1/101. bacillus Calmette-Guerin associated arthropathy mimicking undifferentiated spondyloarthropathy.The development of an inflammatory arthritis mimicking an undifferentiated spondyloarthropathy (SpA) was seen in a patient being treated for a superficial bladder cancer with intravesical bacillus Calmette-Guerin (BCG). Physical findings included classic dactylitis of both feet. This is the fourth report identifying a patient with BCG induced articular findings suggestive of a SpA with dactylitis. Studies of BCG stimulated cytokine secretion from peripheral blood mononuclear cells showed the patient to have enhanced interleukin 6 (IL-6) levels and reduced interferon-gamma (IFN-gamma) levels. Spontaneous IL-6 secretion was markedly elevated for the patient, compared to the control subject, but IFN-gamma secretion was quite similar. No differences were apparent with IL-4.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
2/101. Cystic rheumatoid arthritis with Felty's syndrome and ankylosing spondylitis.A 63-year-old man with strictly axial ankylosing spondylitis since the age of 28 years had a seven-year history of cystic seronegative rheumatoid arthritis with Felty's syndrome. cysts were present in the hands, feet, wrists, shoulders, hips, one elbow, and one knee. There was no evidence of juxtaarticular demineralization, joint space loss, erosions, or joint destruction. Rheumatoid pannus was demonstrated within the cysts, particularly at the hip, ruling out cystic hip disease due to ankylosing spondylitis. HLA typing demonstrated the B27 and DR4 haplotypes. HLA B27 may be associated with a worse prognosis of rheumatoid hip involvement.- - - - - - - - - - ranking = 5keywords = arthritis (Clic here for more details about this article) |
3/101. sacroiliitis - it's not all B 27.We describe an HLA-B27 positive patient in whom posttraumatic pyogenic sacroiliitis led to complete unilateral sacroiliac joint ankylosis in the absence of any signs indicative of HLA-B27 associated spondyloarthropathy. sacroiliitis is the pathologic hallmark - and usually one of the earliest pathologic manifestations - of ankylosing spondylitis (AS). Bilateral sacroiliitis is typical for ankylosing spondylitis. The frequency of asymmetric sacroiliitis may be higher in other inflammatory disorders, e.g., reactive arthritis, Reiters syndrome, spondylitis associated with psoriasis, or inflammatory bowel disease. Most but not all of these disorders show an increased prevalence among individuals who have inherited the HLA-B27 gene. In the context of this case, we discuss the differential diagnosis of unilateral sacroiliitis.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
4/101. Ankylosing spondylitis with severe chondrocalcinosis: case report.The term chondrocalcinosis is often used to describe the radiological or pathological features of calcified joint cartilage, and it usually indicates the deposition in cartilage of calcium pyrophosphate dihydrate. The prevalence of chondrocalcinosis increases with age, with dramatic increases occurring in the decades past age 60. In younger patients with chondrocalcinosis, either clinical evidence of associated metabolic diseases leading to the chondrocalcinosis or familial disease occurrence usually can be detected. We report a 42-year-old Chinese woman with ankylosing spondylitis and arthritis involving multiple peripheral joints. Severe chondrocalcinosis was detected incidentally in this patient, however, subsequent studies revealed no associated metabolic disease or familial susceptibility and the clinical features of this patient were different from those of ankylosing chondrocalcinosis (pseudoankylosing spondylitis). The cause of chondrocalcinosis in this patient remains unknown, but joint damage and repair could have been initiating or aggravating factors of the chondrocalcinosis.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
5/101. Coexisting Behcet's syndrome and spondyloarthritis.A patient suffering from Behcet's syndrome and undifferentiated spondyloarthritis developed dactylitis and psoriasis over the next three years.- - - - - - - - - - ranking = 5keywords = arthritis (Clic here for more details about this article) |
