A 33 years old female with acute myeloid leukemia was treated with induction chemotherapy of 7-3-5 protocol (Cytarabine, Daunorubicine, Etoposide). On day 15 of chemotherapy; 15 days from the first blood transfusion and 1 day from the last, she developed high-grade fever, general erythroderma, diarrhea, hyperbilirubinemia and evaluation of liver enzymes. A diagnosis of TA- GVHD was suspected. The patients had no response to any therapy and expired 5 days later. TA-GVHD is uncommon complication; there is no effective therapy and high mortality. Since TA- GVHD can be prevented by irradiating blood products with 2,500- 3,500 rads, patients at high risk should receive irradiated blood products only.
Arthritis, Gouty ; diagnosis

Investing on quality, quantity, neurophils and mucin test for 30 joint fluid samples collected from 30 patients with various arthral conditions, comparing to control subjects in Arthral-Skeletal Department of Bach Mai Hospital from Mar. 2002 to Jun. 2002. Results: There were changes in macroscopy: the volume of joint fluid was more than 5ml, light or dark yellow, lack of transparency, completely reduced viscosity. Test mucin was positive range from (++) to (+++), counts of white blood cell and neurophil increased. It was suggested that mucin and joint fluid cell studies can add for diagnosis of some arthral conditions.
Arthritis ; Immunophilins ; diagnosis

Animals ; Arthritis ; diagnosis ; pathology ; Arthritis, Rheumatoid ; diagnosis ; pathology ; Humans

No abstract available.
Antibodies* ; Arthritis, Rheumatoid* ; Diagnosis ; Prognosis

INTRODUCTION: Rheumatoid arthritis (RA) is one of systemic chronic progressive inflammatory disorders based on immunological disharmonies. Poorly controlled systemic inflammation in RA often leads to renal diseases such as secondary amyloidosis. CASE PRESENTATION: A 30-year-old man complained of swelling and tenderness of multiple joints gradually worsened the past 7 years. His laboratory examination showed anemia, positive rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA). C-reactive protein (CRP) was 48.7 mg/L (Normal value is <5 mg/L), increase in serum creatinine and protein was +3 in urine. His estimated glomerular filtration rate (e-GFR) was 58.3 mL/min/1.73 m2 Radiologic examinations of joints revealed features that support the diagnosis of rheumatoid arthritis. Renal biopsy was done revealed amyloid deposit. He was diagnosed with rheumatoid arthritis and secondary renal amyloidosis. CONCLUSION: Early proper diagnosis of RA is important and immunosuppressive drugs might slow disease progression by controlling the inflammatory process We discussed the importance of early diagnosis and the use of better treatment in managing RA to prevent renal amyloidosis.
Amyloidosis ; Arthritis, Rheumatoid ; Early Diagnosis

The introduction of new therapeutic agents in recent years has led the early diagnosis of rheumatoid arthritis (RA) increasingly important. Therapeutic intervention early in the disease course of RA allows earlier disease control and less joint damage. The 1987 American College of Rheumatology classification criteria for RA, however, does not reach full efficiency for providing clinicians to distinguish RA from other arthritides in the early phase of the disease. Therefore, diagnostic tools are needed to establish a reliable diagnostic criteria although the lack of an independent gold standard for RA makes it challenging in the evaluation of diagnostic studies. RA has no disease specific clinical, radiological or immunological features. This review describes the diagnostic values of medical history, physical examination, laboratory tests and imaging studies as well as the 1987 American College of Rheumatology classification criteria in the diagnosis of RA in its early phase.
Arthritis ; Arthritis, Rheumatoid ; Early Diagnosis ; Joints ; Physical Examination ; Rheumatology

Rheumatoid arthritis (RA) can be evaluated with ultrasound using both gray scale and Doppler mode. Gray scale provides cross-sectional images of joints, whereas Doppler shows the vascularity of the proliferated synovium. In RA, ultrasound can detect sub-clinical or early synovitis, assess arthritis more accurately than through clinical examination, and predict recurrence. In particular, a Doppler signal detected inside the joint cavity correlates with disease activity. Imaging remission can reflect the true remission status more accurately than with clinical remission. In this review, we focus on the use of ultrasonographic findings for the diagnosis, assessment, and prediction of RA.
Arthritis ; Arthritis, Rheumatoid* ; Diagnosis ; Joints ; Recurrence ; Synovial Membrane ; Synovitis ; Ultrasonography

Multicentric reticulohistiocytosis (MRH) is a rare multisystemic granulomatous disease of unknown cause, characterized by severe debilitating polyarthritis and papular to nodular mucocutaneous lesions. This disease usually manifests as a progressive, destructive polyarthritis with mucocutaneous eruptions consisting of erythematous to brownish-colored papules and nodules. MRH is important, not only because of its disfiguring and disabling manifestations and systemic involvements, but also due to its association with internal malignancy. The histological features of skin and synovial lesions are infiltration of multinucleated giant cells, and histiocytes which contain abundant eosinophilic cytoplasm and have a ground glass appearance. Without the accompanying skin nodules, the patients can be misdiagnosed as having rheumatoid arthritis or psoriatic arthritis, and this inaccurate diagnosis will affect treatment. We report a case of MRH which was misdiagnosed as rheumatoid arthritis.
Arthritis ; Arthritis, Psoriatic ; Arthritis, Rheumatoid* ; Cytoplasm ; Diagnosis ; Eosinophils ; Giant Cells ; Glass ; Histiocytes ; Humans ; Skin

Reiter's syndrome is associated with a classic triad of arthritis, conjunctivitis, urethritis, and is the most common type of reactive arthritis. This syndrome is a one type of seronegative arthropathy, requiring differential diagnosis with psoriatic arthritis and ankylosing spondylitis, since it is associated with psoriasis-like skin lesion, sacroilitis, spondylitis. The arthritis of Reiter's syndrome is known to be acute, short-lived, and transient, but with subsequent attacks, it is more likely that it will lead to permanent joint damage or disability. We recently have experienced one case of Reiter's syndrome with severe joint destruction and significant functional disability, so here we report one case with review of literature.
Arthritis ; Arthritis, Psoriatic ; Arthritis, Reactive ; Conjunctivitis ; Diagnosis, Differential ; Joints* ; Skin ; Spondylitis ; Spondylitis, Ankylosing ; Urethritis

Since last August, 29 cases of synovial punch biopsy have been carried out with Franklin-Silverman needle which was used in liver biopsy, instead of the specialized needle for the synovium. Authors report the applicable utility of Franklin-Silverman needle for the synovial biopsy, diagnostic value of this procedure and histopathologic findings of the results. The rate of the technical success to abtain synovial tissue was about 76%. Complications after procedure have been very rarely encountered, consisting of mild transient hemarthrosis. In 17 cases, the histopathologic changes was compatible with their clinical findings. In the remainders, we experienced the failures to get synovial tiasue at all in 7 cases and to give the significant synovial changes in 5 successful specimens. Fortunately, the important diagnostic aid was achieved in 3 cases which were conformed early diagnosis of tuberculous arthritis. This needle biopsy was also thought to contribute to rule out the gouty arthritis from other hyperuricemic conditions. But the histologic changes were non specific inflammatory findings in the synovial mambrane of rheumatoid arthritis, osteoarthritis, traumatic and infectious arthritis.
Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Early Diagnosis ; Hemarthrosis ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane