Abstract:
:Until recently, renal crisis was the most significant cause of morbidity and mortality in patients with scleroderma (SSc). Nowadays, following the introduction of angiotensin-converting enzyme inhibitors used in renovascular hypertension, pulmonary fibrosis and pulmonary hypertension have become the most common causes of death in SSc. Consequently, the early diagnosis and treatment of pulmonary fibrosis is essential to improve morbidity and mortality in SSc patients. The aim of this study was to investigate the effect of intravenous cyclophosphamide pulse therapy in patients with SSc and evidence of active alveolitis assessed on a high resolution computed tomographic (HRCT) scan, and to compare the effect of cyclophosphamide pulse therapy with oral therapy. Sixteen consecutive patients with SSc were allocated alternately to the two treatment groups. Eight patients were treated with monthly cyclophosphamide pulse therapy (750 mg/ m2) for 12 months; the other eight patients were treated with oral cyclophosphamide (2-2.5 mg/kg/day) for the same period. All patients received concurrently prednisone (10 mg/day). Pulmonary function tests and HRCT scans were performed before therapy and at 6 and 12 months. In the oral cyclophosphamide group, three patients with a grade I pattern showed regression of disease extent. In the other five patients (one with grade II and four with grade III) the pattern and extent of disease remained stable during the study. No statistical differences were found in forced expiratory volume in 1 s, forced vital capacity and total lung capacity during the study period. The diffusing capacity for carbon monoxide increased significantly between baseline and 12 months (p = 0.043). In the cyclophosphamide pulse therapy group, seven patients with a grade I pattern showed regression of disease extent at 6 months (p = 0.018) and 12 months (p = 0.012). One patient with grade III remained stable during the study. In both groups the regression of the extent of disease estimated on HRCT was due to a decrease in the ground glass appearance. The extent of the reticular appearance remained stable throughout the study. Our results indicate that cyclophosphamide pulse therapy is effective in suppressing active alveolitis (ground glass appearance). Although in this study it is not possible to compare pulse therapy with oral therapy because of the different pattern seen on HRCT between the two groups, it seems that oral therapy is also effective in suppressing active alveolitis. Neither regimen improved pulmonary involvement when the reticular appearance predominated over the ground glass appearance on HRCT. It is concluded that either pulse or oral cyclophosphamide therapy may improve the outcome of SSc patients.
journal_name
Clin Rheumatoljournal_title
Clinical rheumatologyauthors
Davas EM,Peppas C,Maragou M,Alvanou E,Hondros D,Dantis PCdoi
10.1007/s100670050138subject
Has Abstractpub_date
1999-01-01 00:00:00pages
455-61issue
6eissn
0770-3198issn
1434-9949journal_volume
18pub_type
临床试验,杂志文章abstract::Catastrophic anti-phospholipid syndrome (CAPS) is a medical emergency characterized by thromboses of multiple small vessels of internal organs and the brain. Herein we present a patient with primary anti-phospholipid syndrome who developed CAPS manifested by hepatic, renal and splenic artery thromboses, as well as cer...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-005-0017-0
更新日期:2006-05-01 00:00:00
abstract::With the growing awareness of the impact of chronic back pain and axial spondyloarthritis and recent breakthroughs in genetics and the development of novel treatments which may impact best on early disease, the need for markers that can facilitate early diagnosis and profiling those individuals at the highest risk for...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-015-2949-3
更新日期:2015-06-01 00:00:00
abstract::We reported a case of dermatomyositis (DM) with liver disturbance in a 50-year-old Japanese female. She presented with fever, muscle weakness, and typical DM rashes. On clinical and serological examinations, the liver impairment was initially diagnosed as probable autoimmune hepatitis, which was denied by a histologic...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-010-1397-3
更新日期:2010-08-01 00:00:00
