of perivascular fibroblasts and mast cells (each in 30-37% of the CTD patients). In contrast, no particular histopathological feature was found in > 25% of the controls, multilayering (22.6%) being the most frequently observed. Comparing the different conditions studied, there were distinct differences in the frequency and nature of the histologically observed microvascular changes. In particular, SLE seems to be based on a separable type of vasculopathy consisting of significantly less frequent microvascular abnormalities. In conclusion, ultrastructural abnormalities of the microvascular system are a frequent finding in CTD. Electron microscopic examination of specimens obtained by capillaroscopically guided nailfold biopsy is able to disclose histopathological differences between defined entities. Therefore, this approach may be a useful tool to gain further insights into potentially separable aetiopathological mechanisms of the various types of CTD.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1272-8"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40728791","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":"A randomized, double-blind, placebo-controlled study of moclobemide and amitriptyline in the treatment of fibromyalgia in females without psychiatric disorder.","authors":"P Hannonen,&nbsp;K Malminiemi,&nbsp;U Yli-Kerttula,&nbsp;R Isomeri,&nbsp;P Roponen","doi":"10.1093/rheumatology/37.12.1279","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1279","url":null,"abstract":"<p><strong>Objective: </strong>To study the usefulness of moclobemide and amitriptyline in the treatment of fibromyalgia (FM) in females without psychiatric disorder.</p><p><strong>Methods: </strong>In the present four centre, 12 week study, 130 female FM patients not suffering from psychiatric disorders were randomized to receive amitriptyline (AMI; 25 37.5 mg), moclobemide (MOCLO; 450-600 mg) or identical placebo.</p><p><strong>Results: </strong>Seventy-four, 54 and 49 per cent of patients on AMI, MOCLO and placebo, respectively, were judged as responders. The patients on AMI also managed best regarding the respective improvements during the trial in general health, pain, sleep quality and quantity, and fatigue on visual analogue scales (VAS), the areas of the Nottingham Health Profile (NHP), as well as in the three Sheehan's functional disability scales. In the within-group comparisons, MOCLO also improved pain assessed both on VAS and on the NHP pain dimension, but the improvement was invalidated by the poor success of the drug with regard to sleep. The tolerabilities of all three drugs were comparable.</p><p><strong>Conclusion: </strong>The study indicates that MOCLO may not be helpful in FM patients free from clinically meaningful psychiatric problems.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1279-86"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40728792","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":"Hypothyroid myopathy as a complication of interferon alpha therapy for chronic hepatitis C virus infection.","authors":"G Ghilardi,&nbsp;J J Gonvers,&nbsp;A So","doi":"10.1093/rheumatology/37.12.1349","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1349","url":null,"abstract":"<p><p>Interferon alpha (IFN-alpha) therapy is associated with a number of immunological side-effects, including autoimmune diseases and a 10% prevalence of thyroiditis. Hepatitis C virus (HCV) infection itself predisposes to autoimmune phenomena including hypothyroidism and myositis. The development of clinical hypothyroidism in the presence of positive thyroid antibodies in patients infected with HCV and treated with IFN-alpha suggests a possible association between the viral disease and the therapy. HCV infection may predispose to autoimmune thyroid disease and IFN-alpha therapy may secondarily lead to the development of thyroid dysfunctions. We report the single case of a female patient who developed a severe proximal myopathy in conjunction with primary hypothyroidism (Hoffmann's syndrome) secondarily to IFN-alpha therapy for HCV infection. This case highlights the need for careful clinical and biological monitoring for potential side-effects in such patients.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1349-51"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729271","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":"Outcome in systemic vasculitis.","authors":"R Luqmani,&nbsp;R Moots,&nbsp;L Guillevin","doi":"10.1093/rheumatology/37.12.1362","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1362","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1362-3"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729280","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":"Clinical course and remission rate in patients with early rheumatoid arthritis: relationship to outcome after 5 years.","authors":"K Eberhardt,&nbsp;E Fex","doi":"10.1093/rheumatology/37.12.1324","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1324","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical course in early rheumatoid arthritis (RA) patients followed prospectively, to relate course to outcome after 5 yr, and to try to identify prognostic features.</p><p><strong>Methods: </strong>A total of 183 patients with definite RA and a mean disease duration of 11 months were included. Of these, 75% were rheumatoid factor (RF) positive; 85% carried the shared epitope, 32% on both alleles. Most patients were assessed every 6 months. Disability was evaluated with the Health Assessment Questionnaire (HAQ) and radiographic findings according to Larsen. Remission was defined in two ways: with the American Rheumatism Association (ARA) criteria and as 'no arthritis at least at one follow-up visit'.</p><p><strong>Results: </strong>Twenty per cent achieved ARA-defined remission periods of at least 6 months duration; 21 were spontaneous and 18 drug induced. Average length of remission was 20.5 months. The remission periods constituted 7% of follow-up for all patients. Another 36% achieved remission according to the second definition. All 56% were considered to have a relapsing-remitting disease pattern, in contrast to the remaining 44% with a persistent disease pattern. More patients with persistent disease were treated with disease-modifying anti-rheumatic drugs (DMARDs) and had also received a larger number of different drugs. Outcome after 5 yr regarding disability, joint inflammation and joint damage was worse for patients with persistent disease. Neither ARA-defined remission nor disease pattern could be accurately predicted.</p><p><strong>Conclusions: </strong>Long-term ARA-defined remission was rare, constituting 7% of follow-up for the entire cohort. For those 20% achieving remission, this period represented 34% of their follow-up. A total of 56% had a relapsing-remitting disease pattern and 44% had a persistent disease pattern. This classification had prognostic implications with persistency being a bad prognostic sign.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1324-9"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729219","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":"Circulating interleukin-16 in systemic lupus erythematosus.","authors":"S Lee,&nbsp;H Kaneko,&nbsp;I Sekigawa,&nbsp;Y Tokano,&nbsp;Y Takasaki,&nbsp;H Hashimoto","doi":"10.1093/rheumatology/37.12.1334","DOIUrl":"https://doi.org/10.1093/rheumatology/37.12.1334","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between interleukin (IL)-16 and systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>Serum levels of IL-16 were examined in SLE patients using an enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>The serum level of IL-16 in the patients was much higher than that in healthy volunteers (P < 0.001). An increase in IL-16 was observed in proportion to the activity of SLE assessed by the SLE Disease Activity Index (SLEDAI) score (P < 0.0001).</p><p><strong>Conclusions: </strong>Our observations suggest an interaction between disease activity and the production of IL-16 in SLE, and reveal that IL-16 is a useful indicator of disease activity. This is the first report describing the relationship between IL-16 and SLE.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 12","pages":"1334-7"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.12.1334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40729268","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":"IgA class serum antibodies against three different Klebsiella serotypes in ankylosing spondylitis.","authors":"O. Mäki-Ikola, M. Nissilä, K. Lehtinen, K. Granfors","doi":"10.1093/RHEUMATOLOGY/37.12.1299","DOIUrl":"https://doi.org/10.1093/RHEUMATOLOGY/37.12.1299","url":null,"abstract":"OBJECTIVE\u0000To investigate the possible predominance of certain Klebsiella pneumoniae capsular types in the pathogenesis of ankylosing spondylitis (AS).\u0000\u0000\u0000METHODS\u0000The prevalence of IgA class antibodies against three different K. pneumoniae strains (with capsular types 21, 30 and 43) was studied in the sera of 177 patients with AS and of 100 healthy blood donors using an enzyme-linked immunosorbent assay.\u0000\u0000\u0000RESULTS\u0000The median Klebsiella-specific antibody levels were always higher in patients than in controls regardless of the serotype used as antigen. When the prevalence of increased antibody levels was compared between the groups, it was highest against the strain with capsular type 30, whereas against strains 21 and 43 it was similar among patients and controls.\u0000\u0000\u0000CONCLUSIONS\u0000A broad range of Klebsiella serotypes may be involved in the pathogenesis of AS. Thus, it is important to take the different Klebsiella serotypes into particular account in these studies.","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"61 1","pages":"1299-302"},"PeriodicalIF":0.0,"publicationDate":"1998-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75883493","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}