Cases reported "Rheumatic Diseases"

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21/63. Chronic tuberculous rheumatism (Poncet's disease) in a gymnast.

    Chronic arthritis, whether primary or reactive, is an unusual manifestation of long standing tuberculosis. We described the case of a 16-year-old gymnast with tuberculous rheumatism (Poncet's disease) secondary to Pott's disease of the dorsal spine. The possible pathogenetic mechanisms are discussed.
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22/63. Improving compliance with prednisone therapy in pediatric patients with rheumatic disease.

    compliance with regimens for pediatric rheumatic diseases is often poor, and few studies have evaluated strategies for improving compliance. This study utilized relatively simple behavioral and educational strategies to improve compliance with prednisone for three patients with pediatric rheumatic diseases (systemic lupus erthematosus and dermatomyositis). These strategies were implemented in a pediatric rheumatology setting and resulted in improved compliance that was maintained at 6- and 12-month follow-up. During baseline, patients were found to be overmedicating as well as undermedicating. This study is a systematic replication of an earlier study that demonstrated that behavioral and educational strategies can improve compliance with medications for juvenile rheumatoid arthritis. It also raises the possibility of overmedicating as a compliance problem to be managed.
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23/63. factor viii related antigen and childhood rheumatic diseases.

    factor viii related antigen (FVIIIRAg) levels were measured in the plasma of 63 children with rheumatic diseases and 20 controls. High levels were found in patients with systemic juvenile arthritis, systemic lupus erythematosus, dermatomyositis and systemic forms of vasculitis. The amount of circulating FVIIIRAg seemed to be independent of values for erythrocyte sedimentation rate, c-reactive protein and fibrinogen, implying that it was not just another acute phase reactant. Rather, a high level of circulating FVIIIRAg most likely reflects the presence of vascular endothelial injury, and this test may be useful in monitoring disease activity in children with rheumatic diseases in which vasculitis is present.
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24/63. Spontaneous pneumothorax complicating rheumatoid lung disease.

    This case report describes the pleuro-pulmonary involvement in a young patient with rheumatoid arthritis (RA) of one and half year duration. The early involvement of lung interstitium in a 27-year-old male and development of pneumothorax were the unusual features. The various aspects of rheumatoid lung disease (RLD) and its clinical significance were briefly discussed.
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25/63. Differential diagnosis of rheumatic disease in the elderly.

    To illustrate the diagnostic problems of rheumatic disease in patients over 60 years of age, 4 cases are presented: 1) osteoarthritis, 2) late-onset rheumatoid arthritis, 3) polymyalgia rheumatica, and 4) pseudogout with crystalline synovitis. In each case the correct diagnosis should have been suspected from the history and physical examination alone, with the laboratory and x-ray findings providing supportive evidence.
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keywords = arthritis
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26/63. Rheumatologic conditions of the wrist.

    With the exception of the arthritis associated with rubella, acute wrist conditions have no pathognomonic physical findings. The primary physician can diagnose and treat the majority of wrist problems presented. Referral to a rheumatologist is necessary only when confronted with an anxious patient or an individual having persistent wrist pain and swelling of obscure etiology. This article focuses on rheumatologic problems of the wrist that are most likely to come to the attention of the primary physician.
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27/63. aspirin hepatotoxicity.

    A case of aspirin hepatotoxicity in a 46-year-old male with rheumatoid arthritis is discussed, and this adverse reaction is reviewed. The patient was started on 900 mg aspirin four times daily; five days later the dose was increased to 1200 mg four times daily. After six days' therapy of 4.8 g aspirin daily, the serum salicylate level rose to 25 mg/100 ml and liver enzymes became elevated. aspirin was discontinued and ibuprofen, 600 mg four times daily, begun. Eight days after cessation of aspirin therapy, the patient's liver enzyme values returned to normal. Previous case reports and studies of aspirin-induced hepatotoxicity are reviewed. It is concluded that aspirin-induced hepatotoxicity occurs much more frequently in patients with rheumatoid arthritis and other connective tissue disorders than previously recognized.
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keywords = arthritis
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28/63. Rheumatoid granuloma of kidney.

    A seventy-year-old black man with long-standing rheumatoid arthritis who had been treated with corticoids presented with painless hematuria originating from the kidney. The clinical findings were suggestive of a renal cell carcinoma. The resected kidney was markedly enlarged, scarred, and disclosed a necrotic rheumatoid granuloma surrounded by chronic inflammatory reaction. The mechanism of hematuria and the clinical significance of the rheumatoid granulomatous involvement of the kidney are discussed.
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29/63. Rheumatoid meningitis: a localized immune process.

    Rheumatoid pachymeningitis is a rare complication of rheumatoid arthritis. This disease was confined to the dura and pia-arachnoid of the lumbar cord in our patient. Her neurologic deficits responded to surgical decompression and corticosteroid therapy. Radiologic evidence and the differences in cell count, protein, and glucose content between lumbar and cisternal cerebrospinal fluid indicate that rheumatoid pachymeningitis can be localized to a discrete region of the central nervous system. Elevated immunoglobulins, IgM and IgG rheumatoid factors, low molecular weight IgM, and immune complexes were found in the cerebrospinal fluid and implicate an immune reaction in the pathogenesis of this disease, which is probably similar to inflammatory processes involving other organs in rheumatoid arthritis.
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keywords = arthritis
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30/63. Silicone and rheumatic diseases.

    Silicone generally has been regarded as a biologically inert material. However, recent reports suggest that inflammatory responses to silicone occur. There is some experimental and clinical evidence of a direct inflammatory response to the presence of liquid or particulate silicone. These include granulomatous skin reaction to injected silicone, synovitis around silicone prosthetic joints, and lymphadenopathy proximal to silicone prostheses. There are case reports of systemic rheumatic disease following silicone prostheses, but no definitive proof of a direct relationship between silicone prostheses and systemic disease. The clinical features of the reported cases following breast augmentation include breast tenderness, axillary adenopathy, sclerodermatous skin changes, arthritis, Raynaud's phenomenon, rheumatoid factors, and ANAs. Prior epidemiologic evidence and the number and consistency of our own and others' clinical findings suggest that silicone may indeed be associated with inflammatory processes and rheumatic diseases.
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