No abstract available.
Arthritis, Rheumatoid* ; Vasculitis*

Relapsing polychondritis is a rare condition of unknown etiology in which recurrent episodes of inflammation are followed by the destruction of cartilaginous structures, which predominantly include the nose, ears, and tracheobronchial tree. Although many autoimmune disorders, such as systemic vasculitis, rheumatoid arthritis, lupus erythematosus, Sjogren's syndrome, and Behcet's disease, are commonly found in patients with relapsing polychondritis, ankylosing spondylitis is rarely associated with this disease. We report a case of relapsing polychondritis with ankylosing spondylitis in the same patient.
Arthritis, Rheumatoid ; Ear ; Humans ; Inflammation ; Nose ; Polychondritis, Relapsing ; Sjogren's Syndrome ; Spondylitis, Ankylosing ; Systemic Vasculitis

Rheumatoid neutrophilic dermatitis (RND) is a rare distinctive complication of rheumatoid arthritis (RA). Clinically, RND is characterized by slightly tender erythematous patches and papules, often associated with vesicles or pustules, which are symmetrically distributed on the extensor surfaces of the extremities. Histopathological findings revealed a dermal neutrophilic infiltration with leukocytoclasia without vasculitis. We report a case of rheumatoid neutrophilic dermatitis associated with seronegative RA.
Arthritis ; Arthritis, Rheumatoid ; Dermatitis ; Extremities ; Neutrophils ; Vasculitis

No abstract available.
Acidosis, Renal Tubular* ; Arthritis, Rheumatoid* ; Sjogren's Syndrome*

No abstract available.
Adalimumab* ; Arthritis, Rheumatoid* ; Necrosis* ; Rheumatoid Nodule*

Demyelinating syndrome can rarely occur in Sjogren's syndrome or rheumatoid arthritis. We describe a patient of Sjogren's syndrome with multiple sclerosis-like features whose rheumatoid arthritis has been managed for 3 years. The patient presented paraparesis and urinary retention, and improved with high-dose corticosteroid therapy.
Arthritis, Rheumatoid* ; Humans ; Multiple Sclerosis* ; Paraparesis ; Sjogren's Syndrome* ; Urinary Retention

Arthritis, Juvenile/complications* ; Humans ; Rheumatoid Nodule

OBJECTIVE: To determine the clinical significance of IgG antibodies to native type II collagen (IgG nCII) in patients with rheumatoid arthritis (RA). METHODS: IgG antibodies to native type II collagen (anti-HnCII) were measured in 287 patients with RA, 34 patients with osteoarthritis (OA) and 50 normal controls by improved ELISA using avidin-biotin system and 100% normal goat serum. The clinical and laboratory variables were investigated in patients with RA at the time of sampling. RESULTS: The titers of anti-HnCII were higher in RA than OA and normal control (median value 5.2 in RA, 3.0 in OA, 1.7 a.u in normal) (p<0.05). The incidence of anti-HnCII positivity was also higher in RA than OA (39.1% vs. 17.6%) (p<0.05). In 218 evaluable patients, 98 patients with anti-HnCII positive had higher levels of ESR (p<0.001) and CRP (p<0.001) than 120 patients with anti-HnCII negative. The titers of anti-HnCII was also closely correlated with CRP (r=0.385) and ESR (r=0.235). However, no differences were found in titers of rheurnatoid factor, positivity of rheumatoid factor and hemogiobin levels. Incidence of anti-HnCII positivity was not related to disease duration (31/59 in <3 year, 63/148 in >3 year). There was no differences in age, sex, erosions on X-ray, mean steroid dose, use of DMARD, extraarticular manifetations such as lung involvement, rheumatoid nodule, Sjogren's syndrome between groups with anti-HnCII positive and negative. However, deformity was more frequently found in anti-HnCII negative (p<0.05). Among the 83 patients measured anti-HnCII serially (mean interval; 15+/-6 month), 11 of 24 patients with anti- HnCII positve (45.8%) were converted to negative and 19 of 59 patients with anti- HnCII negative (32.2%) were converted to positive. The levels of CRP decreased in groups converted from positive to negative (p<0.05) and vice versa (p<0.05). CONCLUSION: These results suggest that the levels of IgG HnCII fluctuate with positive correlation with acute phase reactants and may reflect the inflammatory activity of RA.
Acute-Phase Proteins ; Antibodies* ; Antirheumatic Agents ; Arthritis, Rheumatoid* ; Collagen Type II* ; Congenital Abnormalities ; Enzyme-Linked Immunosorbent Assay ; Goats ; Humans* ; Immunoglobulin G* ; Incidence ; Lung ; Osteoarthritis ; Rheumatoid Factor ; Rheumatoid Nodule ; Sjogren's Syndrome

Sjogren's syndrome is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands resulting in a dry mouth and eyes. The disease can present either alone or in association with other autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and inflammatory myopathy. In addition to symptoms caused by exocrinopathy, about half of patients present with extraglandular (systemic) manifestations including arthritis, Raynaud's phenomenon, lymphadenopathy, vasculitis, peripheral neuropathy, and interstitial nephritis. Patients often suffer from severe fatigue, myalgia, and dryness, which lead to a poor quality of life. Physicians should be aware of the increased risk of lymphoma development in patients with Sjogren's syndrome. Currently, there are no drugs available that are able to improve the natural course of disease, making symptom relief the primary goal of therapy. Currently, pilocarpine is the only drug clinically proven for the treatment of dry eyes and mouth in patients with Sjogren's syndrome.
Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Exocrine Glands ; Fatigue ; Humans ; Lupus Erythematosus, Systemic ; Lymphatic Diseases ; Lymphoma ; Mouth ; Myalgia ; Myositis ; Nephritis, Interstitial ; Peripheral Nervous System Diseases ; Pilocarpine ; Quality of Life ; Scleroderma, Systemic ; Sjogren's Syndrome* ; Vasculitis

Sjogren syndrome is a chronic, slowly progressive, autoimmune disease in which the exocrine glands are damaged by lymphocytic infiltration, resulting in xerostomia and xerophthalmia. Sjogren syndrome may occur in 2 forms: primary Sjogren syndrome, when the clinical manifestations of the syndrome are seen alone, and secondary Sjogren syndrome, when associated with another autoimmune disease, such as rheumatoid arthritis, systemic lupus erythromatosus, or scleroderma. Approximately one third of patients present with extraglandular manifestations: arthritis, Raynaud phenomenon, lymphadenopathy, lung involvement, vasculitis and peripheral nervous system involvement. About 10-50% of patients with Sjogren syndrome had evidence of thyroid disease, mainly hypothyroidism. Several inflammatory thyroid diseases are also considered to be autoimmune in origin. In this respect, the histologic picture of primary Sjogren syndrome exocrine glands and autoimmune thyroid glands show great similarities. Here, we report a new case of Sjogren syndrome accompanying with hyperthyroidism which affected a 10-year-old girl.
Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Child ; Exocrine Glands ; Female ; Humans ; Hyperthyroidism* ; Hypothyroidism ; Lung ; Lymphatic Diseases ; Peripheral Nervous System ; Raynaud Disease ; Sjogren's Syndrome* ; Thyroid Diseases ; Thyroid Gland ; Vasculitis ; Xerophthalmia ; Xerostomia