abstract::This study aimed to investigate the multiple values of 18F-FDG PET/CT in detecting malignant tumors, evaluating myopathy, and determining interstitial lung disease in patients with idiopathic inflammatory myopathy (IIM). We retrospectively analyzed the data of 38 patients who were examined by 18F-FDG PET/CT and eventu...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-017-3794-3
更新日期:2017-10-01 00:00:00
abstract::The effect of niflumic acid on hyaluronic acid and proteoglycan metabolism of human cartilage cells was investigated in vitro. Cartilage cells were obtained from five different donors. Niflumic acid levels used in the test systems ranged from 0 to 22 microgramsr/ml and were comparable to serum concentrations in humans...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02030238
更新日期:1990-03-01 00:00:00
abstract::Behçet's disease is a systemic vasculitic syndrome with unknown etiology. The aim of the present study was to compare the Helicobacter pylori seropositivity and cytotoxin associated gene-A status in patients with Behçet's disease. Ninety-one patients with Behçet's disease and 83 age- and sex-matched persons with or wi...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-006-0416-x
更新日期:2007-06-01 00:00:00
abstract::The prostaglandin series of bioactive compounds is formed by the interaction of two distinct but related enzymes, cyclo-oxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). COX-1 is a constitutive form which is present mainly in the gastric mucosa, kidney and platelets. COX-2 is mainly an inducible form, although also to...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s100670070024
更新日期:2000-01-01 00:00:00
abstract::Forty-three of fifty-eight (74.1%) female patients with fibromyalgia completed an eight-week treatment period testing the combination of carisoprodol, paracetamol (acetaminophen) and caffeine versus placebo. Twenty-three patients received placebo and twenty active medication. In the placebo group 56.5% of the patients...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/BF02030081
更新日期:1989-06-01 00:00:00
abstract::We reviewed the records of 315 patients with rheumatoid arthritis (RA) treated with low-dose methotrexate (MTX) and evaluated the conditions contributing to thrombocytopenia. Thirteen out of 315 patients with RA presented with low platelet counts (< or = 100.000/mm3). The age of these patients (51 +/- 12.6 years) did ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02230334
更新日期:1996-03-01 00:00:00
abstract::To measure serum soluble transferrin receptor (s-TfR) levels in patients with rheumatoid arthritis (RA), sera were obtained from 50 Japanese RA patients and 20 healthy subjects. Both s-TfR and serum erythropoietin (EPO) levels were measured by enzyme-linked immunosorbent assay (ELISA). Routine laboratory tests were al...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/s100670170018
更新日期:2001-01-01 00:00:00
abstract::Our objective was to assess the progression of osteoarthritis (OA) using scoring systems based on the anatomical changes recorded in the finger joints on standard radiographs and to test how far these scoring systems could be used to evaluate the effects of candidate "disease modifying osteoarthritis drugs" (DMOAD). T...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s10067-002-8290-7
更新日期:2002-06-01 00:00:00
abstract::This study aims to develop a sandwich ELISA system for the measurement of soluble folate receptor β (sFRβ) and evaluate whether base line levels of serum sFRβ are a biomarker for the activity of RA synovitis and the response to anti-TNF agents. Serum sFRβ from normal controls (41 samples), patients with OA (29 samples...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-018-4202-3
更新日期:2018-11-01 00:00:00
abstract::The levels of 63 cytokines, chemokines, and growth factors were measured in the serum of four patients with idiopathic morphea and of one patient with vitamin K1-induced morphea employing a multiplex assay to identify the role of inflammatory/immunologic events in their pathogenesis. Full-thickness skin biopsies of af...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-017-3580-2
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Tumor necrosis factor inhibitors (anti-TNF) have become the standard treatment for rheumatoid arthritis (RA). However, evidence is inconsistent as to whether RA patients with anti-TNF are associated with an increased risk of non-melanoma skin cancer (NMSC) compared with those without anti-TNF. We performed a ...
