1/233. Systemic adverse effect of antithyroid drugs.Antithyroid drugs adverse effects are varied and rare. Autoimmune disorders (vasculitis, lupus erythematosus, polyarthritis...) are unusual and serious complications of antithyroid drugs. Since 1945, fewer than 100 cases of systemic manifestations related to antithyroid drugs have been reported in the literature, most frequently with propylthiouracil. The outcome is usually good after drug discontinuation, but some fatal cases have been reported. Because possible cross-sensitivity with other antithyroid drugs, the appropriate treatment for hyperthyroidism relapse if a patient has had an antithyroid drug adverse reaction, should be 131I-iodine or surgery. We report four new cases of systemic manifestations during propylthiouracil therapy.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
2/233. Recurrent aneurysmal bone cyst of the proximal phalanx treated with cryosurgery: a case report.A recurrent aneurysmal bone cyst of the proximal phalanx treated with curettage, cryosurgery, and bone grafting is presented. There is no evidence of recurrence after 5 years. Although cryosurgery is commonly used as an adjuvant for intralesional treatment for aneurysmal bone cyst, there have been no reports of its use for the treatment of a lesion arising in the hand.- - - - - - - - - - ranking = 0.010106415629669keywords = adjuvant (Clic here for more details about this article) |
3/233. Efficacy of filtration leukocytapheresis on rheumatoid arthritis with vasculitis.The present study was designed to determine the efficacy of filtration leukocytapheresis (LCAP) in the treatment of rheumatoid arthritis (RA) with vasculitis. Nine RA patients with vasculitis were studied by the Malignant RA Collaborative Group formed by 8 clinical centers. A total of 7 filtration LCAP procedures using the Cellsorba column (Asahi Medical Co., Ltd., tokyo, japan) were performed with 1 week intervals between treatments. During each apheresis procedure, 3,000 ml of blood was filtered and returned to the patient at a flow rate of 50 ml/min for 60 min. In addition to the amelioration of arthritis, the improvement of extraarticular symptoms associated with rheumatoid vasculitis such as polyneuritis, skin ulcers, digital gangrene and rheumatoid nodules was obtained. In contrast, no improvement was observed in interstitial pneumonia or lung fibrosis. LCAP could be an optional modality for the treatment of RA with vasculitis.- - - - - - - - - - ranking = 6keywords = arthritis (Clic here for more details about this article) |
4/233. Multiple rheumatoid bursitis with migrating chylous cysts. Report of a case in a European woman and review of the literature.We report a case of recurrent multiple bursitis (19 episodes at nine sites) requiring seven surgical procedures in a European women with a 38-year history of severe, nodular, destructive seropositive rheumatoid arthritis unresponsive to second-line drugs. The episodes of bursitis were not correlated with activity of the joint disease. Some cysts migrated over a considerable distance. At least two cysts contained chylous fluid. The histologic study of one cyst demonstrated a cholesterol crystal granuloma. Potential relationships linking cholesterol crystals, chylous cysts, and migrating multiple bursitis are discussed. The relevant literature is reviewed.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
5/233. Rapid death following papillary serous carcinoma of the endometrium without myometrial invasion.A 72-year-old woman was diagnosed with a stage I endometrial carcinoma, and total hysterectomy, bilateral salpingo-oophorectomy, and systematic pelvic and paraaortic lymphadenectomy were performed. Postoperative pathological examination determined that the tumor was confined to the endometrium, with no myometrial invasion or lymph-vascular involvement; histological examination revealed a papillary serous carcinoma of the endometrium. Peritoneal washing cytology during surgery revealed an adenocarcinoma. Despite postoperative adjuvant chemotherapy, early recurrence resulted in death 13 months after surgery. In the absence of myometrial invasion and lymph-vascular involvement, the data suggest that peritoneal washing cytology may serve as a prognostic factor in papillary serous carcinoma of the endometrium.- - - - - - - - - - ranking = 0.010106415629669keywords = adjuvant (Clic here for more details about this article) |
