This article has been retracted.

No abstract available.
Arthritis, Juvenile* ; Crohn Disease* ; Etanercept

Hemorrhagic cystitis is a diffuse inflammation of the mucosa of the bladder, characterized by hematuria and burning upon urination. This might be caused by a variety of reasons, including undergoing chemotherapy (such as cyclophosphamide), radiation therapy, bladder cancer, certain viruses, urinary infections, and thrombocytopenia. There are no previous reports of hemorrhagic cystitis associated with the use of tacrolimus. This is the first case of hemorrhagic cystitis due to tacrolimus for the treatment of rheumatoid arthritis. We describe a case of hemorrhagic cystitis with giant cells in a patient with rheumatoid arthritis treating with tacrolimus. Hematuria resolved spontaneously with discontinuation of the drug.
Arthritis, Rheumatoid* ; Burns ; Cystitis* ; Drug Therapy ; Giant Cells* ; Hematuria ; Humans ; Inflammation ; Mucous Membrane ; Tacrolimus* ; Thrombocytopenia ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urination

The coexistence of rheumatoid arthritis (RA) and Takayasu's arteritis (TA) is a rare combination and described only in case reports in the literature. Although concurrent presence of RA and TA has been described only in a few literatures to date and the number of reports is increasing, the association between RA and TA remains to be clarified. We present a case of a female patient with both RA and TA, presenting with polyarthritis. We also reviewed the clinical features of the cases with coexistence of RA and TA.
Arthritis ; Arthritis, Rheumatoid* ; Female ; Humans ; Takayasu Arteritis*

Leflunomide was licensed for the treatment of rheumatoid arthritis in 1998 and has been available in Korea since 2003. Allergic cutaneous reactions (rash, purpura) are common (<10%) side effects of leflunomide, but severe cases such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are rarely reported. There has not been a report of SJS or TEN induced by leflunomide in Korea. Here we report a case of leflunomide-induced TEN in a patient with rheumatoid arthritis. Leflunomide was discontinued, and the TEN was treated with methylprednisolone, cholestyramine and immunoglobulin. The skin lesion eventually resolved over four weeks with residual post-inflammatory hyperpigmentation.
Arthritis, Rheumatoid* ; Cholestyramine Resin ; Humans ; Hyperpigmentation ; Immunoglobulins ; Korea ; Methylprednisolone ; Skin ; Stevens-Johnson Syndrome*

Primary biliary cirrhosis (PBC) is occasionally developed in patients with rheumatic diseases, such as systemic sclerosis or Sjogren's syndrome. However, there are a few reports of overlap syndrome with PBC. The authors report a case of a 36 year-old female with PBC and overlap syndrome. Systemic sclerosis was diagnosed in 2007, and rheumatoid arthritis in 2010. Adalimumab stopped because of her pregnancy plan in January 2012. One month after delivery, she felt increased hand joint pain and fatigue. Laboratory findings were as follows: elevated AST, ALT, ALP, r-GTP and positive anti-mitochondrial antibody. Histology of a liver biopsy revealed moderate porto-periportal and mild lobular inflammation with bile duct inflammation, which was consistent with PBC. She was treated with prednisolone and UDCA (urosodeoxycholic acid), but her disease was not controlled. From May 2013, she has been treated with adalimumab. Her arthritis was improved and liver function test normalized up until now.
Adalimumab ; Arthralgia ; Arthritis ; Arthritis, Rheumatoid ; Bile Ducts ; Biopsy ; Fatigue ; Female ; Glycogen Storage Disease Type VI ; Hand ; Humans ; Inflammation ; Liver ; Liver Cirrhosis, Biliary* ; Liver Function Tests ; Prednisolone ; Pregnancy ; Rheumatic Diseases ; Scleroderma, Systemic ; Sjogren's Syndrome

Dermatomyositis (DM) is a systemic inflammatory disease affecting skeletal muscles and other organs. Spontaneous pneumomediastinum (PnM) has been previously reported as a rare complication of DM and it is known to occur more frequently in patients with interstitial lung disease (ILD). Here we report on a case of a 52-year-old woman with DM who developed spontaneous PnM, which was treated successfully with high-dose steroid pulse therapy and cyclosporine A (CsA). This case suggests that CsA can be an effective therapeutic agent in DM refractory to glucocorticoid therapy, with ILD or pulmonary fibrosis accompanied by DM. CsA should be considered as an initial immunosuppressive agent for patients with PnM in DM.
Cyclosporine* ; Dermatomyositis* ; Female ; Humans ; Lung Diseases, Interstitial ; Mediastinal Emphysema* ; Middle Aged ; Muscle, Skeletal ; Pulmonary Fibrosis

Relapsing polychondritis is an uncommon disease associated with inflammation in cartilaginous tissues throughout the body, particularly affecting the cartilaginous structures of ears, nose, joints, and respiratory tract. Several autoimmune diseases, including vasculitis, are associated with the concurrent relapsing polychondritis. However, ankylosing spondylitis primarily affecting the sacroiliac joints and spine is rare in patients with relapsing polychondritis. We report on a 54-year-old man with concurrently relapsing polychondritis and ankylosing spondylitis.
Autoimmune Diseases ; Ear ; Humans ; Inflammation ; Joints ; Middle Aged ; Nose ; Polychondritis, Relapsing* ; Respiratory System ; Sacroiliac Joint ; Spine ; Spondylitis, Ankylosing* ; Vasculitis

Extreme thrombocytosis in patients with ankylosing spondylitis (AS) is rarely reported. Because the relationship between high disease activity and increased platelet counts is somewhat contradictory, severe thrombocytosis in AS patients can be secondary to infection, iron deficiency anemia, drug administration, and hematologic malignancies. Essential thrombocythemia (ET) is a rare acquired stem cell neoplasm characterized by overproduction of platelets by megakaryocytes in the bone marrow in the absence of other causes of thrombocytosis. There is no report in the literature regarding the association between AS and ET. We report on a case of a 34-year-old Korean man with active AS diagnosed as JAK2V617F mutation negative ET during adalimumab treatment.
Adult ; Anemia, Iron-Deficiency ; Bone Marrow ; Hematologic Neoplasms ; Humans ; Megakaryocytes ; Platelet Count ; Spondylitis, Ankylosing* ; Stem Cells ; Thrombocythemia, Essential* ; Thrombocytosis ; Tumor Necrosis Factor-alpha ; Adalimumab

Psoriatic onycho-pachydermo-periostitis (POPP) causes severe nail dystrophy, painful soft tissue swelling, and marked periosteal reaction of the involved distal phalanx. There are few reports of POPP involving the great toe. We report on 2 cases of POPP involving the fingertips. A 60-year-old woman presented with fusiform swelling of her right 4th fingertip with severe tenderness, and her fingernails and toenails had varying degrees of onycholysis. She had mixed multiple erosions and meta-epiphyseal periostitis at the distal phalanx of the right 4th finger but was treated successfully with methotrexate and cyclosporine. A 39-year-old woman presented with painful swelling of the left 2nd and 5th fingertip, psoriatic lesions on the knees and soles of the feet, and onycholysis without reactive periostitis of the left 2nd and 5th fingers. She was treated successfully with cyclosporine. Despite its rarity, POPP should be considered when diagnosing arthritic or infectious conditions affecting the distal interphalangeal joint.
Adult ; Arthritis ; Cyclosporine ; Female ; Fingers ; Foot ; Humans ; Joints ; Knee ; Methotrexate ; Middle Aged ; Nails ; Onycholysis ; Periostitis ; Psoriasis ; Toes