Evolve rheumatoid arthritis case study

Revista Colombiana de Reumatología (English Edition)

No changes in autoantibody profiles were seen. No adverse events were observed in any of the patients. In two patients retreatment with a reduced dosage of rituximab 2xmg was given, because of a decrease in elasticity of the skin with development of puffy hands.

Both patients achieved a good clinical response again. Conclusion: B-cell depletion therapy using rituximab was effective and safe in four cases of systemic sclerosis refractory to conventional immunosuppressive therapies. Retreatment every 3 months may be discussed in some patients with a very high disease activity. Background : Juvenile scleroderma JS is a rare type of autoimmune disorder in children that is characterized by skin fibrosis and vascular inflammation.

JLS is the most common type in children. The aim of this study was evaluation of clinical features of childhood scleroderma in Iranian children. Methods: In a retrospective study , all patients who had JS diagnosis in our tertiary center enrolled in this study. The diagnosis was established based on the ACR criteria Organs involvement was evaluated and skin biopsy as well as laboratory evaluation have been performed for all patients.

All patients were followed at least for 7 years. The mean age of patients at the beginning of symptoms and diagnosis time were 7. There was not cardiac and renal involvement in each patient.

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Overlap syndrome was found in One patient had dermatomyositis and another one recurrent Henoch-Schonlein Purpura. There was not any mortality during follow-up period in this study. There is not any risk factor in 23 patients, but in one patient JS occurred following bone marrow transplantation with thalassemia major. There was not any mortality in this study.

Conclusions: Although scleroderma is a rare connective tissue disorder in childhood, it should be considered in children with skin sclerosis especially in patient with other autoimmune disorder. Localized morphea was the most common type of scleroderma in our survey. Background : The objective of this study was to assess the incidence and common type of malignancies and outcome in Korean patients with idiopathic inflammatory myopathy IIM , and to define concomitant malignant disease and the predictive factors of death in patients diagnosed as having IIM.

Methods : From January to May , patients were diagnosed as polymyositis or dermatomyositis at one university hospital, Seoul, Korea.


The medical records of these patients were retrospectively reviewed. We compared the clinical findings of the patients according to existence of malignancy and analyzed the prognostic factors predicting death. Kaplan-Meier curves were used to illustrate the cumulative proportions of survival. Results: 17 out of patients Of malignancy associated patients, 2 patients were simultaneously diagnosed, and 9 patients were diagnosed malignancy within 2 years after diagnosis of IIM.

There was no significant difference in age, sex, the level of muscle enzyme between patients with or without malignancy. But patients with malignancy had significantly lower frequency of interstitial lung disease and older age at onset. The main causes of death were lung complication and malignancy. Older age at diagnosis, existence of malignancy and minimal elevation of CPK were the independent risk factors for death. Conclusion : Malignancies were most serious risk factor for death in IIM.

The prognosis of malignancy associated IIM was extremely poor. Early discovery of malignancy is important in cases of IIM and extensive investigation for searching malignancy should be done at time of diagnosis and each year for the at least first 2 years after diagnosis of IIM. Background: Early differentiation between bacterial infection and rheumatic disease flares is critical to decide between the contradicting treatments.

Method: Seventy-nine autoimmune disease patients with symptoms suggestive of either infection or disease flare were enrolled.

This study was performed retrospectively and the patients were later classified into 2 groups; disease flare and infection by chart review. The best cutoff value for hsCRP was 7. The best cutoff value for PCT was 0. CRP has no additive value when combined with PCT when differentiating bacterial infection from disease flare. Keywords: procalcitonin, autoimmune disease, C-reactive protein, bacterial infection. Background : Systemic lupus erythematosus SLE is associated with complex genetic susceptibility and HLA-DRB1 is a well-accepted susceptibility gene with reports of association with clinical manifestations such as renal disorder.

It has shown relatively consistent association across different ethnicities, but the risk alleles were different. All subjects were Korean.


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In addition, we investigated whether there were any relationships between varios antibodies and clinical features of SLE. We observed that a homogenous staining pattern was associated with renal involement OR The prevalence of renal involvement was higher in anti-nucleosome positive patients OR The anti-tumor necrosis factor TNF agents are now widely used in the management of rheumatoid arthritis RA , spondyloarthritis, and other autoimmune diseases. Concerns should be raised regarding the safety profile of these agents especially with the increasing use and longer periods of treatment.

One of the side-effect of these anti-TNF agents is the development of autoimmune diseases including lupus like syndrome. Here, we report a rare case of a year old female diagnosed with sever seropositive rheumatoid arthritis. In order to control her severe symptoms, adalimumab was started.

She showed significant improvement with complete remission. Shortly, after the adalimumab had been tapered, the patient developed diffuse muscle weakness, mainly proximal rather than distal. In addition, she had conversion of her ANA and anti-ds DNA from negative to strongly positive while her creatinine kinase remained normal. MRI of right arm showed mild edema with post contrast enhancement.

The right arm biopsy revealed inflammatory myositis histopathologically. Diagnosis of adalimumab induced lupus myositis was considered and high dose steroid therapy was initiated.

The genetic pathogenesis, diagnosis and therapeutic insight of rheumatoid arthritis

Given her profound muscle weakness, rituximab was added. The patient responded well with complete restoration of her muscle strength. Acknowledgement: Alzaidi chair of research in rheumatic diseases, Umm Alqura University for supporting this project. Background: Systemic Lupus Erythematosus SLE is one o the most common autoimmune disorders that affect women during their childbearing years. The study is based on the data obtained to study, the outcomes of pregnancy and their influence on the course of the disease in patients with SLE.

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Methods: retrospective observation of pregnant women with SLE was conducted during 5 years. The average age of the patients was Results: 11 patients under study developed 28 pregnancies. In 10 cases In 5 patients, concomitant secondary APS was observed In 2 cases Other pregnancies 16, or They did not need any immunosuppressive drugs. Conclusion: the follow-up during at least 1 year of persistent remission makes successful outcomes of pregnancies possible in patients with SLE receiving maintenance therapy; even in cases they had such severe manifestations of SLE, as renal involvement or secondary APS in their history.

Background: Examination of the population of the Republic of Sakha Yakutia for the purpose of early diagnosis of osteoporosis OP was carried out in Yakutsk city for the first time. A total of patients were surveyed. Analysis of questionnaires revealed that girls and young women consume at least 3 servings of dairy products but are fond of unhealthy drinks coffee, sodas , have chronic diseases which can lead to decrease BMD, and irregularly ingest calcium preparations.

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Injuries were seen in 10 girls most commonly a sports trauma. Conclusions: Health education in the schools and with parents, along with promotion of bone-healthy food appears to be necessary. Also routine testing of BMD and screening for early evidence of diseases of the endocrine and reproductive systems are indicated.

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