6/233. Recurrent monoarthritis in an 11-year-old boy with occult coeliac disease. Successful and stable remission after gluten-free diet.A case of occult coeliac disease (CD) presenting with recurrent monoarthritis in a boy aged 11 years is reported. The case is unique due to the association of occult untreated CD and arthritis in childhood. Peripheral or axial arthritis as a first manifestation of occult CD has been described in adult patients, with an interval between the arthritis and CD of up to 15 years. In our case the interval between the appearance of arthritis and the diagnosis of CD was 2 years. The boy was asymptomatic for bowel disease and his nutritional status was normal. The diagnosis of CD was established using anti-gliadin (AGA) and anti-endomysium (EMA) antibody tests and was confirmed by small bowel biopsy. The introduction of a gluten-free diet resulted in the persistent remission of arthritis. As the treatment of CD-associated arthritis is based on dietary therapy, physicians should be alert to the possibility of occult CD in any child with arthritis of unclear origin.- - - - - - - - - - ranking = 12keywords = arthritis (Clic here for more details about this article) |
7/233. Elevated plantar pressure and ulceration in diabetic patients after panmetatarsal head resection: two case reports.Panmetatarsal head resection (variously called forefoot arthroplasty, forefoot resection arthroplasty, the Hoffman procedure, and the Fowler procedure) was developed for the relief of pain and deformity in rheumatoid arthritis. Although there are successful retrospective series reported in the literature, such an approach is not supported by carefully designed controlled trials. This procedure has also been advocated by some for the relief of plantar pressure in diabetic patients who are at risk for plantar ulceration. The efficacy of the procedure in this context is not supported by existing pressure measurements on rheumatoid arthritis patients in the literature, which has tended to show that although pain relief is obtained, the procedure results in elevation of forefoot pressure. case reports are described of two patients (three feet) with sensory neuropathy who presented to our clinic 1 to 2 years after panmetatarsal head resections had been performed. Peak plantar pressures in these feet during first step gait were above the 99th percentile and outside the measuring range of the device used (EMED SF platform; NOVEL electronics Inc., St. Paul, MN). Both patients had also experienced plantar ulcers subsequent to the surgery. Combining the information on patients with rheumatoid arthritis (RA) with that from our two case studies, we conclude that panmetatarsal head resection does not necessarily eliminate focal regions of elevated plantar pressure.- - - - - - - - - - ranking = 3keywords = arthritis (Clic here for more details about this article) |
8/233. Recurrent reactive arthritis associated with urinary tract infection by escherichia coli.We describe a patient with recurrent escherichia coli urinary tract infection followed by recurrent reactive arthritis. During a 9 year period the patient developed 4 episodes of arthritis. During each attack, triggering infections were thoroughly investigated but no other causative infection was found. Although the urinary tract is not routinely targeted for triggering infections for reactive arthritis, we suggest that urinary tract infections should be included in the diagnostic investigations of patients with acute arthritis.- - - - - - - - - - ranking = 8keywords = arthritis (Clic here for more details about this article) |
9/233. Excision and radiotherapy for heterotopic ossification of the elbow.radiotherapy has a well-defined role in prophylaxis of recurrent heterotopic ossification of the hip, but has been described infrequently in other situations. This article reports the use of excision and low-dose external beam radiotherapy in three patients with heterotopic ossification of the elbow treated between February 1995 and September 1996. radiotherapy was delivered in a single fraction of 7-8 Gy within 48 hours postoperatively using opposed anteroposterior portals. After a median follow-up of 10.5 months, all three patients demonstrated a significant increase in range of motion without any evidence of recurrence. These results indicate adjuvant postexcision radiotherapy may be used for prophylaxis of recurrent heterotopic ossification of the elbow.- - - - - - - - - - ranking = 0.010106415629669keywords = adjuvant (Clic here for more details about this article) |
10/233. Relapse of cutaneous leishmaniasis in a patient with an infected subcutaneous rheumatoid nodule.Cutaneous leishmaniasis is a protozoal infection generally considered to be limited to the skin. In israel, the disease is common in geographically defined areas and is caused predominantly by leishmania major. Sporotrichoid subcutaneous spread has been reported but is uncommon. We describe a patient with rheumatoid arthritis, treated with methotrexate and prednisone, in whom numerous rheumatoid nodules concomitant with cutaneous leishmaniasis were found, mimicking sporotrichoid spread of the disease. In a rheumatoid nodule that was examined by electron microscopy, Leishmania parasites were found at intracellular and extracellular locations. This observation supports the hypothesis that cutaneous leishmaniasis parasites persist after clinical cure of the disease and may re-emerge as a result of immunosuppression.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
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