No abstract available.
Cyclosporine ; Humans ; Immunosuppressive Agents* ; Psoriasis* ; Sarcoma, Kaposi*

No abstract available.
Cyclosporine ; Humans ; Immunosuppressive Agents* ; Psoriasis* ; Sarcoma, Kaposi*

Since 1897 when Poncet first described polyarthritis in the acute stage of extra-articular tuberculosis, Poncet's disease has been considered a reactive arthritis to Mycobacterium tuberculosis. It is characterized by polyarthritis without evidence of direct mycobacterial involvement in patients with active tuberculosis, and eventually resolves without residual joint damage. Even though Poncet's disease is uncommon, the distinction between Poncet's disease and other arthritis, including tuberculous arthritis is clinically important. We report the second case of Poncet's disease diagnosed in a patient with pulmonary tuberculosis in Korea and review the relevant literature.
Arthritis ; Arthritis, Reactive ; Humans ; Joints ; Korea ; Mycobacterium tuberculosis ; Tuberculosis ; Tuberculosis, Pulmonary

Wegener's grandulomatosis (WG) is a systemic small-vessel vasculitis characterized by necrotizing granulomatous lesions and anti-neutrophil cytoplasmic antibodies (ANCA). WG frequently affects the upper and lower respiratory tracts and kidney but involvement of the pachymeninges or large vessels has rarely been reported. We report the first case of WG with periaortitis and pachymeningitis in Korea. A 57-year-old female complained of a stabbing headache, paresthesia below the thoracic 4th nerve level, and lower extremity weakness. During her course, she developed otitis media with sensorineural hearing loss, nodular scleritis, and microhematuria. A neuroimaging study showed an intradural mass in the area from the cervical 7th spine to the thoracic 5th spine, left cerebral convexity, and the left petrous area. A chest computed tomography scan revealed an enhanced and thickened aortic arch. A dural biopsy showed necrotizing granulomatous inflammation, and anti-MPO ANCA was positive. Under a diagnosis of WG, she received high-dose glucocorticoid and oral cyclophosphamide with improvement.
Antibodies, Antineutrophil Cytoplasmic ; Aorta, Thoracic ; Biopsy ; Cyclophosphamide ; Female ; Headache Disorders, Primary ; Hearing Loss, Sensorineural ; Humans ; Inflammation ; Kidney ; Korea ; Lower Extremity ; Meningitis ; Middle Aged ; Neuroimaging ; Otitis Media ; Paresthesia ; Respiratory System ; Scleritis ; Spine ; Thorax ; Vasculitis ; Wegener Granulomatosis

Granulomatosis with polyangiitis (GPA) is a disease characterized by a granulomatous necrotizing vasculitis of the small vessels, along with the presence of antineutrophil cytoplasmic antibody (ANCA), serologically. GPA is a multisystem disease, in which the diagnosis is frequently based on respiratory and renal manifestations, with rare breast invasion. To date, several cases of breast invasion by GPA have been published, and most cases have been positive for ANCA. However, ANCA-negative forms of breast invasion by GPA are extremely rare and have not been reported in Korea thus far. Therefore, we report a case of ANCA-negative GPA in a 70-year-old woman, who was initially presented with a localized palpable mass in the left breast.
Aged ; Antibodies ; Antibodies, Antineutrophil Cytoplasmic ; Breast* ; Cytoplasm* ; Diagnosis ; Female ; Humans ; Korea ; Vasculitis

Exogenous glucocorticoid has anti-inflammatory effect to reduce symptoms and signs of rheumatoid arthritis. However there are few reports about the role of endogenous glucocorticoid in rheumatoid arthritis. Recently we experienced a case of rheumatoid arthritis developed in a female patient with Cushing's disease as her cortisol level decreased during medical management of hypercortisolemia. She underwent trans-sphenoidal surgery for Cushing's disease (pituitary microadenoma). Six years after surgery she had disease recurrence and received brain radiotherapy and ketoconazole medication. Four years later she developed seronegative rheumatoid arthritis. 24 hour urine cortisol level was below the normal value at that time. Polyarthralgia improved with prednisolone (5mg/day). But polyarthralgia was aggravated as cortisol level decreased below the normal value after prednisolone was discontinued. This case and previous reports suggest that the development and aggravation of rheumatoid arthritis is associated with relative cortisol deficiency, or alteration of balance between neuroendocrine system(hypothalamic- pituitary-adrenal axis) and inflammatory process.
Arthralgia ; Arthritis, Rheumatoid* ; Brain ; Female ; Humans ; Hydrocortisone ; Ketoconazole ; Prednisolone ; Radiotherapy ; Recurrence ; Reference Values

BACKGROUND: Behçet disease (BD) is a relapsing inflammatory disease with increased production of inflammatory cytokines in peripheral blood mononuclear cells (PBMCs); however, the underlying molecular mechanisms are not well known. OBJECTIVE: To analyze whether the differential expression of transcription factors is involved in the increased tumor necrosis factor (TNF)-α and interleukin (IL)-6 production by PBMCs of BD patients compared to healthy controls (HCs). METHODS: Expression of transcription factors was examined by real-time reverse transcriptase-polymerase chain reaction and western blotting. Cytokine production by CD11b+ cells transfected with siRNAs against transcription factors was measured by enzyme-linked immunosorbent assay. RESULTS: In the absence of lipopolysaccharide stimulation, the transcript level of CCAAT-enhancer-binding proteins (C/EBP) β was increased in PBMCs from patients with active BD compared to that in PBMCs from patients with stable BD. The C/EBPδ transcript level was higher in PBMCs from patients with active BD than in those from HCs. The activating transcription factor 3 (ATF3) transcript level was increased in PBMCs from patients with stable BD compared to that in PBMCs from HCs. siRNAs targeting C/EBPβ and C/EBPδ significantly reduced the production of IL-6 and TNF-α in lipopolysaccharide-stimulated CD11b+ cells from patients with BD as well as from HCs. CONCLUSION: We found differential expression of C/EBPβ, C/EBPδ, and ATF3 in PBMCs from patients with BD depending on disease activity, indicating the involvement of these molecules in BD pathogenesis.
Activating Transcription Factor 3 ; Behcet Syndrome* ; Blotting, Western ; CCAAT-Enhancer-Binding Proteins ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans ; Interleukin-6 ; Interleukins ; RNA, Small Interfering ; Transcription Factors* ; Tumor Necrosis Factor-alpha

Wegener's granulomatosis is a serious multi-systemic disease pathologically characterized by necrotizing vasculitis and granuloma. Although nervous system is one of major target organs in Wegener's granulomatosis, the involvement of facial nerve was rarely reported as an initial symptom. We experienced a female patient with Wegener's granulomatosis presenting otitis media, sinusitis and right facial palsy. Nasal mucosal biopsy revealed necrotizing vasculitis with granuloma formation, which was consistent with Wegener's granulomatosis. During steroid and cyclophosphamide therapy, she developed paralysis of abducens nerve. Methyprednisolone pulse therapy was administrated with symptomatic improvement. We describe a case of Wegener's granulomatosis presenting facial nerve palsy.
Abducens Nerve ; Biopsy ; Cyclophosphamide ; Facial Nerve ; Facial Paralysis* ; Female ; Granuloma ; Humans ; Nervous System ; Otitis Media ; Paralysis ; Sinusitis ; Vasculitis ; Wegener Granulomatosis*

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Sarcoma* ; Sarcoma, Kaposi

No abstract available.
Hand Deformities ; Humans ; Parkinsonian Disorders*