Abstract:
:This review contrasts the difficulty of differentiating early rheumatoid arthritis (RA) from the many other causes of inflammatory polyarthritis and emphasizes the need for early treatment of RA with drugs that are present considered inappropriate for a mild, self-limiting disease. Pointers to help establish a definitive diagnosis of RA include the use of the American College of Rheumatology (ACR; formerly the American Rheumatism Association) diagnostic criteria, the presence of rheumatoid factor (RF), a raised erythrocyte sedimentation rate (ESR), raised serum levels of C-reactive protein (CRP) and low concentrations of serum sulphydryl (SH) groups. More sophisticated tests that are helpful and indicative of erosive-type disease are genetic markers such as the human leukocyte antigen HLA DR4 (especially the third allelic variable of DR beta 1) as well as an impaired sulphoxidation status. Similarly, the presence of the shared epitope alleles 0401 and 0404 quantitatively increases disease susceptibility and severity as their penetration increases. Experience with treatment indicates that control of the inflammatory process of RA reduces the progression of radiological damage. It is concluded that antimalarials are effective in mild disease, as is auranofin, whilst sulphasalazine is more effective than hydroxychloroquine in patients with disease diagnosed as definitive or classical RA. Intramuscular gold also lessens the development of erosions. The role of corticosteroids has not been defined. A number of combinations of drugs have been used, although they are probably not indicated as the first choice treatment for very early disease. Attitudes towards early treatment are changing; these are briefly reviewed and the authors' opinions on the management of early disease are outlined. Finally some new ideas, both theoretical and practical, on future development are summarized.
journal_name
Clin Exp Rheumatoljournal_title
Clinical and experimental rheumatologyauthors
Dawes PT,Fowler PDsubject
Has Abstractpub_date
1995-05-01 00:00:00pages
381-94issue
3eissn
0392-856Xissn
1593-098Xjournal_volume
13pub_type
杂志文章,评审abstract::A 61-year-old woman, suffering from classic seropositive rheumatoid arthritis with rheumatoid nodule histologically documented, developed temporal arteritis. HLA-DR typing revealed the presence of DR3 and DR4 antigens. The findings from previous studies support the association of HLA-DR antigens, giant cell arteritis-...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVES:Rheumatoid arthritis (RA) is associated with accelerated atherosclerosis and premature cardiovascular death. Anti-TNF therapy is thought to reduce clinical cardiovascular disease risk and improve vascular function in RA patients. However, the specific effects of TNF inhibitors on endothelial cell function ar...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVES:To describe the MRI features of gout tophi in the soft-tissues or joints of the limbs by low-field extremity-dedicated MRI. METHODS:Nine consecutive patients, 8M/1W, affected by chronic tophaceous gout were studied. Mean patients' age was 71.3±11.5 years, mean disease duration 98.1±44.9 months, and mean ser...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2011-05-01 00:00:00
abstract::In recent years, there has been a dramatic rise in the number of trials using monoclonal antibodies, especially those directed against the CD4 molecule, in the treatment of RA. Thus far, the numbers of patients treated in the individual studies have generally been small, and the study designs sometimes not comparable....
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::Cardiac conducting tissue antibodies (CCTA) were detected, using indirect immunofluorescence, in 8 (25%) out of 32 sera from patients with progressive systemic sclerosis (PSS) and in 39 (35%) out of 110 with rheumatoid arthritis (RA). Conduction abnormalities, namely right bundle branch block, were present in 19 (59%)...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1985-04-01 00:00:00
abstract::Apart from their pivotal role in dietary lipid absorption and cholesterol homeostasis, bile acids (BAs) are increasingly recognised as important signalling molecules in the regulation of systemic endocrine functions. As such BAs are natural ligands for several nuclear hormone receptors and G-protein-coupled receptors....
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:An educational programme was conducted in Italy in order to favour the diffusion of the rheumatoid arthritis (RA) treat-to-target (T2T) recommendations among Italian rheumatologists. Our objective was to measure the level of acceptance and applicability of the 10 recommendations to treat RA to a target of re...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2014-07-01 00:00:00
abstract::Rheumatoid arthritis (RA) societal costs are high because the disease may cause not only restricted joint mobility, chronic pain, fatigue, and functional disability, but also psychological distress. Direct health care costs represent about one-fourth of all costs and are prevalently represented by in-patient care expe...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:Secreted aminoacyl-tRNA synthetase-interacting multifunctional protein-1 (AIMP1) has been reported to have pro-inflammatory properties. The aim of this study was to evaluate the clinical significance of serum AIMP1 in patients with systemic lupus erythematosus (SLE). METHODS:Serum levels of AIMP1 were measu...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:Prediction and determination of drug efficacy for radiographic progression is limited by the heterogeneity inherent in axial spondyloarthritis (axSpA). We investigated whether unbiased clustering analysis of phenotypic data can lead to coherent subgroups of axSpA patients with a distinct risk of radiographic...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2020-07-10 00:00:00
abstract::The classification criteria recently developed by the Assessment of Spondyloarthritis International Society (ASAS) highlighted a specific entity: non radiographic axial spondyloarthritis (nr-axSpA). Although more and more widely used in the literature as well as clinical trials, limits and profile of this entity is st...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2014-01-01 00:00:00
abstract::Primary Sjögren's syndrome (pSS) is often considered a B cell-mediated disease, yet the precise role of B cells in the pathogenesis is not fully understood. This is exemplified by the failure of multiple clinical trials directed at B cell depletion or inhibition. To date, most prognostic markers for severe disease out...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2020-07-01 00:00:00
