Extraarticular manifestations of rheumatoid arthritis

Hurd, Eric R.

doi:10.1016/s0049-0172(79)80005-0

Cited by 113 publications

(35 citation statements)

References 221 publications

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“…Extra-articular manifestations (EAMs) of rheumatoid arthritis (RA) correlate with articular severity and with functional impairment [1]. They are associated with high concentrations of IgM rheumatoid factor (RF) and constitute one of the risk factors for early death in patients with RA [2].…”

Section: Introductionmentioning

confidence: 99%

Extra-articular manifestations in 587 Italian patients with rheumatoid arthritis

Cimmino

Salvarani²,

Macchioni³

et al. 2000

Rheumatology International

118

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The aim of the study was to evaluate the frequency of extra-articular manifestations (EAMs) of rheumatoid arthritis (RA) in a series of patients from nine Italian rheumatology clinics. A total of 587 patients underwent direct questioning, complete physical evaluation, and review of medical records and laboratory data. The relationships between EAMs and the eosinophilic count, IgM rheumatoid factor (RF), and antinuclear antibodies (ANA) were studied. EAMs were present in 240/587 (40.9%) patients. The most common features were sicca syndrome (17.5%) and rheumatoid nodules (16.7%). EAMs were significantly more frequent in male patients (OR = 1.68), patients with ANA positivity (OR = 2.82), high anatomical class (OR = 2.3), and rheumatoid factor seropositivity (OR = 2.22). EAMs were more common in patients from southern Italy than in those from northern Italy (P < 0.001). EAMs seem to be rarer in Italy than in the Anglo-Saxon populations of northern Europe and the USA. Differences in prevalence of EAMs can exist even within the same country.

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Section: Introductionmentioning

confidence: 99%

Extra-articular manifestations in 587 Italian patients with rheumatoid arthritis

Cimmino

Salvarani²,

Macchioni³

et al. 2000

Rheumatology International

118

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“…Although synovial inflammation predominates clinically, extra-articular manifestations are often found, sometimes in association with a vasculitis (2). Autoantibodies directed against IgG are a characteristic finding in the sera and 1.…”

Section: Introductionmentioning

confidence: 99%

Anti-Fab antibodies in humans. Predominance of minor immunoglobulin G subclasses in rheumatoid arthritis.

Persselin¹,

Stevens²

1985

J. Clin. Invest.

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Isoelectric focusing analyses of sera from patients with rheumatoid arthritis (RA) demonstrate two populations of antibodies directed aanst the Fab portion of pooled human IgG. One population is composed of polyclonal akline anti-Fab antibodies (aFABA) and the other, acidic aFABA which are more clonally restricted. In this study we have identified the immunoglobulin classes and subclasses of these antibodies in RA sera.

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“…Cardiomyopathy was described in 3%-30% of patients with rheumatoid arthritis (RA) in postmortem studies (4). Similarly, other population-based (5) and clinic-based RA cohorts (6) demonstrated the association between RA and congestive heart failure.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular systolic dysfunction in two patients with ankylosing spondylitis: What is the role of corticosteroids?

2017

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IntroductionAnkylosing spondylitis (AS) is a chronic inflammatory condition that most commonly affects the axial skeleton, including the spine and sacroiliac joints. The most common cardiac manifestation in patients with AS is the aortic root and valve disease, which has been reported in up to 82% of patients (1). Other less common cardiac abnormalities that are observed in patients with AS include conduction and rhythm abnormalities, decreased coronary flow reserve, myocardial infarction, and diastolic dysfunction. However, the presence of systolic dysfunction has been less described in patients with AS. Herein we present two cases of idiopathic dilated cardiomyopathy in patients with AS. These patients were noted to have an improvement of their ejection fractions following treatment of AS, suggesting that cardiomyopathy in AS may be reversible with an effective treatment of the underlying inflammatory process. Written informed consent was obtained from patients who participated in this study. Case PresentationsCase 1 A 25-year-old man, with a known case of AS since 18 months, was referred to our Heart Failure Clinic with the New York Heart Association (NYHA) function class II of dyspnea on exertion. Heart failure was diagnosed prior to his rheumatologic problem, and he was partially treated using an angiotensin-converting enzyme inhibitor [captopril (Captopril, Rouz Darou; Tehran, Iran) 25 mg/BID (i.e., two times a day)] only. Complete rheumatologic panels were ordered, which established the presence of a seronegative spondyloarthropathy. He was receiving indomethacin (Indomethacin, Loghman; Tehran, Iran), sulfasalazine (Sulfasalazine, Mehr Darou; Tehran, Iran), and prednisolone (Prednisolone, Iran Hormone; Tehran, Iran) for AS. Sulfasalazine and prednisolone were initiated after an AS diagnosis, and the doses were maintained at 2000 and 2.5 mg daily, respectively.On arrival to our clinic, his cardiovascular examination revealed a regular heart rate, normal S1 and S2, and left-sided S3. No jugular venous distension was noted. The baseline echocardiography revealed mild left ventricular (LV) enlargement with severe systolic dysfunction [left ventricular ejection fraction (LVEF)=30%] and grade 2 diastolic dysfunction, normal right ventricular (RV) size and function, estimated systolic pulmonary artery pressure of 30 mmHg, no aortic stenosis or regurgitation, mild mitral regurgitation, and mild tricuspid regurgitation. Tissue Doppler study confirmed a reduced systolic myocardial velocity and a significant diastolic dysfunction. A complete laboratory examination, including electrocardiogram, calcium and magnesium levels, complete blood test, liver function tests, renal function tests (blood urea nitrogen and creatinine levels), serum electrolyte levels, thyroid-stimulating hormone levels, hemoglobin A1C, lipid profile, human immunodeficiency virus serological screening, and antinuclear antibody titer, 179Ankylosing spondylitis (AS) is a chronic inflammatory condition that most commonly affects the axial ...

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Extraarticular manifestations of rheumatoid arthritis

Cited by 113 publications

References 221 publications

Extra-articular manifestations in 587 Italian patients with rheumatoid arthritis

Extra-articular manifestations in 587 Italian patients with rheumatoid arthritis

Anti-Fab antibodies in humans. Predominance of minor immunoglobulin G subclasses in rheumatoid arthritis.

Left ventricular systolic dysfunction in two patients with ankylosing spondylitis: What is the role of corticosteroids?

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