Overlapping syndromes, undifferentiated connective tissue disease, and other fibrosing conditions.


:Connective tissue diseases (CTDs) frequently present with one or only a few symptoms, which does not allow prompt diagnosis. Raynaud's phenomenon is one of those symptoms. However, only a minority of patients who present with Raynaud's phenomenon develop a CTD. Prognostic factors for the future development of CTD in such patients are older age at presentation, more severe Raynaud's phenomenon, the presence of antinuclear antibodies, and abnormal patterns on nailfold capillary microscopy. Some patients have overlapping symptoms of various CTDs. Mixed connective tissue disease (MCTD) is the prototype of such an overlapping syndrome. However, during follow-up, most patients with MCTD develop a specific CTD, either scleroderma, systemic lupus erythematosus, rheumatoid arthritis, or combinations of those illnesses. Primary pulmonary hypertension is one of the leading causes of death in MCTD. Its treatment is insufficient, although continuous prostacyclin infusion may provide some relief. New therapies such as nitric oxide and combined heart-lung transplantation in an early stage should be explored. The autoimmune response to small nuclear ribonucleoproteins, which is highly characteristic for MCTD, interestingly shows cross-reactivity with retroviral antigens, and the cooccurrence of human T cell lymphotropic virus type I and HIV infection with MCTD has been reported. This suggests that those viruses, possibly by molecular mimicry, play a role in the induction of the disease. Fibrotic conditions related to silicone exposure still evoke much interest. However, most recent data do not substantiate a role for silicone gel breast implants in the development of autoimmune CTDs.


Curr Opin Rheumatol


Kallenberg CG




Has Abstract


1995-11-01 00:00:00












  • The effect of autoimmune arthritis treatment strategies on regulatory T-cell dynamics.

    abstract:PURPOSE OF REVIEW:Since their discovery over 15 years ago, intensive research has focused on the presence, phenotype and function of FOXP3(+) regulatory T cells (Treg) in autoimmune diseases such as rheumatoid arthritis (RA). The questions of whether Treg deficiencies underlie autoimmune pathology and whether or how Tr...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Mijnheer G,Prakken BJ,van Wijk F

    更新日期:2013-03-01 00:00:00

  • Neutrophils in lupus nephritis.

    abstract:PURPOSE OF REVIEW:Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease characterized by IgG-autoantibodies to nuclear antigens that can deposit in the kidney and trigger lupus nephritis. Neutrophils accumulate in the kidneys of patients with proliferative LUPUS NEPHRITIS and neutrophil products and a s...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Nishi H,Mayadas TN

    更新日期:2019-03-01 00:00:00

  • Nosology of primary vasculitis.

    abstract:PURPOSE OF REVIEW:Recent developments in the nosology of primary systemic vasculitis are placed in the context of an historical overview. The ongoing attempts to develop criteria for classification and diagnosis are discussed. RECENT FINDINGS:Giant cell arteritis has supplanted temporal arteritis as the preferred term...

    journal_title:Current opinion in rheumatology

    pub_type: 历史文章,杂志文章,评审


    authors: Jennette JC,Falk RJ

    更新日期:2007-01-01 00:00:00

  • Management of systemic sclerosis: the first five years.

    abstract:PURPOSE OF REVIEW:This review provides a risk-stratified and evidence-based management for subsets of systemic sclerosis (SSc) patients in the first five years from disease onset. RECENT FINDINGS:Cardiopulmonary disease remains the primary cause of mortality in SSc patients. Morbidity and mortality in SSc-associated p...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Roofeh D,Khanna D

    更新日期:2020-05-01 00:00:00

  • Advances in the treatment of juvenile dermatomyositis.

    abstract:PURPOSE OF REVIEW:Juvenile dermatomyositis is a rare chronic inflammatory disease that primarily affects the muscles and skin. Immunosuppressive therapy has played a very important role in reducing mortality rates and morbidity. The review focuses on the spectrum of medications currently used in the treatment of juveni...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章


    authors: Stringer E,Feldman BM

    更新日期:2006-09-01 00:00:00

  • Blau syndrome revisited.

    abstract:PURPOSE OF REVIEW:Blau syndrome is a monogenic disease resulting from mutations in nucleotide oligomerization domain 2 (NOD2) and is phenotypically characterized by granulomatous polyarthritis and uveitis. Not only there has been significant progress in disease characterization but also the biological pathways associat...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Rose CD,Martin TM,Wouters CH

    更新日期:2011-09-01 00:00:00

  • Calcium crystals in osteoarthritis.

    abstract::Osteoarthritis is the most common form of arthritis in adults and its incidence increases with age. More than 50% of people aged 65 and older have radiographic changes of knee osteoarthritis. Calcium crystals, including calcium pyrophosphate dihydrate and basic calcium phosphate crystals, are also common in the elderl...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Jaovisidha K,Rosenthal AK

    更新日期:2002-05-01 00:00:00

  • Gene expression profiling in pediatric rheumatic disease: what have we learned? What can we learn?

    abstract:PURPOSE OF THIS REVIEW:Gene expression profiling is emerging as a promising methodology in pediatric rheumatology research. There is considerable interest in using this technology as the basis for diagnostic assays. This review will summarize the new knowledge. RECENT FINDINGS:Most gene expression studies of children ...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Jarvis JN

    更新日期:2005-09-01 00:00:00

  • New developments in our understanding of DISH (diffuse idiopathic skeletal hyperostosis).

    abstract:PURPOSE OF REVIEW:Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease is a common disorder among older adults. The diagnosis is based solely on radiographic abnormalities defined using the Resnick criteria. DISH is characterized by ossification of the anterior longitudinal ligament of the spine and v...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Sarzi-Puttini P,Atzeni F

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  • Definition of hyperuricemia and gouty conditions.

    abstract:PURPOSE OF THE REVIEW:To define gout conditions and hyperuricemia. RECENT FINDINGS:Gout is defined as an arthritic condition resulting from the deposition of monosodium urate (MSU) crystals in and/or around joints, following long-standing hyperuricemia. Several recent ultrasound studies disclosed MSU deposits in a lar...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Bardin T,Richette P

    更新日期:2014-03-01 00:00:00

  • New developments in the treatment of Wegener's granulomatosis, polyarteritis nodosa, microscopic polyangiitis, and Churg-Strauss syndrome.

    abstract::With the opportunity for long-term follow-up, it has been appreciated that disease severity may vary considerably in patients with Wegener's granulomatosis, polyarteritis nodosa, microscopic polyangiitis, and Churg-Strauss syndrome. Although combined therapy with cyclophosphamide and glucocorticoids continues to be th...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Langford CA,Sneller MC

    更新日期:1997-01-01 00:00:00

  • Recognizing and managing comorbidities in psoriatic arthritis.

    abstract:PURPOSE OF REVIEW:Many patients with psoriatic arthritis (PsA) have additional medical problems that can have an impact on morbidity and mortality. The goal of this review is to summarize the available evidence to date on the association of medical comorbidities with PsA and the implications these comorbidities have on...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Ogdie A,Schwartzman S,Husni ME

    更新日期:2015-03-01 00:00:00

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    abstract:PURPOSE OF REVIEW:To highlight recent evidence regarding the contribution of traditional and nontraditional [e.g. inflammatory markers, rheumatoid arthritis (RA) features] risk factors toward the excess cardiovascular risk in RA. RECENT FINDINGS:The impact of traditional risk factors on the development of cardiovascul...

    journal_title:Current opinion in rheumatology

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    更新日期:2012-03-01 00:00:00

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    abstract::Osteoporosis occurs in patients with rheumatoid arthritis, acromegaly, anorexia nervosa, chronic liver disease, sickle cell hemoglobinopathies, and mastocytosis. Osteomalacia occurs in patients with renal tubular acidosis, and with tumors. ...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Cormier C

    更新日期:1991-06-01 00:00:00

  • Musculoskeletal manifestations of chronic renal failure.

    abstract::Musculoskeletal problems remain among the main limitations of the quality of life of renal failure patients, in particular of those treated with long-term maintenance dialysis. Renal osteodystrophy continues to receive great attention. The mechanisms of uremic skeletal resistance to parathormone (PTH) are further inve...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Bardin T

    更新日期:2003-01-01 00:00:00

  • Childhood systemic sclerosis.

    abstract:PURPOSE OF REVIEW:Juvenile systemic sclerosis has a variety of clinical manifestations, sometimes different from the adult form. Early recognition, proper classification and treatment may improve the long-term outcome. RECENT FINDINGS:A large multicenter study coordinated by the Pediatric Rheumatology European Society...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Zulian F,Martini G

    更新日期:2007-11-01 00:00:00

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    abstract:PURPOSE OF REVIEW:Glucocorticoids are used in the treatment of most rheumatic diseases, and are used chronically in up to 50% of cases of rheumatoid arthritis. The frequency of their use has in the past been incompletely supported by trial evidence of their benefit and by incomplete understanding of their mechanisms of...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Morand EF

    更新日期:2007-05-01 00:00:00

  • Experiencing painful osteoarthritis: what have we learned from listening?

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    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Hawker GA

    更新日期:2009-09-01 00:00:00

  • Biologic agents in the treatment of inflammatory rheumatic diseases.

    abstract::Due to our increasing knowledge of mechanisms underlying pathogenic events in autoimmune rheumatic diseases, biologic agents have been further explored and tested in open and controlled clinical trials. Based on the results of placebo-controlled trials, monoclonal antibodies to CD4+ T cells have been found ineffective...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Kalden JR,Manger B

    更新日期:1995-05-01 00:00:00

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    abstract::All industrialized nations are facing a crisis in health care financing. Rising expectations coupled with increasing specialization and technologic capacities have forced health care payers to examine their assumptions and to seek data on the outcomes of medical interventions. Clinical investigators who have been taug...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Stucki G,Liang MH

    更新日期:1994-03-01 00:00:00

  • Bone cytokines.

    abstract::Cytokines and growth factors are important in bone tissue as mediators of cell-to-cell and matrix-to-cell communication. Cytokines also locally mediate the effects of several hormones on bone cells. Indeed, calciotropic hormones modulate the bone-cell production rate of these factors and, conversely, can change the nu...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: de Vernejoul MC,Cohen-Solal M,Orcel P

    更新日期:1993-05-01 00:00:00

  • Current concepts in the prevention, detection, and treatment of deep vein thrombosis in total hip and knee replacement.

    abstract::In hip replacement, prophylaxis of thromboembolism with warfarin to 1.5 times control with respect to prothrombin time remains efficacious. Further reduction of the dosage has not met with success. Confirmatory studies on the usefulness of adjusted-dose heparin and low molecular weight heparin continue. Promising new ...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Yen D

    更新日期:1992-04-01 00:00:00

  • T-cell and B-cell signaling biomarkers and treatment targets in lupus.

    abstract:PURPOSE OF REVIEW:Systemic lupus erythematosus is characterized by the production of antinuclear autoantibodies and dysfunction of T-cells, B-cells, and dendritic cells. Here, we review newly recognized genetic factors and mechanisms that underlie abnormal intracellular signal processing and intercellular communication...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Perl A,Fernandez DR,Telarico T,Doherty E,Francis L,Phillips PE

    更新日期:2009-09-01 00:00:00

  • Angiogenesis in osteoarthritis.

    abstract:PURPOSE OF REVIEW:Much has been documented in recent years on the possible involvement of angiogenesis in osteoarthritis. An understanding of the various regulatory mechanisms controlling blood vessel growth in the joint should lead to novel therapeutics, which selectively inhibit undesirable angiogenesis. Here, we sum...

    journal_title:Current opinion in rheumatology

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    authors: Ashraf S,Walsh DA

    更新日期:2008-09-01 00:00:00

  • Raynaud phenomenon and the vascular disease in scleroderma.

    abstract:PURPOSE OF REVIEW:Raynaud phenomenon is the earliest and most common clinical manifestations of scleroderma (systemic sclerosis). Therefore, Raynaud phenomenon offers the best window into the investigation of the early steps in the pathogenesis of systemic sclerosis. This review focuses on the differential diagnosis of...

    journal_title:Current opinion in rheumatology

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    更新日期:2004-11-01 00:00:00

  • Psoriatic arthritis.

    abstract::Recent population-based studies have examined the incidence, prevalence, and survival rates of patients with psoriatic arthritis (PsA). Although there are still no completely satisfactory diagnostic criteria for PsA, Moll and Wright's criteria--although not a true classification/diagnostic scheme--are the most used. T...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Salvarani C,Olivieri I,Cantini F,Macchioni L,Boiardi L

    更新日期:1998-07-01 00:00:00

  • New learnings on the pathophysiology of RA from synovial biopsies.

    abstract:PURPOSE OF REVIEW:To critically appraise the literature related to the pathophysiology of rheumatoid arthritis (RA) focusing on the contribution of synovial tissue pathology (synovitis) in determining diverse clinical outcome/therapeutic response. RECENT FINDINGS:RA synovitis is highly heterogeneous with diverse cellu...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Pitzalis C,Kelly S,Humby F

    更新日期:2013-05-01 00:00:00

  • Antiphospholipid antibodies in systemic lupus erythematosus and Sjögren's syndrome.

    abstract::The spectrum of clinical descriptions and clinicopathologic studies on patients with primary and secondary forms of antiphospholipid antibody syndrome continues to widen. Some differences exist for patients with lupus compared with those with Sjogren's syndrome. Some new thoughts regarding pathogenetic mechanisms and ...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: McCarty-Farid GA

    更新日期:1993-09-01 00:00:00

  • Management of Behçet's syndrome.

    abstract:PURPOSE OF REVIEW:Current trends in the management of Behçet's syndrome will be reviewed in this article. RECENT FINDINGS:Biologic agents have gained increasing importance over the years in the management of Behçet's syndrome. Long-term results of observational studies have shown that anti-tumor necrosis factor agents...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Ozguler Y,Hatemi G

    更新日期:2016-01-01 00:00:00

  • Rheumatic manifestations of skin disease.

    abstract:PURPOSE OF REVIEW:There is an increasing interest in improving the understanding of pathophysiology, outcome measures, and therapies of rheumatic skin disease. Increasingly, studies are using the skin as a primary endpoint for evaluating therapies. This will review the current state of the art for the most common rheum...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审


    authors: Clarke JT,Werth VP

    更新日期:2010-01-01 00:00:00