abstract::This article reviews the rheumatic manifestation of the immune deficiency disorders. In particular, the rheumatic manifestations of hypogammaglobulinaemia and the acquired immune deficiency syndrome (AIDS) are discussed. ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::Of 65 unselected SLE patients from a defined population, 61 were sequentially followed for two years with an SLE supervision programme. The cumulative clinical manifestations included a relatively high frequency of pulmonary vascular disease and gastrointestinal involvement. Flares were more common during the summer s...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine whether low tear production in patients with diabetes mellitus (DM) was related to autonomic nervous system abnormalities, to Sjögren's syndrome, as suggested by a previous study, or to other factors. DESIGN:Cross-sectional study assessment of patients with DM. PA...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:Patients with clinically evident autoimmune disease are at increased risk for premature cardiovascular disease (CVD). Markers of serological autoimmunity such as anti-nuclear antibodies (ANA) are found in approximately 25% of the general population. Yet, the vast majority will not develop clinical autoimmune...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:To determine the clinical characteristics of simultaneous occurrence of antitopoisomerase (ATA) and anticentromere (ACA) autoantibodies in systemic sclerosis (SSc). METHODS:Data of patients (n=4,687) fulfilling the ACR criteria for SSc and followed in the EULAR Scleroderma Trials and Research (EUSTAR) cohor...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2013-03-01 00:00:00
abstract::Remission is now the accepted goal of management in rheumatoid arthritis (RA). This article highlights the controversies surrounding the definition of remission and reviews the potential of current treatment options to achieve remission. Defining "true" remission can be difficult based on current criteria, which do no...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:Gold sodium thiomalate (GST) is a drug commonly used for the treatment of rheumatoid arthritis (RA). To clarify the mechanism of therapeutic effects of GST on RA, we investigated if GST affects the differentiation of dendritic cells (DC), which are thought to play a pivotal role in RA pathogenesis. METHODS:W...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:Granulomatosis with polyangiitis (GPA) is an autoimmune disease with still unknown etiology. Recent studies indicate that neutrophils extra-cellular traps participate in the pathophysiology of GPA. This study investigates the levels of circulating NET formation markers and neutrophil-platelet interaction in ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2016-05-01 00:00:00
abstract::Pulmonary hemorrhage (PH) is a rare but potentially life-threatening manifestation of systemic lupus erythematosus (SLE). In this report we describe a 13 year old girl with PH as the sole presenting clinical manifestation of her SLE. Her serology was diagnostic of SLE and one year after presentation she developed arth...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:To evaluate the patients' characteristics associated with the clinical decision to request SI-MRI and/or HLA-B27 in patients with SpA in daily practice. METHODS:Patients referred to a rheumatology outpatient-clinic in a national referral-centre were selected. Patients with a clinical diagnosis of SpA accord...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:An association of SUMO4 gene, which has recently been shown to be a negative feedback regulator for nuclear factor NF-κB, has been reported in several autoimmune/inflammatory diseases. A case-control study was set up to investigate the contribution of SUMO4 locus to the genetic susceptibility to Behçet's dis...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2010-07-01 00:00:00
abstract::In the context of undeniable evidence that health care can and must be improved, the ACR has committed to lead the effort to develop and implement quality measures designed to identify opportunities to improve sub-optimal care. In the process of creating and offering tools to measure and assess adherence to evidence-b...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2007-11-01 00:00:00
abstract::Salmonella infections usually present with gastrointestinal manifestations including enterocolitis especially in immunocompromised patients. Haematogenous dissemination and abscesses are very rare complications of Salmonella species. This case report documents a patient with Behçet's syndrome (BS) who has pyomyositis ...
journal_title:Clinical and experimental rheumatology
pub_type:
doi:
更新日期:2020-09-01 00:00:00
abstract::Etanercept is a recombinant soluble tumour necrosis factor alpha receptor administered subcutaneously at the dose of 50 mg weekly (or 25 mg/twice weekly) for the treatment of the main chronic arthritides: rheumatoid arthritis and spondyloarthropathies. It shows high qualities in terms of efficacy and manageability. Fa...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2011-09-01 00:00:00
abstract::Serum levels of the aminoterminal type III procollagen peptide (S-PIIINP) have been used as markers of proliferative inflammation in rheumatoid arthritis (RA) and a prognostic significance has been suggested. To test this further we have measured S-PIIINP longitudinally for 2 years in 66 patients with definite RA and ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::Ultrasound (US) is a valuable imaging modality in the evaluation of joint and periarticular abnormalities in osteoarthritis (OA). It is able to image structural lesions as well as inflammatory changes in early and late disease. US is a relatively inexpensive, safe and quick-to-perform tool that can be used as a bedsid...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2014-01-01 00:00:00
abstract::Atherosclerosis may be more prevalent and more extensive in individuals with rheumatoid arthritis (RA) compared with the general population. Despite the fact that traditional and novel cardiovascular disease (CVD) risk factors are clinically important in these patients, it seems that inflammation--a key feature of RA-...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:This study evaluated the SDF-1/CXCL12 and soluble CXCR4 (sCXCR4) levels, and investigated their clinical relevance in adult-onset Still's disease (AOSD). METHODS:Forty-two AOSD patients and 30 healthy controls (HC) were enrolled for serum sampling. Expression levels of CXCL12 and CXCR4 in skin biopsy materi...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2019-11-01 00:00:00