Serum biochemical values in rheumatoid disease.

Cockel, R.; Kendall, M. J.; J, Becker; Hawkins, C F

doi:10.1136/ard.30.2.166

Cited by 59 publications

(9 citation statements)

References 10 publications

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“…5 The bone loss is pronounced in glucocorticoid treated patients' 3 4but is also present in patients treated solely with non-steroidal antirheumatic drugs.' 3 4 It has not been established whether RA-associated osteopenia, if uninfluenced by glucocorticoids, is determined by the degree of functional impairment (disability, impaired ambulation),6-9 or by the duration of the disease.'…”

mentioning

confidence: 99%

Are disease duration and degree of functional impairment determinants of bone loss in rheumatoid arthritis?

Als¹,

Gotfredsen²,

Riis³

et al. 1985

Annals of the Rheumatic Diseases

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SUMMARY One hundred and five patients with rheumatoid arthritis treated with a variety of antirheumatic drugs, excepting glucocorticoids, were stratified according to the degree of functional impairment (functional classes I to IV) and duration of the disease (0-3 years; 4-8 years; and >8 years). The variables investigated were distal forearm bone mineral content (BMC), biochemical markers of bone formation: serum alkaline phosphatase and serum bone gamma-carboxyglutamic acid containing protein (BGP) and biochemical markers of bone resorption: fasting urinary calcium and fasting urinary hydroxyproline. Significant relationships were found between BMC and functional impairment and duration of the disease. Indices of bone formation and bone resorption rose with increasing functional impairment, particularly those of bone resorption. It is concluded that disability induces osteopenia in rheumatoid arthritis by increasing the bone turnover with a more marked increased in resorption than in the formation processes. The effect of the disease duration is merely that of adding more years of functional impairment.

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mentioning

confidence: 99%

Are disease duration and degree of functional impairment determinants of bone loss in rheumatoid arthritis?

Als¹,

Gotfredsen²,

Riis³

et al. 1985

Annals of the Rheumatic Diseases

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“…Overt clinical evidence of liver disease in uncomplicated rheumatoid arthritis is considered to be uncommon, although hepatomegaly has been reported in up to 20 % of patients (Webb et al, 1975;Tiger et al, 1976). Abnormalities in the biochemical tests of liver function are more frequent, with elevated serum alkaline phosphatase levels being found in up to 50% of rheumatoid arthritis patients (Lefkovits and Farrow, 1955;Cockel et al, 1971;Webb et al, 1975). Concomitant increases in gammaglutamyl, transpeptidase and leucine amino-peptidase levels suggest that the alkaline phosphatase may have been of hepatic rather than bone origin.…”

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confidence: 99%

Studies on the frequency and pathogenesis of liver involvement in rheumatoid arthritis.

Fernandes¹,

Sullivan²,

McFarlane³

et al. 1979

Annals of the Rheumatic Diseases

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SUMMARY A systematic prospective survey of 100 outpatients with rheumatoid arthritis revealed that 45 had biochemical evidence of liver disease. In most cases this was due to increases in total serum alkaline phosphatase (ALP) and/or gammaglutamyl transpeptidase (GGT). Examination of serum ALP isoenzyme profiles in 50 of the patients showed that the liver isoenzyme was the sole or major component in 44 patients, including many with normal total ALP levels. 180% had raised serum liver ALP together with raised GGT, suggestive of an underlying hepatobiliary lesion. No correlation could be detected between raised serum levels of liver enzymes and the age or sex of the patient, duration or severity of arthritis, and drug or alcohol history. However, there was a significant correlation between raised serum ALP and lacrimal or salivary gland dysfunction. It is suggested that immunological mechanisms may be involved in the development of hepatic abnormalities in rheumatoid arthritis.

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“…AP of the bone type and 5 0 nucleotidase are found in the synovial fluid of RA patients to a greater extent than in osteoarthritis [91,92]. AP correlates with an increase in 5 0 nucleotidase [83], and drops with corticosteroids [90]. Gamma glutamyl transaminase (GGT) is raised in 23-77% of patients and correlates with active disease [86,93].…”

Section: Liver Disease In Ramentioning

confidence: 98%

“…The spleen can spontaneously rupture even without splenomegaly, perhaps due to involvement of the capsule with the rheumatoid process [82]. Transaminases and bilirubin are generally normal in RA [83,84].…”

Section: Liver Disease In Ramentioning

confidence: 98%

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Gastrointestinal and Hepatic Manifestations of Rheumatoid Arthritis

Ebert

Hagspiel

2011

Dig Dis Sci

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Rheumatoid arthritis (RA), characterized by inflammation of the synovium and surrounding structures, has a prevalence of 0.5-1%. Rheumatoid vasculitis (RV) is an inflammatory condition of the small- and medium-sized vessels that affects up to 5% of patients with RA with intestinal involvement in 10-38% of these cases. Clinically apparent RV of the gastrointestinal (GI) tract, while rare, is often catastrophic, resulting in ischemic ulcers and bowel infarction. Vasculitis of the colon may present as pancolitis clinically similar to ulcerative colitis. Rectal biopsies that include submucosal vessels are positive for vasculitis in up to 40% of cases. Abnormal esophageal motility in RA may result in heartburn and dysphagia. Chronic atrophic gastritis may be associated with hypergastrinemia and hypo- or achlorhydria, promoting small bowel bacterial overgrowth. RA is the most common cause of secondary amyloidosis with GI symptoms in 22% of affected patients. Although amyloid is usually found in the liver, it is rarely evident clinically. Felty's syndrome occurs in less than 1% of patients with RA and is characterized by neutropenia and splenomegaly. The liver may be involved with portal fibrosis or nodular regenerative hyperplasia. Liver histology is abnormal in 92% of RA patients at autopsy, although the changes are usually mild without associated hepatomegaly. Drug-induced liver disease may occur with aspirin, sulfasalazine, and methotrexate. Significant liver damage is rare if the drug is discontinued or the patient is properly monitored. RA can affect both the GI tract and the liver; changes are usually mild except with RV.

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Serum biochemical values in rheumatoid disease.

Cited by 59 publications

References 10 publications

Are disease duration and degree of functional impairment determinants of bone loss in rheumatoid arthritis?

Are disease duration and degree of functional impairment determinants of bone loss in rheumatoid arthritis?

Studies on the frequency and pathogenesis of liver involvement in rheumatoid arthritis.

Gastrointestinal and Hepatic Manifestations of Rheumatoid Arthritis

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