journal_title:Clinical rheumatology
pub_type: 杂志文章,meta分析
doi:10.1007/s10067-019-04865-y
更新日期:2020-03-01 00:00:00
abstract::Clinical characteristics of antitumor necrosis factor (TNF) agents-related tuberculosis (TB) in ankylosing spondylitis (AS) are not well described. The aim was to compare the incidences and the characteristics of TB in AS and rheumatoid arthritis (RA) during TNF inhibitor treatment. AS (n = 1,322) and RA (n = 3,154) p...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-013-2387-z
更新日期:2014-09-01 00:00:00
abstract::Antibodies to 65Kd heat-shock protein (hsp) of mycobacterium leprae were measured by enzyme-linked immunosorbent assay (ELISA) in the three immunoglobulin classes in paired sera and synovial fluids of patients with rheumatoid arthritis (RA). Titers of anti-hsp antibody were expressed by optical density (OD) values for...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02249023
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVES:To test the psychometric properties of the United Kingdom's Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) in patients with spondyloarthritis (SpA) and rheumatoid arthritis (RA) and to implement this questionnaire in daily practice in the Netherlands. METHO...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05076-6
更新日期:2020-10-01 00:00:00
abstract::The objectives of the study were to assess sleep disturbances in systemic lupus erythematosus (SLE) and to compare these with a working sample and a treatment-seeking sample reporting insomnia. The primary sample was 172 people with SLE. This sample represented 32% of all members of two lupus support association. Two ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-008-0884-2
更新日期:2008-09-01 00:00:00
abstract::Mycobacterium bovis Bacillus Calmette-Guérin (BCG) instillations are used in bladder cancer treatment. Adverse effects can occur. Osteoarticular complications are mainly reactive arthritis, but true infections have been described, such as vertebral osteomyelitis. We made a review of M. bovis BCG vertebral osteomyeliti...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-019-04500-w
更新日期:2019-06-01 00:00:00
abstract::Over a period of 10 years 34 patients were diagnosed as suffering from palindromic rheumatism. Eighty-one percent of the patients were of North African origin. This is significantly higher (p = 0.01) than the age-adjusted origin of the general population in the region. Attacks were usually monoarthritic or oligoarthri...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02032105
更新日期:1989-12-01 00:00:00
abstract::Belimumab is an effective and safe treatment option for systemic lupus erythematosus (SLE). However, data on treatment cessation are lacking. Thus, we investigated belimumab-free remission in SLE patients. SLE patients receiving belimumab in our institute (May 1, 2013-May 31, 2019) were retrospectively identified usin...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05052-0
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:The frequency of eighth nerve lesions in patients with giant cell arteritis (GCA) has rarely been examined. However, sudden onset deafness has been recorded as a presenting feature of GCA on several occasions. This study sought to establish how common this and other symptoms of eighth nerve involvement are...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04747-3
更新日期:2019-12-01 00:00:00
abstract::Hypercalcaemia is a common electrolyte abnormality. The vast majority of patients will be shown to have either hyperparathyroidism or malignancy. In less than 10% of patients other, less common causes of hypercalcaemia will be present. Systemic lupus erythematosus is a very rare cause of hypercalcaemia. It may be asso...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s100670170088
更新日期:2001-01-01 00:00:00
abstract::The aims of this study were to characterize a minimally invasive technique of minor salivary gland biopsy of the lower lip and to present a large patient material undergoing this procedure because of a suspicion of Sjögren's syndrome (SS), as well as to assess the procedure's short-term and long-term value as a diagno...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-006-0457-1
更新日期:2007-07-01 00:00:00
abstract::As part of a larger body of work to develop a rheumatology priority referral score, a literature review was conducted. The objective of the literature review was to identify preexisting priority-setting, triage, and referral tools/scales developed to guide referrals from primary care to specialist care/consultation us...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-008-0938-5
更新日期:2008-11-01 00:00:00
abstract::Muscle pain and weakness in a rheumatoid arthritis (RA) patient has a broad differential, and myositis should be considered early in the disease course as serious limb and life-threatening sequelae may occur. A 55-year-old woman with a past medical history of methotrexate-controlled RA presented with right leg pain fo...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-014-2657-4
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:This study evaluated Superb Microvascular Imaging (SMI) technology for detection of active synovitis in patients with rheumatoid arthritis (RA). METHODS:Between June 2015 and October 2016, 56 patients with RA (42 females; mean age, 53.2 years) underwent gray-scale ultrasound (US) imaging, power Doppler imag...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04550-0
更新日期:2019-09-01 00:00:00
abstract::Brucellosis is a chronic infectious disease with articular involvement. Discrimination between brucellosis and rheumatologic disorders is difficult in regions endemic for brucellosis. There are few studies about the rate of positive autoantibodies as rheumatologic biomarkers in brucellosis, and the prevalence is varia...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-016-3171-7
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Sarcoidosis is a chronic inflammatory disease characterized by non-caseating granuloma which etiology is unknown yet. Adipokines are different proteins synthesized by adipose tissue that have an influence on angiogenesis, hemostasis, lipid metabolism, and immune system regulation. Adipokines may play a role ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-04980-1
更新日期:2020-07-01 00:00:00
abstract::The antigens of HLA-DR locus were determined in 127 patients with rheumatoid arthritis and in 175 healthy persons. The frequency of HLA-DR1 antigen was discovered in 45% of the patients and in 22.3% of the examinees from the control group (p less than 0.001). The relative risk is 2.84. 69% of the patients were seropos...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/BF02030241
更新日期:1990-03-01 00:00:00