6/101. Familial reactive arthritis of Reiter's and ankylosing spondylitis types in the HLA-27 genotype.The close relationship between Reiter's disease and ankylosing spondylitis, which had previously been suspected on the grounds of family and population studies, has been re-emphasised following the recent demonstration of their common close association with the HLA-27 genotype. Nevertheless there are few case reports of both conditions occurring simultaneously in first degree relatives; and documentation of HLA genotype in such families was not generally considered before 1973. Both varieties of reactive arthritis are reported here as occurring in first degree relatives sharing HLA-27 genotype.- - - - - - - - - - ranking = 5keywords = arthritis (Clic here for more details about this article) |
7/101. Dramatic response after an intravenous loading dose of azathioprine in one case of severe and refractory ankylosing spondylitis.We describe a 37-yr-old Caucasian male suffering from ankylosing spondylitis (AS) with long-standing severe inflammatory lumbar pain and hip arthritis who was refractory to non-steroidal anti-inflammatory drugs, sulphasalazine and methotrexate up to 25 mg/week. In this patient, administration of an i.v. loading dose of azathioprine (AZA; 40 mg/kg for 36 h followed by 2 mg/kg oral AZA therapy) induced a dramatic response in his clinical condition. Indeed, objective and subjective clinical variables improved within 1 week and were corroborated by a decline in the levels of the inflammatory parameters; anaemia was reported at month 3 but was rapidly reversible. If confirmed, an i.v. loading dose of AZA could represent a valuable alternative in severe and refractory AS, but toxicity of this regimen should be carefully analysed.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
8/101. Secondary amyloidosis: a severe complication of ankylosing spondylitis. Two case-reports.STUDY OBJECTIVE: To report two cases of amyloidosis secondary to ankylosing spondylitis. patients AND RESULTS: Of the 47 ankylosing spondylitis patients who have received follow-up at our department over the last few years, two have developed AA amyloidosis. Both have extremely severe, long-standing joint disease, with virtually complete spinal ankylosis and destructive peripheral arthritis of the hips and wrists; one also has tarsal joint destruction. Renal dysfunction was the first manifestation of amyloidosis in both cases. One patient required chronic hemodialysis and developed peritonitis due to colonic perforation, probably at a site of amyloid deposition. CONCLUSIONS: Secondary amyloidosis is a rare complication of ankylosing spondylitis that can cause severe renal and gastrointestinal complications. No treatment capable of clearing established amyloid deposits is available to date.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
9/101. Atypical methotrexate dermatitis and vasculitis in a patient with ankylosing spondylitis.Reports of histologically proven low-dose methotrexate (MTX)-induced vasculitis are uncommon and mostly found for patients with rheumatoid arthritis. Herein we present a patient with ankylosing spondylitis who developed large atypical erythematopurpuric cutaneous lesions after the second oral dose of 7.5 mg MTX therapy. The histological findings of a cutaneous lesion were consistent with vasculitis. The skin lesions regressed significantly after the discontinuation of MTX therapy. As the clinical picture of the patient's rheumatological condition became progressively severe, prednisolone therapy was initiated 8 days later and the skin rash resolved completely in a couple of weeks.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
10/101. arthritis in myasthenia gravis.Seven patients with myasthenia gravis developed clinical signs of arthropathy. In two patients, the symptoms were due to a deforming rheumatoid arthritis and the myasthenic symptoms appeared as a transitory phase during the course of the disease. Muscle antibodies of IgG class were demonstrated with sera from both patients. Autoreactivity between muscle antibodies and rheumatoid factor was detected in one patient. Both patients died from sudden cardiac failure. Necropsy was performed in one and revealed a spotty myocardial necrosis. One patient had juvenile rheumatoid arthritis. Two patients had mild articular symptoms with indices of multivisceral disease and serological findings indicating a systemic lupus erythematous. One patient had classical ankylosing spondylitis, and one, unspecified arthropathy.- - - - - - - - - - ranking = 2keywords = arthritis (Clic here for more details about this article) |
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